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w = 3.8

cm

h = 2.5

cm

t = 4.0

cm

w

X

Dose of EBRT

Gy

3.8cm

IIA

Vagina:

1.5

cm

Note: extension of vaginal involvement is specified separately,

and should not be included in h

/ /

dd/mm/yy

Signature

At Diagnosis

At Brachytherapy