Irradiation of Pelvic and Para-Aortic Nodes in Carcinoma of the Cervix.
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Abstract
Extended-field irradiation offers a significant chance of cure for patients with para-aortic node metastases if pelvic disease can be controlled. Prognosis is best for patients with microscopic para-aortic disease or with a single enlarged node. Complications of extended-field irradiation can be minimized with careful radiation therapy technique that uses multiple fields and high-energy beams of 18 MV or greater and by avoiding transperitoneal surgical staging. Although the role of prophylactic para-aortic irradiation is still being defined, randomized trials suggest that extended fields do benefit some patients with locoregionally advanced disease.