IMRT with 18FDG-PET\CT based simultaneous integrated boost for treatment of nodal positive cervical cancer

Cihoric, Nikola; Tapia, Coya; Krüger, Kamilla; Aebersold, Daniel M.; Klaeser, Bernd; Lössl, Kristina

IMRT with 18FDG-PET\CT based simultaneous integrated boost for treatment of nodal positive cervical cancer

Files

1748-717X-9-83.pdf (1.88 MB)

Authors

Cihoric, Nikola

Tapia, Coya

Krüger, Kamilla

Aebersold, Daniel M.

Klaeser, Bernd

Lössl, Kristina

Issue Date

2014-03-25

Type

Article

Language

en_US

Keywords

Cervical Cancer , Loco-Regional Lymph Nodes , Intensity Modulated Radiotherapy , Simultaneous Integrated Boost

Abstract

Background: To evaluate toxicity and outcome of intensity modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) to the positive lymph nodes in patients with loco-regional advanced cervical cancer (LRACC). Methods: The study population comprised ten patients with 18FDG-PET\CT positive lymph nodes (LNs), who underwent chemoradiation with IMRT and SIB. A dose of 50.4 Gy, in daily fractions of 1.8 Gy, was delivered to primary tumor and draining LNs. Primary tumor received an additional external beam boost to a total dose of 55.8 Gy. A SIB of 62 Gy, in daily fractions of 2 Gy, was delivered to the 18FDG-PET\CT positive LNs. Finally, a high dose rate brachytherapy (HDRB) boost (15 – 18 Gy) was administered to the primary tumor. The primary goal of this study was to evaluate acute and early late toxicity and loco-regional control. Results: The median number of irradiated LNs per patient was 3 (range: 1–6) with a median middle nodal SIB-volume of 26.10 cm3 (range, 11.9-82.50 cm3). Median follow-up was 20 months (range, 12 to 30 months). Acute and late grade 3 toxicity was observed in 1 patient. Three of the patients developed a recurrence, one in the form of a local tumor relapse, one had a paraaortic LN metastasis outside the treated volume and the last one developed a distant metastasis. Conclusion: IMRT with SIB in the region of 18FDG-PET positive lymph nodes appears to be an effective therapy with acceptable toxicity and might be useful in the treatment of patients with locally advanced cervical cancer.

Citation

Cihoric, N., Tapia, C., Krüger, K., Aebersold, D. M., Klaeser, B., & Lössl, K. (2014). IMRT with ¹⁸FDG-PET\CT based simultaneous integrated boost for treatment of nodal positive cervical cancer. Radiation oncology (London, England), 9, 83. https://doi.org/10.1186/1748-717X-9-83

Publisher

Radiation Oncology (London, England)