Therapeutic orientation in brachytherapy of uterine cervix carcinoma

Brachytherapy is a fundamental step in the treatment of patients with cervical cancer. Brachytherapy allows a significant increase in the local control rate as well as the survival rate. Brachytherapy has to be performed as soon as possible after external irradiation in order to maintain the overall treatment time below 53 days. Technical and dosimetric data characterizing low dose-rate brachytherapy using ICRU 38 recommendations have led to an improvement in local control and a decrease in complications. Data are less well known for other dose rates. The role of interstitial brachytherapy is not clearly defined and its potential benefit is probably balanced by an increase in severe complications. Concomitant brachy-chemotherapy requires further clinical investigations, even if concomitant radio-chemotherapy has become a standard in advanced cervical cancers. (authors)