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Radiation Oncology • Gynecologic Cancers
How would you manage a short-interval (0-3 months) failure in the untreated para-aortic region after definitive treatment of locally advanced cervical cancer?
Assuming no distant metastases, should this scenario be managed with "sequential" chemoradiation to the para-aortic region with an external beam boost, focal radiation alone (including possible SBRT), or chemotherapy followed by restaging?
Answer from: Radiation Oncologist at Academic Institution
The current paraortic disease could perhaps be an area near the edge of the prior pelvic XRT filed.
Since this is the only area of disease now and given short 3 month interval, it is reasonable to give CHEMORADIATION AND TRY TO BOOST THE GROSS DISEASE.
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Answer from: Radiation Oncologist at Community Practice
I would treat with definitive (chemo) RT treating entire pa region to 45 Gy in 25 fractions up to renal vessel. If the node was close to renal vessel, I would extend CTV to include retrocrural region
I would take involved node to 55 to 57.5 Gy in 25 fractions respecting tolerance dose of small bowe...