Radiotherapy for the treatment of locally recurrent cervical cancer

Following radical hysterectomy for stage I-IIA cervical carcinoma, 10%-15% of women will have a recurrence. Sixty percent of these recurrences will be located in the pelvis alone. The treatment of a localized pelvic recurrence depends on a number of factors, but primarily the history of previous radiation therapy (RT) to the pelvis and the location of the recurrence. For patients without a history of prior treatment, RT with or without chemotherapy can lead to disease-free survival rates of 20%-50% and local control rates of 20%-60%, and should be considered first-line treatment. For those with a history of previous RT and sidewall or nodal recurrences, a combination of surgery and brachytherapy or intraoperative radiotherapy may improve survival for these women who were previously considered incurable. However, this requires special expertise and technology not available at most centers.