Treatment Options for Stages IIB, III, and IVA Cervical Cancer

Primary tumor size is an important prognostic factor to carefully evaluate when choosing optimal therapy.[1] Survival and local control are better with unilateral rather than bilateral parametrial involvement.[2] Patterns-of-care studies in patients with stages IIIA and IIIB disease indicate that survival is dependent on the extent of the disease, with unilateral pelvic wall involvement predicting a better outcome than bilateral involvement, which in turn predicts a better outcome than involvement of the lower third of the vaginal wall.[2] These studies also reveal a progressive increase in local control and survival paralleling a progressive increase in paracentral (point A) dose and use of intracavitary treatment. The highest rate of central control was seen with paracentral (point A) doses of more than 85 Gy.[3]

Treatment options for stage IIB, stage III, and stage IVA cervical cancer include: