Universität zu Köln

Marnitz, Simone, Waltar, Till and Herter, Jan (2020). Chemoradiation in cervical cancer. Onkologe, 26 (7). S. 606 - 616. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0415

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Abstract

Background Primary chemoradiation therapy (CRT) remains the standard for locally advanced and/or lymph node-positive cervical cancer. Due to the limited accuracy of radiologic imaging, there is an unacceptably high rate of postoperative adjuvant CRT. This tri-modality treatment doubles chronic therapy-related toxicity compared to CRT alone. Surgical staging prior to treatment can avoid under- and overtreatment. Materials and methods In a literature review of publications mainly focusing on potentially practice-changing data was performed. Results For optimal results, CRT must comprise percutaneous and brachytherapy with a biologically effective dose (EQD2Gy) of 80-85 & x202f;Gy to the tumor. Simultaneous chemotherapy consists of 5-6 weekly doses of cisplatin 40 & x202f;mg/body surface area (BSA). Treatment duration should not exceed 8 weeks (56 days), and has an influence on local control. Outcomes in experienced centers with at least 28 CRT/year are superior to those with smaller numbers of patients. There is no indication for routine hysterectomy after state-of-the-art chemoradiation. In contrast, patients with histologically confirmed residual tumor might benefit from salvage (rescue) hysterectomy. Conclusion Cisplatin-based CRT is standard of care treatment for locally advanced cervical cancer. For the best possible oncologic results, external beam radiation plus brachytherapy plus simultaneous chemotherapy in an overall treatment time of <56 days is crucial. This therapy should be performed in high volume centers by an experienced, interdisciplinary team.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Marnitz, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Waltar, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED Herter, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-337044
DOI:	10.1007/s00761-020-00758-x
Journal or Publication Title:	Onkologe
Volume:	26
Number:	7
Page Range:	S. 606 - 616
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0415
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CELL NEUROENDOCRINE CARCINOMA; RADIATION-THERAPY; RADICAL SURGERY; TREATMENT OUTCOMES; PROGNOSTIC-FACTORS; PHASE-III; STAGE IB2; HYSTERECTOMY; BRACHYTHERAPY; CHEMOTHERAPY Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33704