127 poster: Local Control Results of Radical Radiotherapy of Cervical Cancer. Our Experience

2009 ◽  
Vol 91 ◽  
pp. S47
Author(s):  
R. Dávila-Fajardo ◽  
I. De La Fuente-Muñoz ◽  
A. González-López ◽  
F.J. López-Soler ◽  
R. García-Fernández ◽  
...  
2018 ◽  
Vol 64 (5) ◽  
pp. 645-650
Author(s):  
Olga Kravets ◽  
Yelena Romanova ◽  
Oleg Kozlov ◽  
Mikhail Nechushkin ◽  
A. Gavrilova ◽  
...  

We present our results of 3D CT/MRI brachytherapy (BT) planning in 115 patients with locally advanced cervical cancer T2b-3bN0-1M0. The aim of this study was to assess the differences in the visualization of tumor target volumes and risk organs during the 3D CT/MRI BT. The results of the study revealed that the use of MRI imaging for dosimetric planning of dose distribution for a given volume of a cervical tumor target was the best method of visualization of the soft tissue component of the tumor process in comparison with CT images, it allowed to differentially visualize the cervix and uterine body, directly the tumor volume. Mean D90 HR-CTV for MRI was 32.9 cm3 versus 45.9 cm3 for CT at the time of first BT, p = 0.0002, which is important for local control of the tumor process. The contouring of the organs of risk (bladder and rectum) through MRI images allows for more clearly visualizing the contours, which statistically significantly reduces the dose load for individual dosimetric planning in the D2cc control volume, і.є. the minimum dose of 2 cm3 of the organ of risk: D2cc for the bladder was 24.3 Gy for MRI versus 34.8 Gy on CT (p = 0.045); D2cc for the rectum - 18.7 Gy for MRI versus 26.8 Gy for CT (p = 0.046). This is a prognostically important stage in promising local control, which allows preventing manifestation of radiation damage.


2004 ◽  
Vol 14 (5) ◽  
pp. 846-851 ◽  
Author(s):  
V. Moutardier ◽  
G. Houvenaeghel ◽  
M. Martino ◽  
B. Lelong ◽  
V. J. Bardou ◽  
...  

Pelvic recurrence of cervical cancer is a life-threatening situation and only local control can provide hope for remission. The aim of this study was to evaluate the role of surgery in the treatment of cervical cancer recurrence. This retrospective study analyzed a series of 70 patients who underwent resection of cervix locoregional recurrence. Thirteen patients had palliative salvage surgery for pelvic complications. Twenty-nine resections were considered as curative. Fifty recurrences required pelvic exenterations. The hospital mortality rate was 9% and the morbidity rate was 44%. Overall 5-year actuarial survival rate was 23%. Survival was significantly higher: (a) after curative resection and (b) after centropelvic recurrence resection. Local control was obtained in 48% of the cases and 13 patients are alive with a median follow-up of 75 months. In conclusion, the results of this small and heterogen series seem to justify an attempt to resection for centropelvic recurrences whenever possible. Palliative surgery should be reserved to salvage therapy and highly selected patients.


2020 ◽  
Vol 30 (6) ◽  
pp. 865-872 ◽  
Author(s):  
Cem Onal ◽  
Melis Gultekin ◽  
Ezgi Oymak ◽  
Ozan Cem Guler ◽  
Melek Tugce Yilmaz ◽  
...  

IntroductionData supporting stereotactic body radiotherapy for oligometastatic patients are increasing; however, the outcomes for gynecological cancer patients have yet to be fully explored. Our aim is to analyze the clinical outcomes of stereotactic body radiotherapy in the treatment of patients with recurrent or oligometastatic ovarian cancer or cervical cancer.MethodsThe clinical data of 29 patients (35 lesions) with oligometastatic cervical cancer (21 patients, 72%) and ovarian carcinoma (8 patients, 28%) who were treated with stereotactic body radiotherapy for metastatic sites were retrospectively evaluated. All patients had <5 metastases at diagnosis or during progression, and were treated with stereotactic body radiotherapy for oligometastatic disease. Patients with ≥5 metastases or with brain metastases and those who underwent re-irradiation for primary site were excluded. Age, progression time, mean biologically effective dose, and treatment response were compared for overall survival and progression-free survival.ResultsA total of 29 patients were included in the study. De novo oligometastatic disease was observed in 7 patients (24%), and 22 patients (76%) had oligoprogression. The median follow-up was 15.3 months (range 1.9–95.2). The 1 and 2 year overall survival rates were 85% and 62%, respectively, and the 1 and 2 year progression-free survival rates were 27% and 18%, respectively. The 1 and 2 year local control rates for all patients were 84% and 84%, respectively. All disease progressions were observed at a median time of 7.7 months (range 1.0–16.0) after the completion of stereotactic body radiotherapy. Patients with a complete response after stereotactic body radiotherapy for oligometastasis had a significantly higher 2 year overall survival and progression-free survival compared with their counterparts. In multivariate analysis, early progression (≤12 months) and complete response after stereotactic body radiotherapy for oligometastasis were the significant prognostic factors for improved overall survival. However, no significant factor was found for progression-free survival in the multivariable analysis. No patients experienced grade 3 or higher acute or late toxicities.ConclusionsPatients with early detection of oligometastasis (≤12 months) and with complete response observed at the stereotactic body radiotherapy site had a better survival compared with their counterparts. Stereotactic body radiotherapy at the oligometastatic site resulted in excellent local control rates with minimal toxicity, and can potentially contribute to long-term survival.


2003 ◽  
Vol 13 (6) ◽  
pp. 914-917 ◽  
Author(s):  
LÁSZLÓ PÁLFALVI ◽  
László Ungár

A new surgical method was introduced for the treatment of Ib lymph node positive and IIb cervical cancer patients. The lateral resection plane corresponds to the true pelvic side wall, the plane represented by the internal obturator muscle, the linea arcuata, and the piriformis muscle with the convergent branches of the sacral plexus. The LEP procedure overcomes the limitations of the standard class III-IV radical hysterectomy, which leaves in situ the gluteal superior, inferior and pudendal nodes, thus improving local control and survival.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Oguz Cetinayak ◽  
Ersoy Dogan ◽  
Ahmet Kuru ◽  
Nesrin Akturk ◽  
Barbaros Aydin ◽  
...  

Purpose. The aim was to evaluate the treatment outcomes and prognostic characteristics of patients with early-stage glottic laryngeal carcinoma who underwent radical radiotherapy (RT) with different techniques. Patients and Methods. Radiotherapy was applied using the 2D conventional technique between 1991 and 2004 (130 patients), 3DCRT until 2014 (125 patients), and by VMAT until January 2017 (44 patients). Clinical T stages were 38 (12.7%) for Tis, 209 (69.9%) for T1, and 52 (17.4%) for T2. Radiotherapy technique and energy, anterior commissure involvement, and stage were analyzed as prognostic factors. Results. The median total dose was 66 (50–70) Gy, and median follow-up time was 72 (3–288) months; 5-year disease-specific survival (DSS) rates were 95.8%, 95.5%, and 88.6%, respectively, in Tis, T1, and T2 stages. In multivariate analyses, anterior commissure involvement was found significant for all survival and local control rates. The patients treated with VMAT technique had better local control and DSS rates. However, these results were not statistically significant. Conclusion. In early-stage laryngeal carcinomas, radical RT is a function sparing and effective treatment modality, regardless of treatment techniques.


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