Two cases of forced external beam radiotherapy of the cancer of cervix uteri when brachytherapy is impossible

<jats:p>Cervical cancer (CC) is still a major social and health-care problems. Mortality from CC keeps high during many years and we don’t have always the possibility to diminish it by treatment amenably to official guidelines. Accordingly, actual official recommendations in our country and aboard the radiotherapy of CC consists of two phases. In general, we realize firstly external beam irradiation of primary tumor and zones of regional metastasing, and after that, we must do the brachytherapy boost to gross tumor volume in the primary. However, the second phase impossible to realize in a part of patients. Unfortunately, there is no recommendations what to do the best with the situation in existing guidelines. We demonstrate two successful cases, which we forced to care only by external beam irradiation when brachytherapy is impossible, that is unimodal. Only the external beam irradiation was image guided and adaptive (IGAEBRT) implemented accordingly to target movements and to clinical course. IGAEBRT, realized on advanced technological equipment may be successful in the treatment of some cases of IIIC1 and IVA stages of CC. Today we see the conditions to upgrade principles of radiotherapy of CC. In the goal to improve the results we have to rise discussion about perfection the guidelines in the question. Keywords: cervix uteri, radiotherapy, brachytherapy, cervix cancer, guidelines, standards, image guided adaptive external beam radiation therapy.</jats:p>