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With increasing dose to the recto-vaginal reference point, the probability
of vaginal stenosis G≥2 increases significantly (p=0.003).
Based on the model curve, the risk was 20% at 65Gy, 27% at 75Gy and 34% at 85Gy (recto-
vaginal reference point dose).
Keeping the EBRT dose at 45Gy/25fractions and decreasing the dose contribution of
brachytherapy to the vagina decrease the risk of stenosis.
A planning aim of ≤65Gy EQD2 (EBRT+brachytherapy dose) to the recto-vaginal reference
point is therefore proposed.
Stenosis: ICRU recto-
vaginal reference point
Kirchheiner et al.
RO 2016