Table 6

Chemotherapy and radiotherapy: cervical cancer

High56 Medium56 Low56
Chemotherapy

  • Part of concurrent chemo-radiotherapy7 15 49

  • Stage IB3, IIB-IVA: chemo-radiotherapy56

  • Continuation of standard chemo-radiotherapy, with proven benefit56

  • Consider neoadjuvant chemotherapy for patients with visible tumor49 51

  • Stage IVB: first line, first central recurrence, >12 months disease-free56

  • First recurrence with good performance status or advanced previous untreated disease (Priority 4*)7

  • Metastatic disease (Priority 6†)7 49

Radiotherapy: cervical cancer
High 15 Medium 15 Low 15

  • Part of chemo-radiotherapy ‡7 15 49 56

  • Haemostatic radiotherapy7

  • Salvage radiotherapy for symptomatic local recurrence56

  • As adjuvant therapy in positive surgical margins7

  • Palliation for unresectable, asymptomatic recurrence

  • *Curative therapy with a low (0%–15%) chance of success or non-curative therapy with an intermediate (15%–50%) chance of >1 year life extension.

  • †Non-curative therapy with an intermediate (15%–50%) chance of palliation/temporary tumor control and <1 year life extension.

  • ‡Patients with Royal College of Radiologists category 1 tumors currently being treated with chemo-radiotherapy and brachytherapy for category 1 tumors on external beam radiotherapy.