Preliminary report of using FDG-PET to detect extrapelvic lesions in cervical cancer patients with enlarged pelvic lymph nodes on MRI/CT

2004 ◽  
Vol 58 (5) ◽  
pp. 1506-1512 ◽  
Author(s):  
Chien-Sheng Tsai ◽  
Ting-Chang Chang ◽  
Chyong-Huey Lai ◽  
Cheng-Chien Tsai ◽  
Koon-Kwan Ng ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Preliminary Report ◽  
Pelvic Lymph Nodes

Combining tumor size and diffusion-weighted imaging to diagnose normal-sized metastatic pelvic lymph nodes in cervical cancers

2018 ◽  
Vol 60 (3) ◽  
pp. 388-395 ◽  
Author(s):  
Jiacheng Song ◽  
Qiming Hu ◽  
Junwen Huang ◽  
Zhanlong Ma ◽  
Ting Chen
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Size ◽  
Diffusion Weighted Imaging ◽  
Area Under The Curve ◽  
Adc Value ◽  
Cervical Cancers ◽  
Pelvic Lymph Nodes ◽  
Diffusion Weighted

Background Detecting normal-sized metastatic pelvic lymph nodes (LNs) in cervical cancers, although difficult, is of vital importance. Purpose To investigate the value of diffusion-weighted-imaging (DWI), tumor size, and LN shape in predicting metastases in normal-sized pelvic LNs in cervical cancers. Material and Methods Pathology confirmed cervical cancer patients with complete magnetic resonance imaging (MRI) were documented from 2011 to 2016. A total of 121 cervical cancer patients showed small pelvic LNs (<5 mm) and 92 showed normal-sized (5–10 mm) pelvic LNs (39 patients with 55 nodes that were histologically metastatic, 53 patients with 71 nodes that were histologically benign). Preoperative clinical and MRI variables were analyzed and compared between the metastatic and benign groups. Results LN apparent diffusion coefficient (ADC) values and short-to-long axis ratios were not significantly different between metastatic and benign normal-sized LNs (0.98 ± 0.15 × 10−3 vs. 1.00 ± 0.18 × 10−3 mm2/s, P = 0.45; 0.65 ± 0.16 vs. 0.64 ± 0.16, P = 0.60, respectively). Tumor ADC value of the metastatic LNs was significantly lower than the benign LNs (0.98 ± 0.12 × 10−3 vs. 1.07 ± 0.21 × 10−3 mm2/s, P = 0.01). Tumor size (height) was significantly higher in the metastatic LN group (27.59 ± 9.18 mm vs. 21.36 ± 10.40 mm, P < 0.00). Spiculated border rate was higher in the metastatic LN group (9 [16.4%] vs. 3 [4.2%], P = 0.03). Tumor (height) combined with tumor ADC value showed the highest area under the curve of 0.702 ( P < 0.00) in detecting metastatic pelvic nodes, with a sensitivity of 59.1% and specificity of 78.8%. Conclusions Tumor DWI combined with tumor height were superior to LN DWI and shape in predicting the metastatic state of normal-sized pelvic LNs in cervical cancer patients.

A Phase I Study of Concurrent Weekly Carboplatin and Paclitaxel Combined With Intensity-Modulated Pelvic Radiotherapy as an Adjuvant Treatment for Early-Stage Cervical Cancer Patients With Positive Pelvic Lymph Nodes

2013 ◽  
Vol 23 (7) ◽  
pp. 1279-1286 ◽  
Author(s):  
Seiji Mabuchi ◽  
Ryoko Takahashi ◽  
Fumiaki Isohashi ◽  
Takeshi Yokoi ◽  
Kimihiko Ito ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Dose Level ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Pelvic Radiotherapy ◽  
Pelvic Lymph Nodes ◽  
Early Stage Cervical Cancer ◽  
Grade 3

ObjectivesThe objective of this study was to determine the maximum tolerated dose (MTD) and acute dose-limiting toxicities (DLTs) of intravenous carboplatin plus paclitaxel combined with intensity-modulated pelvic radiotherapy (pelvic IMRT) as an adjuvant treatment for early-stage cervical cancer patients with positive pelvic lymph nodes.MethodsWomen with uterine cervical cancer who were treated with radical hysterectomy and pelvic lymphadenectomy and displayed positive pelvic lymph nodes were eligible for this study. The patients were postoperatively treated with pelvic IMRT (50.4 Gy). The concurrent weekly chemotherapy consisted of carboplatin (area under the curve [AUC], 2) and paclitaxel (starting at 35 mg/m2and escalating by 5 mg/m2in 3 patient cohorts). The primary end point of the escalation study was acute DLT that occurred within 30 days of the completion of radiation therapy.ResultsNine patients were enrolled and treated at 2 dose levels until DLT occurred. The median age of the patients was 47 years (range, 28–66 years). The median radiotherapy treatment time was 39.5 days (range, 38–64 days). At dose level I (35 mg/m2paclitaxel), 2 grade 3 leukopenia and a neutropenia were observed, but no DLT occurred. At dose level II (40 mg/m2paclitaxel), the first patient experienced a grade 2 hypersensitive reaction, which resulted in discontinuation of planned treatment. Thus, 2 more patients were evaluated at this dose level. Of these, 1 patient experienced febrile neutropenia, which was considered to be a DLT, and the other patient experienced long-lasting grade 3 leukopenia and grade 3 neutropenia, which resulted in the discontinuation of chemotherapy for 2 weeks (a DLT). We then evaluated 3 more patients at dose level 1, but no DLT occurred. The MTD of paclitaxel and carboplatin was thus defined as 35 mg/m2and an AUC of 2.0, respectively.ConclusionsWeekly paclitaxel/carboplatin and pelvic IMRT is a reasonable adjuvant treatment regimen for cervical cancer patients after radical hysterectomy. The MTD of paclitaxel and carboplatin for future phase II trials of this regimen is 35 mg/m2and an AUC of 2.0, respectively.

Sign in / Sign up

Export Citation Format

Share Document