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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
Affiliations- Department of Radiotherapy, M. Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
- Division Research Programmes, M. Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
- Department of Radiotherapy Planning, M. Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
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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.
Keywords
cervix cancer; volumetric staging; radiotherapy outcomes
About this articleTitle
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
Article type
Research paper (original)
Pages
167-172
Published online
2020-09-03
Page views
571
Article views/downloads
553
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2020;70(5):167-172.
Keywords
cervix cancer
volumetric staging
radiotherapy outcomes
Authors
Ewa Telka
Bogusław Maciejewski
Leszek Hawrylewicz
Bożena Jochymek
Magdalena Markowska
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