How would you treat an isolated para-aortic node recurrence 1.5 years after receiving primary chemoradiation for locally advanced cervical cancer?

We treat with definitive chemo RT to pa region using IMRT (weekly cisplatinum with 45 in 25 to pa region and 55-57.5 Gy in 25# SIB to node). Small bowel and duodenum dose constraints (V55 < 5 cc and V55 < 1cc respectively).

Agree with Dr. @Dr. First Last, if not previously radiated would definitely consider definitive radiation for this patient in a potentially curative setting. If the area has already received max lifetime dose, could treat with systemic therapy with cisplatin/taxol/bevacizumab) vs evaluate for resect...

This is a variation of a scenario posed in the question. I have a patient who I treated for a node positive IB2 (IIIC2 by today’s staging) cervical cancer for which she completed standard treatment with cis+WPRT&PA nodes+HDR Brachytherapy in 2016. Dose was 4500cGy to whole pelvis and PA nodes with S...

Yes, absolutely agree with @Dr. First Last and @Dr. First Last. I have treated these patients with definitive chemoradiation (45/25 + cisplatin), with integrated boost to the gross nodes to 55 or 57.5, OARs permitting.

Close follow up is paramount in these patients afterwards, as the risk of develo...