Selection of hybrid applicators for adaptive cervical cancer brachytherapy: A practical guide

Cody Kilar; Harjot Kaur Bajwa; Phillip Pifer; Sushil Beriwal

doi:10.5114/jcb.2025.158016

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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abstract:

Original paper

Selection of hybrid applicators for adaptive cervical cancer brachytherapy: A practical guide

Cody R. Kilar

¹

,

Harjot Kaur Bajwa

²

,

Phillip M. Pifer

¹

,

Sushil Beriwal

^{3, 4}

Department of Radiation Oncology, West Virginia University Cancer Institute, Morgantown, WV, USA
Radiation Oncology, American Oncology Institute, Hyderabad, India
Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, Pennsylvania, USA
Varian Medical Systems, Palo Alto, California, USA

J Contemp Brachytherapy 2025; 17, 6

DOI: https://doi.org/10.5114/jcb.2025.158016

Online publish date: 2025/12/18

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Image-based adaptive brachytherapy (IGABT) is now the standard of care for patients with locally advanced cervical cancer. EMBRACE-2 MRI-based brachytherapy study demonstrated improved local control rates and reduced morbidity using hybrid applicators. Utilization of these hybrid applicators in gynecological brachytherapy offers advantages over conventional interstitial techniques; however, practical guidance for applicator selection based on disease extent and image findings remains limited.

This manuscript aimed to provide a practical framework for applicator selection based on five case scenarios to demonstrate optimal applicator selection tailored to disease extent and anatomical considerations.

keywords:

Selection of hybrid applicators for adaptive cervical cancer brachytherapy: A practical guide

Cody R. Kilar 1 , Harjot Kaur Bajwa 2 , Phillip M. Pifer 1 , Sushil Beriwal 3, 4

brachytherapy, cervical cancer, hybrid applicators, image-based adaptive brachytherapy

Cody R. Kilar

¹

,

Harjot Kaur Bajwa

²

,

Phillip M. Pifer

¹

,

Sushil Beriwal

^{3, 4}