A study to evaluate the adequacy of pelvic lymph node coverage in carcinoma cervix patients in Indian population by conventional four field box technique using computerized tomography simulation based pelvic lymph node contouring

Background: Traditionally pelvic External Beam Radiotherapy is delivered with four field box technique in carcinoma cervix patients. The primary aim of this prospective observational study is to determine the adequacy of pelvic lymph nodal coverage by conventional Four Field Box Technique with the help of pelvic lymph node contouring by CT simulation.Methods: Between January 2013 and August 2015 sixty patients with biopsy proven Carcinoma Cervix were enrolled in this study. Of these fifty-three patients were available for final analysis. CT simulation based Pelvic lymph node contouring was done for each patient. Then two External Beam Radiotherapy plans were generated, one contoured based and the other based on bony landmark based Four Field Box Technique. The number of patients whose contoured lymph nodes lies partly outside the field borders of the bony landmark-based plan and also its extent was determined. D90 of various groups of pelvic lymph nodes obtained from both the plans were compared using ‘paired sample t - test’.Results: It was seen that with Four Field Box Technique there is inadequate coverage of common iliac lymph nodes in 34/53 patients. The difference between the mean D90 of common iliac lymph nodes in two sets of plans was found to be statistically significant.Conclusions: Pelvic field planning should be individualized. CT simulation-based radiotherapy planning should be done for each individual patient to adequately cover the nodal microscopic disease.

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Long term results for treatment of prostate cancer by staging pelvic lymph node dissection and definitive irradiation using L.D.R. temporary IR192 interstitial implant and external beam radiotherapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/s0360-3016(01)02368-9 ◽

2001 ◽

Vol 51 (3) ◽

pp. 296

Author(s):

A.A. Puthawala ◽

N. Syed ◽

J.M. Cherlow ◽

S.J. Damore ◽

J.M. Perley ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

External Beam Radiotherapy ◽

Pelvic Lymph Node Dissection ◽

Pelvic Lymph Node ◽

Long Term Results ◽

External Beam ◽

Node Dissection

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External beam radiotherapy versus vaginal brachytherapy in patients with stage II endometrial cancer: a systematic review and meta-analysis

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001199 ◽

2020 ◽

Vol 30 (6) ◽

pp. 797-805 ◽

Cited By ~ 1

Author(s):

Deepa Maheswari Narasimhulu ◽

Adela Cope ◽

Irbaz Bin Riaz ◽

Ivy Petersen ◽

William Cilby ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Recurrence Rate ◽

Locoregional Recurrence ◽

External Beam Radiotherapy ◽

Pelvic Lymph Node ◽

Stage Ii ◽

External Beam ◽

Lymph Node Assessment ◽

Vaginal Recurrence

ObjectiveThe choice of adjuvant treatment for women with stage II endometrial cancer is challenging, given the known increase in morbidity with external beam radiation compared with vaginal brachytherapy, and the lack of consensus on its benefits. We summarized the evidence on survival and recurrence for stage II endometrial cancer, defined as cervical stromal invasion, after adjuvant postoperative external beam radiotherapy and vaginal brachytherapy.MethodsWe searched the MEDLINE, EMBASE, CENTRAL, and Scopus databases from inception to January 2019 to identify studies that compared adjuvant postoperative external beam radiotherapy with or without vaginal brachytherapy and vaginal brachytherapy alone in stage II endometrial cancer. Our primary outcome was the locoregional recurrence rate, defined as recurrence in the pelvis or vagina. Secondary outcomes included the rate of recurrence at any site, distant recurrence rate, vaginal recurrence rate, pelvic recurrence rate, and 5 year overall survival. Study selection, assessment, and data abstraction were performed by an independent set of reviewers. Random effects models were used to synthesize quantitative data.ResultsWe included 15 cohort studies reporting data on 1070 women. Most women with stage II endometrial cancer (848/1070, 79.3%) were treated with external beam radiotherapy with or without vaginal brachytherapy. Subgroup analysis was stratified by whether >90% of the women included underwent pelvic lymph node assessment (sampling or full dissection). Locoregional recurrence (pelvic and vaginal recurrence) was significantly reduced with external beam radiotherapy with or without vaginal brachytherapy compared with vaginal brachytherapy alone (14 studies (n=1057); odds ratio (OR) 0.33 (95% confidence interval (CI) 0.16 to 0.68); I2=5%) regardless of pelvic lymph node assessment. Most women (81.8%) who recurred locoregionally had a least one uterine risk factor (grade 3 tumor, myometrial invasion >50%, or lymphovascular invasion). There was no difference in overall survival with external beam radiotherapy with or without vaginal brachytherapy compared with vaginal brachytherapy alone (five studies (n=463); OR 0.78 (95% CI 0.34 to 1.80); I2=48%).ConclusionsExternal beam radiotherapy with or without vaginal brachytherapy decreased the locoregional recurrence threefold for stage II endometrial cancer, regardless of pelvic lymph node assessment. Most women who suffered recurrence locoregionally had a least one high risk factor. Vaginal brachytherapy alone may be sufficient therapy for node negative stage II endometrial cancer without uterine risk factors, while those with uterine risk factors should be considered for external beam radiotherapy with or without vaginal brachytherapy to improve locoregional control.

