The complex and varied motion of the cervix–uterus target during external beam radiotherapy (EBRT) underscores the clinical benefits afforded by adaptive radiotherapy (ART) techniques. These gains have already been realised in the implementation of image-guided adaptive brachytherapy, where adapting to anatomy at each fraction has seen improvements in clinical outcomes and a reduction in treatment toxicity. With regards to EBRT, multiple adaptive strategies have been implemented, including a personalised internal target volume, offline replanning and a plan of the day approach. With technological advances, there is now the ability for real-time online ART using both magnetic resonance imaging and computed tomography-guided imaging. However, multiple challenges remain in the widespread dissemination of ART. This review investigates the ART strategies and their clinical implementation in EBRT delivery for cervical cancer.

外照射放疗 (EBRT) 期间宫颈 - 子宫靶标的复杂多变运动强调了适应性放疗 (ART) 技术提供的临床益处。这些收益已经在图像引导的自适应近距离放射治疗的实施中实现，其中适应每个部位的解剖结构已经看到临床结果的改善和治疗毒性的降低。在 EBRT 方面，已经实施了多种适应性策略，包括个性化的内部目标量、离线重新规划和每日计划方法。随着技术的进步，现在可以使用磁共振成像和计算机断层扫描引导成像进行实时在线 ART。然而，ART 的广泛传播仍然存在多重挑战。