Cancer Res Treat.  2014 Oct;46(4):374-382. 10.4143/crt.2013.084.

Is Prophylactic Irradiation to Para-aortic Lymph Nodes in Locally Advanced Cervical Cancer Necessary?

• Park SG
• Kim JH
• Oh YK
• Byun SJ
• Kim MY
• Kwon SH
• Kim OB

• KMID: 2380375
• DOI: http://doi.org/10.4143/crt.2013.084

Abstract

PURPOSE
This study evaluated the efficacy of extended field irradiation (EFI) in patients with locally advanced cervical cancer without para-aortic nodal involvement.
MATERIALS AND METHODS
A total of 203 patients with locally advanced cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stage, IB2-IIIB) treated with radiotherapy at Keimyung University Dongsan Medical Center from 1996 to 2010 were retrospectively analyzed. The median patient age was 59 years (range, 29 to 83 years). None of the patients had para-aortic node metastases. Of the 203 patients, 88 underwent EFI and 115 underwent irradiation of the pelvis only. Concurrent chemoradiotherapy (CCRT) was administered to 133 patients. EFI field was used for treatment of 26 patients who received radiotherapy alone and 62 who received CCRT.
RESULTS
The median follow-up period was 60 months. The 2- and 5-year overall survival (OS) rates were 87.8% and 73.5%, respectively, and the 2- and 5-year disease-free survival rates were 81.7% and 75.0%, respectively, however, no survival differences were observed between the two treatment field groups. EFI tended to increase OS in the radiotherapy alone group, but not in the CCRT group.
CONCLUSION
These findings suggest that EFI does not have a significant effect in patients with locally advanced cervical cancer, especially in patients receiving CCRT. Conduct of additional studies will be required in order to confirm these findings.

Keyword

Uterine cervical neoplasms; Radiotherapy; Survival rate; Lymph nodes; Neoplasm metastasis

MeSH Terms

Chemoradiotherapy
Disease-Free Survival
Follow-Up Studies
Gynecology
Humans
Lymph Nodes*
Neoplasm Metastasis
Obstetrics
Pelvis
Radiotherapy
Retrospective Studies
Survival Rate
Uterine Cervical Neoplasms*

Figure

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  Fig. 1. Overall survival curves according to treatment field. EFI, extended field irradiation.

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  Fig. 2. Overall survival curves according to treatment field in patients treated with radiotherapy alone. EFI, extended field irradiation.

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  Fig. 3. Overall survival curves according to treatment field in patients treated with radiotherapy alone. EFI, extended field irradiation.

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  Fig. 4. Overall survival curves according to four different treatment modalities. EFI, extended field irradiation; CCRT, concurrent chemoradiotherapy.

Reference

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