Patterns of Failure in Node Positive Cervical Cancer Patients Treated with Radical Radiotherapy
Background: Chemoradiation plays an important role in cervical cancer treatment but dose to organs at risk (OAR) is the limitation while escalating dose to target. With conformal techniques dose escalation is made possible without increase in toxicities. Though node positive cervical cancers have po...
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| Format: | Article |
| Language: | English |
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West Asia Organization for Cancer Prevention
2022-03-01
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| Series: | Asian Pacific Journal of Cancer Care |
| Subjects: | |
| Online Access: | http://www.waocp.com/journal/index.php/apjcc/article/view/742 |
| _version_ | 1797342266889601024 |
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| author | Geetha Muttath Greeshma Keloth Erakkotan Vinin Narayanan Joneetha Jones Arun. P. Narendran Nabeel Yahiya Akhil. P. Suresh Muhammed Minhaj Muhammed Riyas |
| author_facet | Geetha Muttath Greeshma Keloth Erakkotan Vinin Narayanan Joneetha Jones Arun. P. Narendran Nabeel Yahiya Akhil. P. Suresh Muhammed Minhaj Muhammed Riyas |
| author_sort | Geetha Muttath |
| collection | DOAJ |
| description | Background: Chemoradiation plays an important role in cervical cancer treatment but dose to organs at risk (OAR) is the limitation while escalating dose to target. With conformal techniques dose escalation is made possible without increase in toxicities. Though node positive cervical cancers have poorer prognosis delivering higher dose to the involved nodes have shown benefit. We aim to determine the patterns of failure in node positive cervical cancer patients treated with chemoradiation and to determine the grade III and IV toxicities associated with it.
Methods and Materials: In this retrospective study node positive cervical cancer patients treated with conformal radiotherapy were analysed. 45 Gy -50.4 Gy was given to the pelvis and 55 Gy to positive nodes with sequential or simultaneous integrated boost (SIB) in 25 -28 fractions with weekly cisplatin 40mg/m2 followed by brachy therapy. Extended fields were used to treat patients with positive para aortic lymph nodes. Treatment toxicities were recorded as per CTCAE version 4.3.
Results: Of the 62 patients 87.1% had squamous cell carcinoma and majority were in stage II (38.7%). At a median follow up of 33 months two (3.2%) patients had local recurrence, eight (12.9 %) had distant failure and one (1.6%) had loco regional recurrence. Lung was the most common site of metastasis followed by the supraclavicular region. The 3 year overall and disease free survival were 91.4 % and 77.2 % respectively. Stage of the disease (p=0.001) and residue at the end of therapy (p-0.010) showed significant association with DFS but not with OS. 21 (33%) had Grade III –IV toxicities, nine (13%) having acute toxicities and 12 (19.4%) had late toxicities.
Conclusion: Though node positive cervical cancers have poor prognosis our study showed that aggressive management improves the outcome without increase in toxicities. |
| first_indexed | 2024-03-08T10:30:49Z |
| format | Article |
| id | doaj.art-d0739330a33d44e6a9c3c234eb4beb33 |
| institution | Directory Open Access Journal |
| issn | 2588-3682 |
| language | English |
| last_indexed | 2024-03-08T10:30:49Z |
| publishDate | 2022-03-01 |
| publisher | West Asia Organization for Cancer Prevention |
| record_format | Article |
| series | Asian Pacific Journal of Cancer Care |
| spelling | doaj.art-d0739330a33d44e6a9c3c234eb4beb332024-01-27T05:27:27ZengWest Asia Organization for Cancer PreventionAsian Pacific Journal of Cancer Care2588-36822022-03-0171555910.31557/apjcc.2022.7.1.55-59742Patterns of Failure in Node Positive Cervical Cancer Patients Treated with Radical RadiotherapyGeetha Muttath0Greeshma Keloth Erakkotan1Vinin Narayanan2Joneetha Jones3Arun. P. Narendran4Nabeel Yahiya5Akhil. P. Suresh6Muhammed Minhaj7Muhammed Riyas8Department of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.Department of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, India. 2 Radiographer, Government Medical College, Manjeri,IndiaDepartment of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, IndiaDepartment of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.Department of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, IndiaDepartment of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, IndiaDepartment of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, IndiaRadiographer, Government Medical College, Manjeri,India.Division of Clinical Research and Biostatistics, India.Background: Chemoradiation plays an important role in cervical cancer treatment but dose to organs at risk (OAR) is the limitation while escalating dose to target. With conformal techniques dose escalation is made possible without increase in toxicities. Though node positive cervical cancers have poorer prognosis delivering higher dose to the involved nodes have shown benefit. We aim to determine the patterns of failure in node positive cervical cancer patients treated with chemoradiation and to determine the grade III and IV toxicities associated with it. Methods and Materials: In this retrospective study node positive cervical cancer patients treated with conformal radiotherapy were analysed. 45 Gy -50.4 Gy was given to the pelvis and 55 Gy to positive nodes with sequential or simultaneous integrated boost (SIB) in 25 -28 fractions with weekly cisplatin 40mg/m2 followed by brachy therapy. Extended fields were used to treat patients with positive para aortic lymph nodes. Treatment toxicities were recorded as per CTCAE version 4.3. Results: Of the 62 patients 87.1% had squamous cell carcinoma and majority were in stage II (38.7%). At a median follow up of 33 months two (3.2%) patients had local recurrence, eight (12.9 %) had distant failure and one (1.6%) had loco regional recurrence. Lung was the most common site of metastasis followed by the supraclavicular region. The 3 year overall and disease free survival were 91.4 % and 77.2 % respectively. Stage of the disease (p=0.001) and residue at the end of therapy (p-0.010) showed significant association with DFS but not with OS. 21 (33%) had Grade III –IV toxicities, nine (13%) having acute toxicities and 12 (19.4%) had late toxicities. Conclusion: Though node positive cervical cancers have poor prognosis our study showed that aggressive management improves the outcome without increase in toxicities.http://www.waocp.com/journal/index.php/apjcc/article/view/742chemoradiationcervical cancervolumetric modulated arc therapyynode positivity |
| spellingShingle | Geetha Muttath Greeshma Keloth Erakkotan Vinin Narayanan Joneetha Jones Arun. P. Narendran Nabeel Yahiya Akhil. P. Suresh Muhammed Minhaj Muhammed Riyas Patterns of Failure in Node Positive Cervical Cancer Patients Treated with Radical Radiotherapy Asian Pacific Journal of Cancer Care chemoradiation cervical cancer volumetric modulated arc therapyy node positivity |
| title | Patterns of Failure in Node Positive Cervical Cancer Patients Treated with Radical Radiotherapy |
| title_full | Patterns of Failure in Node Positive Cervical Cancer Patients Treated with Radical Radiotherapy |
| title_fullStr | Patterns of Failure in Node Positive Cervical Cancer Patients Treated with Radical Radiotherapy |
| title_full_unstemmed | Patterns of Failure in Node Positive Cervical Cancer Patients Treated with Radical Radiotherapy |
| title_short | Patterns of Failure in Node Positive Cervical Cancer Patients Treated with Radical Radiotherapy |
| title_sort | patterns of failure in node positive cervical cancer patients treated with radical radiotherapy |
| topic | chemoradiation cervical cancer volumetric modulated arc therapyy node positivity |
| url | http://www.waocp.com/journal/index.php/apjcc/article/view/742 |
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