abstract: Intensity modulated radiation therapy (IMRT) has been used for treating cervical cancer to provide excellent coverage of the clinical target volume while significantly sparing the surrounding normal tissues such as bowel, bladder and active bone marrow. However, organs in pelvic region are mobile and distensible. Their daily position and shape varies greatly, and also tumor geometry usually changes significantly in response to radiation and chemotherapy. Given these factors, an optimal IMRT treatment plan developed before the treatment will likely deteriorate in quality and efficacy as treatment progresses. Therefore, an adaptive therapy scheme is necessary for the treatment of cervical cancer, which should result in an optimal treatment by explicitly considering the daily patient and tumor geometric variation throughout the entire course of the treatment. The goal of this work is to present existing problems and challenges with current cervical cancer IMRT treatment, potential on-line adaptive IMRT strategies, preliminary results, and future work.