Extended-Field Irradiation and Intracavitary Brachytherapy Combined With Cisplatin Chemotherapy for Cervical Cancer With Positive Para-Aortic or High Common Iliac Lymph Nodes: Results of ARM 1 of RTOG 0116

Small, William; Winter, Kathryn; Levenback, Charles; Iyer, Revathy B.; Gaffney, David K.; Asbell, Sucha O.; Erickson, Beth; Jhingran, Anuja; Greven, K.M.

doi:10.1016/j.ijrobp.2007.01.026

Cited by 133 publications

(59 citation statements)

References 24 publications

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“…A combination of extended-field RT and concurrent chemotherapy was associated with high rates of acute and long-term toxicity according to a study by the RTOG [17, 18]. We reported acute and long-term toxicity in these patients (Table 6).…”

Section: Resultsmentioning

confidence: 73%

Prognostic factors associated with radiotherapy for cervical cancer with computed tomography-detected para-aortic lymph node metastasis

Huang

et al. 2013

Journal of Radiation Research

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Patients with cervical cancer diagnosed with a para-aortic lymph node (PALN) metastasis by computed tomography (CT) scan were analyzed to identify associated prognostic factors. A total of 55 patients were reviewed, and 27 of these patients underwent extended-field radiotherapy (EFRT). The median PALN dose in patients receiving EFRT was 45 Gy (range, 27–57.6 Gy). Of the 55 patients, 28 underwent pelvic radiotherapy (RT); concurrent chemoradiotherapy (CCRT) was administered to 41 patients. The Kaplan–Meier method was used to calculate the actuarial rate. Multivariate analysis was performed using the Cox proportional hazards model. Five-year overall survival (OS) rates were 41% and 17.9% in patients undergoing EFRT and pelvic RT (P = 0.030), respectively. Age < 53 years (P = 0.023), FIGO Stage I–II (P = 0.002), and treatment with EFRT (P = 0.003) were independent predictors of better OS. The use of CCRT (P = 0.014), Stage I–II (P = 0.002), and treatment using EFRT (P = 0.036) were independent predictors of distant metastasis. In patients undergoing EFRT plus CCRT, the 5-year OS was 50%. Three-year PALN disease-free rates were 8.8%, 57.9% and 100% (P < 0.001) in CCRT patients who received PALN doses of 0 Gy, ≤45 Gy and ≥50.4 Gy, respectively. Although PALN metastasis is thought to be distant metastasis in cervical cancer, EFRT plus CCRT shows a good outcome, particularly in younger patients in an early FIGO stage. Cervical cancer with a PALN metastasis should not be considered incurable. Doses ≥50.4 Gy for treating PALN may result in better disease control.

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Section: Resultsmentioning

confidence: 73%

Prognostic factors associated with radiotherapy for cervical cancer with computed tomography-detected para-aortic lymph node metastasis

Huang

et al. 2013

Journal of Radiation Research

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“…Several authors have reported that the control rates of para-aortic lymph node metastasis, to which total doses of 45–59.4 Gy were given along with platinum-based chemotherapy, were 50–85% [29,30,31,32]. It remains unknown if dose escalation is useful for the control of para-aortic lymph node metastasis, or whether chemoradiotherapy with new arrival agents or combinations of chemotherapeutic agents may not only improve the control of lymph node metastasis but also effectively prevent further fatal distant metastasis in other organs.…”

Section: Discussionmentioning

confidence: 99%

The Role of Radiation Therapy for Uterine Cervical Cancer with Distant Metastasis

Hata

Omura²,

Miyagi³

et al. 2012

Oncology

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Objective: We carried out a review to determine the role of radiation therapy in uterine cervical cancer with distant metastasis. Methods: Forty-four patients with uterine cervical cancer with distant metastasis underwent radiation therapy; 29 of these also underwent chemotherapy. A total dose of 19.8–90.4 Gy (median 62.9 Gy) was delivered to the cervical tumors. Results: Thirty-three patients died during the follow-up period of 1–94 months (median 10 months) after irradiation. The overall survival rate at 3 years was 20%, and the estimated median survival time was 15 months. Ten patients developed primary tumor progression, and the primary tumor control rate at 3 years was 49%. A distant metastatic site and primary tumor size were significant prognostic factors for their survival. Total radiation dose was considered a significant and useful variable for primary tumor control. With the exception of transient hematologic reactions and hemorrhagic cystitis, there were no therapy-related toxicities of grade 3 or greater. Conclusions: Radiation therapy was safe and effective for local control in patients with uterine cervical cancer with distant metastasis. More aggressive treatment, including radiation therapy with a curative radiation dose, should be considered for patients with favorable prognostic factors for survival.

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“…The clinical treatment procedures for cervical cancer include chemotherapy, radiation therapy, intracavitary or interstitial brachytherapy and even radical hysterectomy [4,5,6]. The patients’ different conditions, such as age, stage of the cancer, and tumor type, determine the different clinical therapeutic schemes [7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Core-Shell Magnetic Gold Nanoparticles for Magnetic Field-Enhanced Radio-Photothermal Therapy in Cervical Cancer

Zheng

et al. 2017

Nanomaterials

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The combination of radiotherapy (RT) and photothermal therapy (PTT) has been considered an attractive strategy in cervical cancer treatment. However, it remains a challenge to simultaneously enhance the radio-sensitivity of tumor tissue, develop tumor tissue-focused radiation therapies and combine dual therapeutic modalities. In this study, core-shell type magnetic gold (Fe3O4@Au) nanoparticles are exploited to achieve the synergistic efficacy of radio-photothermal therapy in cervical cancer. Fe3O4@Au nanoparticles (NPs) with uniform morphology exhibited superior surface plasmon resonance properties, excellent superparamagnetic properties, good biocompatibility and high photothermal conversion efficiency. For the in vitro tests, a low concentration of Fe3O4@Au NPs after a short period of near-infrared irradiation lead to the time-dependent death of cervical cancer cells. Further, the combination of RT and PTT induced synergistic anti-cancer effects in vitro. More importantly, an external magnetic field could significantly enhance the synergistic efficacy of Fe3O4@Au NPs by improving their internalization. Hence, the reported Fe3O4@Au NPs have the potential to be good nanoagents with excellent magnetic targeting ability for cervical cancer radio-photothermal treatment.

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Extended-Field Irradiation and Intracavitary Brachytherapy Combined With Cisplatin Chemotherapy for Cervical Cancer With Positive Para-Aortic or High Common Iliac Lymph Nodes: Results of ARM 1 of RTOG 0116

Cited by 133 publications

References 24 publications

Prognostic factors associated with radiotherapy for cervical cancer with computed tomography-detected para-aortic lymph node metastasis

Prognostic factors associated with radiotherapy for cervical cancer with computed tomography-detected para-aortic lymph node metastasis

The Role of Radiation Therapy for Uterine Cervical Cancer with Distant Metastasis

Core-Shell Magnetic Gold Nanoparticles for Magnetic Field-Enhanced Radio-Photothermal Therapy in Cervical Cancer

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