Abstract
Cervical cancer is the fourth most common cancer in women worldwide. Traditionally, bulky cervical tumors or those with clinical nodal involvement are treated with definitive chemoradiation therapy. Pelvic or extended field radiation has traditionally been delivered using 3-dimensional conformal radiotherapy with fields that are not altered during treatment. However, there is an emerging role for intensity modulated radiotherapy as well as adaptive planning. Although MRI-based linear accelerators have recently been used for image guidance during brachytherapy, to our knowledge, there are no reports of adaptive planning for cervical cancer cases using MRI-based linear accelerators. We present a case of a postpartum patient with a bulky cervical adenocarcinoma who underwent replanning twice during treatment due to uterine and tumor shrinkage. The use of a MRI-based linear accelerator facilitated both replanning and tumor assessment.
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