FIGO stage IB1 cervical carcinoma: Place and principles of brachytherapy

G Model

ARTICLE IN PRESS

CANRAD-3562; No. of Pages 1

Cancer/Radiothérapie xxx (2017) xxx–xxx

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CME: questions

FIGO stage IB1 cervical carcinoma: Place and principles of brachytherapy Place et principes de la curiethérapie dans la prise en charge des carcinomes du col utérin de stade FIGO IB1

QUESTIONS Question 1.– What are the factors justifying adjuvant chemoradiotherapy after surgery for FIGO stage IB1 cervical cancer? A. B. C. D. E.

nodal invasion positive surgical margins maximum tumor diameter larger than 2 cm parametrial involvement adenocarcinoma histology type

B. the intermediate risk-clinical target volume margins are 10 mm in all directions C. the whole uterine corpus is encompassed in the intermediate risk-clinical target volume D. the anterioposterior intermediate risk-clinical target volume margins are limited by the rectal and bladder wall E. the obturator nodes area is included in the intermediate riskclinical target volume Question 5.– Dose–volume brachytherapy are:

constraints

for

preoperative

Question 2.– About FIGO stage IB1 treatments: A. surgery alone and radiotherapy alone have equivalent 5 years overall survival B. severe toxicity is more prevalent after radiotherapy alone than after surgery alone C. in France, preoperative brachytherapy is recommended for tumors at least 2 cm D. preoperative brachytherapy decreases the rates of adjuvant therapy E. extrafascial hysterectomy is as efficient as classical Piver class 2 hysterectomy but less toxic Question 3.– What are the necessary factors for a fertility preservation strategy? A. B. C. D. E.

age under 50 years absence of lymphovascular invasion on the biopsy absence of nodal invasion tumor size under 4 cm negative Human papillovirus status

Question 4.– Concerning clinical target volume delineation for FIGO stage IB1 cervical tumors: A. the high-risk-clinical target volume encompasses the gross tumor volume plus a 10 mm isotropic margin

A. B. C. D. E.

D90 intermediate risk-clinical target volume at least 60 Gy bladder D2cm3 85 Gy or less rectum D2cm3 85 Gy or less dose rate to organs at risk 0.6 Gy/h or less with pulsed dose rate dose–volume constraints were established for definitive irradiation. Lower organs at risk D2cm3 should be aimed at with preoperative brachytherapy

Disclosure of interest The authors declare that they have no competing interest. A. Huertas a,∗ S. Oldrini a J.-P. Nesseler a F. Courrech a P. Rétif b C. Charra-Brunaud a D. Peiffert a a Department of radiotherapy, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54500 Vandœuvre-lès-Nancy, France b Department of radiotherapy, mercy hospital, centre hospitalier régional de Metz-Thionville, 1, allée du Château, 57530 Ars-Laquenexy, France ∗ Corresponding

author. E-mail address: [email protected] (A. Huertas) DOIs of original articles: http://dx.doi.org/10.1016/j.canrad.2016.09.014, http://dx.doi.org/10.1016/j.canrad.2017.01.006 http://dx.doi.org/10.1016/j.canrad.2017.01.007 1278-3218

Please cite this article in press as: Huertas A, et al. FIGO stage IB1 cervical carcinoma: Place and principles of brachytherapy. Cancer Radiother (2017), http://dx.doi.org/10.1016/j.canrad.2017.01.007