What normal tissue constraints do you use, if any, in patients receiving vaginal cuff brachytherapy alone?

We optimize based on the PORTEC 2 and PORTEC 4 protocol recommendations. We use CT-simulation and 5mm optimization points. There are no normal tissue constraints when using this approach and 2D planning can be utilized. We do not insert, for example, bladder points. Many planning studies have demons...

While I agree that with doses utilized, normal tissue constraints may not be exceeded - in our practice, we still document 2 cc doses of bladder, bowel, rectum.

This is particularly valuable if one combines external beam with brachytherapy.

It is also useful if one has to come back and treat a recur...