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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 referene point

Kirchheiner et al.

RO 2016