Radiation-induced tumor regression as a prognostic factor in patients with invasive cervical cancer

Abstract

Radiation-induced tumor regression was evaluated as a prognostic factor in 200 patients with invasive cervical cancer treated at the University of Kentucky Center during the years 1973-1977. Radiation responses were classified as complete (Type A), intermediate (Type B), or incomplete (Type C) based upon pelvic examination findings one month following completion of therapy. Patients with Type A response to radiation had a recurrence rate of 5%, as compared with 27% in patients with a Type B response and 85% in patients with a Type C response. The direct relationship between radiation response and the incidence of tumor recurrence was observed in all stages of disease. Seventy-five percent of patients with Stages IB and IIB disease and a Type C response to radiation developed recurrent cancer, and tumor recurrences were confined to the central pelvis in the majority of cases. Patients with keratinizing squamous cell cancers had the lowest incidence of complete response to radiation. These findings suggest that careful observation of cervical cancer throughout radiation therapy can provide prognostically significant information concerning radiation-induced tumor regression. The therapeutic implications of this data is discussed.

RAR-Beta Expression Is Associated with Early Volumetric Changes to Radiation Therapy in Cervical Cancer

“…In the present study, the status of early volumetric changes assessed by MRI correlated with progression-free and overall survival. These results are consistent with earlier studies showing that early regression during or immediately after RT is a predictor of outcome of cervical cancer [4][5][6][7] .…”

“…Marcial et al [4] and Grossman et al [5] reported a correlation between early tumor regression and the probability of permanent control. Hardt et al [6] and Jacobs et al [7] concluded that patients with no residual tumor 1 month after treatment had a marked survival advantage. These studies suggest that screening for patients with poor prognostic signs is important, in order that adjuvant treatment be started as early as possible.…”

A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy

“…This observation has been confirmed, suggesting that there are differences in the radiosensitivity of cervical carcinomas [52,58,88].…”

Semiquantitative and Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging Measurements Predict Radiation Response in Cervix Cancer

“…Tumor regression was chosen as a short-term endpoint because it has been shown to correlate with local control and outcome (18,19). Tumors with a higher level of perfusion and permeability have a better prognosis.…”