How to treat cervical cancer with a diameter of ≤4cm

For patients with stage IB2 and IIA (>4cm) cervical cancer, a good prognosis can be achieved regardless of whether surgery or radiotherapy is used during treatment. However, in order to reduce the occurrence of complications, the combination of radical surgery and radiotherapy should be avoided when initially selecting a treatment plan.

1. Recommended dose for standard radiotherapy: Patients who receive radiotherapy should generally choose standard radiotherapy, i.e. pelvic external irradiation plus intracavitary brachytherapy, with recommended doses of 80-85 Gy at point A and 50-55 Gy at point B. The total amount of pelvic external irradiation is 45-55 Gy, 180-200 cGy each time.

2. Standard surgical treatment plan: For those who choose surgical treatment, the standard surgical treatment plan is modified radical hysterectomy or radical hysterectomy and pelvic lymph node dissection.

3. Precautions for ovarian preservation: Young patients can preserve their ovaries. For those who are expected to need radiotherapy after surgery, the ovaries should be suspended outside the pelvic cavity. In some special cases, vaginal radical hysterectomy and laparoscopic pelvic lymph node dissection can be performed.

4. Concurrent chemoradiotherapy according to specific circumstances: If lymph nodes are found after surgery, the paracervical and surgical margins are positive, and the vascular area is infiltrated and extends to the outer 1/3 of the cervical stroma, concurrent chemoradiotherapy (5-FU+cisplatin or cisplatin alone) is used.

Tips: Concurrent chemoradiotherapy

Concurrent chemoradiotherapy refers to the use of chemotherapy at the same time as radiotherapy for cervical cancer. Chemotherapy drugs can synchronize tumor cells to enhance the sensitivity of radiotherapy. The patient's tolerance should be considered during treatment. If a combined chemotherapy regimen is used, the dose intensity should be adjusted accordingly.