A Clinical Study of Pelvic Concurrent Chemoradiotherapy Combined with CT-guided Intracavitary Brachytherapy with Adaptive Simultaneous Dose Escalation for Locally Advanced Cervical Cancer

Inclusion Criteria:

1. Sign the informed consent;
2. Age :18 to 75 years old;
3. Histologically or cytologically confirmed cervical cancer;
4. According to the International Federation of Gynecology and Obstetrics (FIGO 2018) stage IB3, IIA2, IIB, III, IV (local advanced), and had not received treatment before enrollment;
5. Measurable lesions according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1;
6. ECOG physical performance score 0-2;
7. Expected survival time \>= 3 months;
8. LVEF \>= 55%;
9. Bone marrow function: neutrophil \>= 1.5×109/L, platelet ≥ 100×109/L, white blood cell 4.0-10.0×109/L, hemoglobin \>= 90 g/L;
10. Liver and kidney function: serum creatinine \<= 1.5 times upper limit of normal; AST and ALT≤2.5 times upper limit of normal (ULN) or \<= 5 times ULN in the presence of liver metastasis; Total bilirubin \<=1.5 times upper limit of normal, or \<= 2.5 times upper limit of normal if the patient has Gilbert's syndrome;
11. Subjects of childbearing age must agree to use effective contraception during the trial, and women of childbearing age must have a negative serum or urine pregnancy test;
12. Non-lactating patients;

Exclusion Criteria:

1. Patients with prior abdominal or pelvic radiotherapy;
2. being mentally ill and unable to cooperate with treatment;
3. Serious uncontrolled medical diseases, such as serious internal medical diseases, including severe heart disease, cerebrovascular disease, uncontrolled diabetes, uncontrolled hypertension, uncontrolled infection, active peptic ulcer, etc.;
4. Unable to tolerate cisplatin chemotherapy;
5. receiving other experimental drugs or participating in clinical trials for other anticancer treatment purposes within 30 days before the first radiotherapy;
6. Severe infection within 4 weeks before study treatment, including but not limited to infectious complications requiring hospitalization, bacteremia, or severe pneumonia;
7. Human immunodeficiency virus (HIV) -positive persons;
8. HBsAg positive and HBV-DNA titer \>= 1×10\^3 IU/mL; Participants were eligible for inclusion if they were HBsAg positive and had a peripheral blood HBV-DNA level of \< 1×10\^3 IU/mL, and if the investigator considered the participant to be in a stable phase of chronic hepatitis B without increasing the risk to the participant.
9. Hepatitis C virus (HCV) antibody positive or human immunodeficiency virus (HIV) antibody positive and HCV RNA test positive;
10. Patients judged by the investigator to be ineligible for the study.