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© 2020 The Author(s).Purpose To analyse the impact of different optimization strategies on the compatibility between planned and delivered doses during radiotherapy of cervical cancer. Material/methods Four treatment plans differing in optimisation strategies were prepared for ten cervical cancer cases. These were volumetric modulated arc therapy with (_OPT) and without optimization of the doses in the bone marrow and for two sets of margins applied to the clinical target volume that arose from image guidance based on the bones (IG()