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Adaptive radiotherapy in the management of cervical cancer: review of strategies and clinical implementation
Shelley, C. E. Barraclough, Lisa H Nelder, Claire L Otter, S. J Stewart, A. J.
Shelley, C. E.
Barraclough, Lisa H
Nelder, Claire L
Otter, S. J
Stewart, A. J.
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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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Date
2021
Publisher
Collections
Keywords
Type
Article
Citation
Shelley CE, Barraclough LH, Nelder CL, Otter SJ, Stewart AJ. Adaptive Radiotherapy in the Management of Cervical Cancer: Review of Strategies and Clinical Implementation. Clinical Oncology. 2021 Sep;33(9):579–90.