Optimizing Cervical Cancer Radiotherapy: Dosimetric Comparison of 3D-CRT, IMRT, and VMAT: Experience at a Single Oncology Center

Background & Objective: Radiotherapy is a cornerstone of cervical cancer treatment. This study was conducted to evaluate the efficacy of three different external beam radiotherapy treatments: Three-Dimensional Conformal Radiotherapy (3D-CRT), Intensity-Modulated Radiotherapy (IMRT), and Volume-Modulated Radiation Therapy (VMAT), with the aim of optimizing cervical cancer treatment. Materials & Methods: This retrospective study was conducted on 10 patients, averaging 56 years old and mostly with squamous cell carcinoma, treated with Three-Dimensional Conformal Radiation Therapy radiotherapy from January to December 2023. Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy plans using computed tomography images with contours were evaluated for dosimetric quality. Results: IMRT and VMAT improved target coverage and reduced doses of organs at risk compared to 3D-CRT. IMRT lowered rectal and bladder doses by 2.51 Gy and 4.94 Gy, respectively, while VMAT reduced them by 2.82 Gy and 5.05 Gy. Both techniques also decreased exposure to the small bowel (IMRT: 1.6 Gy; VMAT: 2.8 Gy) and femoral heads (~0.2 Gy). They offered better conformity but required longer planning and treatment times. Conclusion: Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy are techniques for cervical cancer treatment. IMRT offers precise radiation delivery, sparing surrounding tissues, making it suitable for tumors near critical structures or sensitive organs. VMAT, delivering high doses rapidly, is still ideal for patients with difficulty staying. The choice of treatment depends on collaboration among the radiation oncologist, medical physicist, patient, and available facility resources.