Abstract
Radiotherapy (RT) of the cervical cancer (CC), as distinct from RT of almost all cancers, has essential feature. That is the irradiation consists of two methodically different phases – external beam radiotherapy (EBRT) and intracavitary/interstitial brachytherapy (BT). Nowadays we see the great progress in both methodologies and results of the treatment of majority cancers during last 10–15 years sizable improved. On this background we should to assume the right to expect the consistent improvement of the results of treatment of CC, but it doesn’t take place. Consequently, there is the question, if the cause of failure is contained in the essential feature of RT? We have done the analysis of the problem in the aim to get the way to improve the treatment of CC and revealed the most critical peculiarities in the second phase of RT of CC. on the base of our analysis we presume measures to rise survival. Our historical analysis reveals, that we have exhaustive theoretical elaborations for BT of CC, but its practical implementation constrains in real life of hospitals. The effectiveness of contemporary methods of RT proved and for improvement of results of the treatment of CC it is need to find the changes at first in the second phase of the irradiation and in increase of investment of EBRT. Probably, (it must be investigated undelayable), EBRT needs to rich 60–66 Gy, though in affected parametrium, keeping in mind that BT-boost will work in some centimeters from the source. It is very cumbersome in adaptive RT to perform multiple dosimetric replanning and on-line IGRT, to sum dosimetry from two phases, and EBRT+BT itself is more difficult than usual RT. We ought to consider expenditure of advanced methods of the treatment and do not make them financially toxic for the patients.
Keywords: Cervix uteri, combined radiotherapy, brachytherapy, standards of treatment, critical issues, survival.
For citation:Islim (Salim) N., Stolbovoy A.V., Ryzhkin S.A. Critical issues in the radiotherapy of cervix utery cancer. Clinical review for general practice. 2025; 6 (9): 89–94 (In Russ.). DOI: 10.47407/kr2025.6.9.00678
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