Extended field para-aortic radiation in cervical carcinoma: The case for prophylactic treatmentt

Predictors of distant relapse in patients with FIGO stage IIB–IVA cervical cancer treated with definitive radiotherapy

“…The reason why patients with pretreatment leukocytosis/neutrophilia are at high risk of developing distant relapse remains unclear, but the present results are consistent with the findings of our previous study in which pretreatment leukocytosis/neutrophilia were found to be independent predictors of survival among cervical cancer patients . In the current analysis, tumor size, reported to be a predictor of distant relapse in a previous study, was not found to be a significant prognostic factor. This discrepancy might be explained by the relatively small sample size of the current study or racial differences.…”

“…A previous study showed that nodal status is a significant predictor of distant relapse after definitive RT in LACC patients . Other studies have suggested that the size of the primary tumor and advanced clinical stage are predictors of distant relapse in such patients …”

Three-Dimensional Treatment Planning for Postoperative Radiotherapy in Patients with Node-Positive Cervical Cancer Comparison between a Conventional and a Conformal Technique

“…Since at some levels of the paraaortic region the small bowel closely surrounded the target volume, it was inevitable that some parts of the small intestine received a dose equal or close to the target dose. In the literature, a variable increase in complications is observed in patients receiving over 50 Gy [19,24], although in 1 study [26] doses ranging from 56 to 61 Gy were not significantly more hazardous than in case of pelvis irradiation only.…”

“…In fact, prophylactic para-aortic irradiation is an issue which is currently unresolved. However, Rotman et al [26] did demonstrate a benefit in overall and distant metastasis-free survival in patients with Stage Ib (bulky), IIa and IIb. Also after follow-up of 5 years [7,27] overall survival was significantly better for those treated with extended fields compared to those treated with pelvic radiation (55% vs 44%; p = 0.02, respectively).…”

Radiation Therapy of Para-Aortic Lymph Nodes in Cancer of the Uterine Cervix

“…9, 11, 12) has led to new ways of treatment strategies. However, neither a split-course technique (28) applying 60 Gy, nor the reduction of the total dose (9,21,29,30) has had the expected success.…”