Treatment outcomes of extended-field radiation therapy and the effect of concurrent chemotherapy on uterine cervical cancer with para-aortic lymph node metastasis

Hong In Yoon, Jihye Cha, Ki Chang Keum, Ha Yoon Lee, Eun Ji Nam, Sang Wun Kim, Sunghoon Kim, Young Tae Kim, Gwi Eon Kim, Yong Bae Kim

Research output: Contribution to journalArticle

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Abstract

Purpose: To review the clinical outcomes of extended-field radiation therapy (EFRT) and to analyze prognostic factors significant for survival in patients receiving EFRT for uterine cervical carcinoma with para-aortic node (PAN) metastasis. Patients and methods: We retrospectively reviewed 90 patients with stage IB-IVA cervical cancer and PAN metastasis between 1987 and 2012. Median age was 50 (range, 24-77). Patients received median 70.2 Gy (range, 56-93) to point A and median 50.4 Gy (range, 45-60.4) to PAN over median 69 elapsed days (range, 43-182). Forty-six patients (51.1%) received concurrent chemotherapy. Survival was calculated using the Kaplan-Meier method. We analyzed prognostic factors for overall actuarial survival (OS) and progression-free survival (PFS) using a Cox regression method. Results: The median follow-up period for surviving patients was 55 months (range, 3-252). Seventy patients (77.8%) had complete remission. Forty-six patients experienced treatment failure as follows: 11 patients (12.2%) as local recurrence, 19 (21%) as regional recurrence and 33 (36.7%) as distant metastasis. The 5-yr OS and PFS were 62.6% and 43.9%, respectively. Treatment response was the only statistically independent prognostic factors for OS (p= 0.04) and PFS (p< 0.001) on multivariate analysis. Grade 3 or 4 hematologic gastrointestinal and urogenital toxicities were observed in about 10% of patients. Conclusions: Our institutional experiences showed that EFRT was an effective treatment for cervical cancer patients with PAN metastasis. The addition of chemotherapy to EFRT seems to have uncertain survival benefit with higher hematologic toxicity.

Original languageEnglish
Article number18
JournalRadiation Oncology
Volume10
Issue number1
DOIs
Publication statusPublished - 2015 Jan 13

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Radiation Effects
Uterine Cervical Neoplasms
Radiotherapy
Lymph Nodes
Neoplasm Metastasis
Drug Therapy
Survival
Disease-Free Survival
Recurrence
Treatment Failure
Multivariate Analysis
Carcinoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Yoon, Hong In ; Cha, Jihye ; Keum, Ki Chang ; Lee, Ha Yoon ; Nam, Eun Ji ; Kim, Sang Wun ; Kim, Sunghoon ; Kim, Young Tae ; Kim, Gwi Eon ; Kim, Yong Bae. / Treatment outcomes of extended-field radiation therapy and the effect of concurrent chemotherapy on uterine cervical cancer with para-aortic lymph node metastasis. In: Radiation Oncology. 2015 ; Vol. 10, No. 1.
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title = "Treatment outcomes of extended-field radiation therapy and the effect of concurrent chemotherapy on uterine cervical cancer with para-aortic lymph node metastasis",
abstract = "Purpose: To review the clinical outcomes of extended-field radiation therapy (EFRT) and to analyze prognostic factors significant for survival in patients receiving EFRT for uterine cervical carcinoma with para-aortic node (PAN) metastasis. Patients and methods: We retrospectively reviewed 90 patients with stage IB-IVA cervical cancer and PAN metastasis between 1987 and 2012. Median age was 50 (range, 24-77). Patients received median 70.2 Gy (range, 56-93) to point A and median 50.4 Gy (range, 45-60.4) to PAN over median 69 elapsed days (range, 43-182). Forty-six patients (51.1{\%}) received concurrent chemotherapy. Survival was calculated using the Kaplan-Meier method. We analyzed prognostic factors for overall actuarial survival (OS) and progression-free survival (PFS) using a Cox regression method. Results: The median follow-up period for surviving patients was 55 months (range, 3-252). Seventy patients (77.8{\%}) had complete remission. Forty-six patients experienced treatment failure as follows: 11 patients (12.2{\%}) as local recurrence, 19 (21{\%}) as regional recurrence and 33 (36.7{\%}) as distant metastasis. The 5-yr OS and PFS were 62.6{\%} and 43.9{\%}, respectively. Treatment response was the only statistically independent prognostic factors for OS (p= 0.04) and PFS (p< 0.001) on multivariate analysis. Grade 3 or 4 hematologic gastrointestinal and urogenital toxicities were observed in about 10{\%} of patients. Conclusions: Our institutional experiences showed that EFRT was an effective treatment for cervical cancer patients with PAN metastasis. The addition of chemotherapy to EFRT seems to have uncertain survival benefit with higher hematologic toxicity.",
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Treatment outcomes of extended-field radiation therapy and the effect of concurrent chemotherapy on uterine cervical cancer with para-aortic lymph node metastasis. / Yoon, Hong In; Cha, Jihye; Keum, Ki Chang; Lee, Ha Yoon; Nam, Eun Ji; Kim, Sang Wun; Kim, Sunghoon; Kim, Young Tae; Kim, Gwi Eon; Kim, Yong Bae.

