Adaptive Radiotherapy in the Management of Cervical Cancer: Review of Strategies and Clinical Implementation |
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| Affiliation: | 1. Department of Clinical Oncology, St. Luke''s Cancer Centre, Royal Surrey County Hospital, Guildford, UK;2. Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK;3. Department of Radiotherapy, The Christie NHS Foundation Trust, Manchester, UK;4. University of Surrey, Guildford, UK;1. Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas;2. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas;3. Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France;4. RaySearch Laboratories, Stockholm, Sweden;6. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas;5. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas;1. Department of Radiation Oncology, Academic Medical Centre (AMC) – University of Amsterdam, The Netherlands;2. Department of Radiation Oncology, University Medical Centre Utrecht, The Netherlands |
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| Abstract: | The complex and varied motion of the cervix–uterus target during external beam radiotherapy (EBRT) underscores the clinical benefits afforded by adaptive radiotherapy (ART) techniques. These gains have already been realised in the implementation of image-guided adaptive brachytherapy, where adapting to anatomy at each fraction has seen improvements in clinical outcomes and a reduction in treatment toxicity. With regards to EBRT, multiple adaptive strategies have been implemented, including a personalised internal target volume, offline replanning and a plan of the day approach. With technological advances, there is now the ability for real-time online ART using both magnetic resonance imaging and computed tomography-guided imaging. However, multiple challenges remain in the widespread dissemination of ART. This review investigates the ART strategies and their clinical implementation in EBRT delivery for cervical cancer. |
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| Keywords: | Adaptive radiotherapy cervical cancer external beam radiotherapy gynaecological cancer image-guided radiotherapy |
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