Is Extended-field Concurrent Chemoradiation an Option for Radiologic Negative Paraaortic Lymph Node, Locally Advanced Cervical Cancer?

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2014 Sep 18

PMID 25228820

Citations 17

Authors

Mushabbab Al Asiri

Mutahir A Tunio

Reham Mohamed

Yasser Bayoumi

Abdulrehman AlHadab

Rasha M Saleh

Muhannad Saud AlArifi

Abdelaziz Alobaid

Affiliations

Soon will be listed here.

Abstract

Background: The aim was to evaluate whether extended-field concurrent chemoradiation (EF-CCRT) leads to results better than those obtained by standard whole-pelvis concurrent chemoradiation (WP-CCRT) in locally advanced cervical cancer with radiologic negative paraaortic lymph nodes (PALNs).

Patients And Methods: A total of 102 patients with histopathologically proven squamous cell carcinoma, adenocarcinoma, or adenosquamous cell carcinoma, and radiologic negative PALN locally advanced cervical cancer, stage IIB-IVA, were accrued between July 2007 and April 2008 and were randomly assigned to WP-CCRT (50 patients) or EF-CCRT (52 patients), followed by high-dose rate brachytherapy. Data regarding the safety profile, response rates, and occurrence of local, PALN, or distant failure were recorded.

Results: During a median follow-up time of 60 months (18-66), 74/102 patients completed the treatment protocol and were analyzed. Overall PALN, distant-metastasis control, disease-free survival, and overall survival rates were 97.1%, 86.9%, 80.3%, and 72.4% in EF-CCRT respectively in comparison with WP-CCRT (82.1%,74.7%, 69.1%, and 60.4%), with P-values of 0.02, 0.03, 0.03 and 0.04 respectively. No difference in acute toxicity profile was seen between the groups, and late toxicities were mild and minimal.

Conclusion: Prophylactic EF-CCRT can be a reasonable option in patients with locally advanced cervical cancer with radiologic positive pelvic lymph nodes and radiologic negative PALN.

Citing Articles

Study protocol of Elective Para-aortic and pelvic versus Pelvic only Irradiation in pelvic node positive Cervical cancer: a multicentric open labelled phase III randomised controlled trial (EPIC Study).

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Para-aortic and pelvic lymphadenectomy in locally advanced cervical cancer with pelvic lymph node metastasis.

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Comparative Analysis of Oncologic Outcomes in Patients with Squamous Cell Carcinoma of the Uterine Cervix with High-Risk Features for Para-Aortic Recurrence: Prophylactic Extended-Field versus Pelvic Chemoradiotherapy.

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Surgical Staging of Locally Advanced Cervical Cancer: Current Status and Research Progress.

Zhang H, Kong W, Chen S, Zhao X, Luo D, Xie Y Front Oncol. 2022; 12:940807.

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