Objective: To investigate the survival prediction probability of the nomogram from retro-EMBRACE and the T-score in patients with locally advanced cervical cancer (LACC). Materials and Methods: A total of 204 patients with LACC who underwent curative chemoradiotherapy and brachytherapy (BT) between 2010 and 2021 were included in our single-center retrospective study. Clinical records, examinations, and magnetic resonance images (MRI) before and after external beam radiotherapy (EBRT) were retrospectively reviewed to obtain information on age, tumor size, parametrial involvement, ureteral involvement, bladder invasion, uterine involvement, high-risk clinical target volume at the first brachytherapy application, lymph node involvement, vaginal involvement, recurrence, metastasis, and last follow-up. The 5-year overall survival probabilities of the patients were determined by nomogram. T-score was calculated separately at diagnosis (TS_D) and brachytherapy (TS_BT), and their effects on local recurrence-free survival, disease-free survival, and overall survival were analyzed. Results: The median age was 52 (29–89). The 5-year survival rate of the patients was calculated to be 90.18%. The median nomogram’s survival estimate for 60 months was 70.35% (20.9–87.1). The median TS_D and TS_BT were 5.5 (1–16) and 1 (0–6), respectively. According to the multivariate Cox regression models, TS_D (HR = 1.203, 95% CI 1.021–1.417, p = 0.024) was significantly associated with local recurrence-free survival. Conclusions: This study demonstrated that the nomogram’s predictions for 60-month overall survival are underestimates. Prognosis can be estimated using the TS_D, which can be easily obtained with a clinical examination and detailed MRI examination.

Background and Objectives: The bulboclitoral complex (BCC) is an essential organ for female sexual health. However, it is not defined as an organ at risk in any guideline defining target volumes in radiotherapy of gynecological cancers, and there is no information about dose constraint. Materials and Methods: Simulation computed tomography scans of 20 patients diagnosed with locally advanced cervical cancer were used retrospectively. The volumetric modulated arc therapy treatment plan with a total dose of 45 Gy in 25 fractions was created using the planning target volume (PTV)-standard, which was created without considering the BCC, and the PTV-BCC spared, which were contoured and included in the optimization. Bulboclitoral complex doses in PTV-standard and PTV-BCC spared plans were compared using the paired simple t test. Results: Median BCC volume was 17.6 cm³ (11.20–25.50). Bulboclitoral complex maximum dose (Dmax) was median 49.07 Gy (48.49–50.25) and 28.81 Gy (18.14–44.61) in the PTV-standard and PTV-BCC spared plans, respectively, and the BCC Dmax was statistically significantly lower in the PTV-BCC spared plan (p < 0.001). When comparing BCC percentage of volume receiving 45 Gy (V45), the median values for PTV-standard and PTV-BCC spared plans were 37.5% (13.3–82.6) and 0%, respectively (p ≤ 0.001). Conclusions: The bulboclitoral complex can be dosimetrically protected from radiation by contouring and optimizing it as an organ at risk in the radiotherapy plan. The clinical effects of protecting the BCC from radiation as an organ at risk on sexual health need to be investigated.