Journal article
Radiation Therapy for Cervical Cancer: Executive Summary of an ASTRO Clinical Practice Guideline
Practical Radiation Oncology, v 10(4), pp 220-234
01 Jul 2020
PMID: 32473857
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: This guideline reviews the evidence and provides recommendations for the indications and appropriate techniques of radiation therapy (RT) in the treatment of nonmetastatic cervical cancer.
Methods: The American Society for Radiation Oncology convened a task force to address 5 key questions focused on the use of RT in definitive and postoperative management of cervical cancer. These questions included the indications for postoperative and definitive RT, the use of chemotherapy in sequence or concurrent with RT, the use of intensity modulated radiation therapy (IMRT), and the indications and techniques of brachytherapy. Recommendations were based on a systematic literature review and created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength.
Results: The guideline recommends postoperative RT for those with intermediate risk factors, and chemoradiation for those with high-risk factors. In the definitive setting, chemoradiation is recommended for stages IB3-IVA, and RT or chemoradiation is conditionally recommended for stages IA1-IB2 if medically inoperable. IMRT is recommended for postoperative RT and conditionally recommended for definitive RT, for the purposes of reducing acute and late toxicity. Brachytherapy is strongly recommended for all women receiving definitive RT, and several recommendations are made for target dose and fractionation, the use of intraoperative imaging, volume-based planning, and recommendations for doses limits for organs at risk.
Conclusions: There is strong evidence supporting the use of RT with or without chemotherapy in both definitive and postoperative settings. Brachytherapy is an essential part of definitive management and volumetric planning is recommended. IMRT may be used for the reduction of acute and late toxicity. The use of radiation remains an essential component for women with cervical cancer to achieve cure. (C) 2020 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.
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Details
- Title
- Radiation Therapy for Cervical Cancer: Executive Summary of an ASTRO Clinical Practice Guideline
- Creators
- Junzo Chino - Duke UniversityChristina M. Annunziata - National Cancer InstituteSushil Beriwal - UPMC Hillman Cancer CenterLisa Bradfield - American Society for Radiation OncologyBeth A. Erickson - College Station Medical CenterEmma C. Fields - Virginia Commonwealth UniversityKathrynJane Fitch - Patient Representat, Charlotte, NC USAMatthew M. Harkenrider - Edward Hines, Jr. VA HospitalChristine H. Holschneider - Olive View-UCLA Medical CenterMitchell Kamrava - Cedars-Sinai Medical CenterEric Leung - Sunnybrook Health Science CentreLilie L. Lin - The University of Texas MD Anderson Cancer CenterJyoti S. Mayadev - University of California, San DiegoMarc Morcos - Johns Hopkins MedicineChika Nwachukwu - The University of Texas Southwestern Medical CenterDaniel Petereit - Rapid City Regional HospitalAkila N. Viswanathan - Johns Hopkins University
- Publication Details
- Practical Radiation Oncology, v 10(4), pp 220-234
- Publisher
- Elsevier
- Number of pages
- 15
- Grant note
- American Society for Radiation Oncology
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000546786800009
- Scopus ID
- 2-s2.0-85085295228
- Other Identifier
- 991021897395604721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging