Does more aggressive local therapy improve survival for patients with metastatic cervical cancer? In this retrospective study, 164 patients with either para-aortic lymph node involvement (76%) or distant metastatic disease (24%) were treated with pelvic +/- para-aortic chemoradiation with image guided brachytherapy boost. At 3 years, this resulted in 90% local control with an overall survival rate of 55.5%. They authors found that many of the prognostic factors we’ve seen before in localized disease were also associated with outcomes for N2 and M1 disease. In multivariable analysis, a D90 ≥80 Gy to the high risk CTV was associated with better overall survival. On the other hand, bulky tumors with CTV-HR >40cc and non-squamous histology were associated with poor survival. | Laville, Int J Radiat Oncol Biol Phys 2023
