Sang-Won Kim1,2, Mison Chun3, Hee-Sug Ryu4, Suk-Joon Chang4, Tae Wook Kong4, Eun Ju Lee5, Yong Hee Lee6, Young-Taek Oh1. 1. Department of Radiation Oncology, Ajou University School of Medicine, 164 Worldcup-ro, 16499, Yeongtong-gu, Suwon, Gyeonggi-do, Republic of Korea. 2. Department of Radiation Oncology, Konyang University School of Medicine, Daejeon, Republic of Korea. 3. Department of Radiation Oncology, Ajou University School of Medicine, 164 Worldcup-ro, 16499, Yeongtong-gu, Suwon, Gyeonggi-do, Republic of Korea. chunm@ajou.ac.kr. 4. Department of Obstetrics and Gynecology, Ajou University School of Medicine, 164 Worldcup-ro, 16499, Yeongtong-gu, Suwon, Gyeonggi-do, Republic of Korea. 5. Department of Radiology, Ajou University School of Medicine, 164 Worldcup-ro, 16499, Yeongtong-gu, Suwon, Gyeonggi-do, Republic of Korea. 6. Department of Pathology, Ajou University School of Medicine, 164 Worldcup-ro, 16499, Yeongtong-gu, Suwon, Gyeonggi-do, Republic of Korea.
Abstract
PURPOSE: Treatment outcomes of patients with pelvic recurrence after hysterectomy alone for uterine cervical cancer who received salvage radiotherapy (RT) with or without concurrent chemotherapy were investigated. METHODS: Salvage RT for recurrent cervical cancer confined to the pelvic cavity after hysterectomy alone was received by 33 patients. The median interval between initial hysterectomy and recurrence was 26 months. Whole-pelvic irradiation was delivered to median dose of 45 Gy, followed by a boost with a median dose of 16 Gy to the gross tumor volume. Cisplatin-based concurrent chemotherapy was administered to 29 patients. RESULTS: The median follow-up period was 53 months for surviving patients. Most patients (97.0%) completed salvage RT of ≥45 Gy. Complete response (CR) was achieved in 23 patients (69.7%). Pelvic sidewall involvement and evaluation with positron-emission tomography-computed tomography were significantly associated with CR. The 5‑year progression-free survival (PFS), local control (LC), distant metastasis-free survival (DMFS), and overall survival (OS) rates were 62.7, 79.5, 72.5, and 60.1%, respectively. Initial International Federation of Gynecology and Obstetrics stage, pelvic sidewall involvement, and CR status were significant factors for PFS and OS rates in multivariate analysis. The incidence of severe acute and late toxicities (≥grade 3) was 12.1 and 3.0%, respectively. CONCLUSION: Aggressive salvage RT with or without concurrent chemotherapy for recurrent cervical cancer confined to the pelvic cavity was feasible, with promising treatment outcomes and acceptable toxicities. However, even more intensive novel treatment strategies should be investigated for patients with unfavorable prognostic factors.
PURPOSE: Treatment outcomes of patients with pelvic recurrence after hysterectomy alone for uterine cervical cancer who received salvage radiotherapy (RT) with or without concurrent chemotherapy were investigated. METHODS: Salvage RT for recurrent cervical cancer confined to the pelvic cavity after hysterectomy alone was received by 33 patients. The median interval between initial hysterectomy and recurrence was 26 months. Whole-pelvic irradiation was delivered to median dose of 45 Gy, followed by a boost with a median dose of 16 Gy to the gross tumor volume. Cisplatin-based concurrent chemotherapy was administered to 29 patients. RESULTS: The median follow-up period was 53 months for surviving patients. Most patients (97.0%) completed salvage RT of ≥45 Gy. Complete response (CR) was achieved in 23 patients (69.7%). Pelvic sidewall involvement and evaluation with positron-emission tomography-computed tomography were significantly associated with CR. The 5‑year progression-free survival (PFS), local control (LC), distant metastasis-free survival (DMFS), and overall survival (OS) rates were 62.7, 79.5, 72.5, and 60.1%, respectively. Initial International Federation of Gynecology and Obstetrics stage, pelvic sidewall involvement, and CR status were significant factors for PFS and OS rates in multivariate analysis. The incidence of severe acute and late toxicities (≥grade 3) was 12.1 and 3.0%, respectively. CONCLUSION: Aggressive salvage RT with or without concurrent chemotherapy for recurrent cervical cancer confined to the pelvic cavity was feasible, with promising treatment outcomes and acceptable toxicities. However, even more intensive novel treatment strategies should be investigated for patients with unfavorable prognostic factors.
Authors: R. A. K. Samlal; J. Van Der Velden; T. Van Eerden; M. S. Schilthuis; D. Gonzalez Gonzalez; F. B. Lammes Journal: Int J Gynecol Cancer Date: 1998-01 Impact factor: 3.437
Authors: S Y Ryu; M H Kim; B H Nam; T S Lee; E S Song; C Y Park; J W Kim; Y B Kim; H S Ryu; S Y Park; K T Kim; C H Cho; C Lee; S M Kim; B G Kim; D S Bae; Y T Kim; J-H Nam Journal: Br J Cancer Date: 2013-12-19 Impact factor: 7.640