Image-Guided Adaptive Brachytherapy for Uterine Cancer: A Comprehensive Review.
Simple Summary: Brachytherapy is an essential part of curative treatment for cervical, endometrial, and vaginal malignancies. Over the past two decades, image-guided brachytherapy (IGABT) has transformed brachytherapy by allowing the dose to be tailored more precisely to the tumor in 3D while better...
| Publicado en: | Cancers Vol. 18; no. 4; pp. 693 - 712 |
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| Autores principales: | , |
| Formato: | diagnostic images research systematic review tables/charts Journal Article |
| Publicado: |
MDPI
Feb2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191975707&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191975707 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20726694 B74B jtl: Cancers issn: 20726694 maglogo: N pubinfo: dt: Feb2026 vid: 18 iid: 4 pid: 97109 pub: MDPI artinfo: ui: 191975707 191975707 191975707 10.3390/cancers18040693 191975707 ppf: 693 ppct: 19 formats: tig: atl: Image-Guided Adaptive Brachytherapy for Uterine Cancer: A Comprehensive Review. aug: au: Chen, Yi-Ching Yeh, Chi-Yuan affil: Department of Medical Research, Tungs Taichung MetroHarbor Hospital, Wuchi District, Taichung 435403, Taiwan sug: subj: Brachytherapy Cervix Neoplasms Treatment Outcomes Implementation Science Diagnostic Imaging Utilization Human PubMed Medline Embase Endometrial Neoplasms Vaginal Neoplasms Radiotherapy Pelvic Neoplasms ab: Simple Summary: Brachytherapy is an essential part of curative treatment for cervical, endometrial, and vaginal malignancies. Over the past two decades, image-guided brachytherapy (IGABT) has transformed brachytherapy by allowing the dose to be tailored more precisely to the tumor in 3D while better protecting the surrounding organs. This has translated into improved local control and fewer severe long-term side effects in patients with locally advanced cervical cancer; similar results were seen in IGABT for endometrial and vaginal cancers. In this review, we summarize current evidence for IGABT across uterine cancers, discuss typical dose and volume concepts, and highlight patient-reported outcomes and emerging technologies such as advanced imaging and artificial intelligence. We also outline the practical challenges and opportunities for wider implementation of IGABT in diverse clinical settings. Background/Objectives: Image-guided adaptive brachytherapy (IGABT) has transformed the standard of care for locally advanced cervical cancer (LACC), enabling volumetric target definition and dose–volume histogram (DVH)-based planning to improve pelvic tumor control while limiting severe late toxicity. Methods: A comprehensive literature search of PubMed/MEDLINE and Embase was done for articles published up to August 2024, using combinations of the following keywords and Medical Subject Heading (MeSH) terms: "cervical cancer", "endometrial cancer", "vaginal cancer", "uterine neoplasms", "brachytherapy", "high-dose-rate", "image-guided", "MRI-guided", "3D brachytherapy", "IGABT", "interstitial", "locoregional control", "toxicity", "quality of life", and "patient-reported outcomes". Results: We summarized the contemporary evidence on IGABT for cervical, endometrial, and primary or recurrent vaginal cancers, focusing on local control, survival, late morbidity, and patient-reported outcomes. We described the key target volume concepts (gross tumor volume, high- and intermediate-risk clinical target volumes), and the role of MRI-, CT-, and ultrasound-based planning with intracavitary, intracavitary–interstitial, and interstitial applicators. Conclusions: Image-guided adaptive brachytherapy has redefined the standard of care for the management of locally advanced cervical cancer. Through the integration of volumetric target concepts, DVH-based dose reporting, and advanced imaging, IGABT has enabled consistent dose escalation to the residual tumor while accounting for organ-at-risk constraints, resulting in high local control rates and reduced severe morbidity compared with historical 2D brachytherapy. pubtype: Academic Journal doctype: diagnostic images research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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