Should whole pelvic radiation therapy become past history? A case for the routine use of extended field therapy and multimodality therapy

Total pelvis radiation therapy as refined over the past 40 years has impacted positively on gynecologic cancer management. Improved overall results on a worldwide basis reflect a broader application of contemporary radiation treatment plans. Individual clinical stages of disease and subsets have not seen improvement in several decades. Currently available techniques for the safe application of extended field radiation therapy strongly support its routine use. Concomitant continuous infusion chemotherapy (CCIC) with radiation therapy (RT) should be strongly considered. Primary radical surgery is employed in our hands prior to extended RT and CCIC for most Stage I and II cases.