Cervical cancer brachytherapy

Brachytherapy is an essential component of treatment for cervical cancer, offering real advantages over other cervical cancer treatment options in terms of survival rates and side effects. Depending on the tumor stage, it can be performed with intracavitary or combined intracavitary/interstitial technique. On the basis of high-level evidence from randomized controlled trials, brachytherapy is indicated as standard in combination with chemoradiation in patients with locally advanced cervical cancer (LACC).

Brachytherapy can be used alone in some cases of early-stage cervical cancers.

Doctor and patient

What is the brachytherapy procedure for cervical cancer?

Intracavitary brachytherapy is placed into the vagina (open cavity), close to the cervix uteri. Small radioactive sources precisely deliver radiation through an applicator and are completely removed after delivery, so no radioactivity will remain in the patients’ body.

Modern brachytherapy uses Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) images to control the position of the tumor and the radioactive source. Elekta offers Elekta Studio*, featuring the ImaginRing, that enables imaging through all the steps of the flow without moving the patient.

*Elekta is the authorized Exclusive Distributor of medPhoton in Brachytherapy. ImagingRing is product manufactured by medPhoton GmbH. ImagingRing may not be available in all markets.

Brachytherapy applicators for the treatment of cervical cancer

Choosing the right applicator for brachytherapy in cervical cancer treatment is a crucial decision. Diagnostic imaging serves as a guiding beacon in the selection of brachytherapy applicators for cervical cancer treatment. With the help of CT and MRI the most suitable applicator is chosen to align with the unique needs of each individual, ensuring precise and personalized treatment delivery. Elekta offers the broadest range of CT/MR compatible applicators for gynecological brachytherapy. Our diverse selection of applicators caters to a wide spectrum of applications, from intracavitary to interstitial use, designed to elevate the standard of care in gynecologic brachytherapy.

View applicator guide

How successful is brachytherapy for cervical cancer?

A large-scale study compared treatment outcomes with and without brachytherapy, revealing a remarkable advantage in 5-year survival rates for patients who received brachytherapy. This vital study underscores the potential of brachytherapy in patients to defy the odds and live longer, healthier lives. When brachytherapy was incorporated into the treatment plan, patients experienced a clear advantage in 5-year survival rates. A significant percentage difference emerged, with a 54% survival rate for those who received brachytherapy, compared to a comparatively lower rate of 42% for those without it. These results exemplify the profound impact that brachytherapy can have on the lives of individuals battling cervical cancer. (see picture 1).2

This study was carried out before the era of Image-guided brachytherapy, yet it still yielded notable improvements in survival rates.

graph of overall survival rates with brachytherapy and without

Picture 1. Overall survival in patients with cervical cancer treated with brachytherapy and without brachytherapy2

Image-guided brachytherapy represents a significant leap forward in treatment precision and patient outcomes. A study from the Netherlands showcased a substantial difference in overall survival rates between conventional 2D brachytherapy and image-guided brachytherapy. The image-guided approach demonstrated a far-reaching impact, with overall survival rates reaching an impressive 86% for image-guided brachytherapy, compared to 51% with conventional methods. (see picture 2).3 This is due to brachytherapy under CT - or MRI-guidance is more precise as it targets the tumor but spares surrounding healthy tissues and organs.

graph of cumulative survival rates with 2d brachytherapy and 3d brachytherapy

Picture 2. Overall survival in patients with cervical cancer treated with conventional brachytherapy and image-guided brachytherapy3

The international EMBRACE I study which included 1341 patients with cervical cancer, showed MRI-guided brachytherapy as a powerful tool, ensuring an astounding 92% rate of local control at 5 years across all stages.

For women with stage 1B1 cervical cancer, the local control rate soared even higher, reaching an exceptional 98%. (see picture 3).4 This highlights the potential of early diagnosis and incorporating MRI-guided brachytherapy into treatment plans.

graph of actuarial estimates

Picture 3. Local control in patients with cervical cancer (data from the EMBRACE I study).


1. Banerjee R et al. Int J Womens Health. 2014 Sep;6:555-64. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045176/pdf/ijwh-6-555.pdf Accessed June 2021

2. Han K et al. Int J Radiat Oncol Biol Phys. 2013 Sep 1;87(1):111-9. Available at: https://www.redjournal.org/article/S0360-3016(13)00595-6/fulltext Accessed June 2021

3. Rijkmans EC et al. Gyn Oncol. 2014 Aug 26;135(2):231-8. Available at: https://www.gynecologiconcology-online.net/article/S0090-8258(14)01280-3/fulltext Accessed June 2021

4. Poetter R et al. The Lancet Oncol 2021 April 1;22(4):538-47. Available at: https://doi.org/10.1016/S1470-2045(20)30753-1 Accessed June 2021

What our customers say

The voice of our customers speaks volumes about the impact our technology has on patient lives and treatment outcomes. Dr. Spencer Thompson from the University of Oklahoma highlights the significance of Elekta's gynecological brachytherapy in transforming patient care. Dr. Sabhakar Mutyala from the University of Arizona emphasizes the efficacy of our breast brachytherapy solutions. Their testimonials not only validate our efforts but also inspire us to continue building hope and delivering the best possible cancer care.

Spencer Thompson, MD at University of Oklahoma, on Gynecological Brachytherapy

Sabhakar Mutyala, MD from University of Arizona, on Breast Brachytherapy

Other indications

Find out about our Brachytherapy solutions for other indications.