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Radiation Oncology

, 10:77

First Online: 04 April 2015Received: 11 December 2014Accepted: 05 March 2015DOI: 10.1186-s13014-015-0373-0

Cite this article as: Im, J.H., Yoon, H.I., Kim, S. et al. Radiat Oncol 2015 10: 77. doi:10.1186-s13014-015-0373-0

Abstract

BackgroundTo investigate the role of radiotherapy RT in and to suggest radiotherapeutic strategies for patients presenting with disseminated cervical cancer.

MethodsWe retrospectively analyzed 50 patients diagnosed as the disseminated cervical cancer with distant lymph nodal or visceral organ metastasis between September 1980 and August 2012. Patients were divided into two subgroups according to visceral organ metastasis: 35 patients diagnosed with distant lymph node metastasis only group A and 15 patients with visceral organ metastasis group B. All patients received external beam RT to the pelvis median dose 45 Gy and high-dose rate intracavitary RT median dose 30 Gy. Thirty-nine patients 78% received chemotherapy.

ResultsMedian follow-up time was 74 months. The 5-year pelvic control rate PCR was 85.8%, and the progression-free survival PFS, and overall survival OS rates were 28.7%, and 36.2%, respectively. The major treatment failure was systemic progression 32 patients, 64%. The 5-year PCRs in groups A and B were 87.4% and 74.7%, respectively p > 0.05. Meanwhile, PFS and OS rates for group A were significantly better than those for group B 35.3% vs. 13.3%, p = 0.010; and 46.3% vs. 13.3%, p = 0.009, respectively.

ConclusionOur data revealed considerable prognostic heterogeneity in disseminated cervical cancer. Even though a high PCR was achieved in patients treated with definitive RT, survival outcomes were dependent on progression of visceral organ metastasis. Therefore, personalized RT and chemotherapy treatment strategies according to the presence of visceral organ metastasis in disseminated cervical cancer patients may help improve clinical outcomes.

KeywordsDisseminated uterine cervical neoplasms Lymphatic metastasis Visceral organ metastasis Radiotherapy Chemotherapy AbbreviationsRTRadiotherapy

PCRPelvic control rates

PFSProgression free survival

OSOverall survival

FIGOInternational Federation of Gynecology and Obstetrics

LNLymph node

EFExtended field

CTxChemotherapy

CCRTConcurrent chemoradiotherapy

SCLNSupraclavicular lymph node

EBRTExternal beam radiation therapy

ICRIntracavitary irradiation

CRComplete remission

HRHazard ratios

CIConfidence interval

PALNPara-aortic lymph node

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Autor: Jung Ho Im - Hong In Yoon - Sunghoon Kim - Eun Ji Nam - Sang Wun Kim - Ga Won Yim - Ki Chang Keum - Young Tae Kim -

Fuente: https://link.springer.com/







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