Keiichi Jingu

• MD,PhD
• Professor (Full) at Tohoku University

The Japanese Society for Radiation Oncology (JASTRO) Guidelines for Radiotherapy Treatment Planning have been revised every four years to incorporate the latest findings since the publication of the first edition in 2004. This is a review which presents the 2024 JASTRO Guidelines for radiotherapy treatment planning for esophageal cancer in English....

Background Although radiation therapy (RT) has been established as a leading treatment for cancer patients, alongside surgery and chemotherapy, radiation itself is a well-known risk factor for carcinogenesis (Kamran et al., Cancer. 122(12):1809–21, 2016). A second malignant neoplasm may occur even with a small radiation dose (Diallo et al., Int J R...

This study aimed to develop a deep learning (DL)-based deliverable whole pelvic volumetric arc radiation therapy (VMAT) for patients with gynecologic cancer using a prototype DL-based automated planning support system, named RatoGuide, to evaluate its clinical validity. In our hospital, 110 patients with gynecologic cancer were registered. The pres...

Background Stereotactic radiotherapy (SRT) for kidney cancer, particularly when tumours are situated near critical organs-at-risk (OARs), presents significant challenges in achieving optimal dose delivery. MR-guided online adaptive radiotherapy (MRgoART) offers a promising solution by allowing real-time anatomical modification and plan reoptimisati...

This study is aimed to clarify the effectiveness of the image-rotation technique and zooming augmentation to improve the accuracy of the deep learning (DL)-based dose conversion from pencil beam (PB) to Monte Carlo (MC) in proton beam therapy (PBT). We adapted 85 patients with head and neck cancers. The patient dataset was randomly divided into 101...

The half-life of radioactive iodine (RAI) is prolonged in patients with chronic kidney disease (CKD) because RAI is mainly excreted by the kidneys. There is little information on the RAI half-life in patients with dialysis-dependent CKD (CKDG5d). Estimating the RAI half-life in a patient’s body provides important information for treatment planning....

In the last decade, the role of radiotherapy in rectal cancer has changed significantly with the introduction of total neoadjuvant therapy (TNT) and nonoperative management (NOM). For the setting of irradiation field in rectal cancer, the pararectal, lateral lymph nodes, and those along the inferior mesenteric artery (IMA) are most important. In to...

Purpose: This study aimed to investigate changes in target coverage using magnetic resonance-guided online adaptive radiotherapy (MRgoART) for kidney tumors and to evaluate the suitable timing of treatment. Materials and methods: Among patients treated with 3-fraction MRgoART for kidney cancer, 18 tumors located within 1 cm of the gastrointestin...

Objective: To retrospectively analyze outcomes of patients who received definitive pelvic irradiation for clinically pelvic node-positive (cT1-4N1M0) prostate cancer (PCa). Materials and methods: Clinical records of 148 patients with cT1-4N1M0 PCa treated with definitive pelvic radiotherapy (RT) between 2011 and 2015 were retrospectively collected...

To evaluate the efficacy and safety of diffusing alpha-emitter radiation therapy (DaRT) for recurrent head and neck cancer (rHNC) after radiotherapy. This study was a multicenter prospective clinical trial. Eligibility criteria included all patients with biopsy-proven rHNC and history of radiotherapy. The efficacy of DaRT was evaluated in terms of...

Introduction Treatment strategies that enhance the efficacy of immunotherapy are desired. Radiotherapy can enhance immunity, but the utility of adding radiotherapy to immunotherapy plus platinum-doubled chemotherapy in patients with metastatic NSCLC has not been explored. Methods This multicenter, single-arm phase 2 trial evaluated the efficacy an...

Lung function assessment is essential for determining the optimal treatment strategy for radiation therapy in patients with lung tumors. This study aimed to develop radiomics and dosiomics approaches to estimate pulmonary function test (PFT) results in post-stereotactic body radiation therapy (SBRT). Sixty-four patients with lung tumors who underwe...

The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) is a database that stores anonymized information on medical receipts and health checkups in Japan. The NDB Open Data is a publicly accessible summary table of the NDB database. To reveal annual trends and regional disparities in radiotherapy utilization in...

