scholarly journals Salvage Lymphadenectomy and Definitive Radiotherapy for Recurrent Lymph Node Metastasis 7 Years after Definitive Chemoradiotherapy—Report of a Case—

2015 ◽  
Vol 76 (10) ◽  
pp. 2427-2432
Author(s):  
Kazushi MIYATA ◽  
Kazuhisa SHIRAI ◽  
Eiji NISHIGAKI ◽  
Mihoko YAMADA
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Definitive Chemoradiotherapy ◽  
Definitive Radiotherapy ◽  
Node Metastasis ◽  
Salvage Lymphadenectomy

Prognostic Use of Pretreatment Hematologic Parameters in Patients Receiving Definitive Chemoradiotherapy for Cervical Cancer

2016 ◽  
Vol 26 (6) ◽  
pp. 1169-1175 ◽  
Author(s):  
Cem Onal ◽  
Ozan C. Guler ◽  
Berna A. Yildirim
Keyword(s):  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Univariate Analysis ◽  
Definitive Chemoradiotherapy ◽  
Lymphocyte Ratio ◽  
Node Metastasis ◽  
Cell Counts ◽  
Potential Biomarker

ObjectivesThe aim of this work was to evaluate the prognostic role of pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in recipients of definitive chemoradiotherapy (ChRT) for cervical cancer.MethodsIn 235 patients given definitive ChRT for histologically confirmed cervical cancer, clinical data and pretreatment complete blood cell counts were analyzed. Prognostic and therapeutic ramifications of NLR and PLR were assessed.ResultsMedian pretreatment NLR and PLR were 3.03 (range, 1.04–13.03) and 133.02 (range, 36.3–518.16), respectively. Both NLR and PLR correlated significantly with tumor size, lymph node metastasis, and treatment response. In addition to NLR and PLR, tumor stage, size, and nodal metastasis were identified by univariate analysis as significant predictors of overall survival (OS) and progression-free survival (PFS). By multivariate analysis, independent predictors of OS and PFS were NLR (OS: hazard ratio [HR], 3.322; 95% confidence interval [CI], 1.905–5.790; PFS: HR, 3.579; 95% CI, 2.106–6.082; both P < 0.001) and lymph node metastasis (OS: HR, 2.620; 95% CI, 1.706–4.023; PFS: HR, 2.989; 95% CI, 1.918–4.378; both P < 0.001), although patients’ age (HR, 1.019; 95% CI, 1.003–1.035; P = 0.02) was also significantly predictive of OS.ConclusionsPretreatment NLR and PLR were associated with larger tumors, lymph node metastasis, and poorer therapeutic responses to definitive ChRT. By multivariate analysis, pretreatment NLR and lymph node metastasis were found independently predictive of OS and PFS, whereas patients’ age was significantly predictive of OS only. In patients with advanced cervical cancer, NLR is a potential biomarker, serving to guide systemic therapy and predict treatment outcomes.

scholarly journals Results of definitive radiotherapy with concurrent chemotherapy for maxillary sinus carcinomas with neck lymph node metastasis

2020 ◽  
Vol 62 (1) ◽  
pp. 104-109
Author(s):  
Takanori Abe ◽  
Satoshi Saito ◽  
Misaki Iino ◽  
Tomomi Aoshika ◽  
Yasuhiro Ryuno ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Maxillary Sinus ◽  
Systemic Chemotherapy ◽  
Concurrent Chemotherapy ◽  
Neck Lymph Node ◽  
Definitive Radiotherapy ◽  
Node Metastasis ◽  
Neck Lymph Node Metastasis ◽  
Grade 3

Abstract The purpose of this study was to describe the results of definitive radiotherapy (RT) with concurrent chemotherapy for maxillary sinus carcinomas (MSCs) with neck lymph node metastasis to clarify its limitation. Local control (LC), progression-free survival (PFS) and overall survival (OS) rates were calculated using the Kaplan–Meier method and were compared between subgroups using the log rank test. Toxicity was classified using common terminology criteria of adverse events version 5.0. Eighteen patients with inoperable MSC with neck lymph node metastasis including 12 men and 6 women with a median age of 67 years were analyzed. The histologic diagnoses were as follows: 16 patients had squamous cell carcinomas and 2 had other histology. Four patients had stage T3 MSC, 6 had T4a and 8 had T4b. Among 18 patients, 7 received concurrent systemic chemotherapy and 11 received selective arterial chemo-infusion. The median follow-up period was 17 months. The 2-year LC, PFS and OS rates for the entire cohort were 34, 31 and 46%, respectively. No significant differences were observed for LC, PFS and OS rates between systemic chemotherapy and selective arterial chemo-infusion cohorts. Grade 3 or higher acute toxicity, including both non-hematological and hematological, was observed in nine patients (50%), while no grade 3 or higher late toxicity was observed. In conclusion, we described the results of definitive RT for MSCs with neck lymph node metastasis. Local recurrence of primary tumor was a frequent pattern of failure and it should be addressed in future study.

scholarly journals Neck Dissection for Advanced Lymph Node Metastasis Before Definitive Radiotherapy for Primary Carcinoma of the Head and Neck

