Vol 70, No 5 (2020)
Research paper (original)
Published online: 2020-09-03

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The impact of cervical (GTVCRX) and parametrial (GTVLP, GTVRP) volumetric status on efficacy of radiotherapy for uterine cervix cancer in stage IIB and IIIB

Ewa Telka1, Bogusław Maciejewski2, Leszek Hawrylewicz3, Bożena Jochymek1, Magdalena Markowska2
Nowotwory. Journal of Oncology 2020;70(5):167-172.

Abstract

Introduction. The impact of volumetric staging of cervix and parametria on treatment outcome after combined BRT and IMRT of 135 cervix cancer patients in stage IIB and IIIB is analysed.

Material and methods. Cervical GTVCRX and parametrial (GTVLP, RP) volumes are subdivided into four subgroups. BRT with 30 Gy in three fractions was combined with IMRT 48 Gy in 24 fractions. For GTVCRX ≤35 cm3 5-year local control (LC) was 100%, which decreased to 87% for GTVCRX ≥130 cm3.

Results. Cervix and parametrial local recurrence were not higher than 3%. Major failures were periaortal nodes metastases (PNM) occurring during 5-year follow-up. Dose of ≥60 izoGy2.0 effectively prevented the PNM. Underdosage <55 izoGy2.0 (GTVRP) resulted in an increasing PNM from 7% to 53%, strongly correlated with enlarging GTVCRX from 5 cm3 to >130 cm3.

Conclusion. Although cervix and parametria volumetric status are highly heterogeneous, they turned out to be better prognostic predictors than traditional TNM grading.

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Nowotwory. Journal of Oncology