Purpose: The aims of this study were to investigate the clinical feasibility and to report our preliminary treatment outcomes of combined intracavitary/interstitial brachytherapy (IC/IS BT), using a hybrid applicator and magnetic resonance imaging (MRI)based treatment planning in patients with locally advanced cervical cancer. Materials and Methods: Between January 2017 and December 2018, eight patients with locally advanced uterine cervical cancer were treated with primary radiation therapy including hybrid BT. Patients with distant metastasis other than para-aortic lymph node spread were excluded from this study. A hybrid applicator for guidance of parametrial needles was used to perform highdoseratebrachytherapy (HDR BT) with MRIbased treatment pre-planning. Parametrial extent of the disease or large residual disease in these patients was judged to exceed the coverage limit of intracavitary brachytherapy alone. The number of needles, chosen guiding holes through the ovoids, and insertion depths were based on the extent of residual disease. We investigated the dosimetric gain by comparing the clinical IC/IS optimized plan (IC/IS clinical) with an additionally generated optimized
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