Universität zu Köln

Marnitz, Simone and Koehler, Christhardt (2019). Chemoradiotherapy of cervical cancer. Gynakologe, 52 (12). S. 902 - 910. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0393

Full text not available from this repository.

Abstract

Combined chemoradiotherapy represents the standard of care for locally advanced cervical cancer with or without lymph node metastases. Radiological staging provides a limited accuracy in terms of lymph node evaluation, therefore radical hysterectomy is often carried out followed by adjuvant chemoradiotherapy based on the postoperative risk factors. The rate of this multimodal treatment can be reduced to a great extent by systematic pretreatment operative staging and is recommended in the current German guidelines. The recently finished Uterus-11 trial demonstrated a benefit in terms of cancer-specific survival for pretreatment laparoscopic staging compared to clinical staging. In terms of treatment quality and outcome primary chemoradiotherapy should be performed in experienced high-volume centers with a combination of percutaneous radiotherapy and simultaneous chemotherapy with weekly application of 40mg/m(2) body surface area (BSA) cisplatin. An integral part of primary chemoradiotherapy with curative intent is intracervical brachytherapy to cover the tumor with biologically effective doses of >80Gy. The treatment duration should not exceed 8 weeks (56 days). If these criteria cannot be fulfilled, the oncological outcome of the patient will be dramaticallyworsened. Routinely performed secondary hysterectomy was not found to be beneficial in terms of survival. In contrast, patients with histologically confirmed residual disease 3 months after chemoradiotherapy can benefit fromsecondary hysterectomy with a potentially curative outcome. Treatment of para-aortic lymph nodes should be included in the primary concept (extended field) if the lymph nodes are involved but not for prophylactic reasons. Neoadjuvant chemotherapy should only be carried out as a part of studies. The combination of ovariopexy in young patients and the use of ovary-sparing irradiation techniques helps to avoid the premature occurrence of menopause.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Marnitz, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehler, Christhardt UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-125048
DOI:	10.1007/s00129-019-04534-w
Journal or Publication Title:	Gynakologe
Volume:	52
Number:	12
Page Range:	S. 902 - 910
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0393
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PELVIC RADIATION-THERAPY; RADICAL SURGERY; NEOADJUVANT CHEMOTHERAPY; CHEMORADIATION THERAPY; RANDOMIZED-TRIAL; ADJUVANT HYSTERECTOMY; STAGE IB2; RADIOTHERAPY; CARCINOMA; IIA Multiple languages Obstetrics & Gynecology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12504