Prognostic factors associated with radiotherapy for cervical cancer with computed tomography-detected para-aortic lymph node metastasis
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Authors
Wu, Szu-Yuan
Huang, Eng-Yen
Chanchien, Chan-Chao
Lin, Hao
Wang, Chong-Jong
Sun, Li-Min
Chen, Hui-Chun
Fang, Fu-Min
Hsu, Hsuan-Chih
Huang, Yu-Jie
Issue Date
2013-06-27
Type
Article
Language
en_US
Keywords
Para-Aortic Lymph Node , Cervical Cancer , Extended-Field , Prognostic Factors , Concurrent Chemoradiotherapy
Alternative Title
Abstract
Patients with cervical cancer diagnosed with a para-aortic lymph node (PALN) metastasis by computed tomography (CT) scan were analyzed to identify associated prognostic factors. A total of 55 patients were reviewed, and 27 of these patients underwent extended-field radiotherapy (EFRT). The median PALN dose in patients receiving EFRT was 45 Gy (range, 27–57.6 Gy). Of the 55 patients, 28 underwent pelvic radiotherapy (RT); concurrent chemoradiotherapy (CCRT) was administered to 41 patients. The Kaplan–Meier method was used to calculate the actuarial rate. Multivariate analysis was performed using the Cox proportional hazards model. Five-year overall survival (OS) rates were 41% and 17.9% in patients undergoing EFRT and pelvic RT (P = 0.030), respectively. Age < 53 years (P = 0.023), FIGO Stage I–II (P = 0.002), and treatment with EFRT (P = 0.003) were independent predictors of better OS. The use of CCRT (P = 0.014), Stage I–II (P = 0.002), and treatment using EFRT (P = 0.036) were independent predictors of distant metastasis. In patients undergoing EFRT plus CCRT, the 5-year OS was 50%. Three-year PALN disease-free rates were 8.8%, 57.9% and 100% (P < 0.001) in CCRT patients who received PALN doses of 0 Gy, ≤45 Gy and ≥50.4 Gy, respectively. Although PALN metastasis is thought to be distant metastasis in cervical cancer, EFRT plus CCRT shows a good outcome, particularly in younger patients in an early FIGO stage. Cervical cancer with a PALN metastasis should not be considered incurable. Doses ≥50.4 Gy for treating PALN may result in better disease control.
Description
Citation
Wu, S. Y., Huang, E. Y., Chanchien, C. C., Lin, H., Wang, C. J., Sun, L. M., Chen, H. C., Fang, F. M., Hsu, H. C., & Huang, Y. J. (2014). Prognostic factors associated with radiotherapy for cervical cancer with computed tomography-detected para-aortic lymph node metastasis. Journal of radiation research, 55(1), 129–138. https://doi.org/10.1093/jrr/rrt086
Publisher
Journal of Radiation Research
Journal
Volume
Issue
PubMed ID
DOI
ISSN
DOI: 10.1093/jrr/rrt086