With the addition of pembrolizumab following chemoradiation per KEYNOTE-A18, would you be less likely to treat the paraaortic chain prophylactically?
If a patient with a positive node just above the common iliac bifurcation, and will be treated with chemoradiation --> pembrolizumab according to A18, would you still treat the whole paraaortic chain or just extend a few CM margin above the highest node? Are you concerned that paraaortic LN irradiation may blunt the immunotherapy response?
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Patient with FIGO stage IIIC1/2 cervical cancer with 2cm node at the common iliac bifurcation undergoes induction chemo per INTERLACE. After 6 weeks, the lymph node is not visible on CT. In planning for chemoRT, the superior border of my RT field will be:
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on · Updated on
I would favor the same volume of RT with or without pembro. If there is an indication to treat PA nodal chain, would treat as per plan.
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