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Impact of para-aortic recurrence risk-guided intensity-modulated radiotherapy in locally advanced cervical cancer with positive pelvic lymph nodes.
Lee, Jie; Lin, Jhen-Bin; Chang, Chih-Long; Sun, Fang-Ju; Wu, Meng-Hao; Jan, Ya-Ting; Chen, Yu-Jen.
Afiliação
  • Lee J; Department of Radiation Oncology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, Taiwan; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan. Electronic address: sinus.5706@mmh.org.tw.
  • Lin JB; Department of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan.
  • Chang CL; Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan.
  • Sun FJ; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
  • Wu MH; Department of Radiation Oncology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, Taiwan.
  • Jan YT; Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan.
  • Chen YJ; Department of Radiation Oncology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, Taiwan. Electronic address: oncoman@mmh.org.tw.
Gynecol Oncol ; 148(2): 291-298, 2018 02.
Article em En | MEDLINE | ID: mdl-29269219
ABSTRACT

OBJECTIVES:

A previous study has suggested the benefit of sub-renal vein radiotherapy (SRVRT) for pelvic lymph node (PLN)-positive cervical cancer. In order to better select patients for SRVRT, this study aimed to evaluate the value of a risk-based radiation field based on PLN location and number in PLN-positive cervical cancer.

METHODS:

We reviewed 198 patients with FIGO stage IB2-IVA cervical cancer, positive PLNs, and negative para-aortic lymph nodes (PALNs) from 2004 to 2015 at two tertiary centers. All patients underwent pelvic radiotherapy (PRT) or SRVRT with IMRT. The SRVRT extended the PRT field cranially to the level of the left renal vein. The prescribed doses were 45-50.4Gy in 1.8Gy per fraction.

RESULTS:

Overall, 118 and 80 patients underwent PRT and SRVRT, respectively. The SRVRT group had more advanced disease based on FIGO stage, common iliac PLNs, and number of PLNs. The median follow-up was 63months (range 7-151months). PALN failure was experienced by 28 patients (23.7%) in the PRT group and 1 patient (1.3%) in the SRVRT group (p<0.001). Compared with PRT, SRVRT significantly improved 5-year PALN recurrence-free survival (56.8% vs. 100%, p<0.001) and cancer-specific survival (56.5% vs. 93.9%, p<0.001) among patients with common iliac PLNs or ≥3 PLNs. No significant differences were observed in these outcomes among patients with PLNs below the common iliac bifurcation and 1-2 PLNs. The SRVRT did not increase severe toxicities.

CONCLUSIONS:

Risk-based radiation field based on PLN location and number could optimize outcomes for PLN-positive cervical cancer.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pélvicas / Neoplasias do Colo do Útero / Radioterapia de Intensidade Modulada / Quimiorradioterapia Tipo de estudo: Clinical_trials / Etiology_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Gynecol Oncol Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pélvicas / Neoplasias do Colo do Útero / Radioterapia de Intensidade Modulada / Quimiorradioterapia Tipo de estudo: Clinical_trials / Etiology_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Gynecol Oncol Ano de publicação: 2018 Tipo de documento: Article