Is there a role for chemotherapy and/or vaginal cuff boost to EBRT in FIGO IB1 cervical adenocarcinoma, status post total hysterectomy?
Aside from limit due to extent of her hysterectomy, the patient's disease does not otherwise satisfy Peters' criteria
Answer from: Radiation Oncologist at Community Practice
Recently presented SHAPE trial shows non-inferiority of simple hysterectomy to radical for IB1 disease or lower disease.
So for the above patient, that may not change anything but certainly would need nodal assessment which could be from surgery or RT after PETCT.
Comments
Radiation Oncologist at University of Kentucky I would be very careful in interpreting the SHAPE ...
Radiation Oncologist at Weill Cornell Medical College I agree and would be cautious, particularly adenoc...
Radiation Oncologist at Mallory Radiotherapy, PLLC Would you boost the cuff with HDR and/or the resid...
Radiation Oncologist at Vanderbilt-Ingram Cancer Center I would generally boost cuff with HDR alone. 6 Gy ...
Answer from: Radiation Oncologist at Community Practice
Re-analysis of prior GOG studies to identify histology-specific factors for recurrence can also guide adjuvant therapy decisions in surgically staged patients. Levinson et al., PMID 34217544 As @Sushil Beriwal noted, if only hysterectomy was performed and nodes weren't assessed, ther...
Answer from: Radiation Oncologist at Community Practice
If the patient had IB1 disease, but no other Sedlis or Peters for chemoRT indications, I would not recommend chemotherapy. Because of simple Hys EBRT could be considered, as ideally patient should have received modified rad hys.
In regards to brachytherapy post EBRT - this is a more nuanced q...
Answer from: Radiation Oncologist at Community Practice
I disfavor chemotherapy in this scenario and would utilize EBRT with an HDR brachytherapy boost or at the least brachytherapy alone. The patient likely had surgery performed by a non-Gyn Oncologist without cancer considerations. Brachytherapy in post-op cervical therapy is relatively well tolerated ...
Answer from: Radiation Oncologist at Academic Institution
We have added concurrent chemotherapy for path IB2 patients s/p total hysterectomy but I would not add it for an IB1 given SHAPE trial. Given non-oncologic resection for cervical cancer (assuming no nodal staging), I would at least recommend EBRT + brachytherapy boost in this scenario.
I would be very careful in interpreting the SHAPE ...
I agree and would be cautious, particularly adenoc...
Would you boost the cuff with HDR and/or the resid...
I would generally boost cuff with HDR alone. 6 Gy ...