Is extended-field concurrent chemoradiation an option for radiologic negative paraaortic lymph node, locally advanced cervical cancer?

Asiri, Mushabbab Al; Tunio, Mutahir A.; Mohamed, Reham; Bayoumi, Yasser; Alhadab, Abdulrehman; Saleh, Rasha M; AlArifi, Muhannad Saud; Alobaid, Abdelaziz

Is extended-field concurrent chemoradiation an option for radiologic negative paraaortic lymph node, locally advanced cervical cancer?

Files

cmar-6-339.pdf (1.91 MB)

Authors

Asiri, Mushabbab Al

Tunio, Mutahir A.

Mohamed, Reham

Bayoumi, Yasser

Alhadab, Abdulrehman

Saleh, Rasha M

AlArifi, Muhannad Saud

Alobaid, Abdelaziz

Issue Date

2014-09-09

Type

Article

Language

en_US

Keywords

Prophylactic Extended Field Radiation Therapy , Concurrent Chemotherapy

Abstract

Background: The aim was to evaluate whether extended-field concurrent chemoradiation (EF-CCRT) leads to results better than those obtained by standard whole-pelvis concurrent chemoradiation (WP-CCRT) in locally advanced cervical cancer with radiologic negative paraaortic lymph nodes (PALNs). Patients and methods: A total of 102 patients with histopathologically proven squamous cell carcinoma, adenocarcinoma, or adenosquamous cell carcinoma, and radiologic negative PALN locally advanced cervical cancer, stage IIB-IVA, were accrued between July 2007 and April 2008 and were randomly assigned to WP-CCRT (50 patients) or EF-CCRT (52 patients), followed by high-dose rate brachytherapy. Data regarding the safety profile, response rates, and occurrence of local, PALN, or distant failure were recorded. Results: During a median follow-up time of 60 months (18–66), 74/102 patients completed the treatment protocol and were analyzed. Overall PALN, distant-metastasis control, disease-free survival, and overall survival rates were 97.1%, 86.9%, 80.3%, and 72.4% in EF-CCRT respectively in comparison with WP-CCRT (82.1%,74.7%, 69.1%, and 60.4%), with P-values of 0.02, 0.03, 0.03 and 0.04 respectively. No difference in acute toxicity profile was seen between the groups, and late toxicities were mild and minimal. Conclusion: Prophylactic EF-CCRT can be a reasonable option in patients with locally advanced cervical cancer with radiologic positive pelvic lymph nodes and radiologic negative PALN.

Citation

Asiri, M. A., Tunio, M. A., Mohamed, R., Bayoumi, Y., Alhadab, A., Saleh, R. M., AlArifi, M. S., & Alobaid, A. (2014). Is extended-field concurrent chemoradiation an option for radiologic negative paraaortic lymph node, locally advanced cervical cancer?. Cancer management and research, 6, 339–348. https://doi.org/10.2147/CMAR.S68262

Publisher

Cancer Management and Research