Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences

Purpose Image-guided adaptive brachytherapy (IGABT) is currently state of the art in the comprehensive treatment of patients with cervical cancer. Here, we report mature clinical data regarding IGABT of cervical cancer in a large patient sample, examining clinical outcomes, manifestations of late toxicities, and dosimetric findings. Methods Between May 2012 and October 2020, we performed a total of 544 uterovaginal IGABT applications in 131 consecutive patients with biopsy-proven cervical carcinoma not suitable for surgery. The median duration of follow-up was 43 months. Results The estimated 3‑, 4‑, and 5‑year LC rates were 88.3% (95% confidence interval [CI] 81.1–95.5), 86.9% (95% CI 78.5–95.3), and 85.5% (95% CI 76–95%), respectively. The 3‑, 4‑, and 5‑year OS estimates were 72.66% (95% CI 63.64–81.69%), 68.9% (95% CI 59.15–78.66%), and 63.96% (95% CI 52.94–74.97%), respectively. Patients who received ≥ 5 cycles of chemotherapy had statistically significantly better 3‑year recurrence-free survival (RFS) compared to patients who completed