17
Enhanced Maximal
Abbreviations
CBC, complete blood count; chemoRT, chemotherapy plus radiotherapy; CT, computed
tomography; EBRT, external-beam radiation therapy; EUA, examination under anesthesia;
FS, fertility sparing ; IORT, intraoperative radiation therapy; LFT, liver function test; LN,
lymph node; LND, lymph node dissection; LVSI, lymphovascular space invasion; MRI,
magnetic resonance imaging ; NACT, neoadjuvant chemotherapy; PANB, para-aortic node
biopsy; PET, positron emission tomography; PLND, pelvic lymph node dissection; RT,
radiotherapy
Depending on previous RT and central
vs. noncentral disease:
Central disease: chemoRT or RT ±
brachytherapy if no prior RT
If central and prior RT: exenteration
Noncentral: chemotherapy, tumor-
directed RT, and palliative care
(EB, H, S)
Prior RT plus central disease: pelvic
exenteration OR radical hysterectomy
OR brachytherapy [latter two "in
carefully selected patients with small
(<2 cm) lesions"]
(EB, H, S)
Depending on previous RT and central vs.
noncentral disease:
Central disease: chemoRT or RT ±
brachytherapy if no prior RT If central
and prior RT: exenteration
Noncentral: chemotherapy, tumor-
directed RT, and palliative care
(EB , H, S)
Prior RT plus central disease: pelvic
exenteration ± intraoperative RT OR
radical hysterectomy OR brachytherapy
[latter two "in carefully selected patients
with small (<2 cm) lesions"]
(EB, H, S)
Prior RT plus noncentral disease: tumor-
directed RT ± chemotherapy or best
palliative care
(EB, H, S)
Before palliative care alone, try options
such as RT boost, salvage surgery, or
chemotherapy
Prior RT plus noncentral disease:
tumor-directed RT ± chemotherapy OR
resection with intraoperative RT for
close or positive margins OR clinical trial
OR chemotherapy plus bevacizumab
and/or palliative care
(EB, H, S)
If recurrence aer any of the above, then
clinical trial OR chemotherapy OR best
supportive care
(EB , H, S)
