The Evolving Role of Radiation Oncology in the Management of Uterine Cervical Carcinoma: A State-of-the-Art Review for Non-Radiation Oncologists.

Cervical cancer is one of the most common gynecological tumors globally. When diagnosed, treatment decisions should be based on a risk-benefit analysis of each treatment modality to obtain a cure with minimum complications. The optimal approach for management should consider clinical factors such as age, menopausal status, medical comorbidities, histological type, tumor size, and the extent of disease. Radiotherapy is the cornerstone for successful management in almost all clinical stages of this disease. Options for primary treatment in patients with early cervical cancer may include radical hysterectomy, fertility-sparing surgery, and postoperative radiotherapy with or without platinum-based chemotherapy (CT) according to pathology specimen findings. For locally advanced cervical cancer, chemoradiotherapy has been the standard of care based on the results of clinical trials that showed an overall survival (OS) advantage when adding cisplatin to radiotherapy. After chemoradiotherapy, a cervical boost is mandatory for increased local control and better survival. For metastatic or recurrent cervical cancer, the treatment approach is tailored according to symptoms and performance status. As many techniques and new technologies are available to decrease toxicity while improving the therapeutic ratio, it becomes necessary to collate the current evidence that most effectively enables clinicians to make informed decisions in the management of cervical cancer patients.