Radiochemotherapy for the treatment of cervical cancer

Primary combined radiochemotherapy is standard in locally advanced and node-positive tumors regardless of stage. The combination of radical hysterectomy and chemoradiotherapy should be avoided. Ovariopexy prior to chemoradiation can significantly reduce the dose to the ovaries and prevent early menopause. In histologically confirmed para-aortic lymph node metastasis, extended field radiation therapy (EFRT) provides excellent local para-aortal control, and half of those affected achieve long-term survival. Neoadjuvant chemotherapy followed by hysterectomy should only be performed within studies. Combination of bevacizumab with paclitaxel–cisplatin or paclitaxel–topotecan combination therapy is the current standard in patients with metastases, progressive disease or locally advanced, nonsurgically treatable disease. As an immunogenic tumor, cervical cancer is also a good target for checkpoint inhibition and other immunotherapeutic agents.