Salvage radiotherapy for lymph node recurrence after radical surgery in cervical cancer
Identifieur interne : 003F01 ( Main/Exploration ); précédent : 003F00; suivant : 003F02Salvage radiotherapy for lymph node recurrence after radical surgery in cervical cancer
Auteurs : Wan Jeon [Corée du Sud] ; Hyeon Kang Koh [Corée du Sud] ; Hak Jae Kim [Corée du Sud] ; Hong-Gyun Wu [Corée du Sud] ; Jin Ho Kim [Corée du Sud] ; Hyun Hoon Chung [Corée du Sud]Source :
- Journal of Gynecologic Oncology [ 2005-0380 ] ; 2012.
Abstract
This study was to evaluate the treatment outcomes and prognostic factors of patients treated with salvage radiotherapy for the treatment of isolated lymph node recurrence of cervical cancer.
Between 1990 and 2009, 22 cervical cancer patients with lymph node recurrence who had previously undergone radical hysterectomy and pelvic lymph node dissection were treated with salvage radiotherapy with (n=18) or without (n=4) chemotherapy. Of the 22 patients, 10 had supraclavicular lymph node recurrence, 9 had para-aortic lymph node, and 3 had inguinal lymph node. The median total radiotherapy dose was 60 Gy (range, 40 to 70 Gy). Initial pathologic findings, latent period to lymph node recurrence and other clinical parameters such as squamous cell carcinoma antigen (SCC-Ag) level and concurrent chemotherapy were identified as prognostic factors for survival.
The median follow-up period after salvage radiotherapy was 31.2 months (range, 12.1 to 148.9 months). The 5-year progression-free and overall survival rates of all patients were 32.7% and 30.7%, respectively. Concurrent chemoradiotherapy (p=0.009) and longer latent period to lymph node recurrence (>18 months vs. ≤18 months, p=0.019) were significant predictors of progression-free survival and SCC-Ag level at the time of recurrence (>8 ng/dL vs. ≤8 ng/dL, p=0.008) and longer latent period to lymph node recurrence (p=0.040) for overall survival. Treatment failure after salvage radiotherapy occurred in 14 (63.6%) for the 22 patients (in field, 2; out of field, 10; both in and out field, 2). Grade 3 acute skin (n=2) and hematologic toxicity (n=1) developed in 3 patients.
For isolated lymph node recurrence of cervical cancer, salvage radiotherapy with concurrent chemotherapy should be considered, especially in patients with a long-term progression-free period.
Url:
DOI: 10.3802/jgo.2012.23.3.168
PubMed: 22808359
PubMed Central: 3395012
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>This study was to evaluate the treatment outcomes and prognostic factors of patients treated with salvage radiotherapy for the treatment of isolated lymph node recurrence of cervical cancer.</p>
</sec>
<sec><title>Methods</title>
<p>Between 1990 and 2009, 22 cervical cancer patients with lymph node recurrence who had previously undergone radical hysterectomy and pelvic lymph node dissection were treated with salvage radiotherapy with (n=18) or without (n=4) chemotherapy. Of the 22 patients, 10 had supraclavicular lymph node recurrence, 9 had para-aortic lymph node, and 3 had inguinal lymph node. The median total radiotherapy dose was 60 Gy (range, 40 to 70 Gy). Initial pathologic findings, latent period to lymph node recurrence and other clinical parameters such as squamous cell carcinoma antigen (SCC-Ag) level and concurrent chemotherapy were identified as prognostic factors for survival.</p>
</sec>
<sec><title>Results</title>
<p>The median follow-up period after salvage radiotherapy was 31.2 months (range, 12.1 to 148.9 months). The 5-year progression-free and overall survival rates of all patients were 32.7% and 30.7%, respectively. Concurrent chemoradiotherapy (p=0.009) and longer latent period to lymph node recurrence (>18 months vs. ≤18 months, p=0.019) were significant predictors of progression-free survival and SCC-Ag level at the time of recurrence (>8 ng/dL vs. ≤8 ng/dL, p=0.008) and longer latent period to lymph node recurrence (p=0.040) for overall survival. Treatment failure after salvage radiotherapy occurred in 14 (63.6%) for the 22 patients (in field, 2; out of field, 10; both in and out field, 2). Grade 3 acute skin (n=2) and hematologic toxicity (n=1) developed in 3 patients.</p>
