scholarly journals Does external beam radiation boost to pelvic lymph nodes improve outcomes in patients with locally advanced cervical cancer?

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Caryn Wujanto ◽  
Bok Ai Choo ◽  
David Tan ◽  
Arunachalam Ilancheran ◽  
Joseph Ng ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
External Beam Radiation ◽  
External Beam ◽  
Advanced Cervical Cancer ◽  
Beam Radiation ◽  
Pelvic Lymph Nodes ◽  
Locally Advanced Cervical Cancer ◽  
Radiation Boost

Tumor total lesion glycolysis and number of positive pelvic lymph nodes on pretreatment positron emission tomography/computed tomography (PET/CT) predict survival in patients with locally advanced cervical cancer

2020 ◽  
Vol 30 (11) ◽  
pp. 1705-1712
Author(s):  
Marjolein De Cuypere ◽  
Pierre Lovinfosse ◽  
Christine Gennigens ◽  
Johanne Hermesse ◽  
Ramon Rovira ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Total Lesion Glycolysis ◽  
Recurrence Free Survival ◽  
Advanced Cervical Cancer ◽  
Free Survival ◽  
Pelvic Lymph Nodes ◽  
Locally Advanced Cervical Cancer ◽  
Pet Ct

ObjectiveThe aim of this study was to investigate the prognostic value of metabolic parameters obtained at pretreatment [18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) in patients with locally advanced cervical cancer. We hypothesize that these metabolic parameters could optimize the treatment decision and thus favor the outcome of patients suffering locally advanced cervical cancer.MethodsPatients with locally advanced cervical cancer underwent pretreatment PET/CT. Standard uptake values (maximum, mean, peak), metabolic tumor volume, and total lesion glycolysis were measured in the tumor and in the hypermetabolic pelvic lymph nodes. The relationship between clinical, pathological, and PET/CT metabolic parameters with recurrence-free survival and overall survival was assessed by Cox regression analysis.Results115 patients with a median age of 52 years (range 23–77) presented with locally advanced cervical cancer. After a mean follow-up of 33.0 months after initiation of therapy, 26 patients (22.6%) recurred of which 17 patients had distant metastasis; 18 (15.7%) patients died. Recurrence-free survival at 2 and 5 years was 79.2% and 72.2%, respectively. The total lesion glycolysis of the tumor and the delay between diagnosis and treatment were significantly associated with recurrence-free survival in the multivariate analysis (HR 1.00, p=0.004, and HR 2.04, p=0.02, respectively). Only the total lesion glycolysis of the tumor ≥373.54 (HR 2.49, 95% CI 1.15 to 5.38; p=0.02) remained significant after log rank testing. Overall survival at 2 and 5 years was 91.7% and 68.8%, respectively. The number of PET-positive pelvic lymph nodes was the only independent prognostic factor for overall survival in the multivariate analysis (HR 1.43, 95% CI 1.13 to 1.81; p=0.003).ConclusionTumor total lesion glycolysis and the number of positive pelvic lymph nodes on pretreatment PET/CT appear to be independent prognostic factors for recurrence and survival in patients with locally advanced cervical cancer. This may help to select patients who may benefit from therapeutic optimization and closer surveillance.

Dose to pelvic lymph nodes during brachytherapy of locally advanced cervical cancer with 60Co HDR source

Brachytherapy ◽  
2021 ◽  
Author(s):  
Zahra Siavashpour ◽  
Mahdi Aghili ◽  
Shabnam Anjidani ◽  
Farid Zayeri ◽  
Mona Molekzadeh Moghani ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Pelvic Lymph Nodes ◽  
Locally Advanced Cervical Cancer

Brachytherapy for Locally Advanced Cervix Cancer (Methodological Aspects)

2019 ◽  
Vol 64 (5) ◽  
pp. 76-80
Author(s):  
О. Кравец ◽  
O. Kravets ◽  
А. Дубинина ◽  
A. Dubinina ◽  
Е. Тарачкова ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Tumor Volume ◽  
Maximum Dose ◽  
Locally Advanced ◽  
External Beam Radiation ◽  
High Dose ◽  
Advanced Cervical Cancer ◽  
Beam Radiation ◽  
Locally Advanced Cervical Cancer

Purpose: To increase local control of cervical tumors by developing and introducing into practice the optimization of dose distribution in the primary tumor during concomitant chemoradiation (CRT) and image-guided adaptive brachytherapy (IGABT) i.e. summing up the maximum dose to the tumor volume of HR-CTV> 85 Gy in the shortest possible period of time by the optimal fractionation regime, without increasing the tolerable doses to the organs of risk (bladder, rectum, sigmoid). Material and methods: Data of the study was the of clinical observations of patients with locally advanced cervical cancer proven stage IIb–IIIb according to FIGO, treated with curative radiation therapy. After pelvic +/- para-aortic external-beam radiation therapy (2 Gy × 50 Gy with Cisplatin 40 mg/m2 weekly), they received high-dose rate intracavitary brachytherapy or in combination with interstitial component following GEC-ESTRO recommendations. Results: We managed to achieve maximum dose to the tumor volume of HR-CTV> 85 Gy without increasing the load on the risk organs. The Clinical Contouring at the time of primary diagnosis of cervical cancer and before brachytherapy session based on clinical and diagnostic data using MRI helps to optimize the brachytherapy process, develop patient management tactics and a clear sequence of actions in a complex program of brachytherapy. Conclusion: The presented clinical cases indicate the prospects of using an individual approach in planning the brachytherapy of patients with locally advanced cervical cancer.

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