Background and purpose This study aimed to investigate the intrafractional movement of the spinal cord and spinal canal during MR-guided online adaptive radiotherapy (MRgART) for kidney cancer. Materials and methods All patients who received stereotactic MRgART for kidney cancer between February 2022 and February 2024 were included in this study....

Background To evaluate the efficacy and safety of diffusing alpha-emitter radiation therapy (DaRT) for recurrent head and neck cancer (rHNC) after radiotherapy. Methods This study was a multicenter prospective clinical trial. Eligibility criteria included all patients with biopsy-proven rHNC, history of radiotherapy. The efficacy of DaRT was evalua...

Background There have been several reports showing that heart-related deaths are common in long-term survivors of esophageal cancer after radiation therapy; however, radiotherapy technology is evolving year by year. This study was carried out using the SEER database to determine whether the frequency of mortality from heart disease after radiothera...

Purpose This study evaluates deep learning (DL) based dose prediction methods in head and neck cancer (HNC) patients using two types of input contours. Materials and methods Seventy‐five HNC patients undergoing two‐step volumetric‐modulated arc therapy were included. Dose prediction was performed using the AIVOT prototype (AiRato.Inc, Sendai, Japa...

This study aimed to evaluate the performance for answering the Japanese medical physicist examination and providing the benchmark of knowledge about medical physics in language-generative AI with large language model. We used questions from Japan’s 2018, 2019, 2020, 2021 and 2022 medical physicist board examinations, which covered various question...

Introduction In an MRI-guided linear accelerator (MR-LINAC) system, the planned doses for organs at risk and for tumours are assessed by MR imaging and re-contouring at every treatment. This allows treatment to be safer and more precise by ensuring that it is suitable for the state of the patient’s organs on that day, as well as by allowing images...

We conducted a study to examine the treatment outcomes and prognostic factors for patients who underwent craniospinal irradiation (CSI) for leptomeningeal metastasis of solid tumors. This retrospective study included patients who received CSI for leptomeningeal metastasis at a single institute between 2010 and 2021. Data from clinical records and t...

Urinary toxicities are one of the serious complications of radiotherapy for prostate cancer, and dose-volume histogram of prostatic urethra has been associated with such toxicities in previous reports. Previous research has focused on estimating the prostatic urethra, which is difficult to delineate in CT images; however, these studies, which are l...

Purpose This study identified the factors affecting cerebral microbleed (CMBs) development. Moreover, their effects on intelligence and memory and association with stroke in patients with germinoma who had long-term follow-up were evaluated. Methods This study included 64 patients with germinoma who were histologically and clinically diagnosed wit...

Background There has been no study in which the correlation between clinical results and dosimetry based on a 3D treatment planning system in patients with ¹⁹⁸ Au grains for head and neck cancer was evaluated. Methods Thirty‐two patients who were treated with ¹⁹⁸ Au grains for head and neck cancer were reviewed. Twenty‐five patients were treated w...

Featured Application Importance of the evaluation of the physician’s eye exposure to radiation during ¹⁹⁸Au grain brachytherapy, given that the eye dose limit has been reduced drastically from 150 to 20 mSv/year. Abstract Brachytherapy is a practical, effective procedure for the local treatment of cancer; it delivers a high radiation dose to a lim...

8541 Background: Radiotherapy (RT) can activate the immune system and result in an antitumor effect outside of the radiation field. Several studies showed the efficacy of an addition of RT to immunotherapy for metastatic non-small cell lung cancer (NSCLC). However, the results of RT combined with immunotherapy plus platinum-doublet chemotherapy (ch...

4029 Background: Recently, neoadjuvant chemotherapy or chemoradiotherapy followed by surgery for patients with esophageal cancer have resulted in favorable prognosis, but extended radical esophagectomy with two-field or three-field (neck, mediastinum, and abdomen) lymph node dissection remains a standard treatment. However, there is recurrence in 3...

Lymphopenia is a well-known side effect of radiotherapy and has been shown to have a negative impact on patient outcomes. However, the extent of lymphopenia caused by palliative radiotherapy and its effect on patient prognosis has not been clarified. The aim of this study was to determine the incidence and severity of lymphopenia after palliative r...

