Cervix carcinomas: Place of intensity-modulated radiotherapy

While indications of modulated intensity radiation therapy (IMRT) are perfectly defined in head and neck and prostate cancer patients, this technique remains under evaluation for gynaecologic tumours. The implementation of conformal 3D radiotherapy in the late 1990s has been the first important step for optimisation of treatment of cervix carcinomas, as it permitted a better target coverage with a significant reduction of the bladder dose. However, this technique often leads to an irradiation of a larger volume of rectum in locally advanced stages and could only spare a limited amount of intestine. IRMT is one of the optimisation methods potentially efficient fora better sparing of digestive tract during irradiation of cervix carcinomas. The aim of this literature review is to provide the arguments supporting this hypothesis, and to define the place of this technique for dose escalation. (C) 2009 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.