{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T07:51:54Z","timestamp":1781855514000,"version":"3.54.5"},"reference-count":35,"publisher":"IOP Publishing","issue":"3","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/publishingsupport.iopscience.iop.org\/iop-standard\/v1"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":18,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"crossref","award":["RSG-22-030-01-CTPS"],"award-info":[{"award-number":["RSG-22-030-01-CTPS"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Biomed. Phys. Eng. Express"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"Abstract<\/jats:title>\n \n Purpose.<\/jats:italic>\n High-dose-rate interstitial brachytherapy (HDR-IBT) is an essential component of curative treatment for locally advanced cervical cancer, but it is invasive and resource-intensive. Alternative boost techniques are needed when brachytherapy is not feasible. This study compares the dosimetric performance of stereotactic body radiotherapy (SBRT) and Syed-based HDR-IBT to evaluate the potential role of SBRT as a non-invasive boost modality.\n Materials and Methods.<\/jats:italic>\n Eighteen patients with stage III\u2013IV cervical cancer previously treated with external beam radiotherapy (EBRT) (45 Gy\/25 fx \u00b1 nodal boost) followed by Syed HDR-IBT (28 Gy\/4 fx) in our clinic were retrospectively analyzed. For each patient, SBRT plans prescribing 28 Gy in 4 fractions were generated on EBRT computed tomography images using fused Syed contours. Dosimetric parameters for targets and organs-at-risk (OARs), such as\n D<\/jats:italic>\n 98<\/jats:sub>\n ,\n D<\/jats:italic>\n 90<\/jats:sub>\n , mean dose, maximum dose,\n D<\/jats:italic>\n 2cc<\/jats:sub>\n ,\n D<\/jats:italic>\n 1cc<\/jats:sub>\n , were compared using the Wilcoxon signed-rank test.\n Results.<\/jats:italic>\n For the high-risk clinical target volume (CTV_HR), HDR-IBT provided significantly superior coverage: mean 27 Gy\n D<\/jats:italic>\n 98<\/jats:sub>\n and 32 Gy\n D<\/jats:italic>\n 90<\/jats:sub>\n (Syed) vs. mean 25 Gy\n D<\/jats:italic>\n 98<\/jats:sub>\n and 29 Gy\n D<\/jats:italic>\n 90<\/jats:sub>\n (SBRT) (\n p<\/jats:italic>\n = 0.04 and\n p<\/jats:italic>\n < 0.001). For the intermediate-risk CTV, SBRT plans achieved significantly better coverage: mean 18 Gy\n D<\/jats:italic>\n 98<\/jats:sub>\n and 22 Gy\n D<\/jats:italic>\n 90<\/jats:sub>\n (SBRT) vs. mean 14 Gy\n D<\/jats:italic>\n 98<\/jats:sub>\n and 18 Gy\n D<\/jats:italic>\n 90<\/jats:sub>\n (Syed) (\n p<\/jats:italic>\n < 0.001 for both). OAR doses were largely comparable between the two modalities, except that HDR-IBT resulted in significantly lower mean bladder dose and improved bowel sparing, whereas SBRT yielded significantly lower bladder maximum dose and reduced rectum\n D<\/jats:italic>\n 2cc<\/jats:sub>\n . Overall, SBRT exhibited greater low-dose spread to surrounding tissues, while HDR-IBT produced higher intratumoral dose hot spots.\n Conclusion.<\/jats:italic>\n HDR-IBT remains superior for CTV_HR dose escalation, but SBRT can achieve acceptable target coverage and OAR sparing when brachytherapy is not feasible. SBRT may serve as a practical alternative for selected patients who are medically inoperable, anatomically unsuitable, or lack access to brachytherapy services. Prospective studies are needed to optimize SBRT planning strategies and define appropriate patient selection criteria.\n <\/jats:p>","DOI":"10.1088\/2057-1976\/ae7979","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T22:47:38Z","timestamp":1780958858000},"page":"035084","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dosimetric comparison of high dose rate interstitial brachytherapy and stereotactic body radiotherapy as alternative treatment methods for advanced-stage cervical cancer"],"prefix":"10.1088","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3871-1356","authenticated-orcid":true,"given":"Rui","family":"Zhang","sequence":"first","affiliation":[{"name":"Baylor College of Medicine"},{"name":"Louisiana State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7986-601X","authenticated-orcid":true,"given":"Ashley","family":"Chavana","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YangYang","family":"Shi","sequence":"additional","affiliation":[{"name":"The