Do you modify your treatment for a patient with ulcerative colitis needing vaginal brachytherapy?

For adjuvant treatment, I switch to 6 Gy x 5 to surface to reduce total dose to rectum instead of 7 Gy x 3 at 5 mm.
Also, sometimes I have used a multichannel cylinder to off load Isodose line from rectum based on anatomy.

By doing as above d2cc of rectum is usually in the 10 Gy range which is way l...

Agree with Dr. @Dr. First Last. Also treat with a full bladder to push bowel and sometimes sigmoid out of the way.