16
Treatment
Table 4. Recommendations for Stage IIB, III, IVA, and IVB
and Recurrent Disease (cont'd)
Type of Disease Basic Limited
Recurrent Palliative care
(EB, H, S)
and/or central disease:
chemotherapy
(CB, In, W)
Depending on previous RT and
either "no prior RT or failure
outside of previously treated
field" then may offer tumor-
directed RT plus platinum-based
chemotherapy
(EB, H, S)
Note is is best managed with
exenteration (type of
surgery that is not feasible
to perform in low-resource
setting )
Prior RT plus noncentral disease:
chemotherapy or best palliative care
(EB, H, S)
NOTE. Bold indicates addition of a recommended action over a previous resource level
(eg, in limited setting, a bold action is one that was not recommended in basic). Additional
recommendations regarding settings with limited radiotherapy resources are provided in the main
article.
a
Recommended in setting where chemotherapy is not consistently available.
b
When brachytherapy is not available, extrafascial or radical hysterectomy is recommended only
when there is persistent central pelvic disease and selective lymphadenectomy or LN biopsy for
suspicious lesions.
c
Margins for dysplasia or carcinoma.
