Gyn guide.

It’s taken a while for gyn cancers to embrace the IMRT era, but now that it has, ASTRO has stepped up with new cervical cancer consensus guidelines. What’s changed? IMRT is no-holds recommended for post-op treatment and even “conditionally” recommended for definitive treatment, particularly when delivering simultaneous dose escalation to intact involved nodes, in both cases the advantage being better side effect profiles not better disease control. For brachytherapy, a strong recommendation is given for CT or MRI-guided volume-based planning, including a conditional recommendation to bump the cumulative EQD2 up from ≥80 Gy to ≥85 Gy when using such volume-based planning for poorly-responding or large-volume (>4 cm) disease. Finally, Table 7 provides a good summary of cumulative dose constraints. TBL: Here’s a nice updated guideline on cervical cancer radiation. | Chino, Pract Radiat Oncol 2020