Tailoring adjuvant radiotherapy for stage IB–IIA node negative cervical carcinoma after radical hysterectomy and pelvic lymph node dissection using the GOG score

Yeo, Reuben J.; Chia, Yin Nin; Namuduri, R.; Yap, Swee Peng; Soong, Yoke Lim; Yam, Philip Kwai Lam; Lim, Timothy Yong Kuei; Khoo-Tan, H. S.

doi:10.1016/j.ygyno.2011.06.040

Cited by 19 publications

(17 citation statements)

References 15 publications

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“…52 It is well known that the addition of adjuvant radiotherapy to surgery increases morbidity and thus compromises the quality of life. 95,96 Additionally, combined modality treatment will unnecessarily overburden the surgical and radiation facilities, which are already inadequate in low-resource countries. Therefore, CCRT is the standard of care for Stage IB3 and IIA2 disease.…”

Section: Radiation Therapy For Figo Stage Ib3 and Iia2mentioning

confidence: 99%

Cancer of the cervix uteri

Bhatla

Aoki

Sharma

et al. 2018

Intl J Gynecology & Obste

950

799

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Since the publication of the last FIGO Cancer Report there have been giant strides in the global effort to reduce the burden of cervical cancer, with WHO announcing a call for elimination. In over 80 countries, including LMICs, HPV vaccination is now included in the national program. Screening has also seen major advances with implementation of HPV testing on a larger scale. However, these interventions will take a few years to show their impact. Meanwhile, over half a million new cases are added each year. Recent developments in imaging and increased use of minimally invasive surgery have changed the paradigm for management of these cases. The FIGO Gynecologic Oncology Committee has revised the staging system based on these advances. This chapter discusses the management of cervical cancer based on the stage of disease, including attention to palliation and quality of life issues.

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Section: Radiation Therapy For Figo Stage Ib3 and Iia2mentioning

confidence: 99%

Cancer of the cervix uteri

Bhatla

Aoki

Sharma

et al. 2018

Intl J Gynecology & Obste

950

799

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“…17 In the node-negative group, the predominant risk is for central recurrence; in contrast, node-positive patients tend to relapse regionally or distally. 18 Hong et al 19 retrospectively 20 although the safety and effectiveness of RPV versus traditional adjuvant RT/CRT have not been subjected to comparison in the setting of a randomized controlled trial. In the current study, an RPV was administered to half the patients receiving adjuvant RT/CRT.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Review of Patients With Stage IB2 Cervical Cancer Treated With Radical Radiation Versus Radical Surgery as a Primary Modality

Alleyne-Mike

Wijk²,

Hunter

2013

Int J Gynecol Cancer

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The optimal primary treatment for stage IB2 cervical cancer remains unclear. Both types of primary treatments were found to be feasible therapeutic approaches. Primary surgery seems to have better survival outcomes at our institution. Selection bias including a larger median tumor size in the radiotherapy group and inadequate concurrent chemotherapy (≤3 cycles) in 58% of the patients receiving primary radiotherapy probably accounted for the difference in survival.Thus, primary concurrent chemoradiation is being increasingly used for these patients at our institution in an effort to decrease bimodal treatment and limit the potential for increased toxicity and treatment costs. Evidence from a randomized controlled study is needed to determine the optimal treatment for stage IB2 cervical cancer.

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“…Yeo et al 15 described their SPF borders as extending from the inferior edge of the sacroiliac joints to the inferior of the obturator foramina, and 1-1.5 cm medial to the true pelvic inlet. The protocol was of no adjuvant RT if the GOG score < 40, SPF if the…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of stage IB node-negative cervical cancer treated with adjuvant radiation with standard pelvic versus central small pelvic fields

Ralefala

Wijk

Saidu

2018

Southern African Journal of Gynaecological Oncology

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Materials and methods: A retrospective observational study of patients with stage IB cervical cancer treated with radical surgery between 1984 and 2010. Node-negative patients regarded as at risk of pelvic recurrence received PORT, with or without concurrent cisplatin or additional vaginal brachytherapy. The PORT was given with either whole pelvis fields (WPF), or with central small pelvic fields (SPF). Data concerning indications for adjuvant therapy, treatment outcomes and grade 3-4 treatmentrelated toxicities, including leg lymphoedema, were extracted from clinical records. Results: Thirty-one patients received WPF, and 56 SPF. The overall 5-year survival rate was 85%. No significant differences in survival rates were found between the WPF and SPF groups (log rank p = 0.67). Relapse patterns and the crude grade 3-4 treatment morbidity rates did not differ, although two patients in the WPF group (6%) died of treatment-related complications. Conclusions: The expected benefit of PORT with SPF, which targets the cervical tumour bed and para-cervical tissues only, is a reduction in small bowel morbidity and lymphoedema. It is not possible to ascertain from this audit whether the SPF technique reduces complications, or that it increases out-of-field pelvic relapses. It seems unlikely that a randomised controlled trial will ever be performed, as a large sample size would be required. Comparisons of pooled SPF data with historical WPF controls seem the best option to establish the safety of this approach.

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Tailoring adjuvant radiotherapy for stage IB–IIA node negative cervical carcinoma after radical hysterectomy and pelvic lymph node dissection using the GOG score

Cited by 19 publications

References 15 publications

Cancer of the cervix uteri

Cancer of the cervix uteri

A Retrospective Review of Patients With Stage IB2 Cervical Cancer Treated With Radical Radiation Versus Radical Surgery as a Primary Modality

A retrospective study of stage IB node-negative cervical cancer treated with adjuvant radiation with standard pelvic versus central small pelvic fields

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