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Impact of Boost Irradiation on Pelvic Lymph Node Control in Patients with Cervical Cancer
https://repo.qst.go.jp/records/64823
https://repo.qst.go.jp/records/6482390f1e8ea-670a-4dfe-b1ea-139c790afd4f
| Item type | 会議発表用資料 / Presentation(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2012-11-07 | |||||
| タイトル | ||||||
| タイトル | Impact of Boost Irradiation on Pelvic Lymph Node Control in Patients with Cervical Cancer | |||||
| 言語 | ||||||
| 言語 | eng | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_c94f | |||||
| 資源タイプ | conference object | |||||
| アクセス権 | ||||||
| アクセス権 | metadata only access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_14cb | |||||
| 著者 |
Wakatuki, Masaru
× Wakatuki, Masaru× Ohno, Tatsuya× Kato, Shingo× Ando, Ken× Noda, Shinei× Kiyohara, Hiroki× Shibuya, Kei× Karasawa, Kumiko× Kamada, Tadashi× Nakano, Takashi× 若月 優× 加藤 眞吾× 安藤 謙× 唐澤 久美子× 鎌田 正 |
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| 抄録 | ||||||
| 内容記述タイプ | Abstract | |||||
| 内容記述 | Abstract Purpose/Objectives: To analyze the correlation between size of lymph node and these control dose by radiation therapy (RT) in patients with cervical cancer. \nMaterials/Methods Between January 2002 and December 2007, 245 patients with squamous cell carcinoma of the cervix receiving a combination of external beam irradiation with or without boost irradiation and high-dose rate brachytherapy were investigated. Size of lymph node was measured by computed tomography (CT) before RT and after 50 Gy. Patient age ranged from 30 to 88 years, with a mean of 63 years. The number of patients with stage I, II, III and IV disease was 44, 87, 93, and 21, respectively. In the last period of this study, concurrent chemotherapy was administered to 89 patients. The other 156 patients were treated with irradiation alone. We calculated and used as the biologically equivalent dose at 2-Gy fractions (EQD2) according to the linear quadratic model for incomplete sublethal damage repair. \nResults: Seventy-eight of 245 patients had pelvic lymph node (PLN) metastases, and a total of 129 positive lymph nodes were detected. Median dose of external irradiation to PLN was 56 Gy (range, 45-60.6 Gy). With a median follow-up time of 55 months, 5-year overall survival rates of all cases, PLN-positive and PLN-negative cases were 73.1%, 82.0% and 55.1%, respectively. Late complication with over grade 3 rectum/sigmoid, bowel and bladder obstruction were 3, 4, and 3 cases, respectively. All cases with over grade 3 toxicity received less than or equal to 58 Gy for lymph nodes. Twenty-two of 245 patients had PLN failure. The PLN control rate at 5 years was 79.5% for positive cases and 95.8% for negative cases. In cases with positive PLN, 12 of 129 lymph nodes (9.3%) developed recurrences. There were no significant correlations of lymph node recurrence with dose of external radiation or size of lymph node before RT. In contrast, a significant correlation was seen between lymph node recurrence and size of lymph node after 50 Gy. The lymph node control rate was 96.7% for a size less than 10 mm in long axis after 50 Gy, while the corresponding rate was 75.7% for a size 10 mm or more. In addition, the recurrence of these poor response nodes had significant correlation with dose of external radiation. Nine of 16 nodes (56.3%) receiving less than or equal to 58 Gy were recurrent, but none of 21 nodes receiving more than 58 Gy were recurrent (p=0.0003). \nConclusions: These results suggested that the response of lymph nodes after RT was a more significant predictive factor for recurrence than size of lymph node before RT, and poor response lymph nodes might require boost irradiation for a total dose of over 58 Gy. |
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| 会議概要（会議名, 開催地, 会期, 主催者等） | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | ASTRO's 54th Annual Meeting | |||||
| 発表年月日 | ||||||
| 日付 | 2012-10-31 | |||||
| 日付タイプ | Issued | |||||
