Objective: Evaluation of results of extended field radiotherapy and high–dose rate brachytherapy combined with chemotherapy in patients with locally advanced cervical carcinoma. Type of the study: A retrospective study. Setting: Department of Oncology and Radiotherapy, University Hospital Hradec Králové. Methods: Forty five patients with stage IIB – IVA cervical cancer and radiologically suspicious pelvic and/or paraaortic lymph nodes were treated at the Dept. of Oncology and Radiotherapy Hradec Králové with pelvic and paraaortic radiotherapy, high–dose rate brachytherapy and concomitant chemotherapy with cisplatin or cisplatin and paclitaxel. Results: The 3-years disease free survival estimate was 64%. Hematological toxicity was the most limiting factor of concomitant chemotherapy. Late toxicity grade III and IV was observed in 7 patients. One patient underwent surgery due to ileus caused by lymphoma. Conclusions: Concomitant chemoradiotherapy with paraaortic fields results in high tumor control but also significant acute and late toxicity. New techniques of radiotherapy, such as intensity modulated radiotherapy, may improve the therapeutic ratio.

        Key words: cervical carcinoma, paraaortic irradiation, concomitant chemoradiotherapy