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Advances in Radiotherapy
            & Nuclear Medicine                                    Brachytherapy versus external beam in local dose escalation



            and treatment delivery to post-treatment follow-up and   Consent for publication
            management of potential complications.
                                                               Not applicable.
              Technological and procedural advancements have
            progressively refined IRT, transforming it into a highly   Availability of data
            precise and internationally recognized therapeutic option,   Not applicable.
            with an improved therapeutic index. Looking ahead,
            the integration of personalized oncology and advanced   References
            imaging technologies is anticipated to further enhance the   1.   Suntharalingam N, Podgorsak EB, Tölli H. Brachytherapy:
            clinical effectiveness and precision of IRT. Nevertheless,   Physical and clinical aspects. In: Radiation Oncology Physics:
            despite the growing body of clinical evidence and     A Handbook for Teachers and Students. Vienna: International
            significant technological progress, utilization patterns of   Atomic Energy Agency; 2005. p. 451-484.
            IRT remain inconsistent across institutions and regions.
                                                               2.   Fröhlich G, Mészáros N, Smanykó V, et al. Is stereotactic
              Healthcare policymakers and  insurance systems      cyberknife radiotherapy or multicatheter HDR brachytherapy
            should be encouraged to support optimized care delivery   the better option dosimetrically for accelerated partial breast
            models  that ensure equitable  access to  guideline-based   irradiation? Brachytherapy. 2021;20(2):326-331.
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            appropriate therapeutic options. Considering increasing   3.   Gielda BT, Shah AP, Marsh JC, et al. Helical tomotherapy
            healthcare expenditures, the proven  cost-effectiveness   delivery of an IMRT boost in lieu of interstitial brachytherapy
            of IRT should be recognized as a compelling rationale   in the setting of gynecologic malignancy: Feasibility and
            for the development of clear implementation guidelines   dosimetric comparison. Med Dosim. 2011;36(2):206-212.
            and  sustained  investment  in  professional  training  and      doi: 10.1016/j.meddos.2010.03.005
            education. Although survival data specific to IRT remain
            limited, its demonstrated potential to improve definitive   4.   Shwetha B, Ravikumar M, Palled SR, Supe SS, Sathiyan S.
            cure rates underscores its substantial clinical value.  Dosimetric comparison of high dose rate brachytherapy
                                                                  and intensity-modulated radiation therapy for cervical
            Acknowledgments                                       carcinoma. J Med Phys. 2011;36(2):111-116.
                                                                  doi: 10.4103/0971-6203.79687
            None.
                                                               5.   Akiyama H, Pesznyák C, Béla D, et al. Image guided high-
            Funding                                               dose-rate brachytherapy versus volumetric modulated arc
                                                                  therapy for head and neck cancer: A comparative analysis of
            None.                                                 dosimetry for target volume and organs at risk. Radiol Oncol
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            Conflict of interest
                                                                  doi: 10.2478/raon-2018-0042
            Gyoergy Kovacs and Luca Tagliaferri are members of the
            Editorial Board of this journal but were not involved in any   6.   Major T, Fröhlich G, Ágoston P, Polgár C, Takácsi-Nagy Z.
                                                                  The value of brachytherapy in the age of advanced external
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            that they have no known competing financial interests or
            personal relationships that could have influenced the work      doi: 10.1007/s00066-021-01867-1
            reported in this paper.                            7.   Ullah A, Ullah N, Nawaz T, Aziz T. Molecular mechanisms
                                                                  of sanguinarine in cancer prevention and treatment.
            Author contributions                                  Anticancer Agents Med Chem. 2023;23(7):765-778.
            Conceptualization: Maria A. Gambacorta, Luca Tagliaferri,      doi: 10.2174/1871520622666220831124321
               Gyoergy Kovacs                                  8.   Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020
            Writing–original draft: Valentina Lancellotta, Maria C. La   statement: An  updated  guideline  for reporting systematic
               Milia, Natalia Barogi                              reviews. BMJ. 2021;372:71.
            Writing–review & editing:  Maria A. Gambacorta, Luca      doi: 10.1136/bmj.n71
               Tagliaferri, Gyoergy Kovacs
                                                               9.   Ciabattoni A, Gregucci F, Fastner G,  et al. IOERT versus
            Ethics approval and consent to participate            external beam electrons for boost radiotherapy in stage I/
                                                                  II breast cancer: 10-year results of a phase III randomized
            Not applicable.                                       study. Breast Cancer Res. 2021;23(1):46.


            Volume 3 Issue 3 (2025)                         27                        doi: 10.36922/ARNM025160017
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