Cervical Cancer   

Questions discussed in this category



Previously received pelvic EBRT and intracavitary brachytherapy. IORT was administered to the node-positive side wall at the time of exenteration.

Initially treated with definitive chemoRT but recurred with distant mets. Completed 6 cycles carb/tax/bev with minimal toxicity. Excellent performance...

Recurrence was 2cm and PET confirmed local. Excision with positive margins. Current plan for salvage whole pelvic RT and vaginal cuff brachytherapy +/...

In  patient with PD SCCA 15mm transverse;  5/20mm invasion; LVSI focally present; margins negative;  0/15 Left pelvic and 0/14 right pe...

What dose and technique do you use and how do you integrate the subsequent definitive treatment plan?

The recently released STARS phase 3 RCT found improved DFS, decreased distant recurrence, with reduced toxicities for chemotherapy (cisplatin + taxol)...

Despite the LACC trial, this year's SGO had many posters and discussions around MIS for early cervical cancer. If you offer MIS, what are the key ele...

SIBs of 55-57.5 Gy in 25 fractions are frequently mentioned with bowel volume constraints at this dose, but assuming there is no bowel nearby (e.g., b...

Patient with stage IIB cervical cancer treated 8 years ago, now with large (>10cm), isolated, symptomatic recurrence involving the left SCL and med...

Small bowel is usually the dose limiting OAR while planning cervical HDR brachytherapy. Having the bladder empty during treatment planning and deliver...

Would you consider additional EBRT or vaginal cuff HDR in a patient with previous tx with EBRT (45Gy) + HDR (30Gy) for a R1 resection with a radial ma...

This has been a common practice in the community. Is there a benefit for certain patients?

Patient being treated for cervical cancer noted to have a < 1 cm posterior vaginal fornix defect with a small focus epiploclia herniating into the ...

The limited data on MDA (minimum deviation adenocarcinoma) suggests it has a worse prognosis, but it is hard to disentangle this from stage, as it is ...

Would there be a substanital increase in the risk of toxicity using such a scheme?  We frequently have patients who have to travel long distance...

Would you be more or less likely to use a cisplatin-containing regimen if a patient had previously responded to chemoradiation with concurrent cisplat...

Could you discuss how you decide between IMRT or SBRT boost for a patient who is not able to receive intracavitary or interstitial HDR or LDR brachyth...

What chemotherapy and sequencing with radiation therapy would you recommend? IS surgery a component of the treatment?

Should this be done at the time of recurrence or after failure of 1st line therapy for recurrence?

Do you use a trimmed 10 mm expansion on HR-CTV? Do you also include the entire initial extent of disease? How much does your IR-CTV coverage affect yo...

A literature search indicates that most port site recurrences are managed fairly aggressively with chemoRT or RT doses 45-66 Gy. This is understandabl...

Sequentially or do you integrate the cuff brachy with the EBRT and if so what schedule, BIW, weekly, etc?

For example, a patient with cervical or anal SCC who has missed many treatments due to side effects, low blood counts, hospitalizations, or non-compli...

Do you recommend upfront diversion? Are there unique planning considerations such as the inability to use bladder filling? How do you boost? What are ...

What are your specific protocols for monitoring and for dosing narcotics and sedatives?

Close but negative radial margins? LVSI?  What fractionation/dose do you use for your vaginal cuff boost if used? 

In the setting of a negative lymph node sampling, would you treat a full pelvis or mini-pelvis to compensate for lack of the appropriate surgery? Is a...

In patients who don't meet traditional criteria for adjuvant chemoradiation from Peters (GOG 109) and < 2 high risk factors from Rotman (GOG 92) fo...

What exactly do you contour and what is your dose constraint to that volume?

Does using something like a vienna applicator allow you to avoid dose escalation with more external beam? How do you recommend doing a classic pa...

Some classic references recommend the coverage of the entirety of the sacrum but the volume delineation guidelines for both seem to only cover the mos...

Do you try to keep Hb> 10 or 12? Or somewhere in between? 

The most recent ABS guidelines don't discuss a dose constraint for the small bowel.

Do you treat PAs if pelvic nodes are positive? If common iliacs are involved? Only if there are positive PA nodes?


Papers discussed in this category


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Int. J. Radiat. Oncol. Biol. Phys., 2014-05-01

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International journal of radiation oncology, biology, physics, 2019-05-01

Cochrane Database Syst Rev, 2012 May 16

Int. J. Gynecol. Cancer,

Seminars in radiation oncology, 2019-04

International journal of radiation oncology, biology, physics, 2006-08-01

Gynecologic oncology, 2005-11

Clinical cancer research : an official journal of the American Association for Cancer Research, 2015-12-15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2000-04

Lancet,

Gynecol. Oncol., 2005 Nov 21

J. Clin. Oncol., 2011 Mar 28

BMC Cancer, 2017 Apr 28

N. Engl. J. Med.,

Obstet Gynecol,

Clin Transl Radiat Oncol, 2018 Jan 11

Gynecologic oncology, 2014-01

Cancer, 2000-04-15

Lancet Oncol.,

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2019-01

Gynecologic oncology, 2004-04

J Obstet Gynaecol Res, 2019 Sep 09

The New England journal of medicine, 2018-11-15

International journal of radiation oncology, biology, physics, 1991-07

Cancer,

The Lancet. Oncology, 2017-03

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2019-01-23

Ann Oncol,

Gynecol Oncol, 2018 May 24

Int J Gynecol Cancer,

Gynecologic oncology, 2011-07

BMC Cancer, 2018 May 04

J Gynecol Oncol,

International journal of radiation oncology, biology, physics, 2008-11-15

Int. J. Radiat. Oncol. Biol. Phys., 2012 Aug 14

Practical radiation oncology, 2017

Practical radiation oncology, 2018

The New England journal of medicine, 1999-04-15

Ann Oncol, 2012 Feb 21

JAMA Oncol,

Lancet (London, England), 2017-10-07

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-06-10

J Clin Oncol, 2019 Nov 04

Lancet Oncol, 2021 Apr 09

Int J Gynecol Cancer, 2019 Jan 04

Gynecologic oncology, 1998-08

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-08-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-10-01

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Cancer, 1981-08-15