Treatment outcomes and prognostic factors in uterine cervical cancer patients treated with postoperative extended field radiation therapy.
10.3802/jgo.2009.20.4.227
- Author:
Hak Jae KIM
1
;
Sung Whan HA
;
Hong Gyun WU
Author Information
1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. wuhg@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Cervix cancer;
Postoperative extended field radiotherapy;
Chemotherapy
- MeSH:
Disease-Free Survival;
Follow-Up Studies;
Humans;
Hysterectomy;
Lymph Node Excision;
Survival Rate;
Uterine Cervical Neoplasms
- From:Journal of Gynecologic Oncology
2009;20(4):227-231
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate treatment outcomes and prognostic factors in uterine cervical cancer patients treated with postoperative extended field radiation therapy (POEFRT) with or without chemotherapy. METHODS: Between 1983 and 2006, 35 patients with a pathologically confirmed positive para-aortic node (PAN) or common iliac node (CIN) who underwent a radical hysterectomy with bilateral pelvic lymph node dissection and PAN dissection received POEFRT with (N=23) or without (N=12) chemotherapy. Prognostic factors such as age, stage, size, parametrium invasion, lymphovascular space invasion, nodal station, depth of stromal invasion and use of chemotherapy were analyzed. RESULTS: With a median follow-up of 44 months, the 5-year overall survival (OS), disease-free survival (DFS), distant failure-free survival (DFFS) and loco-regional failure-free survival rates were 51%, 51%, 59% and 93%, respectively. The use of chemotherapy significantly improved the 5-year OS rate (61% vs. 48%, p=0.004), the 5-year DFS rate (54% vs. 38%, p=0.004) and the 5-year DFFS rate (57% vs. 48%, p=0.009). PAN involvement resulted in a compromised 5-year DFS rate (42% vs. 73%, p=0.002) and 5-year DFFS rate (47% vs. 82%, p=0.004) as compared to CIN involvement. Grade 3 or higher hematological toxicity was observed more frequently in patients who received POEFRT combined with chemotherapy as compared to patients who received POEFRT alone (52% vs. 17%, p=0.04). CONCLUSION: The use of POEFRT resulted in an excellent loco-regional control rate. The addition of chemotherapy may improve outcome in patients who have received POEFRT, but with higher manageable toxicity.
