Clinical analysis of intensity modulated radiation therapy in cervical cancer patients with para-aortic lymph node metastasis after initial treatment
10.3760/cma.j.issn.0254-5098.2015.07.010
- VernacularTitle:宫颈癌初始治疗后腹主动脉旁淋巴结转移调强放疗的临床观察
- Author:
Xiaofan LI
;
Yongheng LI
;
Xing SU
- Publication Type:Journal Article
- Keywords:
Cervical cancer;
Para-aortic lymph node metastases;
Intensity modulated radiation therapy;
TP regimen chemotherapy
- From:
Chinese Journal of Radiological Medicine and Protection
2015;35(7):522-527
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and toxicities of intensity modulated radiation therapy (IMRT) with or without concurrent chemotherapy in the treatment of cervical cancer patients with para-aortic lymph node (PALN) metastases after initial treatment.Methods From Oct 2008 to Aug 2013,56 cervical cancer patients with PALN metastases after initial treatment,including radical resection or pelvic radiotherapy/chemoradiotherapy,were selected for analysis.The delivered radiation dose to PALN was 55-60 Gy for GTV and 45-50 Gy for CTV respectively with 25-30 fractions during 5-6 weeks.36 patients received concurrent paclitaxel (135 mg/m2) and cisplatin (60 mg/m2) chemoradiotherapy (CRT group) and 20 patients received RT alone (RT group).Results The median follow-up time after treatment was 22.7 months (2.7 to 74.4 months).98.2％ (55/56) of patients completed RT.In CRT group,38.9％ underwent concurrent TP regimen 2-3 cycles and the rest completed one cycle.The rates of CR plus PR in CRT and RT groups were 91.7％ (33/36) and 85％ (17/20),respectively (x2 =0.516,P ＞0.05).The 3-year overall survival rate in CRT group and RT group were 57.5％ and 32.7％ (x2 =4.059,P ＜ 0.05),and 3-year progression-free survival rates were 50.4％ and 29.2％ (x2 =4.184,P ＜ 0.05),respectively.TP regimen concurrent chemoradiotherapy was more effective than radiotherapy alone.The 3-year overall survival rate was 53％ and 39.5％ in patients with isolated PALN and nonisolated PALN,respectively (x2 =4.265,P ＜ 0.05).Grade 3 or 4 acute leukopenia was found in 10 (27.8％,CRT group) and 6 (30％,RT group) patients (x2 =0.693,P ＞ 0.05).Grade 3 gastrointestinal toxicity occurred in 1 patient each group (x2 =0.847,P ＞ 0.05).Conclusions TP regimen concurrent CRT is associated with better survival than RT alone,and the treatment toxicities could be tolerant.
