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Title: Patterns of Regional Recurrence After Definitive Radiotherapy for Cervical Cancer

Abstract

Purpose: To determine the patterns of regional recurrence in patients treated with definitive radiotherapy (RT) for cervical cancer. Methods and Materials: The records of 198 patients treated with definitive RT for cervical cancer between 1980 and 2000 who experienced a regional recurrence without a central or distal vaginal recurrence were reviewed. All patients received a combination of external-beam RT and intracavitary brachytherapy. In the 180 patients with a documented location of regional recurrence, the relationship between the recurrence and the radiation fields was determined. Results: The median time to regional recurrence was 13 months (range, 2-85 months). Of the 180 patients who had an evaluable regional recurrence, 119 (66%) had a component of marginal failure; 71 patients recurred above-the-field, 2 patients occurred in the inguinal nodes, and 2 patients recurred above-the-field and in the inguinal nodes. In addition, 105 patients (58%) had a component of in-field failure; 59 patients recurred in-field only, 39 patients recurred in-field and above-the-field, 2 patients recurred in-field, above-the-field, and in the inguinal nodes, and 5 patients recurred in-field and in the inguinal nodes. The median survival after regional recurrence was 8 months (range, 0-194 months). Conclusions: Most regional recurrences after definitive RT for cervical cancermore » include a component of marginal failure, usually immediately superior to the radiation field. These recurrences suggest a deficiency in target volume. Recurrences also occur in-field, suggesting a deficiency in dose. Developments in pretreatment staging, field delineation, dose escalation, and posttreatment surveillance may help to improve outcome in these patients.« less

Authors:
; ;  [1];  [2];  [1]
  1. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  2. Department of Gynecologic Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
Publication Date:
OSTI Identifier:
21372204
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 76; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2009.04.009; PII: S0360-3016(09)00565-3; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; NEOPLASMS; UROGENITAL SYSTEM DISEASES; DISEASES; MEDICINE; NUCLEAR MEDICINE; RADIOLOGY; RADIOTHERAPY; THERAPY

Citation Formats

Beadle, Beth M., Jhingran, Anuja, Yom, Sue S., Ramirez, Pedro T., and Eifel, Patricia J., E-mail: peifel@mdanderson.or. Patterns of Regional Recurrence After Definitive Radiotherapy for Cervical Cancer. United States: N. p., 2010. Web. doi:10.1016/j.ijrobp.2009.04.009.
Beadle, Beth M., Jhingran, Anuja, Yom, Sue S., Ramirez, Pedro T., & Eifel, Patricia J., E-mail: peifel@mdanderson.or. Patterns of Regional Recurrence After Definitive Radiotherapy for Cervical Cancer. United States. doi:10.1016/j.ijrobp.2009.04.009.
Beadle, Beth M., Jhingran, Anuja, Yom, Sue S., Ramirez, Pedro T., and Eifel, Patricia J., E-mail: peifel@mdanderson.or. Thu . "Patterns of Regional Recurrence After Definitive Radiotherapy for Cervical Cancer". United States. doi:10.1016/j.ijrobp.2009.04.009.
@article{osti_21372204,
title = {Patterns of Regional Recurrence After Definitive Radiotherapy for Cervical Cancer},
author = {Beadle, Beth M. and Jhingran, Anuja and Yom, Sue S. and Ramirez, Pedro T. and Eifel, Patricia J., E-mail: peifel@mdanderson.or},
abstractNote = {Purpose: To determine the patterns of regional recurrence in patients treated with definitive radiotherapy (RT) for cervical cancer. Methods and Materials: The records of 198 patients treated with definitive RT for cervical cancer between 1980 and 2000 who experienced a regional recurrence without a central or distal vaginal recurrence were reviewed. All patients received a combination of external-beam RT and intracavitary brachytherapy. In the 180 patients with a documented location of regional recurrence, the relationship between the recurrence and the radiation fields was determined. Results: The median time to regional recurrence was 13 months (range, 2-85 months). Of the 180 patients who had an evaluable regional recurrence, 119 (66%) had a component of marginal failure; 71 patients recurred above-the-field, 2 patients occurred in the inguinal nodes, and 2 patients recurred above-the-field and in the inguinal nodes. In addition, 105 patients (58%) had a component of in-field failure; 59 patients recurred in-field only, 39 patients recurred in-field and above-the-field, 2 patients recurred in-field, above-the-field, and in the inguinal nodes, and 5 patients recurred in-field and in the inguinal nodes. The median survival after regional recurrence was 8 months (range, 0-194 months). Conclusions: Most regional recurrences after definitive RT for cervical cancer include a component of marginal failure, usually immediately superior to the radiation field. These recurrences suggest a deficiency in target volume. Recurrences also occur in-field, suggesting a deficiency in dose. Developments in pretreatment staging, field delineation, dose escalation, and posttreatment surveillance may help to improve outcome in these patients.},
doi = {10.1016/j.ijrobp.2009.04.009},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 76,
place = {United States},
year = {Thu Apr 15 00:00:00 EDT 2010},
month = {Thu Apr 15 00:00:00 EDT 2010}
}