PATTERNS OF REGIONAL RECURRENCE AFTER DEFINITIVE RADIOTHERAPY FOR CERVICAL CANCER

被引:71
|
作者
Beadle, Beth M. [1 ]
Jhingran, Anuja [1 ]
Yom, Sue S. [1 ]
Ramirez, Pedro T. [2 ]
Eifel, Patricia J. [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Gynecol Oncol, Houston, TX 77030 USA
关键词
Cervical cancer; Patterns of recurrence; Radiotherapy; Brachytherapy; GYNECOLOGIC-ONCOLOGY-GROUP; SQUAMOUS-CELL CARCINOMA; RADIATION-THERAPY; CONCURRENT CHEMOTHERAPY; UTERINE CERVIX; STAGE IIB; PELVIC RADIATION; IVA CARCINOMA; LYMPH-NODES; CISPLATIN;
D O I
10.1016/j.ijrobp.2009.04.009
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To determine the patterns of regional recurrence in patients treated with definitive radiotherapy (RT) for cervical cancer. Methods and Materials: The records of 198 patients treated with definitive RT for cervical cancer between 1980 and 2000 who experienced a regional recurrence without a central or distal vaginal recurrence were reviewed. All patients received a combination of external-beam RT and intracavitary brachytherapy. In the 180 patients with a documented location of regional recurrence, the relationship between the recurrence and the radiation fields was determined. Results: The median time to regional recurrence was 13 months (range, 2-85 months). Of the 180 patients who had an evaluable regional recurrence, 119 (66%) had a component of marginal failure; 71 patients recurred above-the-field, 2 patients occurred in the inguinal nodes, and 2 patients recurred above-the-field and in the inguinal nodes. In addition, 105 patients (58%) had a component of in-field failure; 59 patients recurred in-field only, 39 patients recurred in-field and above-the-field, 2 patients recurred in-field, above-the-field, and in the inguinal nodes, and 5 patients recurred in-field and in the inguinal nodes. The median survival after regional recurrence was 8 months (range, 0-194 months). Conclusions: Most regional recurrences after definitive RT for cervical cancer include a component of marginal failure, usually immediately superior to the radiation field. These recurrences suggest a deficiency in target volume. Recurrences also occur in-field, suggesting a deficiency in dose. Developments in pretreatment staging, field delineation, dose escalation, and posttreatment surveillance may help to improve outcome in these patients. (C) 2010 Elsevier Inc.
引用
收藏
页码:1396 / 1403
页数:8
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