2000 ◽  
Vol 110 (7) ◽  
pp. 1210-1214 ◽  
Author(s):  
Ludwig E. Smeele ◽  
Charles R. Leemans ◽  
Colin B.A. Reid ◽  
Rammohan Tiwari ◽  
Gordon B. Snow
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Head And Neck ◽  
Neck Dissection ◽  
Primary Carcinoma ◽  
Definitive Radiotherapy ◽  
Node Metastasis

Predicting tumor recurrence in patients with cervical carcinoma treated with definitive chemoradiotherapy: value of quantitative histogram analysis on diffusion-weighted MR images

2016 ◽  
Vol 58 (4) ◽  
pp. 481-488 ◽  
Author(s):  
Gurcan Erbay ◽  
Cem Onal ◽  
Elif Karadeli ◽  
Ozan C Guler ◽  
Sami Arica ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Tumor Recurrence ◽  
Disease Recurrence ◽  
Definitive Chemoradiotherapy ◽  
Node Metastasis ◽  
The Mean

Background Further research is required for evaluating the use of ADC histogram analysis in more advanced stages of cervical cancer treated with definitive chemoradiotherapy (CRT). Purpose To investigate the utility of apparent diffusion coefficient (ADC) histogram derived from diffusion-weighted magnetic resonance images in cervical cancer patients treated with definitive CRT. Material and Methods The clinical and radiological data of 50 patients with histologically proven cervical squamous cell carcinoma treated with definitive CRT were retrospectively analyzed. The impact of clinicopathological factors and ADC histogram parameters on prognostic factors and treatment outcomes was assessed. Results The mean and median ADC values for the cohort were 1.043 ± 0.135 × 10−3 mm2/s and 1.018 × 10−3 mm2/s (range, 0.787–1.443 × 10−3 mm2/s). The mean ADC was significantly lower for patients with advanced stage (≥IIB) or lymph node metastasis compared with patients with stage <IIB or no lymph node metastasis. The mean ADC, 75th percentile ADC (ADC75), 90th percentile ADC (ADC90), and 95th percentile ADC (ADC95) were significantly lower in patients with tumor recurrence compared with patients without recurrence. In multivariate analysis, tumor size, ADC75 and ADC95 were independent prognostic factors for both overall survival and disease-free survival. Conclusion ADC histogram parameters could be markers for disease recurrence and for predicting survival outcomes. ADC75, ADC90, and ADC95 of the primary tumor were significant predictors of disease recurrence in cervical cancer patients treated with definitive CRT.

The Utility of Pretreatment and Posttreatment Lymphopenia in Cervical Squamous Cell Carcinoma Patients Treated With Definitive Chemoradiotherapy

2018 ◽  
Vol 28 (8) ◽  
pp. 1553-1559 ◽  
Author(s):  
Cem Onal ◽  
Berna Akkus Yildirim ◽  
Ozan Cem Guler ◽  
Huseyin Mertsoylu
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Treatment Response ◽  
Squamous Cell ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Definitive Chemoradiotherapy ◽  
Node Metastasis

ObjectiveThe aim of this study was to investigate the prognostic significance of pretreatment and posttreatment lymphopenia in locally advanced squamous cell carcinoma (SCC) cervical cancer patients treated with definitive chemoradiotherapy (ChRT).MethodsData from 95 patients with SCC were retrospectively analyzed. Relationships between pretreatment or posttreatment lymphopenia and patient or tumor characteristics, and overall survival (OS) and disease-free survival (DFS) were evaluated.ResultsMedian follow-ups for the entire cohort and survivors were 68 months (range, 3–133 months) and 88 months (range, 22–133 months), respectively. Ten patients (11%) exhibited pretreatment lymphopenia, whereas 58 patients (61%) exhibited posttreatment lymphopenia. Median pretreatment total lymphocyte counts decreased from 2029 cells/μL to 506 cells/μL 2 months after ChRT (P< 0.001). The 5-year OS and DFS rates were significantly higher in patients without pretreatment lymphopenia compared with patients with pre-retreatment lymphopenia (61% vs 20% [P< 0.001], 55% vs 20% [P< 0.001]). Patients without posttreatment lymphopenia had significantly higher 5-year OS and DFS rates than their counterparts (70% vs 46% [P= 0.02], 70% vs 39% [P= 0.004]). Complete response (CR) was observed in significantly fewer patients with pretreatment lymphopenia than in those without, after ChRT. Patients with posttreatment lymphopenia had higher rates of lymph node metastasis (P= 0.001) and lower posttreatment CR rates (P= 0.01) versus patients without posttreatment lymphopenia. In univariate analysis, International Federation of Gynecology and Obstetrics stage, tumor size, lymph node metastasis, and treatment response were prognostic for OS and DFS. In multivariate analysis, pretreatment lymphopenia, lymph node metastasis, and treatment response were independent predictors of OS and DFS. Age was predictive of OS. Tumor size was prognostic for DFS.ConclusionsPretreatment lymphopenia and posttreatment lymphopenia are associated with worse treatment response in patients given ChRT for cervical SCC. Pretreatment lymphopenia is predictive for OS and DFS. Therapeutic strategies including pretreatment or posttreatment immune preservation or modulation may improve response rates and survival in women with cervical SCC.

Sign in / Sign up

Export Citation Format

Share Document