What is your technique to calculate the vaginal surface dose in gyn intracavitary brachytherapy?

The limited published data on image based brachytherapy has not found any dosimetric correlate of upper vaginal morbidity. The traditional point dose tolerence has underassessed tolerence of the upper vagina

The recent multi-institutional EMBRACE study with different techniques and dose of cervical b...

Overall, I agree with the comments above. Vaginal surface dose was, historically, used in part as a surrogate for the dose to other surrounding structures. The maximum lateral surface dose allowed in treatment planning at MD Anderson varied depending on the type of applicator used and, in particular...

I agree with @Dr. First Last but I have also heard that GEC ESTRO has found, using a rectal point, a good surrogate for vaginal toxicity. We await presentation/publication of this validated marker from their group.

I agree with @Dr. First Last and we await futher data.