How would you manage a cervical cancer patient who develops new oligomet to the spine during primary cis/RT?  

The finding of metastatic disease to the spine during primary radiation therapy for cervical cancer suggests the presence of systemic, hematogenous disease at the start of treatment. PET-CT scan and/or bone scan are useful diagnostic tools to detect distant metastases and also to differentiate betwe...

I would continue the definitive pelvic radiation as planned including brachytherapy, but stop all radiosensitizing chemotherapy and plan ablative dose SRS to the spine to be delivered during the brachytherapy weeks. I would try to keep the mean bone marrow dose under 26 if possible.

I would like to confirm mets with bx if solitary and plan accordingly. If mets for sure then based on KPS, can complete chemo RT and plan for systemic chemo afterwards or just palliative RT followed by chemo. The question seems to suggest it was picked up during chemo RT which is a bit unusual and t...