Use of small pelvic field instead of whole pelvic field in postoperative radiotherapy for node-negative, high-risk stages I and II cervical squamous cell carcinoma. Issue 2 (1st February 2003)

• Record Type: Journal Article
• Authors: Ohara, K.; Tsunoda, H.; Nishida, M.; Sugahara, S.; Hashimoto, T.; Shioyama, Y.; Hasezawa, K.; Yoshikawa, H.; Akine, Y.; Itai, Y.
• Is Part Of: International journal of gynecological cancer. Volume 13:Issue 2(2003)
• Page Start: 170
• Page End: 176
• Publication Date: 2003-02-01
• Subjects: complication -- lymph node metastasis -- pelvic failure -- prognostic factor; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-00009577-200303000-00012
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : We investigated whether a small pelvic (SP) field that covers primarily the pericervical regions in postoperative radiotherapy for cervical squamous cell carcinoma is adequate for a subgroup of node-negative patients. Of 84 patients with stage I–II disease treated with postoperative radiotherapy due to pathologic risk factors, 42 node-negative patients received SP-field radiotherapy, whereas remaining 42 node-positive patients were treated with a conventional whole pelvic (WP) field that also covered pelvic lymph nodes, both with 50.0–50.4 Gy/25–28 fractions. The pathologic risk factors included positive nodes, deep stromal invasion (≥2 /3 thickness), parametrial extension, and positive or close surgical margin. Recurrence was identified for 20 patients: three in the SP group and 17 in the WP group. Intrapelvic recurrence accounted for all three recurrences in the SP group and for four in the WP group; 5-year pelvic-control rate did not differ significantly between the SP (93%) and WP (90%) groups. Extrapelvic recurrence ( n = 11) was identified exclusively in the WP group. Patterns of recurrence indicate that use of an SP field instead of a WP field may be adequate in postoperative radiotherapy for a subgroup of node-negative, high-risk patients.