University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boran","family":"Zhou","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Ugarte","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2316-2195","authenticated-orcid":true,"given":"Baozhou","family":"Sun","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beibei","family":"Guo","sequence":"additional","affiliation":[{"name":"Louisiana State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2715-8038","authenticated-orcid":true,"given":"Samaneh","family":"Kazemifar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, US Oncology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1378-1809","authenticated-orcid":true,"given":"Alfredo","family":"Echeverria","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8860-7269","authenticated-orcid":true,"given":"Michelle","family":"Ludwig","sequence":"additional","affiliation":[{"name":"University of Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3228-2431","authenticated-orcid":true,"given":"Amir","family":"Owrangi","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"bpexae7979bib1","doi-asserted-by":"publisher","first-page":"e197","DOI":"10.1016\/S2214-109X(22)00501-0","type":"journal-article","article-title":"Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the. WHO Global Cervical Cancer Elimination Initiative","volume":"11","author":"Singh","year":"2023","journal-title":"Lancet Glob. Health"},{"key":"bpexae7979bib2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","type":"journal-article","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"bpexae7979bib3","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1002\/ijgo.12608","type":"journal-article","article-title":"FIGO Cancer Report 2018","volume":"143","author":"Bhatla","year":"2018","journal-title":"Int. J. Gynecol. Obstet."},{"key":"bpexae7979bib4","doi-asserted-by":"publisher","first-page":"64","DOI":"10.6004\/jnccn.2019.0001","type":"journal-article","article-title":"Cervical cancer, version 3.2019, NCCN clinical practice guidelines in oncology","volume":"17","author":"Koh","year":"2019","journal-title":"J. Natl Compr. Cancer Netw."},{"key":"bpexae7979bib5","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1056\/NEJM199904153401501","type":"journal-article","article-title":"Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer","volume":"340","author":"Morris","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"bpexae7979bib6","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1056\/NEJM199904153401502","type":"journal-article","article-title":"Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer","volume":"340","author":"Rose","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"bpexae7979bib7","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.radonc.2004.12.015","type":"journal-article","article-title":"Recommendations from gynaecological (GYN) GEC-ESTRO working group (I): concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV","volume":"74","author":"Haie-meder","year":"2005","journal-title":"Radiother. Oncol."},{"key":"bpexae7979bib8","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1016\/S1470-2045(20)30753-1","type":"journal-article","article-title":"MRI-guided adaptive brachytherapy in locally advanced cervical cancer (EMBRACE-I): a multicentre prospective cohort study","volume":"22","author":"Potter","year":"2021","journal-title":"Lancet Oncol."},{"key":"bpexae7979bib9","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.radonc.2016.03.011","type":"journal-article","article-title":"Image guided brachytherapy in locally advanced cervical cancer: improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study","volume":"120","author":"Sturdza","year":"2016","journal-title":"Radiother. Oncol."},{"key":"bpexae7979bib10","doi-asserted-by":"publisher","first-page":"e65","DOI":"10.3802\/jgo.2024.35.e65","type":"journal-article","article-title":"Evolving standards and future directions for systemic therapies in cervical cancer","volume":"35","author":"Ang","year":"2024","journal-title":"J. Gynecol. Oncol."},{"key":"bpexae7979bib11","first-page":"1321","type":"book","volume":"Vol 404","author":"Lorusso","year":"2024"},{"key":"bpexae7979bib12","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.clon.2014.10.006","type":"journal-article","article-title":"Need for radiotherapy in low and middle income countries\u2014the silent crisis continues","volume":"27","author":"Zubizarreta","year":"2015","journal-title":"Clin. Oncol."