Would you offer brachytherapy for a patient with metastatic cervical cancer s/p 30Gy/10 fx to the pelvis followed by chemotherapy who only has isolated disease in the cervix?
If a patient presents with metastatic disease (by virtue of extensive PA nodal burden, mediastinal/SCV involvement, no solid organs) but received urgent 30 Gy to the pelvis in 10 fractions for uncontrolled bleeding at diagnosis, followed by chemotherapy and now only has isolated (now asymptomatic) residual disease in the cervix, would you offer brachytherapy? If so, what dose?
Answer from: at Community Practice
Control of central pelvic disease in cervical cancer is a main goal of treatment, regardless of whether the patient has metastatic disease or not. This is important for maintaining quality of life. Death from central pelvic disease is very unpleasant. Therefore, I recommend brachytherapy in this pop...
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Answer from: at Community Practice
If that's the only site, that or possibly surgery. It possibly is resectable.
Comments
Radiation Oncologist at Universite de Montreal
I don’t think there’s much evidence in...
I don’t think there’s much evidence in...
Radiation Oncologist at Tampa Bay Radiation Oncology
Agree
Agree
at ProMedica Toledo Hospital
Completely agree.
Completely agree.
Answer from: Radiation Oncologist at Community Practice
Very reasonable depending on the patient’s performance status. Controlling the local disease is vital for the prevention of symptoms, even more so as systemic options develop.
Most rad-oncs with a large gynecological and advanced cervical cancer practice have done this or something similar. D...
Comments
Radiation Oncologist at Varian Medical Systems/Allegheny health network
For oligopersistence disease, can consider brachy ...
For oligopersistence disease, can consider brachy ...
Answer from: Radiation Oncologist at Academic Institution
In a patient with diffuse metastatic disease, where a thought of consolidative radiation to all sites of disease was not at play at initial diagnosis, I do not think there would be a clinical benefit of providing brachytherapy in an otherwise asymptomatic patient.
If the thought was to consider con...