Intensity-modulated radiation therapy for definitive treatment of cervical cancer: a meta-analysis

Lin, Yanzhu; Chen, Kai; Lu, Zhiyuan; Zhao, Lei; Tao, Yijing; Ouyang, Yan‐Qiong; Cao, Xuejun

doi:10.1186/s13014-018-1126-7

Cited by 97 publications

(77 citation statements)

References 23 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A multi-institutional study evaluating the toxicity and survival outcomes after IMRT in 111 patients reported a 3-year OS rate of 78% and 3-year DFS rate of 69%. 19 Recently, a meta-analysis of six studies conducted by Lin et al 20 compared the efficacies and toxicities of IMRT with conventional RT for radical treatment of cervical cancers. They concluded there was no significant difference between 3-year OS and DFS, but toxicities were significantly reduced.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Toxicity and Efficacy of Intensity-Modulated Radiation Therapy in Cervical Cancers: Experience of a Cancer Hospital in Pakistan

Mansha

Sadaf

Waheed

et al. 2020

JCO Global Oncology

View full text Add to dashboard Cite

PURPOSE To report the chronic toxicity and disease outcomes attributable to intensity-modulated radiation therapy (IMRT) in patients with cervical cancer. METHODS AND MATERIALS Between January 2014 and December 2018, a retrospective review of medical records of patients with cervical cancer who received radiation therapy with IMRT was performed. Disease and treatment-related details were documented. Follow-up notes were reviewed, and severity of late toxicities was recorded. Overall survival (OS) and disease-free survival (DFS) at 3 years were estimated. RESULTS A total of 222 patients’ records were reviewed. Mean age was 50.7 years. Median follow-up duration was 33 months (range, 2-70 months). The most common toxicity was vaginal stricture (grade 2, n = 59, 26.6%; grade 3, n = 4, 1.80%), followed by proctitis (grade 2, n = 24; 10.8%; grade 3, n = 7; 3.20%). Seven patients (grade 2, n = 5, 2.3%; grade 3, n = 2; 0.90%) developed cystitis, and only 5 (grade 2; 2.3%) were found to have colitis. None of the patients had grade 4 or grade 5 toxicities. There was a significant difference in late complications in patients with nodal disease or those who underwent prior surgery ( P < .05). Three-year OS and DFS rates were 79.7% and 81.9%, respectively. Patients with tumor size > 5 cm and those with pelvic lymph node metastasis had poor survival rates ( P < .05). CONCLUSION IMRT is an effective and well-tolerated technique that should be considered in patients with lymph node disease and in postoperative patients. There is an inverse relationship between tumor size and nodal involvement with respect to OS and DFS.

show abstract

Section: Discussionmentioning

confidence: 99%

“…They concluded there was no significant difference between 3-year OS and DFS, but toxicities were significantly reduced. 20 …”

Section: Discussionmentioning

confidence: 99%

Long-Term Toxicity and Efficacy of Intensity-Modulated Radiation Therapy in Cervical Cancers: Experience of a Cancer Hospital in Pakistan

Mansha

Sadaf

Waheed

et al. 2020

JCO Global Oncology

View full text Add to dashboard Cite

show abstract

“…has become more and more common 22,23 . Our data cannot assess whether IMRT and 3D-CRT will increase the risk of second primary tumor.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Risk of Second Primary Lung Cancer After Cervix Cancer: A Population-Based Study

Qian

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Lung cancer as a second primary malignancy is increasingly common, but the clinical characteristics of second primary non-small cell lung cancer after cervix cancer (CC-NSCLC) in comparison with first primary non-small cell lung cancer (NSCLC1) is unknown.Methods: The Surveillance, Epidemiology and EndResults (SEER) cancer registry between 1998 and 2010 was used to conduct a large population-based cohort analysis. Demographic and clinical characteristics as well as prognostic data were systematically analyzed. We further compared overall survival (OS) in the two cohorts. Risk factors of secondary primary lung cancer in cervical cancer patients were also analyzed.Results: 557 (3.52%) had developed second primary lung cancer after cervix cancer and 451 were eligible for inclusion in the final analyses. In comparison to NSCLC1, patients with CC-NSCLC had a higher rate of squamous cell carcinoma (SCC) (36.59% vs. 19.07%, p<0.01). Median OS was longer for CC-NSCLC than for NSCLC1 before propensity score matching (PSM) (16 vs. 13months) but there was no significant difference after PSM. High-risk factors in cervical cancer to developing CC-NSCLC include: 50-79years old, black race (OR 1.417; 95%CI 1.095-1.834; p<0.05)and history of radiotherapy (OR 1.392; 95%CI 1.053-1.841; p<0.05).Conclusion: 50-79years old, black race and history of radiotherapy were independent risk factors of second primary lung cancer in cervical cancer patient. CC-NSCLC patients had distinctive clinical characteristics and a better prognosis compared with NSCLC1 patients.

show abstract

“…Several prospective randomized trials and one meta-analysis demonstrated that the toxicities of IMRT were lower than that of conformal radiation therapy in patients with LACC treated with definitive radiation therapy ( 48 – 51 ). In the study by Gandhi et al ( 51 ), 44 patients with 2009 FIGO stage IIB-IIIB cervical cancer were randomized to receive whole pelvic conventional radiation therapy or IMRT.…”

Section: The Toxicities Of Efimentioning

confidence: 99%

Prophylactic Extended-Field Irradiation in Patients With Cervical Cancer: A Literature Review

et al. 2020

View full text Add to dashboard Cite

Currently, the standard radiation field for locally advanced cervical cancer patients without evidence of para-aortic lymph node (PALN) metastasis is the pelvis. Due to the low accuracy of imaging in the diagnosis of PALN metastasis and the high incidence of PALN failure after pelvic radiotherapy, prophylactic pelvic and para-aortic irradiation, also called extended-field irradiation (EFI), is performed for patients with cervical cancer. In the era of concurrent chemoradiotherapy, randomized controlled trials are limited, and whether patients with cervical cancer can benefit from prophylactic EFI is still controversial. With conformal or intensity-modulated radiation therapy, patients tolerate prophylactic EFI very well. The severe toxicities of prophylactic EFI are not significantly higher than those of pelvic radiotherapy. We recommend delivering prophylactic EFI to cervical cancer patients with common iliac lymph nodes metastasis. Clinical trials are needed to investigate whether patients with ≥3 positive pelvic lymph nodes and FIGO stage IIIB disease can benefit from prophylactic EFI. According to the distribution of PALNs, it is reasonable to use the renal vein as the upper border of the radiation therapy field for patients treated with prophylactic EFI. The clinical target volume expansion of the node from the vessel should be smaller in the right para-caval region than in the left lateral para-aortic region. The right para-caval region above L2 or L3 may be omitted from the PALN target volume to reduce the dose to the duodenum. More clinical trials on prophylactic EFI in cervical cancer are needed.

show abstract

Intensity-modulated radiation therapy for definitive treatment of cervical cancer: a meta-analysis

Cited by 97 publications

References 23 publications

Long-Term Toxicity and Efficacy of Intensity-Modulated Radiation Therapy in Cervical Cancers: Experience of a Cancer Hospital in Pakistan

Long-Term Toxicity and Efficacy of Intensity-Modulated Radiation Therapy in Cervical Cancers: Experience of a Cancer Hospital in Pakistan

Clinical Characteristics and Risk of Second Primary Lung Cancer After Cervix Cancer: A Population-Based Study

Prophylactic Extended-Field Irradiation in Patients With Cervical Cancer: A Literature Review

Contact Info

Product

Resources

About