Limits...
Intensity-modulated radiation therapy versus three-dimensional conformal radiation therapy with concurrent nedaplatin-based chemotherapy after radical hysterectomy for uterine cervical cancer: comparison of outcomes, complications, and dose-volume histogram parameters.

Isohashi F, Mabuchi S, Yoshioka Y, Seo Y, Suzuki O, Tamari K, Yamashita M, Unno H, Kinose Y, Kozasa K, Sumida I, Otani Y, Kimura T, Ogawa K - Radiat Oncol (2015)

Bottom Line: Between March 2008 and February 2014, 62 patients were treated with concurrent nedaplatin-based chemotherapy and whole-pelvic external beam radiation therapy (RT).The median follow-up periods were 40 months (range 2-74 months).V40 and V45 of the small bowel loops or bowel bag were predictive for development of both acute and chronic GI complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D10) Yamadaoka, Suita, Osaka, 565-0871, Japan. isohashi@radonc.med.osaka-u.ac.jp.

ABSTRACT

Background: The purpose of this study is to report our clinical outcomes using intensity-modulated radiation therapy (IMRT) for adjuvant treatment of cervical cancer, compared with three-dimensional conformal radiation therapy (3DCRT), in terms of tumor control, complications and dose-volume histogram (DVH) parameters.

Methods: Between March 2008 and February 2014, 62 patients were treated with concurrent nedaplatin-based chemotherapy and whole-pelvic external beam radiation therapy (RT). Of these patients, 32 (52%) received 3DCRT and 30 (48%) received IMRT.

Results: The median follow-up periods were 40 months (range 2-74 months). The 3-year overall survival rate (OS), locoregional control rate (LRC) and progression-free survival rate (PFS) were 92, 95 and 92% in the IMRT group, and 85, 82 and 70% in the 3DCRT group, respectively. A comparison of OS, LRC and PFS showed no significant differences between IMRT and 3DCRT. The 3-year cumulative incidences of grade 2 or higher chronic gastrointestinal (GI) complications were significantly lower with IMRT compared to 3DCRT (3% vs. 45%, p < .02) and in patients with V40 of the small bowel loops of ≤340 mL compared to those with >340 mL (3% vs. 45%, p < .001). Patients treated with IMRT had a higher incidence of grade 3 acute hematologic complications (p < .05). V40 and V45 of the small bowel loops or bowel bag were predictive for development of both acute and chronic GI complications.

Conclusions: Our results suggest that IMRT for adjuvant treatment of cervical cancer is useful for decreasing GI complications without worsening outcomes.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier estimates for comparison of a overall survival (OS), b locoregional control rate (LRC), and c progression-free survival (PFS) between IMRT and 3DCRT. OS, LRC and PFS did not differ significantly between the cohorts
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4554318&req=5

Fig1: Kaplan-Meier estimates for comparison of a overall survival (OS), b locoregional control rate (LRC), and c progression-free survival (PFS) between IMRT and 3DCRT. OS, LRC and PFS did not differ significantly between the cohorts

Mentions: The mean V95% values for the planning target volume were 97 % (range 91–99 %) and 97 % (93-100 %) in the 3DCRT and IMRT groups, respectively, with no significant difference between the groups (p = .32). Similarly, the mean V93% did not differ significantly between the groups (99 % vs. 99 %, p = .57). A comparison of OS, LRC and PFS also showed no significant differences between IMRT and 3DCRT (Fig. 1). The 3-year OS, LRC and PFS were 92 %, 95 % and 92 % in the IMRT group, and 85 %, 82 % and 70 % in the 3DCRT group, respectively.Fig. 1


Intensity-modulated radiation therapy versus three-dimensional conformal radiation therapy with concurrent nedaplatin-based chemotherapy after radical hysterectomy for uterine cervical cancer: comparison of outcomes, complications, and dose-volume histogram parameters.

Isohashi F, Mabuchi S, Yoshioka Y, Seo Y, Suzuki O, Tamari K, Yamashita M, Unno H, Kinose Y, Kozasa K, Sumida I, Otani Y, Kimura T, Ogawa K - Radiat Oncol (2015)

Kaplan-Meier estimates for comparison of a overall survival (OS), b locoregional control rate (LRC), and c progression-free survival (PFS) between IMRT and 3DCRT. OS, LRC and PFS did not differ significantly between the cohorts
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554318&req=5

Fig1: Kaplan-Meier estimates for comparison of a overall survival (OS), b locoregional control rate (LRC), and c progression-free survival (PFS) between IMRT and 3DCRT. OS, LRC and PFS did not differ significantly between the cohorts
Mentions: The mean V95% values for the planning target volume were 97 % (range 91–99 %) and 97 % (93-100 %) in the 3DCRT and IMRT groups, respectively, with no significant difference between the groups (p = .32). Similarly, the mean V93% did not differ significantly between the groups (99 % vs. 99 %, p = .57). A comparison of OS, LRC and PFS also showed no significant differences between IMRT and 3DCRT (Fig. 1). The 3-year OS, LRC and PFS were 92 %, 95 % and 92 % in the IMRT group, and 85 %, 82 % and 70 % in the 3DCRT group, respectively.Fig. 1

Bottom Line: Between March 2008 and February 2014, 62 patients were treated with concurrent nedaplatin-based chemotherapy and whole-pelvic external beam radiation therapy (RT).The median follow-up periods were 40 months (range 2-74 months).V40 and V45 of the small bowel loops or bowel bag were predictive for development of both acute and chronic GI complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D10) Yamadaoka, Suita, Osaka, 565-0871, Japan. isohashi@radonc.med.osaka-u.ac.jp.

ABSTRACT

Background: The purpose of this study is to report our clinical outcomes using intensity-modulated radiation therapy (IMRT) for adjuvant treatment of cervical cancer, compared with three-dimensional conformal radiation therapy (3DCRT), in terms of tumor control, complications and dose-volume histogram (DVH) parameters.

Methods: Between March 2008 and February 2014, 62 patients were treated with concurrent nedaplatin-based chemotherapy and whole-pelvic external beam radiation therapy (RT). Of these patients, 32 (52%) received 3DCRT and 30 (48%) received IMRT.

Results: The median follow-up periods were 40 months (range 2-74 months). The 3-year overall survival rate (OS), locoregional control rate (LRC) and progression-free survival rate (PFS) were 92, 95 and 92% in the IMRT group, and 85, 82 and 70% in the 3DCRT group, respectively. A comparison of OS, LRC and PFS showed no significant differences between IMRT and 3DCRT. The 3-year cumulative incidences of grade 2 or higher chronic gastrointestinal (GI) complications were significantly lower with IMRT compared to 3DCRT (3% vs. 45%, p < .02) and in patients with V40 of the small bowel loops of ≤340 mL compared to those with >340 mL (3% vs. 45%, p < .001). Patients treated with IMRT had a higher incidence of grade 3 acute hematologic complications (p < .05). V40 and V45 of the small bowel loops or bowel bag were predictive for development of both acute and chronic GI complications.

Conclusions: Our results suggest that IMRT for adjuvant treatment of cervical cancer is useful for decreasing GI complications without worsening outcomes.

No MeSH data available.


Related in: MedlinePlus