Oncology and Fibroids
A female having carcinoma cervix stage IIIB. What is the treatment (AIIMS Nov. 2011)
|D||Intracavitary brachy therapy with external beam radiotherapy|
Intracavitary brachy therapy with external beam radiotherapy
Cancer Cervix: Treatment and Its Problems
1. Patients with cervical cancer usually present with disease that is clinically confined to the pelvis, hence locoregional disease control is the primary purpose of physicians.
2. Surgery is generally reserved for the early stage patients only (Wertheim’s radical effective till stage II A Maximum), however, radiotherapy is used for all stages but needs to be carefully tailored to a particular patient and to the extent of the disease.
3. Treatment must ideally have a combination of external
4. Beam irradiation and brachytherapy. The role of chemotherapy as a radiosensitizer is currently the best modality of cancer cervix treatment for stages II B onwards.
5. External beam radiation is used to treat the central disease and to sterilize known or suspected regional metastases.
6. For patients with bulky central disease, a course of external beam radiation to the pelvis usually causes significant tumor regression, potentially improving the dose distribution of subsequent intracavitary radiation by shrinking the endocervical disease to bring it within the high dose range of intracavitary therapy
7. The amount of dose given with external beam or intracavitary radiation must be balanced carefully.
8. Proportion of external radiation increases with increase in tumor bulk and stage, and except for small tumors external radiation generally precedes intracavitary treatment.