A comparison of the biological effective dose of 50-kV electronic brachytherapy with 192Ir high-dose-rate brachytherapy for vaginal cuff irradiation

BED takes into account the higher RBE of low-energy photons generated with EBT and provides a more accurate estimate of the biological effect. When using EBT, physical dose may underestimate the biological effect on the vaginal mucosa and overestimate the benefit for the bladder and rectum. Dose adjustment for EBT based on BED should be considered.