Introduction Patients with esophageal cancer who are in a poor general condition receive radiotherapy alone, but outcomes are often unsatisfactory. The aim of this study was to clarify recent outcomes of radiotherapy alone for esophageal cancer. Methods Patients who underwent 50 Gy or more of radiotherapy without chemotherapy were retrospectively...

Measurement-based verification is impossible for the patient-specific quality assurance (QA) of online adaptive magnetic resonance imaging-guided radiotherapy (oMRgRT) because the patient remains on the couch throughout the session. We assessed a deep learning (DL) system for oMRgRT to predict the gamma passing rate (GPR). This study collected 125...

Purpose This study identified the factors affecting cerebral microbleed (CMBs) development. Moreover, their effects on intelligence and memory and association with stroke in patients with germinoma who had long-term follow-up were evaluated. Methods Patients histologically and clinically diagnosed with and treated for germinoma were included in th...

Nicaraven has been reported to inhibit the activity of poly (ADP-ribose) polymerase (PARP). In this study, we investigated the probable ability of nicaraven to attenuate cancer radioresistance during fractionated radiotherapy. Tumor models were established in C57BL/6 mice and BALB/c nude mice by subcutaneous injection of Lewis mouse lung carcinoma...

Objective We retrospectively analyzed breast cancer patients who received adjuvant radiotherapy to determine the incidence of lymphocytopenia and its risk factors. Methods We reviewed 812 patients with breast cancer who received postoperative radiotherapy. Patients were divided into two groups based on the use of chemotherapy, and a generalized li...

Background and Objective In the field of radiation therapy, image-guided radiotherapy (IGRT) technology has been gradually improving and highly accurate radiation treatment has been possible. Research on IGRT using 1.5 Tesla magnetic resonance imaging (MRI) began in 1999, and a radiation therapy device called 1.5 Tesla magnetic resonance linear acc...

The purpose of this study was to show the safety of volumetric modulated arc therapy (VMAT) with deep inspiration breath-hold (DIBH) in hypofractionated radiotherapy for left-sided breast cancer after breast-conserving surgery in a clinical setting. Twenty-five Japanese women, aged 20–59 years, who were enrolled in this prospective non-inferiority...

Whole brain radiation therapy (WBRT) is effective for multiple brain metastases (BMs) but may impair neurocognitive function (NCF). The incidence of hippocampal metastasis (HM) is low, and the factors associated with the occurrence of HM remain unclear. This study aimed to assess the occurrence of limbic system metastasis (LSM), including HM, and t...

Background/aim: This retrospective study aimed to investigate the outcomes of relapse-free survival (RFS) after salvage radiation therapy (SRT) to the prostate bed for postoperative biochemical recurrence of prostate cancer. Patients and methods: A total of 87 patients were analyzed. There were 27, 32, and 24 patients with pathological grade gro...

Magnetic resonance imaging (MRI) provides excellent soft-tissue visualization, thereby increasing the sensitivity for detecting tumor and normal tissue boundary [1, 2]. The role of MRI in radiotherapy has largely been relegated to the initial radiotherapy planning stages (e.g., before treatment). Recently, hybrid MR scanners and linear accelerators...

Background In the treatment of vertebral bone metastases, estimating patient prognosis is important to select the optimal treatment strategy. The purpose of this study was to identify prognostic factors for vertebral bone metastases treated with palliative radiotherapy and to establish a nomogram for predicting patient survival. Materials and meth...

Purpose Whole-brain radiotherapy (WBRT) may not be beneficial for patients with brain metastases (BMs). The Glasgow Prognostic Score (GPS) is a suggested prognostic factor for malignancies. However, GPS has never been assessed in patients with BMs who have undergone WBRT. The purpose of this study was to determine whether GPS can be used to identif...

To investigate radiation-induced cytopenia and establish predictive nomograms for hematological toxicity, we reviewed 3786 patients aged 18 or older who received radiation monotherapy between 2010 and 2021 for non-hematologic malignancies. We collected data on patient background, treatment content and hematologic toxicities for 12 weeks after the s...

Nicaraven selectively protects normal tissue from radiation-induced injury. To further develop the clinical application of nicaraven for mitigating the side effects of cancer radiotherapy, we investigated the potential effect of nicaraven administration in radiation-induced inhibition of tumor growth. A subcutaneous tumor model was established in m...

