The Clinical Practice and Dosimetric Outcome of the Manual Adaptive Planning during Definitive Radiotherapy Treatment for Cervical Cancer

We found the most significant organ motion happened after 15 fractions during treatment. The manual adaptive planning of definitive radiotherapy improved the dose coverage and decreased the volume of organs at risk of receiving clinically significant doses of RT in patients with LACC. Patients with bulky mass or with parametrial infiltration were highly suggested to receive manual adaptive planning after 15 fractions during definitive radiotherapy, a timesaving strategy compared to the daily online adaptive radiotherapy without compromising the target dose coverage.