Curative Chemoradiotherapy in Patients With Stage IVB Cervical Cancer Presenting With Paraortic and Left Supraclavicular Lymph Node Metastases

Kim, Ji-Yoon; Kim, Joo-Young; Kim, Jin Hee; Yoon, Myung Ha; Kim, Juree; Kim, Young Seok

doi:10.1016/j.ijrobp.2012.01.070

Cited by 61 publications

(51 citation statements)

References 16 publications

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“…All seven cases of SCN metastases cited above in Tran et al 7) passed away, from distant metastasis after CCRT. In addition, as one might expect, among the cases in which metastases reached the SCN in Kim JK et al 10) , 15 of the 25 cases (60%) that received CCRT were distant recurrences. Therefore, they were recommended frequent follow-up with PET-CT scans and adjuvant chemotherapy after CCRT had been completed.…”

Section: Discussionmentioning

confidence: 84%

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A Patient with Stage IVB Cervical Cancer with Para-aortic Lymph Node (PAN) and Supraclavicular Lymph Node (SCN) Metastases Who Reached Long-term Survival with Chemoradiotherapy

Gomi

Shinozaki

Okada

et al. 2015

J St. Marianna Univ

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We report a case of a patient who demonstrated long-term survival following completion of concurrent chemoradiotherapy (CCRT) for stage IVB advanced uterine cervical cancer. When the patient was referred to us, her radiological findings showed para-aortic and supraclavicular lymph node (SCN) metastases. The CCRT for primary lesions and para-aortic lymph node (PAN) were performed, followed by radiotherapy for SCN, resulting in successful control of the lesions. After five and a half years of strict follow-up, recurrent PAN was observed with PET-CT. Systemic chemotherapy was re-stored and controlled recurrent PAN without signs of serious adverse events. The patient has showed no recurrent signs with any related symptoms for the past 8 years since the initial treatment. As seen in this case, favorable prognosis can be achieved even for stage IVB advanced uterine cervical cancer patients, when the distant metastases are located in lymph nodes where CCRT could fully cover.

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Section: Discussionmentioning

confidence: 84%

“…Three cases (33%) survived disease-free for more than two years. In the 2012 report by Kim JK et al 10) , all 25 of their patients received CCRT and the SCN for all were irradiated with 59.4Gy. As a result, the three-year OAS was 49% and the three-year disease-free survival rate (DFS) was 33%.…”

Section: Discussionmentioning

confidence: 99%

A Patient with Stage IVB Cervical Cancer with Para-aortic Lymph Node (PAN) and Supraclavicular Lymph Node (SCN) Metastases Who Reached Long-term Survival with Chemoradiotherapy

Gomi

Shinozaki

Okada

et al. 2015

J St. Marianna Univ

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“…We did note a significantly longer OS in patients with distant nodal metastases only, as compared to patients with visceral metastases in addition to the nodal metastases at presentation. In the literature, several groups have described complete responses to multi-modality treatment of patients with SCLN metastases [18,19,23] . Our finding of improved survival in the nodal metastases only group lends further credence to the use of pretreatment FDG-PET/CT modality for identification of best candidates for the aggressive chemo-RT administration, as patients with isolated nodal metastases did survive longer and may have the potential of lasting response to highdose multi-modality treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In this cohort, the 5-year survival rate was 22% [17] . Korean investigators have also reported on favorable outcomes of 25 patients with para-aortic and left supraclavicular metastases treated with concurrent chemo-radiotherapy (RT), citing a 3-year OS and PFS rates of 49 and 33% for the cohort, respectively [18] . In addition, Kim et al [19] reported a 60% complete response rate in patients with stage IVB disease and distant lymph node metastases treated with combination of chemotherapy and radiation.…”

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confidence: 99%

Survival of Cervical Cancer Patients Presenting with Occult Supraclavicular Metastases Detected by FDG-Positron Emission Tomography/CT: Impact of Disease Extent and Treatment

