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Review
Radiation oncology management of stage III and IVA cervical carcinoma
  1. Idalid Franco1 and
  2. Akila N Viswanathan2
  1. 1 Harvard Radiation Oncology Program, Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Akila N Viswanathan, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; anv{at}jhu.edu

Abstract

Worldwide, stage III–IVA carcinomas of the uterine cervix comprise a significant proportion of cases at presentation, and have a higher rate of recurrence and worse overall survival. This review will discuss the epidemiology, prevention strategies, clinical presentation, and treatment recommendations for stage III–IVA cervical cancer. The focus will be on the role of radiation therapy, concurrent chemoradiotherapy, and brachytherapy, including the potential benefits and anticipated toxicities. The unique challenges and considerations of fistula formation and approaches to management will be highlighted, and follow-up care and future directions discussed. As low and middle income countries bear the highest burden of advanced stage carcinoma of the uterine cervix, this review will address the unique needs of global communities.

  • radiation oncology
  • cervical cancer

https://doi.org/10.1136/ijgc-2021-002491

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    Footnotes

    • Contributors AV contributed to the writing of the draft, edits, creation of tables and figures. IF contributed to the conception and design of the manuscript in addition to drafting and reviewing the manuscript and providing approval of the final version and is accountable for all aspects of the work ensuring accuracy and integrity.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.