Would you give additional radiation for a positive margin after salvage hysterectomy for a patient with cervical cancer who had initial definitive chemoradiation with EBRT+T&R?

Would you consider additional EBRT or vaginal cuff HDR in a patient with previous tx with EBRT (45Gy) + HDR (30Gy) for a R1 resection with a radial margin (+) at the vaginal cuff and parametria?

Would a Mesonephric Adenocarcinoma histology affect your recommendations?

Answer from: Radiation Oncologist at Community Practice

I would favor repeat surgery if that is an option as otherwise salvage rate very low. If it can't be done, then assess for interstitial brachy.

Comments

Radiation Oncologist at Radiotherapy Cancer Center (RTCC)
If considering to treat the positive margin with H...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
I would try to give 35 to 40 Gy EQ dose if feasibl...

Answer from: Radiation Oncologist at Community Practice

Patients usually have radical hysterectomy, so repeating surgery is not an option for most cases. I may recommend vaginal cuff brachytherapy in this case.

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Would you give additional radiation for a positive margin after salvage hysterectomy for a patient with cervical cancer who had initial definitive chemoradiation with EBRT+T&R?

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