ArticleJournal of contemporary brachytherapy2026
Can image-guided external beam radiotherapy boost be an alternative when intracavitary brachytherapy is unavailable for locally advanced cervical cancer? A dosimetric analysis and literature review.
Article in Journal of contemporary brachytherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Intracavitary brachytherapy (ICBT) is a critical component of definitive radiotherapy for locally advanced cervical cancer (LACC). However, ICBT may be unavailable due to resource limitations, anatomical constraints, or patient refusal. This study aimed to evaluate the feasibility of an image-guided external beam radiotherapy (EBRT) boost using modern techniques, such as intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) from a dosimetric perspective, and to compare the results with published data from ICBT and stereotactic body radiotherapy (SBRT) studies. Material and methods: Ten patients with LACC (FIGO stage IIB-IVA) were prospectively enrolled and treated using whole pelvic IMRT/VMAT (45 Gy in 25 fractions) with a simultaneous integrated boost (SIB) or sequential boost to high-risk clinical target volume (HR-CTV). Prescribed dose to HR-CTV was 70 Gy (EQD Results: The mean D Conclusions: From a dosimetric perspective, an image-guided EBRT boost using IMRT/VMAT with daily IGRT is feasible for LACC patients when ICBT is not an option. It provides a high, uniform dose to the target while respecting OAR constraints. While ICBT remains the gold standard, modern EBRT techniques offer a promising alternative in resource-constrained settings. The dosimetric findings from this study support the design of a prospective clinical trial (in development, planned registration) to evaluate clinical outcomes, including toxicity and local control.
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