Image Based Brachytherapy in Locally Advanced Cervical Cancers - a Randomized Controlled Trial

Purpose of the study is to determine whether Image based brachytherapy is superior in terms of local control to Conventional radiograph based brachytherapy in locally advanced cervical cancers in a Phase III randomized setting.

Sex

Female

Inclusion Criteria:

* Cancer of the uterine cervix considered suitable for curative treatment with definitive radio-(chemo) therapy including MRI guided Brachytherapy.
* Positive biopsy showing squamous-cell carcinoma, adenocarcinoma or adeno-squamous cell carcinoma of the uterine cervix.
* Stage IIB/IIIB according to FIGO and tumor node metastasis (TNM) guidelines
* Suitable for Brachytherapy boost
* MRI of pelvis at diagnosis is performed
* MRI, Computed Tomography (CT) or Positron Emission Tomography (PET) -CT of the retroperitoneal space and abdomen at diagnosis is performed to rule out Para-aortic lymph node metastasis.
* Patient informed consent
* Pre-treatment Haemoglobin level \>10 g/dL

Exclusion Criteria:

* Other primary malignancies except carcinoma in situ of the cervix and basal cell carcinoma of the skin.
* Metastatic disease
* Patients with para-aortic metastatic nodes (stage IVB) to the level of L2 vertebra or further dissemination
* Previous pelvic or abdominal radiotherapy
* Previous total or partial hysterectomy
* Combination of preoperative radiotherapy with surgery
* Patients receiving BT only
* Patients receiving EBRT only
* Patients receiving neoadjuvant chemotherapy
* Contraindications to MRI
* Contraindications to BT
* Active infection or severe medical condition endangering treatment delivery.
* Pregnant, lactating or childbearing potential without adequate contraception

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