Abstract
Cervical cancer is the one of the most common cancer in female patients inThailand. Radiotherapy has the role for the treatment of cervical cancer by postoperative, radical and palliative treatments. For radical radiotherapy, the combination of external beam radiation therapy and brachytherapy will be used to increase the tumor dose to curative goal. With the new development of medical images (Computed tomography (CT), Magnetic Resonance Imaging (MRI) or Ultrasonography (US)), the treatment with brachytherapy will be developed from point-based to volume-based concepts. Many studies reported the benefit of image-based brachytherapy over conventional brachytherapy and clinical benefit of using image-based brachytherapy in the treatment of cervical cancer.
Highlights
Cervical cancer is one of the most common in female populations in Thailand
High-risk clinical target volume (HR-CTV) was defined to Gross tumor volume (GTV) plus the whole cervix with the suspected extension describing on magnetic resonance imaging that represents the tumor at brachytherapy (85 - 90 Gy)
Intermediate-risk Clinical target volume (IR-CTV) was identified to HR-CTV plus 5 - 15 mm margin excluded the organs at risk (OARs) which relate to tumor at diagnosis (60 Gy)
Summary
Cervical cancer is one of the most common in female populations in Thailand. Treatment of cervical cancer composed of surgery, radiation therapy and systemic treatments. The roles of radiation therapy in cervical cancer are radical, adjuvant and palliative treatments. Surgery plays the main role of treatment. Radiotherapy can be used as adjuvant to reduce the risks of recurrence. In some patients who are unfit to perform surgery, radiotherapy is an option. Concurrent chemoradiation with cisplatin-based regimen is the standard treatment. Many studies showed the benefit of concurrent chemoradiation over radiotherapy alone [2,3,4]. External beam radiation (EBRT) and brachytherapy are used together to increase the dose to tumor at cervix and reduce the dose to organs at risk (bladder and rectum)
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