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Cervical Brachytherapy Essential — SCE Medical Oncology MCQ

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HardGynaecological CancersCervical Brachytherapy EssentialSCE Medical Oncology

A patient with locally advanced cervical cancer completes 45 Gy pelvic chemoradiotherapy, but theatre availability would delay MRI-guided brachytherapy so that the whole course lasts 9 weeks. Which plan best follows European specialist guidance?

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Correct answer: C — Deliver image-guided brachytherapy and keep total treatment within 7 weeks

Definitive treatment for locally advanced cervical cancer includes concomitant chemotherapy, external-beam radiotherapy and image-guided adaptive brachytherapy; an external-beam boost should not routinely replace brachytherapy. ESGO/ESTRO/ESP guidance says the overall treatment time including chemoradiotherapy and image-guided brachytherapy should aim not to exceed 7 weeks. Response on MRI does not remove the brachytherapy component, and restarting the whole course is not the corrective strategy.

Reference: ESGO/ESTRO/ESP cervical cancer pocket guidelines (Published 2023): https://guidelines.esgo.org/media/2023/05/Pocket-Guidelines_Cervical-cancer.pdf