Adaptive extended-field intensity-modulated radiation therapy with simultaneously integrated boost for locally advanced cervical cancer with lymph node metastases

Abstract

Performing external beam radiotherapy alone without chemotherapy or brachytherapy for locally advanced cervical cancer with multiple lymph node metastases is challenging. The purpose of this case report is to present the efficacy of high-dose adaptive extended-field intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) in treating locally advanced cervical cancer with multiple lymph node metastases. A 67-year-old woman with locally advanced squamous cell carcinoma of the uterine cervix was treated by external beam radiotherapy alone due to the refusal of chemotherapy and intracavitary brachytherapy. In order to maximize the efficacy of treatment, extended-field radiotherapy that includes the paraaortic lymph nodes as well as an adaptive IMRT-SIB plan, was applied. The treatment was successful, resulting in complete tumor disappearance without severe adverse events. In conclusion, high-dose adaptive IMRT-SIB may be an alternative treatment option for locally advanced cervical cancer with multiple lymph node metastases.