Use of bladder dose points for assessment of the spatial dose distribution in the posterior bladder wall in cervical cancer brachytherapy and the impact of applicator position

Location of the 2cc subvolume varies in cervical cancer brachytherapy. Maximum doses are at the bladder base if vaginal sources are also in the vicinity of the bladder base indicated by BICRU/D2cc ratio of 1 or higher. Such variation should be considered in dose-effect analyses and intercomparisons, as the same D2cc at different bladder locations may correlate with different morbidity profiles and severity Reporting D2cc and BICRU doses together therefore remains essential.