Advanced Squamous Cell Carcinoma Of Uterine Cervix With Metastases- Unpredicted Long Survival Obtained After Stereotactic Radiation Directed To The Lung Metastases

Introduction/Background Expected median survival for patients with cervical carcinoma stage IV B is 17–26 months. Methodology This is a case report of 6 years survival for patients with metastatic cervical cancer. Results 59 years old women was diagnosed with squamous cell cervical cancer in 2012. MRI- revealed cervical tumor 7 cm involving anterior fornix, vaginal wall, parametrium and metastases to iliac lymph nodes. FDG/PET confirmed disease in pelvis and show metastases to III and X segment of the right lung. The patient was treated with palliative radiotherapy directed to pelvis (20 Gy, 4 Gy/fx). Completed response was achieved. After RT 4 cycles of chemotherapy (Carboplatin and Paclitaxel) stabilization was observed but the treatment had to be ceased because of toxicity. Three months after the chemotherapy, CT show progression of the lung metastases. Stereotactic radiation therapy (SRT) was applied: 40 Gy, 20Gy/fx to the tumors. Complete regression on CT was observed but after 5 months a new lesion in the apex of the right lung was diagnosed. It was treated with SRT (45 Gy, 15Gy/fx) - three months after the treatment a complete response was observed but a new nodules was seen in the right hilum. This one was treated with SRT (30 Gy, 10 Gy/fx). A complete regression was observed. The patient was well until the February of 2018 when local recurrence was diagnosed. The patient was reirradiated (30 Gy, 10 Gy/fx). Near complete regression was seen. After one months a second local progression was observed. The patients underwent palliative chemotherapy, but it was discontinued due to lack of effectiveness. The treatment described above allowed sixed year survival for patients with metastases to lung. Conclusion Agressive treatment is warrant in radiosensitive cervical cancer, even in case of multiple metastases. Disclosure Nothing to disclose.