Hyun Ju Kim1, Jee Suk Chang2, Woong Sub Koom3, Kyu Chan Lee4, Gwi Eon Kim5, Yong Bae Kim6. 1. Department of Radiation Oncology, Gachon University Gil Medical Center, 774 Namdongdae-ro, Incheon 21565, Republic of Korea. Electronic address: hjkim@gilhospital.com. 2. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Electronic address: changjeesuk@yuhs.ac. 3. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Electronic address: mdgold@yuhs.ac. 4. Department of Radiation Oncology, Gachon University Gil Medical Center, 774 Namdongdae-ro, Incheon 21565, Republic of Korea. Electronic address: kyu22@gilhospital.com. 5. Department of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Aran 13gil-15, Jeju 63241, Republic of Korea. Electronic address: gekim@yuhs.ac. 6. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Electronic address: ybkim3@yuhs.ac.
Abstract
OBJECTIVE: The feasibility of salvage radiotherapy (RT) for patients with recurrent cervical cancer after definitive treatment is contentious. The purpose of this study was to investigate the feasibility and benefit of RT, particularly intensity-modulated RT (IMRT), for salvage treatment in patients with recurrent cervical cancer. METHODS: We retrospectively analyzed 125 patients with recurrent cervical cancer treated with RT at Yonsei Cancer Center between January 2007 and December 2016. All patients received salvage RT for the recurred or metastatic tumor mass. Irradiating dose and volume were determined depending on initial treatment. IMRT was selected in challenging cases, such as re-irradiation or for patients for whom implementing a satisfactory 3-dimensional conformal RT plan was challenging. RESULTS: The median follow-up period was 5.5 years (range, 10.8 months to 41 years). The 5-year local failure-free survival (LFFS) and progression-free survival (PFS) rates were 63.9% and 39.6%, respectively. The 5-year overall survival (OS) rate was 66%; 10-year OS reached 51%. The median PFS rates in patients with locoregional failure, distant metastases, or both were 45.4, 29.1, and 14.7 months, respectively (p = 0.005). For the 45 patients that received re-irradiation, 5-year LFFS, PFS, and OS rates were 47.1%, 33.2%, and 66.5%, respectively. Late complications were observed in 12 patients (12/125, 9.6%). CONCLUSIONS: Our data suggest that salvage RT is safe and effective against recurrent cervical cancer. IMRT is a safe and effective salvage modality for these patients, including those requiring re-irradiation.
OBJECTIVE: The feasibility of salvage radiotherapy (RT) for patients with recurrent cervical cancer after definitive treatment is contentious. The purpose of this study was to investigate the feasibility and benefit of RT, particularly intensity-modulated RT (IMRT), for salvage treatment in patients with recurrent cervical cancer. METHODS: We retrospectively analyzed 125 patients with recurrent cervical cancer treated with RT at Yonsei Cancer Center between January 2007 and December 2016. All patients received salvage RT for the recurred or metastatic tumor mass. Irradiating dose and volume were determined depending on initial treatment. IMRT was selected in challenging cases, such as re-irradiation or for patients for whom implementing a satisfactory 3-dimensional conformal RT plan was challenging. RESULTS: The median follow-up period was 5.5 years (range, 10.8 months to 41 years). The 5-year local failure-free survival (LFFS) and progression-free survival (PFS) rates were 63.9% and 39.6%, respectively. The 5-year overall survival (OS) rate was 66%; 10-year OS reached 51%. The median PFS rates in patients with locoregional failure, distant metastases, or both were 45.4, 29.1, and 14.7 months, respectively (p = 0.005). For the 45 patients that received re-irradiation, 5-year LFFS, PFS, and OS rates were 47.1%, 33.2%, and 66.5%, respectively. Late complications were observed in 12 patients (12/125, 9.6%). CONCLUSIONS: Our data suggest that salvage RT is safe and effective against recurrent cervical cancer. IMRT is a safe and effective salvage modality for these patients, including those requiring re-irradiation.
Authors: Cui Hua Liu; Zhe Hao Huang; Xin Yu Dong; Xin Qiang Zhang; Yuan Hang Li; Gang Zhao; Bao Sheng Sun; Yan Nan Shen Journal: Oxid Med Cell Longev Date: 2020-03-04 Impact factor: 6.543