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Patterns of treatment failure following radiotherapy with combination chemotherapy for patients with high-risk stage IIB cervical carcinoma

Authors
 Tchan-Kyu Park  ;  Ja-Young Kwon  ;  Gwi Eon Kim  ;  Soo-Nyung Kim  ;  Sung-Hoon Kim  ;  Sang-Wun Kim 
Citation
 INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, Vol.9(2) : 120-124, 2004 
Journal Title
 INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 
ISSN
 1341-9625 
Issue Date
2004
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Brachytherapy ; Carcinoma/pathology ; Carcinoma/therapy* ; Combined Modality Therapy ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Radiotherapy/methods* ; Retrospective Studies ; Treatment Failure ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/therapy*
Abstract
BACKGROUND: To evaluate the patterns of treatment failure in patients with stage IIB cervical carcinoma with high-risk factors following radiotherapy given concurrently with combination chemotherapy. METHODS: A retrospective analysis of 349 patients with stage IIB cervical carcinoma with high-risk factors (lesion size >/= 4 cm, lymph node metastasis, high-risk cell type) treated by radiotherapy and cisplatin-based chemotherapy was performed. Sites of treatment failure were categorized as pelvic, pelvic plus distant metastases, and distant metastases alone. Pelvic failure included local and pelvic nodal failures. RESULTS: Of the 349 patients, treatment failure occurred in 79 patients (22.6%). Forty-six (13.2%) had persistent disease and 33 (9.5%) had recurrent disease. Among these 79 patients, overall pelvic failure was observed in 67%, of whom 72% had local failure; 19%, pelvic nodal failure; and 9%, local with pelvic nodal failure. Incidences of distant metastases alone and pelvic with distant metastases were 24% and 9%. In the 26 patients with distant metastases either alone or combined with pelvic failure, the most frequent metastatic region was the paraaortic lymph node (50%). The distant metastasis rate was 6.5% (19/289) in the pelvic tumor control group and 11.6% (7/60) in the pelvic failure group. Pelvic failure was the most frequent failure in the group with tumor size of 4 cm or more, whereas, for the positive-lymph-node group, distant metastasis was most frequent and metastases to paraaortic lymph nodes were common. The incidences of pelvic failure alone and distant metastases were similar in the high-risk cell-type group, and the distant metastasis regions were mostly paraaortic lymph nodes. CONCLUSION: Although systemic chemotherapy was administered concurrently with radiotherapy, the incidence of pelvic failure was highest, followed by paraaortic lymph node metastases, in patients with stage IIB cervical carcinoma with high-risk factors, following radiotherapy with combination chemotherapy. To evaluate the patterns of treatment failure in patients with stage IIB cervical carcinoma with high-risk factors following radiotherapy given concurrently with combination chemotherapy.
Full Text
http://link.springer.com/article/10.1007%2Fs10147-003-0378-9
DOI
10.1007/s10147-003-0378-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ja Young(권자영) ORCID logo https://orcid.org/0000-0003-3009-6325
Kim, Gwi Eon(김귀언)
Kim, Sang Wun(김상운) ORCID logo https://orcid.org/0000-0002-8342-8701
Kim, Sung Hoon(김성훈) ORCID logo https://orcid.org/0000-0002-1645-7473
Park, Chan Gyu(박찬규)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111274
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