This study investigated mental health, sleep quality, and quality of life among family members of patients with first-episode cancer. A survey was conducted with 39 family members of patients with cancer, using the Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Caregiver Quality of Life Index-Cancer (CQOLC)...

This study aims to evaluate the dosimetric accuracy of a deep learning (DL)-based deliverable volumetric arc radiation therapy (VMAT) plan generated using DL-based automated planning assistant system (AIVOT, prototype version) for patients with prostate cancer. The VMAT data (cliDose) of 68 patients with prostate cancer treated with VMAT treatment...

Purpose: This study aimed to investigate the clinical significance of residual hyperintensity on T2-weighted magnetic resonance imaging in patients with glioblastoma (GB) without enhanced lesions at the end of initial treatment with debulking surgery and concomitant radiotherapy and temozolomide. Methods: Among 185 GB cases, 80 cases without enhanc...

The Unity magnetic resonance (MR) linear accelerator (MRL) with MR-guided adaptive radiotherapy (MRgART) is capable of online MRgART where images are acquired on the treatment day and the radiation treatment plan is immediately replanned and performed. We evaluated the MRgART plan quality and plan reproducibility of the Unity MRL in patients with p...

Background Megavoltage computed tomography (MVCT) images acquired during each radiotherapy session may be useful for delta radiomics. However, no studies have examined whether the MVCT-based radiomics has prognostic power. Therefore, the purpose of this study was to examine the prognostic power of the MVCT-based radiomics for head and neck squamous...

Background/aim: The purpose of this study was to evaluate the impact of recent radiotherapy on mortality from heart disease in Asians or Pacific islanders with breast cancer using the Surveillance, Epidemiology, and End Results (SEER) database. Patients and methods: Asians or Pacific islanders with stage 0 or I (AJCC 6th) breast cancer between 2...

In external radiotherapy of head and neck (HN) cancers, the reduction of irradiation accuracy due to HN volume reduction often causes a problem. Adaptive radiotherapy (ART) can effectively solve this problem; however, its application to all cases is impractical because of cost and time. Therefore, finding priority cases is essential. This study aim...

Background: The purpose of this study was to investigate treatment outcomes of chemoradiotherapy (CRT) using S-1 with or without conversion surgery after gemcitabine plus nab-paclitaxel (GnP) for borderline resectable (BR) and unresectable locally advanced (UR-LA) pancreatic cancer. Methods: From 2016 to 2020, patients without disease progressio...

This prospective study aimed to evaluate whether radiation (RT)-induced myocardial damage by cardiac magnetic resonance (CMR) imaging could be a predictor of cardiac events after chemoradiotherapy (CRT) for esophageal cancer and determine the dose-volume histogram (DVH) parameters of the left ventricle (LV) in predicting cardiac events. CMR imaging...

Purpose: Deep learning-based virtual patient-specific quality assurance (QA) is a novel technique that enables patient QA without measurement. However, this method could be improved by further evaluating the optimal data to be used as input. Therefore, a deep learning-based model that uses multileaf collimator (MLC) information per control point a...

Purpose: The purpose of this study was to investigate the treatment results with focus on local control (LC) by computed tomography (CT)-guided intracavity brachytherapy and interstitial brachytherapy (ICBT/ISBT) for locally advanced cervical cancer (LACC). Methods and materials: Patients with LACC undergoing ICBT/ISBT at least once in our insti...

To detect errors in patient-specific quality assurance (QA) for volumetric modulated arc therapy (VMAT), we proposed an error detection method based on dose distribution analysis using unsupervised deep learning approach and analyzed 161 prostate VMAT beams measured with a cylindrical detector. For performing error simulation, in addition to error-...

Objective: To assess the feasibility of external beam radiotherapy without central shielding in definitive radiotherapy for Japanese patients with cervical cancer. Methods: We retrospectively analysed the data of cervical cancer patients treated with definitive radiotherapy consisting of external beam radiotherapy without central shielding and t...

Radiotherapy for breast cancer has attracted attention in Western countries because radiation to the heart can cause cardiac events. The purposes of this study were to evaluate the relationship between radiotherapy after breast-conserving surgery and the frequency of cardiac events in Japanese patients and to investigate the risk factors of cardiac...