},{"key":"bpexae7979bib13","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1016\/j.brachy.2020.12.008","type":"journal-article","article-title":"Interstitial brachytherapy for gynecologic malignancies: complications, toxicities, and management","volume":"20","author":"Kamrava","year":"2021","journal-title":"Brachytherapy"},{"key":"bpexae7979bib14","doi-asserted-by":"publisher","first-page":"4078","DOI":"10.1118\/1.3438081","type":"journal-article","article-title":"Stereotactic body radiation therapy: the report of AAPM Task Group 101","volume":"37","author":"Benedict","year":"2010","journal-title":"Med. Phys."},{"key":"bpexae7979bib15","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.ijrobp.2019.10.042","type":"journal-article","article-title":"A phase II trial of stereotactic ablative radiation therapy as a boost for locally advanced cervical cancer","volume":"106","author":"Albuquerque","year":"2020","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"bpexae7979bib16","doi-asserted-by":"publisher","first-page":"1684","DOI":"10.1136\/ijgc-2019-001104","type":"journal-article","article-title":"Non-invasive stereotactic ablative boost in patients with locally advanced cervical cancer","volume":"30","author":"Dalwadi","year":"2020","journal-title":"Int. J. Gynecol. Cancer."},{"key":"bpexae7979bib17","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/898953","type":"journal-article","article-title":"Stereotactic body radiotherapy as an alternative to brachytherapy in gynecologic cancer","volume":"2013","author":"Kubicek","year":"2013","journal-title":"Biomed. Res. Int."},{"key":"bpexae7979bib18","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.ijrobp.2004.09.028","type":"journal-article","article-title":"Fractionated stereotactic radiotherapy boost for gynecologic tumors: an alternative to brachytherapy?","volume":"62","author":"Molla","year":"2005","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"bpexae7979bib19","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1118\/1.597458","type":"journal-article","article-title":"Dosimetry of interstitial brachytherapy sources: recommendations of the AAPM Radiation Therapy Committee Task Group No. 43","volume":"22","author":"Nath","year":"1995","journal-title":"Med. Phys."},{"key":"bpexae7979bib20","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.ctro.2018.01.001","type":"journal-article","article-title":"The EMBRACE II study: the outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies","volume":"9","author":"Potter","year":"2018","journal-title":"Clin. Transl. Radiat. Oncol."},{"key":"bpexae7979bib21","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.radonc.2011.07.012","type":"journal-article","article-title":"Clinical outcome of protocol based image (MRI) guided adaptive brachytherapy combined with 3D conformal radiotherapy with or without chemotherapy in patients with locally advanced cervical cancer","volume":"100","author":"Potter","year":"2011","journal-title":"Radiother. Oncol."},{"key":"bpexae7979bib22","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.radonc.2010.01.001","type":"journal-article","article-title":"From point A to the sculpted pear: MR image guidance significantly improves tumour dose and sparing of organs at risk in brachytherapy of cervical cancer","volume":"94","author":"Tanderup","year":"2010","journal-title":"Radiother. Oncol."},{"key":"bpexae7979bib23","author":"International Atomic Energy Agency","year":"2024","type":"other"},{"key":"bpexae7979bib24","doi-asserted-by":"publisher","first-page":"e376","DOI":"10.1016\/S1470-2045(23)00299-1","type":"journal-article","article-title":"Radiotherapy resources in Latin America and the Caribbean: a review of current and projected needs based on International Atomic Energy Agency data","volume":"24","author":"Elbanna","year":"2023","journal-title":"Lancet Oncol."},{"key":"bpexae7979bib25","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1200\/GO.21.00029","type":"journal-article","article-title":"Global radiotherapy: current status and future directions-white paper","volume":"7","author":"Abdel-Wahab","year":"2021","journal-title":"JCO Glob. Oncol."},{"key":"bpexae7979bib26","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1016\/S1470-2045(15)00222-3","type":"journal-article","article-title":"Expanding global access to radiotherapy","volume":"16","author":"Atun","year":"2015","journal-title":"Lancet Oncol."