When would you recommend surgical debulking of pelvic or para-aortic lymph nodes in cervical cancer prior to definitive chemoradiation therapy?
Do you use size criteria (i.e. bulky nodes over 3 cm), specific adverse histology (adenocarcinoma), or location (near small bowel), etc.
Answer from: Radiation Oncologist at Community Practice
We have not favored dissection and treated with SIB and sometimes added sequential boost ( EQ@ dose 58-66 Gy) based on sizemost current literature shows excellent regional control but high distant failure in these ptsfor bowel and duodenum ( two organs which could be limiting factor) we use v55 dose...
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Radiation Oncologist at Medical College of Wisconsin Patients with bulky adenopathy pose a challenge an...
Answer from: Radiation Oncologist at Academic Institution
Often these large pelvic and periaortic nodes are adherent to surrounding nerves and vessels and resection is not possible. Our usual approach in this situation is to consider neo-adjuvant chemotherapy. The hope would be that the chemotherapy would reduce the size of the nodes defi...
Patients with bulky adenopathy pose a challenge an...