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Contrast agents in the vagina are being used to determine the position of vaginal surfaces relative to applicators in an effort to assess dose at these sites. Computer treatment planning allows consideration of dose at many more sites than was formerly possible, but dose prescription to critical tumor volumes then becomes of greater importance. Vaginal reference dose points VR, VL, VA, and VP are proposed. With dose specification determined at these points, the problem of low vaginal dose from overly wide vaginal ovoid geometries and related difficulties can be avoided. Attention to central vaginal doses can reduce the probability of central pelvic recurrence in the vagina. We have found the VR, VL doses were much larger than VA, VP doses in standard loaded implant configurations.
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