A 48-year-old woman has been diagnosed with FIGO Stage IIB carcinoma of the cervix (parametrial involvement, no pelvic wall extension, no hydronephrosis). She is medically fit for treatment. The standard of care is:
- A Radical hysterectomy (Wertheim's) with pelvic lymph node dissection
- B Neoadjuvant chemotherapy followed by radical surgery
- C Concurrent cisplatin-based chemoradiation with external beam radiotherapy followed by brachytherapy ✓
- D Radiotherapy alone without sensitising chemotherapy
Correct answer: C. Concurrent cisplatin-based chemoradiation with external beam radiotherapy followed by brachytherapy
Explanation
FIGO 2018 Stage IIB cervical cancer (parametrial involvement) is not amenable to primary surgery as surgical margins would be compromised. The international standard is concurrent platinum-based chemoradiation: weekly cisplatin (40 mg/m²) with pelvic EBRT followed by intracavitary brachytherapy to boost the cervix. This regimen significantly improves survival compared to radiotherapy alone. Surgery (Wertheim's) is standard for Stage IA2–IIA1 disease only. Neoadjuvant chemotherapy followed by surgery is investigational.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.