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Copyright ©2014 Baishideng Publishing Group Co.
World J Clin Oncol. May 10, 2014; 5(2): 86-92
Published online May 10, 2014. doi: 10.5306/wjco.v5.i2.86
Table 1 Institutional capabilities, advantages and disadvantages of the main strategies of treatment for treating locally advanced cervical cancer International Federation of Gynecology and Obstetrics stage IB2-IIB
Institutional capabilitiesAdvantagesDisadvantages
CT-RTWell radiotherapy equipment (ideally, intensity-modulated radiotherapy IMRT) Availability of schedule for radiotherapyWell-documented oncologic benefit over radiotherapy alone Standardized treatmentLimited benefit in case of delay of treatment for toxicity or difficult access to radiation treatment (schedule, few equipment, etc.) Possible permanent local toxicity of radiotherapy, mainly in young and sexually active women
NACT + RSWelltrained surgeons Institutional support for complex surgical procedure (Intensive care units, Urologists, Internist, etc.)Reduce the tumor size Control of metastasis Select chemosensitive patients (prognostic factor) Allow to spare RT for relapsed disease or chemorefractory patientsDelay local treatment such as RT or RS selection of resistant cells clones chemotherapy-induced immunosuppression Negative lymph nodes at RS Cumulative toxicity of multimodal treatment, mainly in case of adding postoperative RT
Chemoradiation + adjuvant chemotherapySimilar to CT-RT strategyPossible but not welldocumented benefit yet (limited trials)Similar to chemoradiation cumulative toxicity of multimodal treatment