Local Radiotherapy or Chemotherapy for Oligo-recurrent Cervical Cancer in Patients With Prior Pelvic Irradiation

Kobayashi, Kazuma; Murakami, Naoya; Takahashi, Kana; Inaba, Koji; Hamamoto, Ryuji; Itami, Jun

doi:10.21873/invivo.11652

Cited by 8 publications

(12 citation statements)

References 23 publications

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“…The results of the present study demonstrated that RT was an effective salvage treatment for recurrent patients, with excellent 5-year OS, PFS, and LC rates of 81%, 75%, and 87%. Compared with the median EQD2 that ranged from 45 to 82.5 Gy in previous studies, the median EQD2 of the salvage RT was 64.9 Gy (range, 25.0 to 95.8 Gy) in this study ( 7 , 8 , 11 , 12 , 22 ), which indicated that larger RT doses contributed to the outstanding clinical outcomes. The application of advanced RT techniques, including volumetric modulated arc therapy (VMAT), TOMO, 3D-BT, intracavitary with or without interstitial (IC ± IS) technique, and individualized RT field design for patients with re-irradiation, all contributed to the delivery of higher RT doses in this study.…”

Section: Discussioncontrasting

confidence: 55%

“…As for RT-naïve patients, higher RT doses could be delivered resulting in a better tumor remission. However, the dose of re-irradiation was limited because of the initial radiation damage on the surrounding tissue and the potential severe radiogenic side effects, especially for in-field recurrence ( 7 ). In a previous study, the 5-year LFFS in postoperative recurrent patients without RT history receiving salvage RT was 63.9%, while it was 47.1% in patients that received re-irradiation ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

“…The optimal salvage treatment regimen includes salvage radiotherapy (RT), chemotherapy, and reoperation such as pelvic exenteration depending on the primary treatment, type of recurrence, and associated comorbidities. RT with or without concurrent chemotherapy as salvage treatment seems to present promising treatment outcomes and tolerable toxicities (7)(8)(9). Several studies have proved that salvage RT can achieve better survival outcomes (8,10), especially when using brachytherapy (BT) for re-irradiation due to its conformal dose distribution (11,12).…”

Section: Introductionmentioning

confidence: 99%

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Radiotherapy for Vaginal Recurrences of Cervical Cancer in Patients After Prior Surgery: Analysis of Effect and Prognostic Factors

et al. 2021

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ObjectiveThe role of salvage radiotherapy (RT) in the treatment for vaginal recurrence of cervical cancer in patients after prior surgery remains controversial. The aim of this study was to evaluate the efficacy and toxicity of salvage RT and explore prognostic factors associated with the survival after recurrence.MethodsPatients with cervical cancer, treated for vaginal recurrences at Peking Union Medical College Hospital between July 2011 and November 2019, were identified. All the patients underwent prior surgery for primary tumor and received salvage RT including external beam radiotherapy (EBRT), brachytherapy (BT), or both. The irradiation field and dose depended on the conditions of patients. Recurrence patterns were classified into four categories according to the site of recurrence. Prognostic factors on the overall survival (OS), progression-free survival (PFS), and local control (LC) were analyzed, and late toxicity was evaluated.ResultsA total of 141 patients were included in the analysis, with a median follow-up time of 40.8 months. The estimated 5-year OS, PFS, and LC rates were 81%, 75%, and 87%, respectively. In multivariate analysis, endovaginal recurrence and no irradiation history were favorable prognostic factors associated with OS (all p < 0.05), PFS (all p < 0.05), and LC (all p < 0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of the recurrence pattern is larger than the stage of primary tumor (0.734 vs. 0.670).ConclusionsRT was an effective treatment with tolerable toxicity for vaginal recurrences of cervical cancer in patients with prior surgery. Recurrence pattern and irradiation history were important prognostic factors.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Radiotherapy for Vaginal Recurrences of Cervical Cancer in Patients After Prior Surgery: Analysis of Effect and Prognostic Factors

et al. 2021

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“…The regimen was tolerable and offered >60% five-year overall survival rate [ 216 ]. Patients with relapsed and advanced cervical cancer involving lymphatic metastasis were treated with radical surgery—salvage radiotherapy with concurrent chemotherapy (combination of docetaxel and cisplatin/cyclophosphamide, cisplatin and 5-fluorouracil, and paclitaxel and carboplatin) [ 213 , 217 ].…”

