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Tailored radiotherapeutic strategies for disseminated uterine cervical cancer patients

 Jung Ho Im  ;  Hong In Yoon  ;  Sunghoon Kim  ;  Eun Ji Nam  ;  Sang Wun Kim  ;  Ga Won Yim  ;  Ki Chang Keum  ;  Young Tae Kim  ;  Gwi Eon Kim  ;  Yong Bae Kim 
 RADIATION ONCOLOGY, Vol.10 : 77, 2015 
Journal Title
Issue Date
Adenocarcinoma/mortality ; Adenocarcinoma/radiotherapy* ; Adenocarcinoma/secondary ; Adult ; Aged ; Brachytherapy* ; Carcinoma, Small Cell/mortality ; Carcinoma, Small Cell/radiotherapy* ; Carcinoma, Small Cell/secondary ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/radiotherapy* ; Carcinoma, Squamous Cell/secondary ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Prognosis ; Radiotherapy Dosage ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms/mortality ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/radiotherapy*
Disseminated uterine cervical neoplasms ; Lymphatic metastasis ; Visceral organ metastasis ; Radiotherapy ; Chemotherapy
BACKGROUND: To investigate the role of radiotherapy (RT) in and to suggest radiotherapeutic strategies for patients presenting with disseminated cervical cancer. METHODS: We retrospectively analyzed 50 patients diagnosed as the disseminated cervical cancer with distant lymph nodal or visceral organ metastasis between September 1980 and August 2012. Patients were divided into two subgroups according to visceral organ metastasis: 35 patients diagnosed with distant lymph node metastasis only (group A) and 15 patients with visceral organ metastasis (group B). All patients received external beam RT to the pelvis (median dose 45 Gy) and high-dose rate intracavitary RT (median dose 30 Gy). Thirty-nine patients (78%) received chemotherapy. RESULTS: Median follow-up time was 74 months. The 5-year pelvic control rate (PCR) was 85.8%, and the progression-free survival (PFS), and overall survival (OS) rates were 28.7%, and 36.2%, respectively. The major treatment failure was systemic progression (32 patients, 64%). The 5-year PCRs in groups A and B were 87.4% and 74.7%, respectively (p > 0.05). Meanwhile, PFS and OS rates for group A were significantly better than those for group B (35.3% vs. 13.3%, p = 0.010; and 46.3% vs. 13.3%, p = 0.009, respectively). CONCLUSION: Our data revealed considerable prognostic heterogeneity in disseminated cervical cancer. Even though a high PCR was achieved in patients treated with definitive RT, survival outcomes were dependent on progression of visceral organ metastasis. Therefore, personalized RT and chemotherapy treatment strategies according to the presence of visceral organ metastasis in disseminated cervical cancer patients may help improve clinical outcomes.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
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
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Nam, Eun Ji(남은지) ORCID logo https://orcid.org/0000-0003-0189-3560
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Yim, Ga Won(임가원)
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