TY - JOUR
T1 - Radiation Therapy for Cervical Cancer
T2 - Executive Summary of an ASTRO Clinical Practice Guideline
AU - Chino, Junzo
AU - Annunziata, Christina M.
AU - Beriwal, Sushil
AU - Bradfield, Lisa
AU - Erickson, Beth A.
AU - Fields, Emma C.
AU - Fitch, Kathryn Jane
AU - Harkenrider, Matthew M.
AU - Holschneider, Christine H.
AU - Kamrava, Mitchell
AU - Leung, Eric
AU - Lin, Lilie L.
AU - Mayadev, Jyoti S.
AU - Morcos, Marc
AU - Nwachukwu, Chika
AU - Petereit, Daniel
AU - Viswanathan, Akila N.
N1 - Funding Information:
Sources of support: This work was funded by the American Society for Radiation Oncology. Christina Annunziata (American Society of Clinical Oncology representative): MaxCyte, Medivir, and Precision Biologics (research), Horizon Pharma and Merck (provided drugs for clinical trial), BMC Cancer and Frontiers in Oncology (editor); Sushil Beriwal: American Board of Radiology (board examiner), Brachy Journal and iJROBP (editorial board); Eisai, Institute of Education, and Via Oncology (honoraria), International Journal of Radiation Oncology, Biology, Physics (senior editor); Varian (consultant), XOFT (DSMB); Junzo Chino (vice chair): American Board of Radiology (board examiner); NanoScint (stock); International Journal of Radiation Oncology, Biology, Physics (editorial board); Matthew Harkenrider: ACR (program director and trustee), AstraZeneca (advisory board [ended]), International Journal of Radiation Oncology, Biology, Physics (editorial board); Varian (advisory board [ended]); Christine Holschneider (Society of Gynecologic Oncology representative): NRG-GOG and GOG Foundation (research), National Institutes of Health grants (research—family member), UpToDate (honoraria); Mitchell Kamrava: American Board of Radiology (board examiner), Augmenix (speaker's bureau), Brachytherapy and International Journal of Radiation Oncology, Biology, Physics (editorial board); Lilie Lin: American Board of Radiology (board examiner); AstraZeneca (research); Jyoti Mayadev: AstraZeneca (consultant), NRG GOG Foundation (member), NRG Oncology Cervical Board (cochair), Varian (advisory board); Marc Morcos: Elekta (travel); Daniel Petereit (American Brachytherapy Society representative and President): American Board of Radiology (board examiner), BMS Foundation (research and salary support), Irving A Hansen Memorial Foundation (patient funding), Ralph Lauren Pink Pony Foundation (board member); Akila Viswanathan (chair): NCI Uterine Task force (cochair), American Board of Radiology (board examiner), Brachytherapy and Gynecologic Oncology Journal (editorial board), Springer textbook (chapter editor); Beth Erickson: American Brachytherapy Society (CME cochair); ASTRO (MOC-CME cochair); Brachytherapy and International Journal of Radiation Oncology, Biology, Physics (editorial board), Elekta (research and travel), Springer textbook (chapter editor). Emma Fields, KathrynJane Fitch (patient representative), Eric Leung, and Chika Nwachukwu reported no disclosures.
Funding Information:
Sources of support: This work was funded by the American Society for Radiation Oncology .
Publisher Copyright:
© 2020 American Society for Radiation Oncology
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.prro.2020.04.002
DO - 10.1016/j.prro.2020.04.002
M3 - Article
C2 - 32473857
AN - SCOPUS:85085295228
SN - 1879-8500
VL - 10
SP - 220
EP - 234
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
IS - 4
ER -