Section: Treatment Regimensmentioning

confidence: 99%

Current Updates on Cancer-Causing Types of Human Papillomaviruses (HPVs) in East, Southeast, and South Asia

Xia

Long

et al. 2021

Cancers

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Human papillomavirus (HPV) infection remains one of the most prominent cancer-causing DNA viruses, contributing to approximately 5% of human cancers. While association between HPV and cervical cancers has been well-established, evidence on the attribution of head and neck cancers (HNC) to HPV have been increasing in recent years. Among the cancer-causing HPV genotypes, HPV16 and 18 remain the major contributors to cancers across the globe. Nonetheless, the distribution of HPV genotypes in ethnically, geographically, and socio-economically diverse East, Southeast, and South Asia may differ from other parts of the world. In this review, we garner and provide updated insight into various aspects of HPV reported in recent years (2015–2021) in these regions. We included: (i) the HPV genotypes detected in normal cancers of the uterine cervix and head and neck, as well as the distribution of the HPV genotypes by geography and age groups; (ii) the laboratory diagnostic methods and treatment regimens used within these regions; and (iii) the oncogenic properties of HPV prototypes and their variants contributing to carcinogenesis. More importantly, we also unveil the similarities and discrepancies between these aspects, the areas lacking study, and the challenges faced in HPV studies.

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“…Second, the RT mode to be selected for CCRT in patients with local recurrence of cervical cancer remains undetermined. At present, there are two common RT modes: involved-eld RT combined with regional lymph nodes (regional RT) and involvedeld RT alone (local RT) [2,6,7]. Many studies have shown that RT covering both the regional lymph node area and gross tumor is an appropriate RT mode [8,9].…”

Section: Introductionmentioning

confidence: 99%

Salvage Radiotherapy Strategy and Its Prognostic Significance for Patients With Locally Recurrent Cervical Cancer After Radical Resection: a Retrospective 10-year Analysis

Zou

Shan

Hou

et al. 2021

Preprint

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Background: Salvage radiotherapy modes for treating patients with local cervical cancer recurrence after radical surgery are controversial. Therefore, we aimed to evaluate the clinical efficacy and prognostic significance of two radiotherapy modes—involved-field radiotherapy combined with regional lymph nodes (regional radiotherapy) and involved-field radiotherapy alone (local radiotherapy)—in these patients.Methods: We retrospectively enrolled patients with local recurrence who underwent radical surgery without radiotherapy for early-stage cervical cancer from January 2010 to January 2020. Clinical outcomes were analyzed using the Kaplan–Meier method and a Cox proportional hazards model.Results: Forty-four patients underwent intensity-modulated radiotherapy (IMRT)-based salvage treatment. The 5-year overall survival and progression-free survival rates were 64% and 60.2%, respectively. Sixteen of 18 patients with stump recurrence and 15 of 26 patients with pelvic and abdominal cavity recurrence received regional radiotherapy, while others received local radiotherapy. Univariate analysis showed that patients with stump recurrence, who underwent regional radiotherapy, and with a lower systemic inflammation response index (SIRI) had better prognosis than their counterparts. Patients aged < 51 years, with stump recurrence, recurrence time ≤ 24 months, recurrence site=1, and a lower SIRI who received regional radiotherapy had a better prognosis than patients who received local radiotherapy. SIRI correlated with the recurrence site and radiotherapy mode.Conclusion: Locally recurrent cervical cancer treated with IMRT-based salvage therapy has a good prognosis. Recurrence site, SIRI, and the radiotherapy mode significantly influenced prognosis. Regional radiotherapy may be suitable for patients with stump recurrence, recurrence time ≤ 24 months, and one recurrence site.

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Local Radiotherapy or Chemotherapy for Oligo-recurrent Cervical Cancer in Patients With Prior Pelvic Irradiation

Cited by 8 publications

References 23 publications

Radiotherapy for Vaginal Recurrences of Cervical Cancer in Patients After Prior Surgery: Analysis of Effect and Prognostic Factors

Radiotherapy for Vaginal Recurrences of Cervical Cancer in Patients After Prior Surgery: Analysis of Effect and Prognostic Factors

Current Updates on Cancer-Causing Types of Human Papillomaviruses (HPVs) in East, Southeast, and South Asia

Salvage Radiotherapy Strategy and Its Prognostic Significance for Patients With Locally Recurrent Cervical Cancer After Radical Resection: a Retrospective 10-year Analysis

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