The addition of bevacizumab to platinum-based chemotherapy is recommended when the risk of significant gastrointestinal/genitourinary toxicities has been carefully assessed and discussed with the patient [I, A]. After SLN biopsy, if SLN are negative on frozen section, a systematic pelvic lymphadenectomy should be performed as the standard LN staging [III, A]. Platinum-based chemotherapy±bevacizumab is recommended for chemo-naïve, medically fit patients with recurrent/metastatic disease. Carboplatin/paclitaxel and cisplatin/paclitaxel are the preferred regimens [I, A]. Alexandra Stewart (UK), Åsa Carlsson Tedgren (SE), Csaba Polgár (HU), Frank-André Siebert (DE), Ina Schulz-Jurgenliemk (NL), Jean-Michel Hannoun-Levi (FR), Kari Tanderup (DK), Luca Tagliaferri (IT), Peter Hoskin (UK), Piotr Wojcieszek (PL) The use of whole-body diffusion-weighted imaging MRI (WB-DWI/MRI) can reliably obviate the need for gadolinium contrast and radiation for nodal and distant staging during pregnancy. If not available, chest CT scan with abdominal shielding is an alternative. PET-CT should be avoided during pregnancy [IV, B].

Patients with oligometastatic or oligorecurrent disease should be considered for radical and potentially curative treatment options [IV, B]. Building on previous congresses, the next step towards this goal is to reflect and act on the radiotherapy opportunities and challenges brought on, and brought to light, around the world in recent years. With this aim, the congress theme is Radiation Oncology: Bridging the Care Gap. Diindolylmethane (DIM) Can help balance your hormones by improving menopausal symptoms, PCOS, weight loss and hormonal acne . Intra-operative assessment of LN status (evaluated by frozen section) is recommended. Sentinel nodes from both sides of the pelvis and/or any suspicious LN should be sent for intra-operative assessment [III, A]. ESTRO SUPPORT BLEND: Uncover the potential well-being benefits of Estro Support, a proprietary blend of 100% natural alkaline herbs crafted with women's wellness in mind.Fertility sparing therapy for patients with tumors greater than 2 cm is significantly associated with a higher risk of recurrence and should not be considered as a standard treatment. The risk of recurrence must be comprehensively discussed with the patient. NACT followed by radical vaginal trachelectomy and abdominal radical trachelectomy or cone has been described for fertility sparing treatment in patients with tumors >2 cm. PLN staging should be performed before starting NACT to confirm tumor-free LN. The optimal number of chemotherapy cycles, chemotherapy regimen as well as extent of cervical resection following NACT, are still a matter of debate [IV, B]. Jointly with the IT department, ensure the effective operation and maintenance of the platform, aiming for optimal functionality. Please enjoy adding Quantum Estro Support to your daily nutritional regimen and feel the difference. Go Quantum! If SLN is negative bilaterally in the pelvic level I area (below iliac bifurcation) LN dissection can be limited to level I [IV, B].

After frozen section, all SLN should be processed according to pathological protocol for ultrastaging (see the principles of pathological evaluation) [III, A].

The ambition of ESTRO to further reinforce radiation oncology as a core partner in multidisciplinary cancer care, and to guarantee accessible and high-value radiation therapy for all cancer patients who need it, is expressed in the society’s vision statement for 2030: ‘Radiation Oncology. Optimal Health for All, Together.’ LN staging is not indicated in T1a1 LVSI-negative patients but can be considered in T1a1 LVSI-positive patients. Sentinel lymph node (SLN) biopsy (without additional PLN dissection (PLND)) is recommended in this situation [IV, B]. Patients with recurrent/metastatic disease should have a full clinical-diagnostic evaluation to assess the extent of disease and the most appropriate treatment modality including best supportive care [V, A]. metastatic involvement of PLN (macrometastases pN1 or micrometastases pN1(mi)) on final pathologic assessment. Additional dose of radiation should be applied to pathological LN on imaging, preferentially using a simultaneous integrated boost (60 Gy EQD2, combined EBRT and estimated dose from IGBT).

Quantum Nutrition Labs is proud to offer a high-quality nutritional product line tomeet all the needs of you and your family. We provide a wide range of quantum-state nutritional formulas, including Quantum Estro Support . Our products are manufactured and diligently tested for identity, purity, strength, and nutrient content, as well as for potential contaminants such as pesticides, non-organic materials, and heavy metals including arsenic, mercury, cadmium and lead, that may negatively impact health. These ultra-quality products provide you with full confidence in our company ’s integrity that you can count on . . . day in and day out. After CTRT and BT, patients should be counseled about sexual rehabilitation measures including the use of vaginal dilators. Topical estrogens are indicated [IV, B]. Every patient diagnosed with cervical cancer in pregnancy must be counseled by a multidisciplinary team. This team should consist of experts in the fields of gynecological oncology, neonatology, obstetrics, pathology, anesthesiology, radiation oncology, medical oncology, psycho-oncology, and, spiritual and ethical counseling. National or international tumor board counseling may be considered [V, A].

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Additional BT boost as part of adjuvant CTRT can be considered in cases with vaginal and/or parametrial positive disease (see principles of radiotherapy) [IV, B]. Minimally invasive approach could be considered before 14–16 weeks of gestation; however, the sentinel node biopsy concept using indocyanine green is still experimental [IV, C].

Work with consultants and suppliers to create visually engaging materials, including infographics, printed materials, and videos in line with ESTRO branding. A network of healthcare providers including all care providers should be involved in the care of survivors (eg, primary care physicians, gynecologists, psychologists, sexologists, physiotherapists, dieticians, social workers) for the follow-up [V, A]. Early palliative care, integrated with oncological treatments, should be offered by the clinical team to all the patients diagnosed with advanced cervical cancer for managing symptoms and improving quality of life. A multidisciplinary approach must be included in the care plan with discussion and planning for specific treatment of these symptoms [IV, A].In case of positive margins (except for low-grade intraepithelial lesion in ectocervix), a repeat conization should be performed to rule out more extensive invasive disease [IV, B].