How would you proceed when a cervical cancer undergoing brachytherapy has exceeded the rectal dose but not met the target dose?

Rectal dose and target dose have range.

Preferred rectal dose for D2cc < 65 Gy but can accept up to D2cc < 75 Gy, provided you understand expected risk of complications with increased dose.

Preference would be to do hybrid applicator with 3D imaging to optimize HRCTV and OAR.

Priority, for me, would be to treat the cancer, at least to a D90 EQD2 minimum of 80 (goal of > 85) as per EMBRACE data, if residual disease > 4cm at time of brachytherapy. If < 4cm, then would be content with EQD2 > 80.

While IGBT and consideration of hybrid approach, if possible, are ideal options ...