Evolutionary development of radiotherapy technologies in locally advanced cervical cancer

Over the past two decades, radiation therapy paradigms have shifted from a two-dimensional (2D) approach based solely on anatomical bone landmarks to a three-dimensional (3D) approach under visual control, taking into account differences in tumor size and position, in order to deliver focal doses more accurately to clinical targets with simultaneous increased respect for risk organs (OR).In this article, we have tried to briefly describe the achievements in the field of remote radiotherapy (RRT) and brachytherapy (BT) for the treatment of locally advanced cervical cancer. We emphasize the historical evolution from the use of 2D radiation therapy to 3D conformal radiation therapy (3DCRT), followed by the transition to intensity modulated radiation therapy (IMRT), which hasnow become the standard for planning and conducting RRT. We also discuss advances in brachytherapy, in particular the evolution from the Manchester BT delivery system to the currently widespread adaptive brachytherapy under three-dimensional imaging (3D-IGABT). In this context, we highlight recently conducted large cohort studies that have shown a significant improvement in local control (LC) and a reduction in toxicity associated with the use of 3D-IGABT technology. Finally, we briefly describe other technological advances in this area,