How do you manage an inoperable T1b1 N1 M0 Cervix adenocarcinoma which developed 6 years after treatment of a rectal adenocarcinoma s/p LAR with adjuvant posterior pelvic radiation and chemotherapy?

The right obturator sentinel node had a 1.5mm metastasis with no ece. Additional right pelvic node and 6 left pelvic nodes are negative. The cervix mass on CT and PET is contained in the cervix and measures 1.5 cm.

Is brachytherapy alone an option and if so what dose and fractionation is recommended?

Answer from: Radiation Oncologist at Community Practice

There is no one answer but for central area, I would do brachy alone using IGBT with a dose of 7.5 Gy x 5 to HRCTV but aiming d98 GTV 95 Gy and above if possible based on rectal and bladder dosimetry.

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How do you manage an inoperable T1b1 N1 M0 Cervix adenocarcinoma which developed 6 years after treatment of a rectal adenocarcinoma s/p LAR with adjuvant posterior pelvic radiation and chemotherapy?

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