Trial reportThe Lancet. Oncology2021
MRI-guided adaptive brachytherapy in locally advanced cervical cancer (EMBRACE-I): a multicentre prospective cohort study.
Trial report in The Lancet. Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 327 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Phase III Trial to Assess the Effectiveness of NRF2 Activator (Oral Sodium-copper- Chlophyllin ) in Locally Advanced Cervical Cancer to Reduce Late Radiotherapy Toxicity. (CHOC-LATE Trial)
Asian Gynecological Brachytherapy Registry in Cervical Cancer
Integration of Multi-modality Imaging Protocols With emphAsis on CT in Image Guided Adaptive Brachytherapy (IGABT) for Cervical Cancer - EMBRACE III-IMPACT STUDY
Who cites it
327 citing papers in PubMed, 6 syntheses or guidelines pooled it, 600 citations in OpenAlex.
- Organ-sparing radiotherapy in penile cancer: therapeutic approaches.International urology and nephrology · 2026Pooled it
- Spanish Society for Radiation Oncology and Spanish Society of Medical Physicists recommendations on reirradiation in gynecological cancer: reirradiation techniques, survival outcomes, dose, and toxicity.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Guideline
- Survival outcomes in IIIC cervical cancer by treatment strategies: a systematic review and meta-analysis.BMC cancer · 2025Pooled it
- AAPM medical physics practice guideline 13.a: HDR brachytherapy, part B.Journal of applied clinical medical physics · 2025Guideline
- Cardiac metastasis in uterine cervical cancer : A systematic review and case study.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Pooled it
- Dose-response relationship between volume base dose and tumor local control in definitive radiotherapy for vaginal cancer.BMC cancer · 2024Pooled it
- Tislelizumab (anti-PD-1) plus chemotherapy as neoadjuvant therapy for patients with stage IB3/IIA2 cervical cancer (NATIC): a prospective, single-arm, phase II study.Signal transduction and targeted therapy · 2025Trial
- Incorporation of triapine (T) to cisplatin chemoradiation (CRT) for locally advanced cervical and vaginal cancer: Results from NRG-GY006, a phase III randomized trial.Gynecologic oncology · 2025Trial
- Tolerability, safety and feasibility of metformin combined with chemoradiotherapy in patients with locally advanced cervical cancer: A phase II, randomized study.Acta oncologica (Stockholm, Sweden) · 2025Trial
- Neoadjuvant or concurrent atezolizumab with chemoradiation for locally advanced cervical cancer: a randomized phase I trial.Nature communications · 2025Trial
- Radiation Therapy With or Without Cisplatin for Local Recurrences of Endometrial Cancer: Results From an NRG Oncology/GOG Prospective Randomized Multicenter Clinical Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Trial
- Longitudinal Costs of Image-Guided Intensity-Modulated Radiation Therapy Versus Three-Dimensional Conformal Radiation: Lessons From Phase III PARCER Trial for Shaping Resource-Stratified Guidelines in Low- and Middle-Income Countries.JCO global oncology · 2024Trial
- Effects of rectal retractor use on dosimetric parameters, treatment-related adverse events, and clinical outcomes of cervical cancer brachytherapy: A retrospective tertiary-centre study.Clinical and translational radiation oncology · 2027Article
- The future of brachytherapy physics: Innovation, quality, and the next generation of clinical practice.Journal of applied clinical medical physics · 2026Article
- Timeliness of Primary Radiotherapy for Cervical Cancer in Queensland: A 10 Year Rural-Urban Retrospective Cohort Study.The Australian & New Zealand journal of obstetrics & gynaecology · 2026Article
- MYC upregulation as candidate predictive biomarker for radioresistance in cervical cancer.Japanese journal of radiology · 2026Article
- Abscopal effect following palliative radiotherapy after cemiplimab in recurrent cervical cancer: a case report.Gynecologic oncology reports · 2026Article
- Exploring Fistula Development in Gynaecologic Malignancies: Aetiology, Diagnosis and Treatment Advances.International urogynecology journal · 2026Review
- Centralization of MR image-guided adaptive brachytherapy for cervical cancer in Austria: feasibility and outcomes.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Thirty-Two Years of Radiotherapy for T1 Anal Cancer: Patterns, Outcomes, and Side-effects at a Single Institution.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
267 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
27 authors at 18 institutions in 10 countries.
Funding
Abstract
backgroundThe concept of the use of MRI for image-guided adaptive brachytherapy (IGABT) in locally advanced cervical cancer was introduced 20 years ago. Here, we report on EMBRACE-I, which aimed to evaluate local tumour control and morbidity after chemoradiotherapy and MRI-based IGABT.
methodsEMBRACE-I was a prospective, observational, multicentre cohort study. Data from patients from 24 centres in Europe, Asia, and North America were prospectively collected. The inclusion criteria were patients older than 18 years, with biopsy-proven squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma of the uterine cervix, The International Federation of Gynecology and Obstetrics (FIGO) stage IB-IVA disease or FIGO stage IVB disease restricted to paraaortic lymph metastasis below the L1-L2 interspace, suitable for curative treatment. Treatment consisted of chemoradiotherapy (weekly intravenous cisplatin 40 mg/m
findingsPatient accrual began on July 30, 2008, and closed on Dec 29, 2015. A total of 1416 patients were registered in the database. After exclusion for not meeting patient selection criteria before treatment, being registered but not entered in the database, meeting the exclusion criteria, and being falsely excluded, data from 1341 patients were available for analysis of disease and data from 1251 patients were available for assessment of morbidity outcome. MRI-based IGABT including dose optimisation was done in 1317 (98·2%) of 1341 patients. Median high-risk clinical target volume was 28 cm
interpretationChemoradiotherapy and MRI-based IGABT result in effective and stable long-term local control across all stages of locally advanced cervical cancer, with a limited severe morbidity per organ. These results represent a positive breakthrough in the treatment of locally advanced cervical cancer, which might be used as a benchmark for clinical practice and all future studies.
fundingMedical University of Vienna, Aarhus University Hospital, Elekta AB, and Varian Medical Systems.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.