scholarly journals Early toxicity and treatment outcomes of extended field-intensity modulated radiotherapy for cervical cancer patients with para-aortic nodal metastasis

2019 ◽  
Vol 13 ◽  
Author(s):  
Meetakshi Gupta
Keyword(s):  
Cervical Cancer ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Field Intensity ◽  
Intensity Modulated Radiotherapy ◽  
Nodal Metastasis ◽  
Intensity Modulated ◽  
Extended Field ◽  
Early Toxicity

scholarly journals Extended field intensity-modulated radiotherapy plus concurrent nedaplatin treatment in cervical cancer

2016 ◽  
Vol 11 (5) ◽  
pp. 3421-3427 ◽  
Author(s):  
YUNQIN LIU ◽  
JINMING YU ◽  
LITING QIAN ◽  
HONGYAN ZHANG ◽  
JUN MA
Keyword(s):  
Cervical Cancer ◽  
Field Intensity ◽  
Intensity Modulated Radiotherapy ◽  
Intensity Modulated ◽  
Extended Field

Extended-Field Intensity-Modulated Radiotherapy and Concurrent Cisplatin-Based Chemotherapy for Postoperative Cervical Cancer With Common Iliac or Para-Aortic Lymph Node Metastases: A Retrospective Review in a Single Institution

2012 ◽  
Vol 22 (7) ◽  
pp. 1220-1225 ◽  
Author(s):  
Guangyu Zhang ◽  
Chunli Fu ◽  
Youzhong Zhang ◽  
Jianbo Wang ◽  
Naian Qiao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Field Intensity ◽  
Intensity Modulated Radiotherapy ◽  
Endocrine Function ◽  
Ovarian Transposition ◽  
Intensity Modulated ◽  
Extended Field ◽  
Grade 3

ObjectiveRetrospectively, to assess the toxicity of delivering postoperative extended-field intensity-modulated radiotherapy (EF-IMRT) and concurrent cisplatin chemotherapy for patients with cervical cancer with a pathologically confirmed positive common iliac node and/or a para-aortic node.MethodsEach patient received postoperative EF-IMRT and concurrent cisplatin chemotherapy. The clinical target volume included regional lymph node regions (obturator; common, internal, and external iliac nodal regions; presacral region; and para-aortic regions) and the upper 2.0 cm of the vagina and paravaginal soft tissue lateral to the vagina. The acute and late toxicity were scored using the Common Terminology Criteria for Adverse Events (CTCAE) and the Radiation Therapy Oncology Group late radiation morbidity scoring criteria, respectively.ResultsFifty-eight patients were treated with postoperative EF-IMRT and concurrent cisplatin chemotherapy. The median follow-up was 34 months. Eighteen patients (31%) had recurrence. The region of recurrence was in-field in 2 patients (3.4%) and out-field in 16 patients (27.6%). Acute grade 3 or higher gastrointestinal, genitourinary, and hematologic toxicity occurred in 2, 1, and 11patients, respectively. Three patients (5.1%) had late grade 3 toxicities. Thirteen patients experienced ovarian transposition; of these, 10 patients (77%) maintained ovarian function. Forty-one patients (71%) were alive at the last follow-up.ConclusionsConcurrent cisplatin chemotherapy with postoperative EF-IMRT was safe and well tolerated. The acute and late toxicities are acceptable. The locoregional control rates are hopeful, although distant metastases continue to be the primary mode of failure. Postoperative EF-IMRT provides an opportunity to preserve endocrine function for patients with ovarian transposition.

Low-Dose, Prophylactic, Extended-Field, Intensity-Modulated Radiotherapy Plus Concurrent Weekly Cisplatin for Patients With Stage IB2-IIIB Cervical Cancer, Positive Pelvic Lymph Nodes, and Negative Para-aortic Lymph Nodes

2014 ◽  
Vol 24 (5) ◽  
pp. 901-907 ◽  
Author(s):  
Ji-An Liang ◽  
Shang-Wen Chen ◽  
Yao-Ching Hung ◽  
Lian-Shung Yeh ◽  
Wei-Chun Chang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Field Intensity ◽  
Low Dose ◽  
Intensity Modulated Radiotherapy ◽  
Free Survival ◽  
Intensity Modulated ◽  
Extended Field ◽  
Grade 3 ◽  
Weekly Cisplatin

ObjectiveThe objective of this study was to assess prospectively the clinical outcomes of low-dose prophylactic extended-field, intensity-modulated radiotherapy (IMRT) plus concurrent weekly cisplatin for patients with stage IB2-IIIB cervical cancer, positive pelvic lymph nodes (PLNs), and negative para-aortic lymph nodes (PALNs).MethodsThirty-two patients with stage IB2-IIIB cervical cancer with positive PLN and negative PALN were included prospectively. All lymph nodes were assessed with positron emission tomography. The PALN field, including lymphatics from the superior border of L1 to the L4-L5 interphase, was irradiated concurrently with pelvic IMRT with a prescribed dose of 40 Gy in 25 fractions. Chemotherapy consisted of cisplatin delivered weekly at a dose of 40 mg/m2. Using historical controls treated with pelvic radiotherapy, the survival curves were compared to assess the difference between the 2 treatment periods.ResultsThirty-one patients completed the allocated extended-field IMRT, and all finished the planned pelvic IMRT and brachytherapy. Acute ≥ grade 3 gastrointestinal, genitourinary, and hematologic toxicities were seen in 2, 1, and 18 patients, respectively. During a median follow-up of 33 months, 5 patients developed out-field distant recurrences. One patient had a late grade 3 gastrointestinal complication, and 1 patient had genitourinary toxicity. The 3-year actuarial overall survival, disease-free survival, and distant metastasis–free survival for the study cohort and historic controls were 87% versus 62% (P = 0.02), 82% versus 54% (P = 0.02), and 79% versus 57% (P = 0.01), respectively.ConclusionsExtended-field IMRT of 40 Gy to the PALN plus concurrent cisplatin can effectively eradicate subclinical disease at the PALN and improve the outcome for patients with PLN-positive stage IB2-IIIB cervical cancer.

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