Is Prophylactic Irradiation to Para-aortic Lymph Nodes in Locally Advanced Cervical Cancer Necessary?
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PurposeThis study evaluated the efficacy of extended field irradiation (EFI) in patients with locallyadvanced cervical cancer without para-aortic nodal involvement. Materials and MethodsA total of 203 patients with locally advanced cervical cancer (International Federation ofGynecology and Obstetrics [FIGO] stage, IB2-IIIB) treated with radiotherapy at KeimyungUniversity Dongsan Medical Center from 1996 to 2010 were retrospectively analyzed. Themedian patient age was 59 years (range, 29 to 83 years). None of the patients hadpara-aortic node metastases. Of the 203 patients, 88 underwent EFI and 115 underwentirradiation of the pelvis only. Concurrent chemoradiotherapy (CCRT) was administered to133 patients. EFI field was used for treatment of 26 patients who received radiotherapyalone and 62 who received CCRT. ResultsThe median follow-up period was 60 months. The 2- and 5-year overall survival (OS) rateswere 87.8% and 73.5%, respectively, and the 2- and 5-year disease-free survival rates were81.7% and 75.0%, respectively, however, no survival differences were observed betweenthe two treatment field groups. EFI tended to increase OS in the radiotherapy alone group,but not in the CCRT group. ConclusionThese findings suggest that EFI does not have a significant effect in patients with locallyadvanced cervical cancer, especially in patients receiving CCRT. Conduct of additionalstudies will be required in order to confirm these findings.
Abstract
PurposeThis study evaluated the efficacy of extended field irradiation (EFI) in patients with locallyadvanced cervical cancer without para-aortic nodal involvement. Materials and MethodsA total of 203 patients with locally advanced cervical cancer (International Federation ofGynecology and Obstetrics [FIGO] stage, IB2-IIIB) treated with radiotherapy at KeimyungUniversity Dongsan Medical Center from 1996 to 2010 were retrospectively analyzed. Themedian patient age was 59 years (range, 29 to 83 years). None of the patients hadpara-aortic node metastases. Of the 203 patients, 88 underwent EFI and 115 underwentirradiation of the pelvis only. Concurrent chemoradiotherapy (CCRT) was administered to133 patients. EFI field was used for treatment of 26 patients who received radiotherapyalone and 62 who received CCRT. ResultsThe median follow-up period was 60 months. The 2- and 5-year overall survival (OS) rateswere 87.8% and 73.5%, respectively, and the 2- and 5-year disease-free survival rates were81.7% and 75.0%, respectively, however, no survival differences were observed betweenthe two treatment field groups. EFI tended to increase OS in the radiotherapy alone group,but not in the CCRT group. ConclusionThese findings suggest that EFI does not have a significant effect in patients with locallyadvanced cervical cancer, especially in patients receiving CCRT. Conduct of additionalstudies will be required in order to confirm these findings.
참고문헌 (25)
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