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Xiaomei Fan
Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3035-876X
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This work is licensed under a CC BY 4.0 License. Read Full License
Objective: To compare and evaluate survival, prognosis, treatment failure, and toxicity between two treatment regimens in cervical cancer patients radiologically diagnosed with pelvic lymphadenopathy and without para-aortic lymphadenopathy.
Methods: Thirty-one patients with cervical cancer were prospectively selected for primarily treatment as the extended-field, intensity-modulated radiation group (EF-IMRT group), and 37 patients were chosen simultaneously as the pelvic intensity-modulated radiation group (P-IMRT group). Both groups were diagnosed with pelvic lymphadenopathy without para-aortic lymphadenopathy before treatment by radiology. Pelvic and para-aortic IMRT was employed in the EF-IMRT group, with an upper exposed level of the left renal vein, while pelvic IMRT was employed in P-IMRT group. Both groups were treated with high dose rate 192Ir brachytherapy and platinum-based concurrent chemotherapy.
Results: In the short-term, there was no effective difference between the groups. Regarding long-term efficacy, the 3-year overall survival (OS), progression-free survival (PFS), and progression and metastasis-free survival (PAMFS) in the EF-IMRT group and P-IMRT group were 87.0% vs. 74.6%, 83.6% vs. 61.7% and 96.0% vs. 80.5%, respectively. Treatment regimens, tumor size, and radiation time were all independent prognostic factors of OS and PFS. Treatment regimens, tumor size, and total equivalent dose in 2 Gy/f (EQD2) of point A were independent prognostic factors of PAMFS.
Conclusions: The risk of mortality, tumor progression, and metastasis in the para-aortic lymph nodes were significantly lower when using EF-IMRT than when using P-IMRT. EF-IMRT did not increase the incidence of gastrointestinal toxicities and genitourinary toxicities, and the toxicities at the late stages were mild.
Keywords
Para-aortic lymph node, Cervical cancer, Prophylactic intensity-modulated radiation, Survival, Prognosis, Toxicity
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Xiaomei Fan
Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3035-876X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 11 Aug, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: To compare and evaluate survival, prognosis, treatment failure, and toxicity between two treatment regimens in cervical cancer patients radiologically diagnosed with pelvic lymphadenopathy and without para-aortic lymphadenopathy.
Methods: Thirty-one patients with cervical cancer were prospectively selected for primarily treatment as the extended-field, intensity-modulated radiation group (EF-IMRT group), and 37 patients were chosen simultaneously as the pelvic intensity-modulated radiation group (P-IMRT group). Both groups were diagnosed with pelvic lymphadenopathy without para-aortic lymphadenopathy before treatment by radiology. Pelvic and para-aortic IMRT was employed in the EF-IMRT group, with an upper exposed level of the left renal vein, while pelvic IMRT was employed in P-IMRT group. Both groups were treated with high dose rate 192Ir brachytherapy and platinum-based concurrent chemotherapy.
Results: In the short-term, there was no effective difference between the groups. Regarding long-term efficacy, the 3-year overall survival (OS), progression-free survival (PFS), and progression and metastasis-free survival (PAMFS) in the EF-IMRT group and P-IMRT group were 87.0% vs. 74.6%, 83.6% vs. 61.7% and 96.0% vs. 80.5%, respectively. Treatment regimens, tumor size, and radiation time were all independent prognostic factors of OS and PFS. Treatment regimens, tumor size, and total equivalent dose in 2 Gy/f (EQD2) of point A were independent prognostic factors of PAMFS.
Conclusions: The risk of mortality, tumor progression, and metastasis in the para-aortic lymph nodes were significantly lower when using EF-IMRT than when using P-IMRT. EF-IMRT did not increase the incidence of gastrointestinal toxicities and genitourinary toxicities, and the toxicities at the late stages were mild.
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