Ioffe

Massad²,

Powell

et al. 2017

Gynecol Obstet Invest

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Aims: The study aimed to do the following: (1) describe progression free survival (PFS) and overall survival (OS) of women with cervical cancer presenting with occult supraclavicular lymph node (SCLN) metastases, identified by positron emission tomography CT (PET-CT) and (2) compare OS of patients with isolated SCLN metastases to that of patients with SCLN and extranodal metastatic disease. Methods: Patients were identified retrospectively. Treatment intent was abstracted. PFS and OS in the high-dose chemo-radiotherapy (RT), palliative RT, and supportive treatment groups, as well as OS of patients with SCLN metastases only vs. SCLN and extranodal metastases were calculated. Results: Fourteen patients received high-dose chemo-RT, 32 received palliative RT, and 6 received supportive care (n = 52). Median PFS was 3 months in high-dose chemo-RT group and 1 month in palliative RT (p = ns). Median OS was 12 months in high-dose chemo-RT group, 7 months in palliative RT group, and 2 months in palliative care group (p = 0.05). OS was significantly different between patients with isolated SCLN disease vs. SCLN and extranodal disease, that is, 10.5 vs. 3 months (p = 0.009, χ² = 6.9). Conclusions: In this limited analysis, median OS of cervical cancer patients with PET/CT-positive SCLN metastases was the longest when treated with high-dose chemo-RT. Patients with SCLN and extranodal metastases experienced significantly shorter OS, as compared to patients with SCLN only disease.

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“…Kim et al pronounced the better therapeutic effect of chemoradiotherapy for the supraclavicular lymph node metastasis 2012 [21]. The reason of the better therapeutic effect is that chemotherapy was effective for all the patients.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic response to a new enzyme-targeting radiosensitization treatment (KORTUC-SC) for patients with chemotherapy-resistant supraclavicular lymph node metastasis

Aoyama¹,

Ogawa²,

Kubota³

et al. 2013

J Cancer Res Ther

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IntroductionLinear accelerator (Linac)-generated high-energy X-rays and electron beams that are generally used for radiotherapy are low-linear energy transfer (LET) forms of radiation, and have a relatively weak biological effect. High-energy X-rays and electron beams have minimal effects on tumors that contain many hypoxic cancer cells and/or large amounts of antioxidative enzymes. Examples of such tumors include malignant melanoma, various types of sarcomas, glioblastoma multiforme, and most relatively large tumors more than several centimeters in their long diameter. Thus, effective treatment of these tumors requires strategies to re-oxygenate hypoxic tumor cells and to inhibit antioxidative enzymes. Therapeutic response to a new enzyme-targeting radiosensitization treatment (KORTUC-SC) for patients with chemotherapy-resistant supraclavicular lymph node metastasis AbstractWe have developed a new radiosensitizer containing hydrogen peroxide and sodium hyaluronate, part of a method we call "KORTUC II". This study aimed to evaluate the safety and effectiveness of KORTUC II specifically for patients with chemotherapy-resistant supraclavicular lymph node metastasis (KORTUC-SC). Twelve patients were enrolled after providing fully informed written consent. Most of the patients underwent PET-CT examinations prior to and 3-8 months after KORTUC-SC, and every 6 months thereafter if possible. The patients' age ranged from 58 to 77. The radiotherapy regimen was 4 Gy/ fraction, 3 fractions/ week, for 4 weeks, and the total dose was 48 Gy. The injection of 3 to 6 mL of the agent was started from the fifth radiotherapy fraction, and it was performed twice a week under ultrasonographic guidance. Therapeutic effects were evaluated by PET-CT examinations performed before and after KORTUC-SC treatment. The patients were well tolerated with minimal adverse effects. Of the 12 patients, 4, 5, 2 and 1 patient showed complete response, partial response, stable disease and progressive disease, respectively. The overall survival rate was 83% at 1 year and 75% at 2 years. The mean duration of follow-up at the end of February 2011 was 35.1 months. Based on the PET-CT studies, remarkable therapeutic effects of the KORTUC II treatment were clearly identified. The treatment outcomes were satisfactory. Welldesigned, prospective, randomized, clinical trials are needed to confirm the therapeutic efficacy of KORTUC-SC.

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Curative Chemoradiotherapy in Patients With Stage IVB Cervical Cancer Presenting With Paraortic and Left Supraclavicular Lymph Node Metastases

Cited by 61 publications

References 16 publications

A Patient with Stage IVB Cervical Cancer with Para-aortic Lymph Node (PAN) and Supraclavicular Lymph Node (SCN) Metastases Who Reached Long-term Survival with Chemoradiotherapy

A Patient with Stage IVB Cervical Cancer with Para-aortic Lymph Node (PAN) and Supraclavicular Lymph Node (SCN) Metastases Who Reached Long-term Survival with Chemoradiotherapy

Survival of Cervical Cancer Patients Presenting with Occult Supraclavicular Metastases Detected by FDG-Positron Emission Tomography/CT: Impact of Disease Extent and Treatment

Therapeutic response to a new enzyme-targeting radiosensitization treatment (KORTUC-SC) for patients with chemotherapy-resistant supraclavicular lymph node metastasis

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