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3D Conformal Radiotherapy Versus the Conventional Box Technique for Cervical Cancer: A Dosimetric Observational

Jagrati Yadav1,2, Seema Gupta2, Ajay K Venugopal2

  • 1Department of Medical Oncology, Jawaharlal Nehru Medical College, Wardha, IND.

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|September 12, 2025
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Summary

3D-conformal radiotherapy (3D-CRT) offers superior target dose conformity and homogeneity compared to conventional techniques for locally advanced cervical cancer. This advanced radiotherapy approach also significantly reduces radiation exposure to critical pelvic organs.

Keywords:
3d-crtcervical cancerconventional radiotherapydosimetric evaluationoar sparing

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Area of Science:

  • Radiation Oncology
  • Gynecologic Oncology
  • Medical Physics

Background:

  • Advanced radiotherapy techniques like intensity-modulated radiotherapy (IMRT) and 3D-conformal radiotherapy (3D-CRT) have improved gynecologic cancer treatment.
  • Access to these advanced techniques is limited in resource-constrained settings.
  • This study evaluates 3D-CRT against the conventional four-field box technique for locally advanced cervical cancer.

Purpose of the Study:

  • To perform a comparative dosimetric analysis of 3D-CRT and conventional radiotherapy for locally advanced cervical cancer.
  • To evaluate the efficacy of 3D-CRT using the cervical dosimetry mapping and planning (CERV-DOSIMAP) framework.
  • To assess improvements in target dose coverage and reductions in organ-at-risk doses.

Main Methods:

  • Radiotherapy planning was conducted on 30 patients with FIGO stage IIB-IIIB cervical carcinoma.
  • CT-based planning defined gross tumor volume (GTV), clinical target volume (CTV), planning target volume (PTV), and organs at risk (OAR).
  • Dose-volume histogram (DVH) analysis compared conformity index (CI), homogeneity index (HI), and OAR doses between conventional and 3D-CRT plans using paired t-tests.

Main Results:

  • 3D-CRT demonstrated significantly higher conformity (CI: 0.92 ± 0.03) and homogeneity (HI: 0.08 ± 0.01) compared to conventional plans (CI: 0.85 ± 0.04; HI: 0.13 ± 0.02).
  • A statistically significant reduction in radiation dose to the bladder, rectum, and femoral heads was observed with 3D-CRT.
  • The CERV-DOSIMAP framework facilitated this comparative dosimetric evaluation.

Conclusions:

  • The CERV-DOSIMAP framework confirms 3D-CRT as a superior radiotherapy technique for locally advanced cervical cancer.
  • 3D-CRT significantly improves target dose conformity and homogeneity.
  • 3D-CRT effectively minimizes radiation exposure to critical pelvic organs, enhancing patient safety.