Radiotherapy for gynecological cancer
Survival
rate up
Side effects down
As part of combination therapy, image-guided adaptive brachytherapy achieved an 87% three-year survival rate for women with cervical cancer, while reducing side effects.
A global health priority with deeply personal impact
Gynecological cancers, including cervical, endometrial, ovarian, vaginal, and vulvar, remain among the most common cancers affecting women globally, with over 1.47 million new diagnoses and more than 680,000 deaths each year.1
Cervical cancer in particular highlights global inequities: it is highly curable with radiotherapy, yet access remains limited in many low- and middle-income countries. Expanding access to advanced techniques like online adaptive radiotherapy and brachytherapy is essential to improve outcomes and quality of life for women everywhere.
Proven precision, better outcomes
Key clinical studies confirm that adaptive radiotherapy improves precision, safety, and outcomes for gynecological cancers.
>93% 3-year local control
EMBRACE II showed that chemoradiotherapy including MRI-based image-guided adaptive brachytherapy achieves excellent local control rates in locally advanced cervical cancer, significantly improving outcomes combined with low toxicity.2
Up to 6–7 mm shifts between sessions
MR-Linac imaging showed >5mm motion of the cervix and uterus within a session, but up to 6–8 mm shifts between sessions, highlighting the need for daily adaptation.3
Lowered dose to bladder and rectum
Daily MR-guided adaptation in cervical cancer improves target coverage and reduces bladder/rectum doses, highlighting the benefit of online adaptive radiotherapy.4
How adaptive radiotherapy helps you respond to clinical changes
| Your challenge | Adaptive helps you... |
| Daily variation in bladder and bowel filling | Re-optimize plans each day to account for pelvic organ motion and volume changes |
| Tumor regression or shifts between sessions | Adjust margins and dose distribution based on current anatomy |
| Critical organs (bladder, rectum, bowel) close to the target | Safely reduce dose to organs at risk with precise daily adaptation |
| Limited clinical time and planning resources | Accelerate replanning with fast, automated optimization |
Clinics are already adapting and redefining what’s possible
Why brachytherapy should remain essential to cervical cancer care
Dr. Alina Sturdza of the Medical University of Vienna highlights how MRI-guided adaptive brachytherapy and the EMBRACE trials have improved cervical cancer outcomes, offering better survival rates and fewer side effects.
Watch video
Yaowarat is philosophical about overcoming cervical cancer
“I believe Unity will change the world for radiation oncologists, not only delivering the best treatment plan for every fraction but also providing the information regarding treatment response and the prognosis of the patient based on the MR images.”, Dr. Sittiwong, Radiation Oncologist, Siriraj Hospital
Read article
Standardizing cervical cancer brachytherapy in India
Dr. Umesh Mahantshetty talks about the challenges of multi-room brachytherapy and the reasons why he believes treatment should be kept in one room. Learn about the importance of image-guided BT and how to get the best from your technology.
Read articleNobody does adaptive like Elekta
Gynecological cancers demand daily precision and sensitivity. With Elekta's solutions offering MR-guided and CT-guided radiotherapy and along with brachytherapy, we bring more than technology: we provide expertise, training, and global collaboration to help clinicians adapt to pelvic anatomy changes while protecting bladder, bowel, and reproductive health. Together, we can advance gynecological cancer treatment so more patients benefit from personalized, precise care.
Responding to what makes each patient different
Tumors in the pelvic region are highly sensitive to changes in surrounding anatomy. Bowel filling, bladder volume, and tumor regression can cause shifts that affect treatment accuracy from day to day.
Adaptive radiotherapy accounts for these variations in real-time, adjusting the plan based on daily imaging to protect organs at risk and maintain clinical precision.
Adaptation moves with your patient’s anatomy
Today, radiotherapy is highly effective in treating gynecological cancers, providing proven tumor control through carefully planned treatment volumes. However, the dynamic nature of pelvic anatomy, with daily changes in bladder and bowel filling and organ motion, presents ongoing challenges.
Adaptive treatment builds on the strengths of radiotherapy, enabling your team to respond to these daily anatomical changes. With precise imaging and daily plan adaptation, you can:
Balance coverage and protection
Safely reduce margins to protect the bladder, rectum, and bowel, minimizing side effects while ensuring tumor coverage.
Adapt to daily anatomical shifts
Adjust treatment plans each session to reflect what you see, maintaining accuracy despite organ motion.
Personalize treatment confidently
Tailor every fraction to your patient’s actual anatomy, improving precision and supporting better long-term quality of life.
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Delivering the future of gynecological cancer care
From cervical and endometrial cancers to recurrent pelvic disease, patients deserve treatment that adapts to their anatomy every day. Evidence from EMBRACE II confirms the value of image-guided adaptive brachytherapy, while MRgRT brings real-time adaptation to external beam therapy—together enabling more precise dosing, better protection of organs at risk, and truly personalized care.
Explore our adaptive solutions for gynecological cancer
Our image-guided adaptive solutions help clinicians tailor every fraction to protect bladder, bowel, and reproductive health while improving outcomes.
References
- 2025 Global Impact Report. Available at: https://aboutadaptive.com
(Accessed: 16 October 2025). - Pötter, R., et al. 2638 EMBRACE II - a multicenter prospective interventional cohort study on IGRT-IMRT+cisplatin+MR-IGABT in locally advanced cervix cancer: overall results. Available at: https://www.thegreenjournal.com/article/S0167-8140(25)01194-6/fulltext
(Accessed: 16 October 2025). - Wang, H., Li, Z., Shi, D. et al. (2024) ‘Assessing intra- and interfraction motion and its dosimetric impacts on cervical cancer adaptive radiotherapy based on 1.5T MR-Linac’, Radiation Oncology, 19, 176. Available at: https://doi.org/10.1186/s13014-024-02569-5
(Accessed: 16 October 2025). - Alshamrani, A., Chuter, R., Aznar, M. et al. (2025) ‘Quantifying the dosimetric impact of online daily adaptation for MR-guided radiotherapy in cervical cancer’, MJS Publishing, 64, pp. 693–702. Available at: https://doi.org/10.2340/1651-226X.2025.42898
(Accessed: 16 October 2025).