Radiation therapy with chemotherapy for patients with cervical cancer and supraclavicular lymph node involvement
Open Access
- 1 January 2012
- journal article
- Published by Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology and Colposcopy in Journal of Gynecologic Oncology
- Vol. 23 (3), 159-167
- https://doi.org/10.3802/jgo.2012.23.3.159
Abstract
We wanted to evaluate the outcomes of cervical cancer patients with supraclavicular lymph node (SCLN) involvement and who received radiation therapy (RT) combined with chemotherapy. From August 2001 to April 2009, nine cervical cancer patients with SCLN involvement were treated by RT and cisplatin-based chemotherapy. Most of the patients (8/9, 88.9%) also had a positive para-aortic lymph node (PALN). The RT field was designed to include the whole pelvis, the involved PALNs and the SCLN area. The median SCLN RT dose was 66.6 Gy (range, 60 to 70 Gy). The median follow-up period was 61 months (range, 13 to 98 months). The 3- and 5-year overall survival rates were 66.7% and 55.6%, respectively and the 3- and 5-year progression-free survival rates were 66.7% and 44.4%, respectively. The acute hematologic toxicities according to the criteria of Radiation Therapy of Oncology Group (RTOG) were G1/2 leucopenia in 3 (33.3%), G3/4 leukopenia in 6 (66.7%), G1/2 anemia in 7 (77.8%), G3 anemia in 1 (11.1%), G2 thrombocytopenia in 2 (22.2%), and G3/4 thrombocytopenia in 2 (22.2%). Within 6 months after RT, most of the patients (5/6, 83.3%) recovered from the G3/4 leukopenia, except for 1 patient who received chemotherapy after completing RT due to subsequent bone metastasis. For patients with advanced cervix cancer and SCLN involvement, RT with chemotherapy as active therapy can be expected to provide favorable results, although there is an increased risk of G3/4 hematologic toxicity.Keywords
This publication has 21 references indexed in Scilit:
- The type of metastasis is a prognostic factor in disseminated cervical cancerJournal of Gynecologic Oncology, 2010
- High-dose Extended-Field Irradiation and High-Dose-Rate Brachytherapy With Concurrent Chemotherapy for Cervical Cancer With Positive Para-Aortic Lymph NodesInternational Journal of Radiation Oncology*Biology*Physics, 2009
- Revised FIGO staging for carcinoma of the cervixInternational Journal of Gynecology & Obstetrics, 2009
- Positron emission tomography in evaluating the feasibility of curative intent in cervical cancer patients with limited distant lymph node metastasesGynecologic Oncology, 2008
- IMRT dose escalation for positive para-aortic lymph nodes in patients with locally advanced cervical cancer while reducing dose to bone marrow and other organs at riskInternational Journal of Radiation Oncology*Biology*Physics, 2004
- Recurrent squamous cell carcinoma of cervix after definitive radiotherapyInternational Journal of Radiation Oncology*Biology*Physics, 2004
- Pelvic Irradiation With Concurrent Chemotherapy Versus Pelvic and Para-Aortic Irradiation for High-Risk Cervical Cancer: An Update of Radiation Therapy Oncology Group Trial (RTOG) 90-01Journal of Clinical Oncology, 2004
- Extended‐field radiotherapy and high–dose‐rate brachytherapy in carcinoma of the uterine cervixCancer, 2003
- Cisplatin, Radiation, and Adjuvant Hysterectomy Compared with Radiation and Adjuvant Hysterectomy for Bulky Stage IB Cervical CarcinomaNew England Journal of Medicine, 1999
- Radiation therapy alone in the treatment of carcinoma of the uterine cervix: A 20-year experienceGynecologic Oncology, 1986