What is the optimal approach for a younger female with borderline resectable cervix cancer who may need adjuvant radiation, in light of a medical history significant for ulcerative colitis?

It all depends on the colitis status on therapy including the extent and response to ongoing treatment.

No induction chemo.

Either radical hysterectomy with the possibility of adjuvant RT or definitive RT based on colitis status.

If high risk with RT, would proceed with surgery.

I would not use induction chemotherapy. If the patient is likely to require adjuvant RT with or without sensitizing chemotherapy, definitive chemoradiation is preferable. Triple modality toxicity should be avoided when possible. Ulcerative colitis alone, while associated with more side effects would...

Agree with @Dr. First Last and @Dr. First Last.

I would not recommend induction chemotherapy - there is no evidence supporting such approach.

If, based on initial exam, pathology, and imaging, it appears that the patient will require adjuvant treatment, then we would consider treating the patient w...

I'm not entirely sure why the patient is considered a borderline surgical candidate. 3.5 cm on imaging without parametrial extension on MRI with a negative PET/CT puts a very low likelihood of ending up requiring adjuvant chemoRT.

Adjuvant RT alone to 50.4 Gy as per GOG 99 using IMRT/VMAT would cause...