This study aimed to develop and validate a collapsed cone convolution for magnetic resonance-guided radiotherapy (CCCMR). The 3D energy deposition kernels (EDKs) were generated in water in a 1.5-T transverse magnetic field. The CCCMR corrects the inhomogeneity in simulation geometry by referring to the EDKs according to the mass density between the...

Background Radiation-induced heart damage has recently attracted attention, and serious heart damage due to radiation has been reported in patients with breast cancer. The purpose of this study was to evaluate the impact of radiotherapy on mortality from heart disease in Asians or Pacific islanders with breast cancer using the Surveillance, Epidemi...

The purpose of this study was to evaluate the deformable image registration (DIR) accuracy using various CT scan parameters with deformable thorax phantom. Our developed deformable thorax phantom (Dephan, Chiyoda Technol Corp, Tokyo, Japan) was used. The phantom consists of a base phantom, an inner phantom, and a motor‐derived piston. The base phan...

Background: Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophage...

Purpose: To study the dosimetry impact of deformable image registration (DIR) using radiophotoluminescent glass dosimeter (RPLD) and custom developed phantom with various inserts. Methods: The phantom was developed to facilitate simultaneous evaluation of geometric and dosimetric accuracy of DIR. Four computed tomography (CT) images of the phant...

This study investigated the effectiveness and safety of low-dose salvage craniospinal irradiation (CSI) for recurrent germinoma. We retrospectively reviewed long-term tumor control and late adverse effects in 15 recurrent germinoma patients treated at our hospital between 1983 and 2019. Following the first recurrence of germinoma, seven were treate...

Objectives: In the treatment of castration-resistant prostate cancer (CRPC) with bone metastases, radium-223 dichloride (Ra-223) is the only bone-targeted drug that shows survival benefits. Completing six courses of Ra-223 treatment is thought to be associated with better patient survival, but this treatment has a relatively high rate of acute adv...

Pancreatic diseases are difficult to treat with high doses of radiation, as they often present both periodic and aperiodic deformations. Nevertheless, we expect that these difficulties can be overcome, and treatment results may be improved with the practical use of a device that can capture 2-D slices of organs during irradiation. However, since on...

Purpose: Radiation pneumonitis (RP) is dose-limiting toxicity for non-small-cell cancer (NSCLC). This study developed an RP prediction model by integrating dose-function features from computed four-dimensional computed tomography (4DCT) ventilation using the least absolute shrinkage and selection operator (LASSO). Methods: Between 2013 and 2020,...

Background and purpose The purpose of this prospective study was to investigate changes in longitudinal parameters after stereotactic radiotherapy for lung cancer and to identify possible pretreatment factors related to radiation-induced lung toxicity and the decline in pulmonary function after radiotherapy. Materials and methods Protocol-specifie...

The PARP-1 expression level and poly (ADP-ribosyl)ation activity in cancer markedly affect the therapeutic outcome. Nicaraven, a free radical scavenger has been found to inhibit PARP, but the effect on cancer cells is still unclear. In this study, we investigated the potential role and molecular mechanism of nicaraven on cancer cells. Using U937 ly...

Objective Radiation-induced lung injury (RILI) is one of the serious complications of radiotherapy. We have recently demonstrated that nicaraven can effectively mitigate RILI in healthy mice. Here, we further tried to optimize the dose and time of nicaraven administration for alleviating the side effects of radiotherapy in tumor-bearing mice. Meth...

Background: There has been an increasing number of elderly patients with intraductal papillary mucinous neoplasm (IPMN), who are surgically intolerant and require less invasive treatment options, which are limited. In the present study, we report a case of IPMN presenting with acute recurrent pancreatitis (ARP), in which radiation therapy effectiv...

This study assessed the efficacy of chemoradiotherapy for squamous cell carcinoma of the anal canal (SCCAC). Patients with T1–4N0-3M0 SCCAC received chemoradiotherapy with 5-fluorouracil (5-FU, 800 mg/m2/day, 96-h infusion) and mitomycin-C (MMC, 10 mg/m2 bolus). Patients treated with 3-dimensional conformal radiotherapy (3D-CRT) or intensity-modula...

