Whether individualized dose escalation should be recommended for lymph nodes with different sizes in the definitive radiotherapy of cervical cancer?

doi:10.1186/s13014-022-02132-0

	Whether individualized dose escalation should be recommended for lymph nodes with different sizes in the definitive radiotherapy of cervical cancer?
	Lv, Xiaojuan 1,2; Rao, Huiting 1,3; Feng, Tao 1,3; Wu, Chufan 1,3; Lou, Hanmei 1,2,3
刊名	RADIATION ONCOLOGY
	2022-10-20
卷号	17
关键词	Radiotherapy Dose escalation Lymph node Uterine cervical neoplasms
DOI	10.1186/s13014-022-02132-0
通讯作者	Lou, Hanmei(louhm@zjcc.org.cn)
英文摘要	Background and purpose Dose escalation for positive node maybe improve the regional control of patients with node-positive cervical cancer, but the optimal dose for nodes of different sizes remains controversial. The purpose of this study was to explore the individualized dose escalation for lymph nodes (LNs) with different sizes in the definitive radiotherapy of cervical cancer. Methods A total of 1002 cervical cancer patients with the International Federation of Gynecology and Obstetrics (FIGO 2009) stage IB1-IVA, who were treated by definitively radiotherapy between September 2013 and December 2016 were enrolled. All LNs identified by computed tomography/magnetic resonance imaging (CT/MRI) were assigned into three groups according to the short diameters of < 1 cm, 1-2 cm or >= 2 cm at pretreatment. Results In total, 580 patients with 1310 LNs were detected. The nodal control rate in groups of LNs < 1 cm, 1-2 cm and >= 2 cm was 99.4%, 96%, and 75.9%, respectively (P = 0.000). Among LNs < 1 cm, the control, overall survival (OS) and progression-free survival (PFS) rates did not significantly differ among three dose-based groups (<= 50.4 Gy, 50.4-60 Gy, > 60 Gy) (control rate, 99.4% vs. 99.3% vs. 100%, P = 0.647) (5-year OS, 76.2% vs. 79% vs. 81.6%, P = 0.682) (5-year PFS, 74.1% vs. 73.9% vs. 78.9% P = 0.713). Among LNs of 1-2 cm, the control and PFS rates were significantly higher in the group of dose >= 55 Gy than the group of dose < 55 Gy (control rate, 98% vs. 93.6%, P = 0.028) (5-year PFS, 69.6% vs. 56.7%, P = 0.025). However, this did not cause a significant difference for 5-year OS rate (72.6% vs. 68.3%, P = 0.5). Among LNs >= 2 cm, the control, OS, and PFS rates were higher in the group of dose >= 55 Gy than the group of dose < 55 Gy, while no significant difference was found (control rate, 82.1% vs. 63.2%, P = 0.107) (5-year OS, 60.6% vs. 37.5%, P = 0.141) (5-year PFS, 51.5% vs.37.5%, P = 0.232). Conclusions Radiation dose escalation is not necessary for LNs < 1 cm, and dose escalation of 55 Gy is enough for LNs of 1-2 cm.
资助项目	Zhejiang Province Health Department Foundation, China[2018KY306] ; Zhejiang Province Health Department Foundation, China[2022KY647]
WOS关键词	GUIDED ADAPTIVE BRACHYTHERAPY ; RADIATION-THERAPY ; BOOST IRRADIATION ; CHEMORADIATION ; METASTASES ; PATTERNS
WOS研究方向	Oncology ; Radiology, Nuclear Medicine & Medical Imaging
语种	英语
出版者	BMC
WOS记录号	WOS:000870739400001
资助机构	Zhejiang Province Health Department Foundation, China
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/129456]
专题	中国科学院合肥物质科学研究院
通讯作者	Lou, Hanmei
作者单位	1.Univ Chinese Acad Sci, Dept Gynecol Radiat Oncol, Canc Hosp, Zhejiang Canc Hosp, Banshan East Rd 1, Hangzhou 310022, Zhejiang, Peoples R China 2.Chinese Acad Sci, Inst Basic Med & Canc IBMC, Banshan East Rd 1, Hangzhou 310022, Zhejiang, Peoples R China 3.Zhejiang Chinese Med Univ, Affiliated Coll 2, Binwen Rd 548, Hangzhou 310053, Zhejiang, Peoples R China
推荐引用方式 GB/T 7714	Lv, Xiaojuan,Rao, Huiting,Feng, Tao,et al. Whether individualized dose escalation should be recommended for lymph nodes with different sizes in the definitive radiotherapy of cervical cancer?[J]. RADIATION ONCOLOGY,2022,17.
APA	Lv, Xiaojuan,Rao, Huiting,Feng, Tao,Wu, Chufan,&Lou, Hanmei.(2022).Whether individualized dose escalation should be recommended for lymph nodes with different sizes in the definitive radiotherapy of cervical cancer?.RADIATION ONCOLOGY,17.
MLA	Lv, Xiaojuan,et al."Whether individualized dose escalation should be recommended for lymph nodes with different sizes in the definitive radiotherapy of cervical cancer?".RADIATION ONCOLOGY 17(2022).