Cervical cancer

Question 1

Intact cervix EBRT constraint
Bowel V45:

Answer 1

soft constraint V45</= 200 cc
hard constraint V45 < 250 cc

Question 2

Intact cervix EBRT constraint
Bladder:

Answer 2

soft constraint: V45 < 50%
Hard constrain: Dmax < 57.5 Gy

Question 3

Intact cervix EBRT constraint
Rectum:

Answer 3

Soft constraint: V45 < 50%
Hard constraint: Dmax < 57.5 Gy

Question 4

Intact cervix EBRT constraint
Femoral heads

Answer 4

Hard constraint: Dmax < 55Gy

Question 5

Intact cervix EBRT constraint
Kidney

Answer 5

Soft constraint: Dmean < 10 Gy
Hard constraint: Dmean < 15 Gy

Question 6

Intact cervix EBRT constraint
Duodenum

Answer 6

Soft constraint: V55 < 5 cc
Hard constraint: V55 < 15 cc

Question 7

Cumulative brachy constraint
Rectum

Answer 7

Ideal: < 65 D2cc
Max: < 75 D2cc

Question 8

Cumulative brachy constraint
Bladder

Answer 8

Ideal: 75 - 80 D2cc
Max: < 90 D2cc

Question 9

Cumulative brachy constraint
Vagina

Answer 9

Ideal: < 65 point dose
Max: < 75 point dose

Question 10

Cumulative brachy constraint
Sigmoid

Answer 10

Ideal: < 70 D2cc
Max: < 75 D2cc

Question 11

Cumulative brachy constraint
Bowel

Answer 11

Ideal: < 70 D2 cc
Max: < 75 D2cc

Question 12

Cervical HDR prescription

Answer 12

Goal EQD2 D90 > 90 Gy to tumor, 85 is acceptable, 28 in 4 implants after 45 Gy EBRT

Question 13

Cervical Staging: Diagnosed by microscopy - DOI </= 5mm

Answer 13

Stage IA

IA1: invasion </= 3 mm
IA2: invastion > 3 but </= 5 mm

Question 14

Cervical Staging: Limited to cervix, DOI >5 mm, up to 2 cm in greatest dimension

Answer 14

Stage IB1

Question 15

Cervical Staging: Limited to cervix, DOI >5 mm, > 2 cm but >/= 4 cm in greatest dimension

Answer 15

Stage IB2

Question 16

Cervical Staging: Limited to cervix, DOI >5 mm, > 4 cm in greatest dimension

Answer 16

Stage IB3

Question 17

Cervical Staging: Extends beyond cervix, but limited to upper 2/3 of vagina, </= 4 cm in greatest dimension

Answer 17

Stage IIA1

Question 18

Cervical Staging: Extends beyond cervix, but limited to upper 2/3 of vagina, > 4 cm in greatest dimension

Answer 18

Stage IIA2

Question 19

Cervical Staging: Extends beyond cervix, but limited to upper 2/3 of vagina and parametrial invasion without pelvic wall involvement

Answer 19

Stage IIB

Question 20

Cervical Staging: Involves lower 1/3 of vagina

Answer 20

Stage IIIA

Question 21

Cervical Staging: extends to pelvic wall/hydronephrosis/nonfunctioning kidney

Answer 21

Stage IIIB

Question 22

Cervical Staging: pelvic lymph node involvement

Answer 22

IIIC1

Question 23

Cervical Staging: P-A lymph node involvement

Answer 23

IIIC2

Question 24

Cervical Staging: Biopsy proven spread to rectum or bladder

Answer 24

Stage IVA

Question 25

Cervical Staging: Spread to distant organs

Answer 25

Stage IVB

Question 26

Cervical Concurrent chemo, agent and dosing

Answer 26

Cisplatin 40 mg/m2 weekly Pembro for high risk

Question 27

Cervical EBRT dosing

Answer 27

45 Gy / 25 fx to pelvis SIB nodes to 57.5 Gy