What are the indications for postoperative irradiation of the pelvis for the treatment of stage IA2, IB, or IIA cervical cancer?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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Postoperative irradiation of the pelvis reduces the risk of local recurrence in patients with high-risk factors (ie, positive pelvic nodes, positive surgical margins, and residual parametrial disease). [74] A randomized trial showed that patients with parametrial involvement, positive pelvic nodes, or positive surgical margins benefit from a postoperative combination of cisplatin-containing chemotherapy and pelvic irradiation. [75]

Postoperative radiation therapy is also recommended in patients who have at least 2 intermediate risk factors (including tumor size greater than 2 cm, deep stromal invasion, or lymphovascular space invasion). For patients with IB2 or IIA cancer and tumors larger than 4 cm, radiation and chemotherapy is selected in most cases. Risks are associated with combined therapy, but many of these patients will meet either intermediate- or high-risk criteria after radical hysterectomy and therefore are strong candidates for this approach.

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