[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 :
Oncologie
Auteur, co-auteur :
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
Langue du document :
Anglais
Titre :
Optimal treatment in locally advanced cervical cancer.
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