A female having carcinoma cervix stage IIIb. What is the treatment:-

Rx of Cervical cancer NOTE: THERE IS NO ROLE OF SURGERY IN TREATMENT OF STAGE IIB AND ABOVE - Stage I - IIA - Surgical management: Radical Hysterectomy (aka type 3 hysterectomy) - Structures removed in radical hysterectomy are : Uterus, cervix, upper 1/3 - 1/2 of vagina, entire parametrium, uterine aery ligated at its origin from internal iliac aery, uterosacral ligament at most distal attachment (rectum) - Stage >= IIB - Chemoradiation - Radiotherapy alone is effective Rx in all stages. - Maximum radiation given at Point A 2cm above and 2 cm lateral to external os Ureter crosses the uterine aery (bridge over water) here ureter is under the uterine aery Parametrium seen here Upto 7500 to 8000 RADs given here Point B 3cm lateral to point B Obturator lymph nodes at the pelvis side walls Obturator lymph nodes -sentinel group of LN Upto 6000 RADS given here.