Recurrent cervical cancer Journal Article


Authors: Leitao, M. M. Jr; Chi, D. S.
Article Title: Recurrent cervical cancer
Abstract: There are limited treatment options for patients with recurrent cervical carcinoma. Because of low response rates and a negligible impact on long-term survival, the use of chemotherapy in patients with unresectable recurrent disease should be considered palliative. Generally, radiation therapy in previously irradiated patients is considered palliative. For patients who develop recurrent disease after definitive surgery who have not received prior radiation therapy, salvage radiation therapy is the treatment of choice. Similarly, patients who have received definitive primary radiation therapy are candidates for surgical resection of their recurrence. However, there are specific criteria for surgical resection. Radical hysterectomy may be an option for the very rare patient with a small (<2 cm) centrally located recurrence in the cervix or vaginal fornices. However, for most patients, pelvic exenteration remains the only therapeutic option that offers the possibility of long-term survival. Patients who are candidates for exenteration are those with central local recurrences that have not extended to the pelvic sidewalls. The introduction of high-dose-rate intraoperative radiation therapy (HDR-IORT) combined with radical surgical resection has widened the scope of patients who may be offered surgery. Patients who in the past may not have been surgical candidates may benefit from radical surgical resection combined with HDR-IORT. All patients who are surgically fit and have undergone previous radiation therapy should be considered for surgical resection for centrally located recurrences. Patients whose recurrences extend close to the pelvic sidewalls should be referred to centers where HDR-IORT is available.
Keywords: review; multimodality cancer therapy; radiation dose; combined modality therapy; intraoperative care; palliative care; neoplasm recurrence, local; palliative therapy; practice guideline; pathology; radiation dosage; tumor recurrence; brachytherapy; uterine cervical neoplasms; uterine cervix tumor; peroperative care; practice guidelines; humans; human; female
Journal Title: Current Treatment Options in Oncology
Volume: 3
Issue: 2
ISSN: 1527-2729
Publisher: Springer  
Date Published: 2002-04-01
Start Page: 105
End Page: 111
Language: English
PUBMED: 12057073
PROVIDER: scopus
DOI: 10.1007/s11864-002-0056-6
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
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  1. Dennis S Chi
    707 Chi
  2. Mario Leitao
    575 Leitao