Sekundarni povzetek: |
Brachytherapy, in combination with external beam radiotherapy and chemotherapy, plays an essential role in radical treatment of locally advanced cervical cancer. Implementation of MRI based treatment planning and individual optimization of dwell-times and dwell-positions of 192Ir pulsed- and high-dose rate stepping sources enables dose escalation in the target volume while respecting normal tissue tolerance. Development of novel combined intracavitary/interstitial applicators allows for an accurate, reproducible and individualized insertion of a low number of needles into the parametria to achieve an adequate target coverage in tumors with unfavorable topography. When compared to standard, Manchester point »A« based method, these innovative approaches result in improved local control without increasing side effects rates |