In: Radiation Oncology, Vol. 10, No. 1, 18, 13.01.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Treatment outcomes of extended-field radiation therapy and the effect of concurrent chemotherapy on uterine cervical cancer with para-aortic lymph node metastasis

AU - Yoon, Hong In

AU - Cha, Jihye

AU - Keum, Ki Chang

AU - Lee, Ha Yoon

AU - Nam, Eun Ji

AU - Kim, Sang Wun

AU - Kim, Sunghoon

AU - Kim, Young Tae

AU - Kim, Gwi Eon

AU - Kim, Yong Bae

PY - 2015/1/13

Y1 - 2015/1/13

N2 - Purpose: To review the clinical outcomes of extended-field radiation therapy (EFRT) and to analyze prognostic factors significant for survival in patients receiving EFRT for uterine cervical carcinoma with para-aortic node (PAN) metastasis. Patients and methods: We retrospectively reviewed 90 patients with stage IB-IVA cervical cancer and PAN metastasis between 1987 and 2012. Median age was 50 (range, 24-77). Patients received median 70.2 Gy (range, 56-93) to point A and median 50.4 Gy (range, 45-60.4) to PAN over median 69 elapsed days (range, 43-182). Forty-six patients (51.1%) received concurrent chemotherapy. Survival was calculated using the Kaplan-Meier method. We analyzed prognostic factors for overall actuarial survival (OS) and progression-free survival (PFS) using a Cox regression method. Results: The median follow-up period for surviving patients was 55 months (range, 3-252). Seventy patients (77.8%) had complete remission. Forty-six patients experienced treatment failure as follows: 11 patients (12.2%) as local recurrence, 19 (21%) as regional recurrence and 33 (36.7%) as distant metastasis. The 5-yr OS and PFS were 62.6% and 43.9%, respectively. Treatment response was the only statistically independent prognostic factors for OS (p= 0.04) and PFS (p< 0.001) on multivariate analysis. Grade 3 or 4 hematologic gastrointestinal and urogenital toxicities were observed in about 10% of patients. Conclusions: Our institutional experiences showed that EFRT was an effective treatment for cervical cancer patients with PAN metastasis. The addition of chemotherapy to EFRT seems to have uncertain survival benefit with higher hematologic toxicity.

AB - Purpose: To review the clinical outcomes of extended-field radiation therapy (EFRT) and to analyze prognostic factors significant for survival in patients receiving EFRT for uterine cervical carcinoma with para-aortic node (PAN) metastasis. Patients and methods: We retrospectively reviewed 90 patients with stage IB-IVA cervical cancer and PAN metastasis between 1987 and 2012. Median age was 50 (range, 24-77). Patients received median 70.2 Gy (range, 56-93) to point A and median 50.4 Gy (range, 45-60.4) to PAN over median 69 elapsed days (range, 43-182). Forty-six patients (51.1%) received concurrent chemotherapy. Survival was calculated using the Kaplan-Meier method. We analyzed prognostic factors for overall actuarial survival (OS) and progression-free survival (PFS) using a Cox regression method. Results: The median follow-up period for surviving patients was 55 months (range, 3-252). Seventy patients (77.8%) had complete remission. Forty-six patients experienced treatment failure as follows: 11 patients (12.2%) as local recurrence, 19 (21%) as regional recurrence and 33 (36.7%) as distant metastasis. The 5-yr OS and PFS were 62.6% and 43.9%, respectively. Treatment response was the only statistically independent prognostic factors for OS (p= 0.04) and PFS (p< 0.001) on multivariate analysis. Grade 3 or 4 hematologic gastrointestinal and urogenital toxicities were observed in about 10% of patients. Conclusions: Our institutional experiences showed that EFRT was an effective treatment for cervical cancer patients with PAN metastasis. The addition of chemotherapy to EFRT seems to have uncertain survival benefit with higher hematologic toxicity.

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