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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 Telka, Bogusław Maciejewski, Leszek Hawrylewicz, Bożena Jochymek, Magdalena Markowska
DOI: 10.5603/NJO.a2020.0036

open access

Ahead of print
Original article
Published online: 2020-09-03

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.

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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Keywords

cervix cancer; volumetric staging; radiotherapy outcomes

About this article
Title

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

Journal

Nowotwory. Journal of Oncology

Issue

Ahead of print

Published online

2020-09-03

DOI

10.5603/NJO.a2020.0036

Keywords

cervix cancer
volumetric staging
radiotherapy outcomes

Authors

Ewa Telka
Bogusław Maciejewski
Leszek Hawrylewicz
Bożena Jochymek
Magdalena Markowska

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