Dose escalation by brachytherapy for gynecological cancers.

Brachytherapy (BT), a type of focal cancer radiation therapy, delivers a highly focused dose of radiation to localized tumors, sparing surrounding normal tissue. Brachytherapy has been used to treat gynecologic malignancies, particularly cervical cancer, for over 100 years. From the first gynecologic brachytherapy treatments in the early 20th century to the modern era, significant transformations have taken place, largely due to advances in technology. The development of high-dose-rate sources, remote afterloaders, new applicators, and three-dimensional image guidance has increased tumor dose and, consequently, local control and survival, reinforcing brachytherapy's role as an integral component of gynecologic cancer treatment. Current research efforts involving biomarker research, integration of new imaging modalities, radiosensitizing therapies are aimed at further personalizing the dose delivered in BT to further improve local control and reduce treatment's related toxicities.