J Gynecol Oncol.  2009 Dec;20(4):227-231. 10.3802/jgo.2009.20.4.227.

Treatment outcomes and prognostic factors in uterine cervical cancer patients treated with postoperative extended field radiation therapy

• Kim HJ
• Ha SW
• Wu HG

• KMID: 2288587
• DOI: http://doi.org/10.3802/jgo.2009.20.4.227

Abstract

OBJECTIVE
To evaluate treatment outcomes and prognostic factors in uterine cervical cancer patients treated with postoperative extended field radiation therapy (POEFRT) with or without chemotherapy.
METHODS
Between 1983 and 2006, 35 patients with a pathologically confirmed positive para-aortic node (PAN) or common iliac node (CIN) who underwent a radical hysterectomy with bilateral pelvic lymph node dissection and PAN dissection received POEFRT with (N=23) or without (N=12) chemotherapy. Prognostic factors such as age, stage, size, parametrium invasion, lymphovascular space invasion, nodal station, depth of stromal invasion and use of chemotherapy were analyzed.
RESULTS
With a median follow-up of 44 months, the 5-year overall survival (OS), disease-free survival (DFS), distant failure-free survival (DFFS) and loco-regional failure-free survival rates were 51%, 51%, 59% and 93%, respectively. The use of chemotherapy significantly improved the 5-year OS rate (61% vs. 48%, p=0.004), the 5-year DFS rate (54% vs. 38%, p=0.004) and the 5-year DFFS rate (57% vs. 48%, p=0.009). PAN involvement resulted in a compromised 5-year DFS rate (42% vs. 73%, p=0.002) and 5-year DFFS rate (47% vs. 82%, p=0.004) as compared to CIN involvement. Grade 3 or higher hematological toxicity was observed more frequently in patients who received POEFRT combined with chemotherapy as compared to patients who received POEFRT alone (52% vs. 17%, p=0.04).
CONCLUSION
The use of POEFRT resulted in an excellent loco-regional control rate. The addition of chemotherapy may improve outcome in patients who have received POEFRT, but with higher manageable toxicity.

Keyword

Cervix cancer; Postoperative extended field radiotherapy; Chemotherapy

MeSH Terms

Disease-Free Survival
Follow-Up Studies
Humans
Hysterectomy
Lymph Node Excision
Survival Rate
Uterine Cervical Neoplasms

Figure

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  Fig. 1 Overall survival (OS) and disease-free survival (DFS) for 35 patients analyzed in this study.

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