Faculty Collaboration Database

Management of Nodal Disease in Advanced Cervical Cancer. Semin Radiat Oncol 2019 Apr;29(2):158-165

Date

03/05/2019

Pubmed ID

30827454

DOI

10.1016/j.semradonc.2018.11.002

Scopus ID

2-s2.0-85059326461 (requires institutional sign-in at Scopus site)   37 Citations

Abstract

During the last decade the adoption of image-guided adaptive brachytherapy has dramatically improved local control in patients with locally advanced cervical cancer (LACC) treated with radiotherapy and concomitant chemotherapy; however, nodal failure remains an obstacle. Metastatic lymph nodes can be detected by surgical and imaging approaches with different sensitivities and specificities, that improve the definition of relevant targets for macroscopic and microscopic nodal disease, and that influence our understanding of dose levels of external beam radiotherapy. Systematic use of modern radiotherapy techniques including intensity modulated radiotherapy and simultaneously integrated nodal boosts in combination with daily position verification is emerging as increasingly important for obtaining nodal control in LACC. This review summarizes published and ongoing efforts for optimizing nodal disease treatment in LACC, elaborates the state of the art approach for nodal disease detection, radiotherapy planning and delivery, and discusses future investigational efforts needed for precise optimization.

Author List

Jürgenliemk-Schulz IM, Beriwal S, de Leeuw AAC, Lindegaard JC, Nomden CN, Pötter R, Tanderup K, Viswanathan AN, Erickson B

Author

Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Brachytherapy
Contrast Media
Female
Humans
Lymphatic Irradiation
Lymphatic Metastasis
Neoplasm Staging
Radiotherapy Dosage
Radiotherapy, Image-Guided
Radiotherapy, Intensity-Modulated
Uterine Cervical Neoplasms