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Cervical Cancer — SCE Medical Oncology MCQ

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HardGynaecological CancersCervical CancerSCE Medical Oncology

A patient has FIGO 2014 stage IIIB cervical squamous-cell carcinoma, adequate renal function and no distant metastases. Which backbone remains the usual definitive treatment in England while pembrolizumab-chemoradiotherapy appraisal guidance is not a routine positive recommendation?

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Correct answer: C — Concurrent cisplatin-based external-beam radiotherapy followed by image-guided brachytherapy

Locally advanced stage IIIB cervical cancer is treated with definitive external-beam radiotherapy and concomitant cisplatin whenever possible, followed by image-guided adaptive brachytherapy. Surgery is not the usual definitive route for parametrial or pelvic-wall disease, and brachytherapy is not replaced by response-adapted omission. The 2026 NICE appraisal documents identify chemoradiotherapy as usual care and did not establish routine pembrolizumab-chemoradiotherapy use in England.

Reference: ESGO/ESTRO/ESP cervical cancer pocket guidelines (Published 2023): https://guidelines.esgo.org/media/2023/05/Pocket-Guidelines_Cervical-cancer.pdf; NICE ID6138 final-draft documents: pembrolizumab with chemoradiation for untreated high-risk locally advanced cervical cancer (Final-draft documents published June 2026): https://www.nice.org.uk/guidance/awaiting-development/gid-ta11215/documents