Izvorni znanstveni članak
Intensity-modulated Radiation Therapy Versus Para-aortic Field Radiotherapy to Treat Para-aortic Lymph Node Metastasis in Cervical Cancer: Prospective Study
Xue-lian Du
; Department of Gynecologic Oncology, Shandong Tumor Hospital and Institute, Jinan, People’s Republic of China
Xiu-gui Sheng
; Department of Gynecologic Oncology, Shandong Tumor Hospital and Institute, Jinan, People’s Republic of China
Tao Jiang
; Department of Gynecologic Oncology, Shandong Tumor Hospital and Institute, Jinan, People’s Republic of China
Hao Yu
; Department of Gynecologic Oncology, Shandong Tumor Hospital and Institute, Jinan, People’s Republic of China
Yu-feng Yan
; Department of Gynecologic Oncology, Shandong Tumor Hospital and Institute, Jinan, People’s Republic of China
Rong Gao
; Department of Gynecologic Oncology, Shandong Tumor Hospital and Institute, Jinan, People’s Republic of China
Chun-hua Lu
; Department of Gynecologic Oncology, Shandong Tumor Hospital and Institute, Jinan, People’s Republic of China
Qing-shui Li
; Department of Gynecologic Oncology, Shandong Tumor Hospital and Institute, Jinan, People’s Republic of China
Sažetak
Aim To compare dosimetry, efficacy, and toxicity of intensity-
modulated radiation therapy (IMRT) with para-aortic
field radiotherapy in patients with para-aortic lymph node
(PALN) metastasis of cervical cancer.
Methods This prospective study examined 60 patients
with cervical cancer with PALN metastasis who underwent
whole-pelvis radiotherapy followed by brachytherapy between
November 1, 2004 and May 31, 2008. After 3 cycles
of chemotherapy, patients were serially allocated into two
groups and treated with IMRT or para-aortic field RT at
doses of 58-68 Gy and 45-50 Gy, respectively. Treatment
response was evaluated and toxicities were assessed. Patients
in the IMRT group were treated with both para-aortic
field RT and IMRT in order to compare the exposure dose
of organs at risk.
Results In the IMRT group, the mean dose delivered to the
planning target volume was 67.5 Gy. At least 99% of the
gross tumor volume received effective coverage and radical
dose (median, 63.5 Gy; range, 54.5-66) during treatment.
IMRT plans yielded better dose conformity to the target
and better sparing of the spinal cord and small intestine
than para-aortic field RT. The IMRT patients experienced
less acute and chronic toxicities. The IMRT group also had
higher 2- and 3-year survival rates than the para-aortic RT
group (2-year, 58.8% vs 25.0%, P = 0.019; 3-year, 36.4% vs
15.6%, P = 0.016). However, no significant difference was
found in 1-year survival (67.7% vs 51.3%, P =0.201). The median
survival in the IMRT group was 25 months (range, 3 to
37 months). The actuarial overall survival, disease-free survival,
and locoregional control rates at 2 years were 67%,
77%, and 88%, respectively, in the IMRT group.
Conclusions IMRT provides better clinical outcomes than
para-aortic field radiotherapy in patients with PALN metastasis.
However, cervical local and distal recurrence remain a
problem. Long-term follow-up and studies involving more
patients are needed to confirm our results.
Ključne riječi
endometrial cancer; heat shock protein; radiosensitivity; invasiveness
Hrčak ID:
55659
URI
Datum izdavanja:
15.6.2010.
Posjeta: 1.179 *