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This page discusses the use of radiation therapy for the treatment of cervical cancer. For a thorough review of radiation therapy for cancer treatment, please see the radiation therapy treatment monograph .
Radiation therapy is the use of penetrating beams of high-energy waves or streams of particles called radiation to treat disease. Radiation therapy destroys the ability of cancer cells to grow and divide.
Radiation therapy is a primary treatment option for cervical cancer. It is often used concurrently with chemotherapy . In early-stage disease, it is a notable alternative to radical surgery . It is also often used after surgery to help prevent or minimize recurrences of cancer.
Advantages of radiation therapy are that it can usually be given on an outpatient basis, with intraoperative and postoperative complications avoided. In addition, the time to receive each treatment is very short. As with other cancer treatments, though, its adverse effects on normal tissues are often long-term.
Radiation therapy is used in the following cervical cancer stages:
Stage IA:
Stage IB:
Stage IIA:
Stage IIB:
Stage III:
Stage IVA:
Stage IVB:
Radiation therapy is administered in two forms:
For external radiation therapy, rays are directed at the tumor from outside the body. External beam whole pelvic radiation is generally given in divided doses for four to five weeks on an outpatient basis. Most centers administer radiation in single doses of 180 to 200 centigray (cGy) each weekday, until an accumulative dose of 4500 to 5000 cGy to the pelvis is administered.
Tandem and ovoid brachytherapy is a means to deliver high-dose radiation directly to the tumor. Most applicators are placed in the vagina under anesthesia. The cervix is dilated, and a hollow tube is placed in the endocervical canal and into the body of the uterus. Two small, hollow, round applicators are placed external to the cervix, to sit in the vagina on either side of the exocervix. The bladder and rectum are packed away from the applicators using gauze. Typically, 4000 to 8000 additional cGy can be given to the cervix by transvaginal application.
Radiation therapy has been used with great success in early-stage cervical cancer. Five-year cure rates for women with stage IB or IIA with radiation therapy are 85% to 90%. Stages IIB, III, and IVA are best treated with radiation therapy combined with chemotherapy. The 5-year survival rate for stage IIB is 60% to 65%. The 5-year survival rates for stage III ranges from 25% to 40%. For stage IV, 5-year survival rates are in the 15% to 20% range.
Radiation therapy may cause the following adverse effects:
Call your doctor if you experience any of the following:
For more information on radiation therapy, including how to manage the side effects, please see the radiation therapy treatment monograph.
Sources:
American Cancer Society
National Cancer Institute
DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology , 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins;2001:1519-1549.
Im SS, Monk BJ. New developments in the treatment of invasive cervical cancer. Obstetrics and Gynecology Clinics . 2002; 29.
Otto SE. Oncology Nursing . 4th ed. St. Louis, MO: Mosby, Inc; 2001:248-257.
Ryan KJ, Berkowitz RS, Barbieri RL. Kistner's Gynecology & Women's Health. 7th ed. St. Louis, MO: Mosby, Inc; 1999:112-114.
Last reviewed February 2003 by Jondavid Pollock, MD, PhD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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