Multi-institutional study of radiation therapy for isolated para-aortic lymph node recurrence in uterine cervical carcinoma: 84 subjects of a population of more than 5,000

Journal Article · Fri Dec 01 04:00:00 EST 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.07.1384· OSTI ID:20850258

Niibe, Yuzuru ^[1]; Kenjo, Masahiro ^[2]; Kazumoto, Tomoko ^[3]; Michimoto, Koichi ^[4]; Takayama, Makoto ^[5]; Yamauchi, Chikako ^[6]; Kataoka, Masaaki ^[7]; Suzuki, Kazunori ^[8]; Ii, Noriko ^[9]; Uno, Takashi ^[10]; Takanaka, Tsuyoshi ^[11]; Higuchi, Keiko ^[12]; Yamazaki, Hideya ^[13]; Tokumaru, Sunao ^[14]; Oguchi, Masahiko ^[4]; Hayakawa, Kazushige ^[1]

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1. Department of Radiology, Kitasato University School of Medicine, Kanagawa (Japan)
2. Department of Radiology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima (Japan)
3. Department of Radiology, Saitama Cancer Center, Saitama (Japan)
4. Department of Radiation Oncology, Cancer Institute Hospital, the Japanese Foundation for Cancer Research, Tokyo (Japan)
5. Department of Radiology, Kyorin University School of Medicine, Tokyo (Japan)
6. Department of Radiation Oncology, Kyoto University Graduate School of Medicine, Kyoto (Japan)
7. Department of Radiology, National Shikoku Cancer Center, Ehime (Japan)
8. Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu (Japan)
9. Department of Radiology, Mie University School of Medicine, Mie (Japan)
10. Department of Radiation Oncology, Chiba University Graduate School of Medicine, Chiba (Japan)
11. Department of Radiology, Kanazawa University School of Medicine, Kanazawa (Japan)
12. Department of Radiology, Gunma Cancer Center, Gunma (Japan)
13. Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)
14. Department of Radiology, Saga University School of Medicine, Saga (Japan)

Purpose: Most patients who had any recurrent sites of cancer have been considered to be in their last stage of life. However, recent advances of clinical research reveal some patients achieve long-term survival even in recurrence. Furthermore, for patients who had only one recurrent region, radiation therapy could play an important role. As for uterine cervical carcinoma, the most common recurrent site other than the pelvis is the para-aortic lymph nodes. Thus we conducted the current study. Patients and Methods: Between 1994 and 2003, more than 5,000 uterine cervical carcinoma patients were treated with curative intended treatments at 13 Japanese hospitals. Of these patients, 84 developed para-aortic lymph node recurrence as the only site of initial tumor progression. These patients were treated with external beam radiation therapy. Radiation therapy protocol was as follows: 1.7-2.0 Gy per fraction, 5 fractions per week, and the mean total dose was 50.8 Gy (25-60 Gy). Results: Three- and 5-year overall survival rates of all patients were 49.5% and 31.3%, respectively. Stratified by symptom sign, 3-year overall survival rate of symptom positive was 27.6% and those of the negative was 56.1% (p = 0.018). Three-year overall survival rates of the total dose {>=}51 Gy and that of {<=}50 Gy were 58.0% and 42.8%, respectively (p = 0.07). As for morbidity, no patients received Grade 3 or greater late toxicity. Conclusions: The current study suggested that radiation therapy for isolated para-aortic lymph node recurrence in uterine cervical carcinoma could have a significant impact on survival.

• OSTI ID: 20850258
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 66; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BEAMS
CARCINOMAS
DISEASE INCIDENCE
HOSPITALS
LYMPH NODES
PATIENTS
PELVIS
RADIATION DOSES
RADIOTHERAPY
SYMPTOMS
TOXICITY