ArticleCancers2026
Moderately Hypofractionated Online Adaptive Radiotherapy for Cervical Cancer: A Prospective Study of Feasibility, Acute Toxicity and Dosimetric Benefits.
Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05994300 (Clinical Research of Moderately Hypofractionated Radiotherapy for Cervical Cancer), which is not on this map. Not yet cited in PubMed.
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Clinical Research of Moderately Hypofractionated Radiotherapy for Cervical Cancer
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7 authors.
Funding
Abstract
BACKGROUND/
objectivesModerately hypofractionated radiotherapy (MHRT) may shorten treatment duration for cervical cancer but raises concerns regarding toxicity due to substantial interfractional pelvic organ motion. This prospective study evaluated the feasibility, workflow efficiency, dosimetric benefits, and acute toxicities of daily online adaptive radiotherapy (oART)-guided MHRT.
methodsThirty patients with FIGO 2018 stage IB1-IIB or IIIC1 cervical squamous cell carcinoma receiving definitive chemoradiotherapy were prospectively included between September 2023 and April 2024 (NCT05994300). All patients underwent daily oART, receiving 43.35 Gy in 17 fractions to the pelvic target volume, with a simultaneous integrated boost to 54.40 Gy in 17 fractions for involved lymph nodes. The adaptive workflow consisted of iterative cone-beam computed tomography acquisition, artificial intelligence-assisted contouring, physician review, plan adaptation, and treatment verification. Workflow efficiency, plan selection, target coverage, organ-at-risk (OAR) sparing, treatment completion, early tumor response and acute toxicity were prospectively assessed.
resultsA total of 510 adaptive fractions were delivered. The first-attempt adaptation success rate was 99.0%, and adapted plans were selected in 99.4% of fractions. The mean adaptive workflow and total treatment times were 17.3 and 23.3 min per fraction, respectively. Compared with scheduled plans, adapted plans significantly improved target coverage, with V
conclusionsDaily oART-guided MHRT was feasible and efficient, providing improved target coverage and reduced OAR doses compared with scheduled plans. Acute toxicity was acceptable. These findings provide early prospective evidence supporting the feasibility of this treatment strategy and warrant further validation in larger prospective studies with longer follow-up.
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