Clinical Report: Addressing Dose Hot Spots in Adaptive Radiotherapy for Cervical Cancer

Background

Cervical cancer is a prevalent malignancy in women, and radiotherapy is a key treatment modality. Accurate dose delivery is complicated by anatomical changes during treatment, which can lead to inadequate target coverage and increased risk to surrounding organs at risk. Online adaptive radiotherapy (ART) offers a solution by recalibrating treatment plans based on daily imaging, yet it may introduce dosimetric uncertainties.

Data Highlights

No numerical data available in the source material.

Key Findings

• Hot spots can occur in adaptive radiotherapy plans due to anatomical changes and limitations in the planning workflow.
• The Ethos system's automated planning may lead to excessive dose accumulation in the target area.
• Improved online ART workflows can reduce the risk of hot spots by correcting target deviations.
• This case study is the first report of hot spots in the Ethos adaptive plan for cervical cancer.
• Dosimetric uncertainties can arise from auto-segmentation errors and image artifacts.

Clinical Implications

The findings highlight the need for careful monitoring of adaptive radiotherapy plans to prevent hot spots. Implementing improved workflows may enhance the safety and efficacy of treatment for cervical cancer patients.

Conclusion

Addressing dose hot spots in adaptive radiotherapy is crucial for ensuring patient safety and treatment effectiveness. The proposed workflow improvements may contribute to better treatment outcomes.

Related Resources & Content

1. Frontiers in Oncology, 2026 -- Advanced dose calculation strategies for clinical linear accelerators: a systematic review
2. Frontiers in Oncology, 2026 -- Past present and future of radiosensitization in cervical cancer
3. Frontiers in Oncology, 2026 -- Bibliometric Analysis of Global Research Trends in Spatially Fractionated Radiotherapy
4. Guideline-based standard of care for locally advanced cervical cancer, 2023
5. Four-Dimensional Image-Guided Adaptive Brachytherapy for Cervical Cancer: A Systematic Review and Meta-Regression Analysis - PMC
6. Frontiers in Oncology — Glandular tissue–based versus anatomical landmark–based CTV delineation in postoperative breast cancer radiotherapy: a dosimetric comparison
7. https://guidelines.esgo.org/media/2023/05/Pocket-Guidelines_Cervical-cancer.pdf
8. Four-Dimensional Image-Guided Adaptive Brachytherapy for Cervical Cancer: A Systematic Review and Meta-Regression Analysis - PMC
9. The Current use of Adaptive Strategies for External Beam Radiotherapy in Cervical Cancer: A Systematic Review - ScienceDirect
10. Deformable dose accumulation is required for adaptive radiotherapy practice - PMC