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Treatment of prostate cancer using external beam radiotherapy after laparoscopic pelvic lymph node dissection

BJU International ◽

10.1046/j.1464-410x.1996.98818.x ◽

1996 ◽

Vol 77 (6) ◽

pp. 870-875 ◽

Cited By ~ 8

Author(s):

G.S. Gerber ◽

G.T. Bales ◽

H.L. Gornik ◽

D.J. Haraf ◽

G.W. Chodak ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

External Beam Radiotherapy ◽

Pelvic Lymph Node Dissection ◽

Pelvic Lymph Node ◽

External Beam ◽

Node Dissection

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Feasibility of Predicting Pelvic Lymph Node Metastasis Based on IVIM-DWI and Texture Parameters of the Primary Lesion and Lymph Nodes in Patients with Cervical Cancer

Academic Radiology ◽

10.1016/j.acra.2021.08.026 ◽

2021 ◽

Author(s):

Yu Zhang ◽

Kai-yue Zhang ◽

Hao-dong Jia ◽

Xin Fang ◽

Ting-ting Lin ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Primary Lesion ◽

Pelvic Lymph Node ◽

Node Metastasis ◽

Pelvic Lymph Node Metastasis ◽

Texture Parameters

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Corrigendum to: National practice patterns for lymph node irradiation in 197,000 men receiving external beam radiotherapy for localized prostate cancer

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2019.07.003 ◽

2019 ◽

Vol 37 (8) ◽

pp. 563

Author(s):

Adam B. Weiner ◽

Oliver S. Ko ◽

Alec Zhu ◽

Daniel E. Spratt ◽

Jim C. Hu ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Practice Patterns ◽

External Beam Radiotherapy ◽

Localized Prostate Cancer ◽

External Beam ◽

Lymph Node Irradiation ◽

National Practice

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Principles of external beam radiotherapy planning techniques

Treatment of Cancer ◽

10.1201/b13550-58 ◽

2008 ◽

pp. 1261-1281

Keyword(s):

External Beam Radiotherapy ◽

Radiotherapy Planning ◽

External Beam ◽

Planning Techniques

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A PROSPECTIVE RANDOMIZED STUDY TO COMPARE THE CONCURRENT CHEMO-RADIATION VERSUS HYPO-FRACTIONATED CHEMO-RADIATION IN LOCALLY ADVANCED CERVICAL CANCER.

10.36106/ijar/8001653 ◽

2021 ◽

pp. 40-42

Author(s):

Arpan Jana ◽

Pabitra Das ◽

Poulami Gupta ◽

Phalguni Gupta

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

External Beam Radiotherapy ◽

Locally Advanced ◽

Intracavitary Brachytherapy ◽

External Beam ◽

Carcinoma Cervix ◽

Advanced Carcinoma

Background: Concurrent chemo-radiation is the standard treatment worldwide for locally advanced squamous Cell carcinoma cervix. However, conventional chemo-radiotherapy is also associated with unacceptable local and systemic failure rates for locally advanced disease. Biologically squamous cell carcinoma of head- neck cancer and cervical cancer behaves quite similarly in response to radiotherapy. So, it can be expected that, altered fractionation can increase the local control in case of squamous cell carcinoma cervix than conventional radiotherapy. There is no randomised control trial for carcinoma cervix till date, which compares conventional chemo-radiation with hypo-fractionated chemo-radiation. Aims And Objectives: The present study was planned to compare local disease control and acute toxicity of conventional chemo-radiation with hypo-fractionated chemo-radiation in locally advanced carcinoma cervix. Materials And Methods: In Conventional Chemo-radiation Arm A patients (n=30) received external beam radiotherapy 50 Gy in 25 fractions in 5 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 7 Gy per fraction once in a week for 3 weeks. The second group of hypo-fractionated Arm B received external beam radiotherapy 45 Gy in 20 fractions in 4 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 9 Gy per fraction once in a week for 2 weeks. Results: Grade II diarrhea were seen more in Arm B 17 (56.66%) compare to Arm A 12(40%) and grade III diarrhea was seen 4 (3.33%) in Arm B and 2(6.66%) in Arm A. At 2 months and 6 months after completion of treatment Complete response were 25 (83.4%) in Arm A compare to 22 (73.3%) in Arm B and 20 (74.1%) in Arm A and 18 (72%) in Arm B respectively. Conclusion: Hypo-fractioned radiotherapy may be used as an alternate protocol for treatment of locally advanced carcinoma cervix with acceptable toxicities.

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