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Details of recurrence sites after definitive radiation therapy for cervical cancer

OBJECTIVE: This is a retrospective study aimed at clarifying the details of recurrence patterns and sites in patients with cervical cancer treated with definitive radiation therapy (RT). METHODS: Data were analyzed from consecutive patients, admitted to the University of Tokyo Hospital (Tokyo, Japan...

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Autores principales: Kobayashi, Reiko, Yamashita, Hideomi, Okuma, Kae, Ohtomo, Kuni, Nakagawa, Keiichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717221/
https://www.ncbi.nlm.nih.gov/pubmed/26463432
http://dx.doi.org/10.3802/jgo.2016.27.e16
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author Kobayashi, Reiko
Yamashita, Hideomi
Okuma, Kae
Ohtomo, Kuni
Nakagawa, Keiichi
author_facet Kobayashi, Reiko
Yamashita, Hideomi
Okuma, Kae
Ohtomo, Kuni
Nakagawa, Keiichi
author_sort Kobayashi, Reiko
collection PubMed
description OBJECTIVE: This is a retrospective study aimed at clarifying the details of recurrence patterns and sites in patients with cervical cancer treated with definitive radiation therapy (RT). METHODS: Data were analyzed from consecutive patients, admitted to the University of Tokyo Hospital (Tokyo, Japan) between 2001 and 2013, who had received definitive RT, with or without chemotherapy, for International Federation of Gynecology and Obstetrics stages IB–IVA cervical cancer. RESULTS: One hundred and thirty-seven patients formed the patient cohort. The median follow-up period for surviving patients was 57.0 months. A complete response was achieved in 121 patients (88%). Of these, 36 (30%) developed a cancer recurrence during follow-up. The first sites of recurrence were located in intra-RT fields in nine, outside RT fields in 20, and both in seven patients. In the intra-RT field group, all patients showed a local recurrence, while no one experienced an isolated pelvic lymph node (PLN) recurrence. In the outside RT field group, the most frequent site of recurrence was lung (60%), and three-quarters of patients were free from intra-RT field recurrence until the last follow-up. Of the entire cohort, including 48 PLN-positive patients, only seven patients (5.1%) developed PLN persistence or recurrence, all in the common iliac, internal iliac, and/or obturator nodes, and all with another synchronous relapse. CONCLUSION: Local disease was a major type of intra-RT field recurrence, while PLN control was favorable even in initially PLN-positive patients. The predominance of outside RT field recurrence alone highlights issues concerning distant control, including the intensity enhancement of systematic therapy.
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spelling pubmed-47172212016-03-01 Details of recurrence sites after definitive radiation therapy for cervical cancer Kobayashi, Reiko Yamashita, Hideomi Okuma, Kae Ohtomo, Kuni Nakagawa, Keiichi J Gynecol Oncol Original Article OBJECTIVE: This is a retrospective study aimed at clarifying the details of recurrence patterns and sites in patients with cervical cancer treated with definitive radiation therapy (RT). METHODS: Data were analyzed from consecutive patients, admitted to the University of Tokyo Hospital (Tokyo, Japan) between 2001 and 2013, who had received definitive RT, with or without chemotherapy, for International Federation of Gynecology and Obstetrics stages IB–IVA cervical cancer. RESULTS: One hundred and thirty-seven patients formed the patient cohort. The median follow-up period for surviving patients was 57.0 months. A complete response was achieved in 121 patients (88%). Of these, 36 (30%) developed a cancer recurrence during follow-up. The first sites of recurrence were located in intra-RT fields in nine, outside RT fields in 20, and both in seven patients. In the intra-RT field group, all patients showed a local recurrence, while no one experienced an isolated pelvic lymph node (PLN) recurrence. In the outside RT field group, the most frequent site of recurrence was lung (60%), and three-quarters of patients were free from intra-RT field recurrence until the last follow-up. Of the entire cohort, including 48 PLN-positive patients, only seven patients (5.1%) developed PLN persistence or recurrence, all in the common iliac, internal iliac, and/or obturator nodes, and all with another synchronous relapse. CONCLUSION: Local disease was a major type of intra-RT field recurrence, while PLN control was favorable even in initially PLN-positive patients. The predominance of outside RT field recurrence alone highlights issues concerning distant control, including the intensity enhancement of systematic therapy. Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 2016-03 2015-12-01 /pmc/articles/PMC4717221/ /pubmed/26463432 http://dx.doi.org/10.3802/jgo.2016.27.e16 Text en Copyright © 2016. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kobayashi, Reiko
Yamashita, Hideomi
Okuma, Kae
Ohtomo, Kuni
Nakagawa, Keiichi
Details of recurrence sites after definitive radiation therapy for cervical cancer
title Details of recurrence sites after definitive radiation therapy for cervical cancer
title_full Details of recurrence sites after definitive radiation therapy for cervical cancer
title_fullStr Details of recurrence sites after definitive radiation therapy for cervical cancer
title_full_unstemmed Details of recurrence sites after definitive radiation therapy for cervical cancer
title_short Details of recurrence sites after definitive radiation therapy for cervical cancer
title_sort details of recurrence sites after definitive radiation therapy for cervical cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717221/
https://www.ncbi.nlm.nih.gov/pubmed/26463432
http://dx.doi.org/10.3802/jgo.2016.27.e16
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