},{"key":"bpexae7979bib27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcpo.2024.100485","type":"journal-article","article-title":"Radiotherapy resources in the Philippines: a 2022 update","volume":"41","author":"Canal","year":"2024","journal-title":"J. Cancer Policy"},{"key":"bpexae7979bib28","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1016\/S1470-2045(19)30308-0","type":"journal-article","article-title":"Scale-up of radiotherapy for cervical cancer in the era of human papillomavirus vaccination in low-income and middle-income countries: a model-based analysis of need and economic impact","volume":"20","author":"Rodin","year":"2019","journal-title":"Lancet Oncol."},{"key":"bpexae7979bib29","doi-asserted-by":"publisher","first-page":"6773","DOI":"10.1118\/1.4934823","type":"journal-article","article-title":"Point\/counterpoint. Medical use of all high activity sources should be eliminated for security concerns","volume":"42","author":"Capala","year":"2015","journal-title":"Med. Phys."},{"key":"bpexae7979bib30","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1177\/153303461000900509","type":"journal-article","article-title":"Hypofractionated extracranial stereotactic radiotherapy boost for gynecologic tumors: a promising alternative to high-dose rate brachytherapy","volume":"9","author":"Jorcano","year":"2010","journal-title":"Technol. Cancer Res. Treat."},{"key":"bpexae7979bib31","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1118\/1.2818738","type":"journal-article","article-title":"Volumetric modulated arc therapy: IMRT in a single gantry arc","volume":"35","author":"Otto","year":"2008","journal-title":"Med. Phys."},{"key":"bpexae7979bib32","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.brachy.2011.12.001","type":"journal-article","article-title":"Comparison of intracavitary brachytherapy and stereotactic body radiotherapy dose distribution for cervical cancer","volume":"11","author":"Cengiz","year":"2012","journal-title":"Brachytherapy"},{"key":"bpexae7979bib33","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1186\/s13014-023-02295-4","type":"journal-article","article-title":"Boost modalities in cervical cancer: dosimetric comparison between intracavitary BT vs. intracavitary + interstitial BT vs. SBRT","volume":"18","author":"Benkhaled","year":"2023","journal-title":"Radiat. Oncol."},{"key":"bpexae7979bib34","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2025.111306","type":"journal-article","article-title":"Diffusion weighted imaging for gross tumor volume delineation in primary radiochemotherapy and image guided adaptive brachytherapy for cervical cancer","volume":"214","author":"Zimmermann","year":"2025","journal-title":"Radiother. Oncol."},{"key":"bpexae7979bib35","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3390\/curroncol32030170","type":"journal-article","article-title":"A systematic review of SBRT boost for cervical cancer patients who cannot benefit from brachytherapy","volume":"32","author":"Gazsi","year":"2025","journal-title":"Curr. Oncol."}],"container-title":["Biomedical Physics & Engineering Express"],"original-title":[],"link":[{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979","content-type":"text\/html","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T07:07:19Z","timestamp":1781852839000},"score":1,"resource":{"primary":{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2057-1976\/ae7979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":35,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6,19]]},"published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1088\/2057-1976\/ae7979","relation":{},"ISSN":["2057-1976"],"issn-type":[{"value":"2057-1976","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"assertion":[{"value":"Dosimetric comparison of high dose rate interstitial brachytherapy and stereotactic body radiotherapy as alternative treatment methods for advanced-stage cervical cancer","name":"article_title","label":"Article Title"},{"value":"Biomedical Physics & Engineering Express","name":"journal_title","label":"Journal Title"},{"value":"paper","name":"article_type","label":"Article Type"},{"value":"\u00a9 2026 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2026-01-02","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-06-08","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-06-19","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}