{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T21:13:58Z","timestamp":1793740438984,"version":"4.6.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["por-journal.com"],"crossmark-restriction":true},"short-container-title":["Pathol. Oncol. Res."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>MRI-based image-guided adaptive brachytherapy (IGABT) is a new approach for individual dose escalation and control of organ at risk (OAR) doses and toxicities in the treatment of locally advanced cervical cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Various radiotherapy-related parameters and the feasibility of the treatment based on acute toxicity were analyzed in a total of 50 cases in two cohorts who received a brachytherapy (BT) boost after definitive chemoradiotherapy with either an MRI-based IGABT technique (24 patients) or CT-only image guidance (26 patients). For target volume, OAR delineation, and dose prescription, the EMBRACE II protocol was followed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The features of the target volumes and dose coverage did not differ between the two groups regarding teletherapy. At BT, however, while the High-Risk Clinical Target Volumes (CTVHR) did not differ the D90 dose coverage was significantly higher in the MRI-based IGABT group than in the non-MRI-based group (7.37 \u00b1 0.55 Gy vs. 6.87 \u00b1 0.84 Gy, p = 0.015). The CTVHR D98 doses showed a strong trend in favor of the MRI-based technique (6.16 \u00b1 0.59 Gy, vs. 5.72 \u00b1 0.95 Gy, p = 0.051). Cumulative doses to the CTVHR by means of both D90 and D98 were significantly higher in the MRI-based treatment group than the other group (86.64 \u00b1 4.76 Gy vs. 81.56 \u00b1 8.29 Gy, p = 0.011 and 77.23 \u00b1 4.39 Gy vs. 73.40 \u00b1 7.80 Gy, p = 0.037, respectively). Regarding OAR exposure, doses to the bladder, rectum, and sigmoid did not differ between the two cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our first clinical results support the implementation of IGABT as a key component of image-guided adaptive radiotherapy (IGART) aiming at tumor dose-escalation and OAR protection.<\/jats:p><\/jats:sec>","DOI":"10.3389\/pore.2025.1612077","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T04:11:38Z","timestamp":1746072698000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["MRI-based image-guided adaptive brachytherapy for locally advanced cervical cancer in clinical routine: a single-institution 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