Skip to content

Cervical Cancer Health Center

Font Size

Cervical Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stages IIB, III, and IVA Cervical Cancer Treatment

Standard Treatment Options for Stages IIB, III, and IVA Cervical Cancer

The size of the primary tumor is an important prognostic factor and should be carefully evaluated in choosing optimal therapy.[1] Survival and local control are better with unilateral rather than bilateral parametrial involvement.[2] Patterns-of-care studies in stages IIIA and IIIB patients indicate that survival is dependent on the extent of the disease, with unilateral pelvic wall involvement predicting a better outcome than bilateral involvement, which in turn predicts a better outcome than involvement of the lower third of the vaginal wall.[2] These studies also reveal a progressive increase in local control and survival paralleling a progressive increase in paracentral (point A) dose and use of intracavitary treatment. The highest rate of central control was seen with paracentral (point A) doses of more than 85 Gy.[3]

Recommended Related to Cervical Cancer

Understanding Cervical Cancer -- the Basics

Cervical cancer is cancer of the cervix, the narrow neck at the lower part of a woman's uterus, just above the vagina (Figure 1). The cervix connects the uterus to the vagina. Approximately eight out of 10 cervical cancers originate in surface cells lining the cervix (squamous cell carcinomas). These cancers do not form suddenly. Over time, healthy cervical cells can become abnormal in appearance -- this is called dysplasia. Although these cells are not cancerous, they can eventually become...

Read the Understanding Cervical Cancer -- the Basics article > >

Standard treatment options for stage IIB, stage III, and stage IVA cervical cancer include the following:

  1. Radiation therapy with concomitant chemotherapy. [4]

Radiation therapy with concomitant chemotherapy

Strong consideration should be given to the use of intracavitary radiation therapy and external-beam radiation therapy (EBRT) to the pelvis combined with cisplatin or cisplatin/fluorouracil (5FU).[5,6,7,8,9,10,11,12]

Evidence (radiation therapy with concomitant chemotherapy):

  1. Five randomized, phase III trials have shown an overall survival (OS) advantage for cisplatin-based therapy given concurrently with radiation therapy,[5,6,7,8,9,10] but one trial that examined this regimen demonstrated no benefit.[13] The patient populations in these studies included women with Féderation Internationale de Gynécologie et d'Obstétrique (FIGO) stages IB2 to IVA cervical cancer treated with primary radiation therapy, and women with FIGO stages I to IIA disease who, at the time of primary surgery, were found to have poor prognostic factors, including metastatic disease in pelvic lymph nodes, parametrial disease, and positive surgical margins.
    • Although the positive trials vary somewhat in terms of the stage of disease, dose of radiation, and schedule of cisplatin and radiation, the trials demonstrate significant survival benefit for this combined approach.
    • The risk of death from cervical cancer was decreased by 30% to 50% with the use of concurrent chemoradiation therapy.
    Next Article:

    Today on WebMD

    cancer cell
    HPV is the top cause. Find out more.
    doctor and patient
    Get to know the Symptoms.
    sauteed cherry tomatoes
    Fight cancer one plate at a time.
    Lung cancer xray
    See it in pictures, plus read the facts.
    Integrative Medicine Cancer Quiz
    Lifestyle Tips for Depression Slideshow
    Screening Tests for Women
    what is your cancer risk