Background Hematomas that slowly increase in size for more than 1 month after the initial hemorrhage are referred to as chronic expanding hematomas. Chronic expanding hematoma can also occur after radiosurgery; however, there have been no reports about chronic expanding hematoma in the trunk after stereotactic body radiotherapy. We report a case of...

Purpose We aimed to assess radiomics approaches for estimating three pulmonary function test (PFT) results (forced expiratory volume in one second [FEV1], forced vital capacity [FVC], and the ratio of FEV1 to FVC [FEV1/FVC]) using data extracted from chest computed tomography (CT) images. Methods This retrospective study included 85 lung cancer pa...

Purpose: There are limited reports on outcomes of three-dimensional image-guided brachytherapy (3D-IGBT) for cervical adenocarcinoma in Asia. In a multi-institutional retrospective study, we assessed the clinical outcomes of three-dimensional image-guided brachytherapy for cervical adenocarcinoma or adenosquamous carcinoma (CA/CAC) in Asian countr...

This study evaluated accuracy of deformable image registration (DIR) with twelve parameter settings for thoracic images. We used peak-inhale and peak-exhale images for ten patients provided by DIR-lab. We used a prototype version of iCView software (ITEM Corporation) with DIR to perform intensity, structure, and hybrid-based DIR with the twelve par...

The purpose of this study was to compare acute gastrointestinal (GI) toxicities in patients who underwent 3-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) in chemoradiotherapy (CRT) with S-1 including prophylactic regions for pancreatic cancer. We also investigated the predictive factor of acute GI toxicities...

Purpose: A phase II study carried out to assess the efficacy of a risk-adapted strategy of stereotactic radiosurgery (SRS) for lung cancer. The primary endpoint was 3-year local recurrence, and the secondary endpoints were overall survival (OS), disease-free survival (DFS), rate of start of systemic therapy or best supportive care (SST-BSC), and t...

The first magnetic resonance (MR)-guided radiotherapy system in Japan was installed in May 2017. Implementation of online MR-guided adaptive radiotherapy (MRgART) began in February 2018. Online MRgART offers greater treatment accuracy owing to the high soft-tissue contrast in MR-images (MRI), compared to that in X-ray imaging. The Japanese Society...

Background The coronavirus disease 19 (COVID-19) vaccination has been progressing. The safety of vaccination during radiotherapy is not clear. Case presentation We experienced a patient who received a COVID-19 vaccine during radiotherapy. A 60-year-old woman with breast cancer underwent postoperative radiotherapy. She received two vaccine doses an...

Purpose Intensity-modulated radiotherapy (IMRT) is currently used more commonly than 3-dimensional conformal radiation for definitive thoracic radiation. We examined the efficacy profiles of concurrent chemoradiotherapy (CCRT) with IMRT after durvalumab became clinically available. Methods We reviewed the clinical records of patients with stage II...

Purpose: To evaluate the benefit of concurrent chemotherapy with radiotherapy (RT) for esophageal cancer in Asian patients aged ≥ 80 years using the Surveillance, Epidemiology, and End Results (SEER) database. Materials and methods: Among more than 7000 patients with squamous cell carcinoma or adenocarcinoma who were treated by RT without surger...

Purpose The purpose of this study is to introduce differential dose–volume histogram (dDVH) features into machine learning for radiation pneumonitis (RP) prediction and to demonstrate the predictive performance of the developed model based on integrated cumulative dose–volume histogram (cDVH) and dDVH features. Materials and methods: cDVH and dDVH...

Early regression—the regression in tumor volume during the initial phase of radiotherapy (approximately 2 weeks after treatment initiation)—is a common occurrence during radiotherapy. This rapid radiation-induced tumor regression may alter target coordinates, necessitating adaptive radiotherapy (ART). We developed a deep learning-based radiomics (D...

Purpose: The purpose of the present study was to evaluate patterns of recurrence after salvage chemoradiotherapy (SCRT) for postoperative loco-regional recurrent esophageal cancer. Methods: We reviewed records for 114 patients with postoperative loco-regional recurrent esophageal cancer treated by platinum-based chemoradiotherapy between 2000 an...

This study is an international multi-institutional retrospective study comparing the clinical outcomes between intracavitary brachytherapy (ICBT) and the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients treated with definitive radiation therapy. Locally advanced cervical cancer, the initial...