Clinical application of intensity-modulated radiotherapy for locally advanced cervical cancer

Brian D. Kavanagh, Tracey E. Schefter, Qiuwen Wu, Shidong Tong, Francis Newman, Mark Arnfield, Stanley H Benedict, Steve McCourt, Radhe Mohan

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Intensity-modulated radiotherapy (IMRT) offers technical advantages over conventional external beam radiotherapy (CXRT) that might prove clinically advantageous in the management of gynecologic malignancies. Especially in the case of locally advanced cervical cancer, IMRT provides an opportunity to improve the therapeutic ratio by allowing a selective combination of normal tissue dose reduction and/or concomitant integrated boost dose to the tumor. The clinical and biologic rationale for IMRT in this setting is presented here, and pertinent technical considerations such as the delineation of relevant clinical and planning target volumes are discussed. The capacity for IMRT-mediated normal tissue sparing is illustrated by example and review of the literature. Furthermore, for a small cohort of patients with locally advanced or recurrent cervical cancer treated with concomitant integrated boost IMRT and concurrent chemotherapy, preliminary clinical observations of toxicity and tumor response are presented. Concomitant integrated boost IMRT appears clinically tolerable and efficacious in this setting, and formal clinical investigation is warranted as a means of exploiting the fraction-size dependence of radiosensitizers in common clinical use.

Original languageEnglish (US)
Pages (from-to)260-271
Number of pages12
JournalSeminars in Radiation Oncology
Issue number3
StatePublished - 2002
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Radiation


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