</sec>
<sec><title>Conclusion</title>
<p>For isolated lymph node recurrence of cervical cancer, salvage radiotherapy with concurrent chemotherapy should be considered, especially in patients with a long-term progression-free period.</p>
</sec>
</div>
</front>
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<author><name sortKey="Doering, Dl" uniqKey="Doering D">DL Doering</name>
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<author><name sortKey="Bosscher, Jr" uniqKey="Bosscher J">JR Bosscher</name>
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<author><name sortKey="Day, Tg" uniqKey="Day T">TG Day</name>
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<author><name sortKey="Rao, Cv" uniqKey="Rao C">CV Rao</name>
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<author><name sortKey="Baker, S" uniqKey="Baker S">S Baker</name>
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<author><name sortKey="Fournier, L" uniqKey="Fournier L">L Fournier</name>
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<author><name sortKey="Nelson, Be" uniqKey="Nelson B">BE Nelson</name>
</author>
<author><name sortKey="Hunter, Re" uniqKey="Hunter R">RE Hunter</name>
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</analytic>
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</author>
<author><name sortKey="Kim, Js" uniqKey="Kim J">JS Kim</name>
</author>
<author><name sortKey="Kim, Sy" uniqKey="Kim S">SY Kim</name>
</author>
<author><name sortKey="Kim, Kh" uniqKey="Kim K">KH Kim</name>
</author>
<author><name sortKey="Cho, Mj" uniqKey="Cho M">MJ Cho</name>
</author>
</analytic>
</biblStruct>
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</author>
<author><name sortKey="Wang, Cc" uniqKey="Wang C">CC Wang</name>
</author>
<author><name sortKey="Qiu, Jt" uniqKey="Qiu J">JT Qiu</name>
</author>
<author><name sortKey="Lai, Ch" uniqKey="Lai C">CH Lai</name>
</author>
<author><name sortKey="Hong, Jh" uniqKey="Hong J">JH Hong</name>
</author>
<author><name sortKey="Huang, Yt" uniqKey="Huang Y">YT Huang</name>
</author>
</analytic>
</biblStruct>
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</TEI>
<affiliations><list><country><li>Corée du Sud</li>
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<region><li>Région capitale de Séoul</li>
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<settlement><li>Séoul</li>
</settlement>
</list>
<tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Jeon, Wan" sort="Jeon, Wan" uniqKey="Jeon W" first="Wan" last="Jeon">Wan Jeon</name>
</region>
<name sortKey="Chung, Hyun Hoon" sort="Chung, Hyun Hoon" uniqKey="Chung H" first="Hyun Hoon" last="Chung">Hyun Hoon Chung</name>
<name sortKey="Chung, Hyun Hoon" sort="Chung, Hyun Hoon" uniqKey="Chung H" first="Hyun Hoon" last="Chung">Hyun Hoon Chung</name>
<name sortKey="Kim, Hak Jae" sort="Kim, Hak Jae" uniqKey="Kim H" first="Hak Jae" last="Kim">Hak Jae Kim</name>
<name sortKey="Kim, Jin Ho" sort="Kim, Jin Ho" uniqKey="Kim J" first="Jin Ho" last="Kim">Jin Ho Kim</name>
<name sortKey="Koh, Hyeon Kang" sort="Koh, Hyeon Kang" uniqKey="Koh H" first="Hyeon Kang" last="Koh">Hyeon Kang Koh</name>
<name sortKey="Wu, Hong Gyun" sort="Wu, Hong Gyun" uniqKey="Wu H" first="Hong-Gyun" last="Wu">Hong-Gyun Wu</name>
<name sortKey="Wu, Hong Gyun" sort="Wu, Hong Gyun" uniqKey="Wu H" first="Hong-Gyun" last="Wu">Hong-Gyun Wu</name>
<name sortKey="Wu, Hong Gyun" sort="Wu, Hong Gyun" uniqKey="Wu H" first="Hong-Gyun" last="Wu">Hong-Gyun Wu</name>
</country>
</tree>
</affiliations>
</record>
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