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Front Oncol. 2015 Mar 17;5:64. doi: 10.3389/fonc.2015.00064. eCollection 2015.

Image-guided radiotherapy and -brachytherapy for cervical cancer.

Author information

1
Medicine and Radiation Oncology PA , San Antonio, TX , USA.
2
Department of Radiation Oncology, Howard University , Washington, DC , USA.
3
Department of Radiation Oncology, Lindenhofspital , Bern , Switzerland.
4
Department of Radiation Oncology, Centre Val d'Aurelle , Montpellier , France.
5
Florida Radiation Oncology Group, Department of Radiation Oncology , Jacksonville, FL , USA.
6
Department of Radiation Oncology, University of Arizona , Tucson, AZ , USA.
7
Department of Radiation Oncology, University of West Virginia , Morgantown, WV , USA.
8
Southwest PET/CT Institute , Tucson, AZ , USA.
9
Department of Radiation Oncology, Richard A. Henson Cancer Institute , Salisbury, MD , USA.
10
Department of Radiation Oncology, Akron City Hospital , Akron, OH , USA.
11
Department of Radiation Oncology, Michael D. Watchtel Cancer Center , Oshkosh, WI , USA.
12
Department of Radiation Oncology, Marshfield Clinic , Marshfield, WI , USA.
13
Department of Radiation Oncology, Camden Clark Cancer Center , Parkersburg, WV , USA.

Abstract

Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT), and 2-dimensional intracavitary brachytherapy. Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron-emission tomography and magnetic resonance imaging has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT) may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT), allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.

KEYWORDS:

IGBT; IGRT; cervical cancer; normal tissue sparing

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