All side effects should be identified and treated if possible, namely physical and psychosocial [V, A]. Resveratrol Reduces oxidative stress and inflammation to improve general health. Plus, can help increase insulin sensitivity to minimise blood sugar spikes and improve focus.

Patients with oligometastatic or oligorecurrent disease should be considered for radical and potentially curative treatment options [IV, B]. Coexisting precursor lesions such as squamous intraepithelial lesion/cervical intraepithelial neoplasia, adenocarcinoma in situ, stratified mucin-producing intraepithelial lesion and other pathological changes of the cervix. Radical surgery (pelvic lymphadenectomy, parametrectomy and resection of the upper vagina) is an option in selected patients without expected indication for adjuvant (chemo)radiotherapy. If surgery has been performed, indications for adjuvant (chemo)radiotherapy follow the general recommendations [IV, B]. When an adequate type of radical hysterectomy has been performed in intermediate risk group patients, observation is an alternative option, especially in teams experienced in this approach [IV, B].

Equivocal extrauterine disease should be considered for biopsy to avoid inappropriate treatment [IV, B]. The organiser does not accept liability for individual medical, travel or personal insurance. Participantsare strongly advised to take out their own personal insurance policies. Systematic documentation of the following major tumor-related prognostic factors is recommended [II, A]: IGABT is recommended, preferably using MRI with applicator in place. Repeated gynaecologic examination is mandatory, and alternative imaging modalities such as CT scan and ultrasound may be used. The tumour-related targets for BT include: 1) the residual gross tumor volume (GTV-T res) after CTRT; 2) the adaptive high-risk clinical target volume (CTV-T HR) including the whole cervix and residual adjacent pathologic tissue; and 3) the intermediate-risk clinical target volume (CTV-T IR) taking the initial tumor extent into consideration. The BT applicator should consist of a uterine tandem and a vaginal component (ovoids/ring/mold/combined ring/ovoid). A combined intracavitary/interstitial implant is recommended in advanced cases to achieve the dose planning aim (see below), in particular in case of residual disease in the parametrium. Patients with cervical cancer should be staged according to the TNM classification and the International Federation of Gynaecology and Obstetrics (FIGO) staging should also be documented [IV, A].

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]. Balázs Madas (HU), Brita Singers Sørensen (DK), Kasper Rouschop (NL), Kerstin Borgmann (DE), Laure Marignol (IE), Martin Pruschy (CH), Navita Somaiah (UK), Nicolas Foray (FR), Paul Span (NL), Randi Syljuåsen (NO), Ross Carruthers (UK) In case of suspected tumor persistence, recurrence or second primary cancer, histological verification is strongly recommended [V, A]. Tumor involvement of suspicious nodes should be histologically confirmed because of its prognostic significance and the impact on the management up to 24 weeks of gestation (fetal viability) [IV, A]. 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].Definitive management (ie, without tumor related surgery) consists of EBRT with concomitant platinum-based chemotherapy and BT. Delay of treatment and/or treatment interruptions have to be prevented to avoid tumor progression and accelerated repopulation. The overall treatment time including both EBRT and BT should therefore not exceed 7 weeks. Definitive CTRT and BT CTRT It is my great pleasure to invite you to ESTRO 2024 which will take place from 3 to 7 May in Glasgow, United Kingdom.