Radiation Therapy for Cervical Cancer: Executive Summary of an ASTRO Clinical Practice Guideline.

Female Humans Radiation Oncology / standards Uterine Cervical Neoplasms / radiotherapy

Journal

Practical radiation oncology
ISSN: 1879-8519
Titre abrégé: Pract Radiat Oncol
Pays: United States
ID NLM: 101558279

Informations de publication

Date de publication:
Historique:
received: 01 04 2020
accepted: 02 04 2020
pubmed: 1 6 2020
medline: 16 3 2021
entrez: 1 6 2020
Statut: ppublish

Résumé

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. 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. 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. 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.

Identifiants

DOI: 10.1016/j.prro.2020.04.002 PMID: 32473857 PMC: PMC8802172
pubmed: 32473857
pii: S1879-8500(20)30094-1
doi: 10.1016/j.prro.2020.04.002
pmc: PMC8802172
mid: NIHMS1765427
pii:
doi:

Types de publication

Journal Article Practice Guideline

Langues

eng

Sous-ensembles de citation

IM

Pagination

220-234

Subventions

Organisme : Intramural NIH HHS
ID : ZIA BC011584
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

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Auteurs

Junzo Chino (J)

Department of Radiation Oncology and Guideline Vice-Chair, Duke University Cancer Center, Durham, North Carolina. Electronic address: junzo.chino@duke.edu.

Christina M Annunziata (CM)

Women's Malignancies Branch, National Cancer Institute, Bethesda, Maryland.

Sushil Beriwal (S)

Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania.

Lisa Bradfield (L)

American Society for Radiation Oncology, Arlington, Virginia.

Beth A Erickson (BA)

Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.

Emma C Fields (EC)

Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virgina.

KathrynJane Fitch (K)

Patient Representative, Charlotte, North Carolina.

Matthew M Harkenrider (MM)

Department of Radiation Oncology, Loyola University Chicago, Chicago, Illinois; Department of Radiation Oncology, Edward Hines Jr. VA Hospital, Hines, Illinois.

Christine H Holschneider (CH)

Department of Obstetrics and Gynecology, Olive View/UCLA Medical Center, Sylmar, California.

Mitchell Kamrava (M)

Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California.

Eric Leung (E)

Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.

Lilie L Lin (LL)

Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas.

Jyoti S Mayadev (JS)

Department of Radiation Medicine and Applied Sciences, University of California, San Diego, California.

Marc Morcos (M)

Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, Maryland.

Chika Nwachukwu (C)

Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas.

Daniel Petereit (D)

Department of Radiation Oncology, Rapid City Regional Health, Rapid City, South Dakota.

Akila N Viswanathan (AN)

Department of Radiation Oncology and Molecular Radiation Sciences and Guideline Chair, Johns Hopkins University, Baltimore, Maryland.

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