Optimal treatment in locally advanced cervical cancer.

[en] INTRODUCTION: Locally advanced cervical cancer (LACC) (International Federation of Gynecology and Obstetrics (FIGO) 2009/2018 - stages IB2-IVA/IB3-IVA, respectively) is treated using a multimodal approach that includes chemoradiotherapy followed by brachytherapy. AREAS COVERED: This review provides an overview of the progress made over the past decade in the treatment of LACC. Prognostic factors, FIGO classification and the role of imaging staging will be discussed. Efficacy of external-beam radiotherapy, brachytherapy and chemotherapy will be detailed. Indications for paraaortic staging lymphadenectomy and adjuvant hysterectomy, as well as follow-up and special population, will be covered. EXPERT OPINION: The initial workup is one of the most crucial steps in the optimal care of patients, which should be realized by a multi-disciplinary expert team. With the implementation of modern conformal radiotherapy techniques, the local control rate has been optimized. Nevertheless, 40% of patients experience recurrence with distant metastasis and a dismal prognosis. Currently, a clear benefit of neo- and adjuvant chemotherapy has not been established. The future likely involves (1) improved selection of patients for whom treatment intensification is justified, (2) a combination of new drugs with chemoradiation that are currently being tested in trials, and (3) the development of tailored treatment based on molecular characteristics.

Disciplines :

Oncology
Oncology
Oncology

Author, co-author :

GENNIGENS, Christine ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service d'oncologie médicale

DE CUYPERE, Marjolein ; Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Secteur oncologie

HERMESSE, Johanne ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiothérapie

KRIDELKA, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Service de gynécologie-obstétrique

JERUSALEM, Guy ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service d'oncologie médicale

Language :

English

Title :

Optimal treatment in locally advanced cervical cancer.

Publication date :

2021

Journal title :

Expert Review of Anticancer Therapy

ISSN :

1473-7140

eISSN :

1744-8328

Publisher :

Taylor & Francis, United Kingdom

Pages :

657-671

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 17 March 2021

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