SUPPORTIVE CARE FOR WOMEN WITH GYNAECOLOGIC CANCER ...

TREATMENT SCHEDULE AND PLANNING @ MUV

SUPPORTIVE CARE FOR WOMEN WITH GYNAECOLOGIC CANCER

RECEIVING RADIOTHERAPY

Alina Sturdza, MD, FRCPC Medical University of Vienna, Austria

Outline

? Work up @ MUW ? General aspects of Radiochemotherapy ? Potential acute toxicities related to IGABT ? Special issues related to Brachytherapy

supportive care ? Conclusions

Staging

? PET CT/PET-MR ? MRI ? Laparoscopic lymph node Staging ? Pelvic/PAN

Primary radiochemotherapy in cervical cancer

External beam radiotherapy and concurrent chemotherapy

Start

45 Gy

1. Cycle

Cisplatin 40 mg/m?

5-6 Cycles

Week 1 Week 2 Week 3 Week 4 Week 5 Week 6

Brachytherapy

HDR or PDR EQD2 60 Gy

EQD2 85 Gy

Week 1 Week 2 Week 3 Week 4 Week 5 Week 6

RChTh + BT in < 50 days

EBRT Chemotherapy

Brachy

week 1 week 2 week 3 week 4 week 5 week 6 week 7 week 1 week 2 week 3 week 4 week 5 week 6 week 7 week 1 week 2 week 3 week 4 week 5 week 6

EMBRACE II

CTV-N LR CTV-T

IMRT + IGRT

PTV45 CTV-E

Initial GTV-T

Initial HR CTV-T

Initial GTV

Initial GTV

+ Para-aortic

High Risk

Large pelvis Small pelvis

Intermediate

Risk

Low

200 Patients

Risk

enrolled in 5 centers

Initial GTV GTVres

CTVHR

CTVIR

CTVLR

Nodal CTV-E based on Risk Group

Residual GTV-T, Adaptive HR CTV-T, IR CTV-T

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