Image-Guided Stereotactic Body Radiation Therapy in Patients With Isolated Para-Aortic Lymph Node Metastases From Uterine Cervical and Corpus Cancer

Chul Won Choi, Chul Koo Cho, Seong Yul Yoo, Mi Sook Kim, Kwang Mo Yang, Hyung Jun Yoo, Young Seok Seo, Jin Kyu Kang, Dong Han Lee, Kyung Hee Lee, Eui Don Lee, Sang Young Rhu, Suck Chul Choi, Moon Hong Kim, Beob Jong Kim

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Abstract

Purpose: The aims of this study were to evaluate the role of stereotactic body radiation therapy (SBRT) as a local treatment for isolated para-aortic lymph node (PALN) metastases originating from uterine cervical and corpus cancer. Methods and Materials: We retrospectively enrolled 30 patients with isolated PALN metastases originating from uterine cervical and corpus cancer who had received SBRT using the CyberKnife (CK). All patients were shown to have isolated PALN metastases by computed tomography (CT) and/or positron emission tomography (PET)-CT. The overall survival (OS), local control (LC) rate, and disease progression-free survival (DPFS) rate were calculated according to the Kaplan-Meier method. Comparison between prognosis groups was performed using log-rank analysis. Toxicities were also evaluated. Results: The 4-year OS rate was 50.1%, and the median survival time was not reached. The OS rate among symptomatic patients was significantly lower than that among asymptomatic patients (p = 0.002). The 4-year actuarial LC rate was 67.4%. Patients with a planning target volume of ≤17 ml had significantly higher LC rates (p = 0.009). The 4-year DPFS rate was 45.0%, and the median time to disease progression was 32 months. Small planning target volume was a favorable prognostic factor (p = 0.043). Grade 3 or 4 complications requiring hospitalization were reported in 1 patient at 20 months after SBRT. Conclusion: The OS and LS rates were promising, and the incidence of toxicities was low. Use of SBRT with the CyberKnife is an effective modality for treating isolated PALN metastases in patients with uterine cervical and corpus cancer.

Original languageEnglish
Pages (from-to)147-153
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume74
Issue number1
DOIs
Publication statusPublished - 2009 May 1
Externally publishedYes

Fingerprint

lymphatic system
metastasis
Uterine Cervical Neoplasms
radiation therapy
Radiotherapy
Lymph Nodes
cancer
Neoplasm Metastasis
Survival Rate
Disease-Free Survival
Disease Progression
progressions
tomography
toxicity
planning
Survival
prognosis
Hospitalization
grade
positrons

Keywords

  • CyberKnife
  • Para-aortic lymph node metastasis
  • Stereotactic body radiation therapy
  • Uterine cervical and corpus cancer

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Image-Guided Stereotactic Body Radiation Therapy in Patients With Isolated Para-Aortic Lymph Node Metastases From Uterine Cervical and Corpus Cancer. / Choi, Chul Won; Cho, Chul Koo; Yoo, Seong Yul; Kim, Mi Sook; Yang, Kwang Mo; Yoo, Hyung Jun; Seo, Young Seok; Kang, Jin Kyu; Lee, Dong Han; Lee, Kyung Hee; Lee, Eui Don; Rhu, Sang Young; Choi, Suck Chul; Kim, Moon Hong; Kim, Beob Jong.

In: International Journal of Radiation Oncology Biology Physics, Vol. 74, No. 1, 01.05.2009, p. 147-153.

Research output: Contribution to journalArticle

Choi, Chul Won ; Cho, Chul Koo ; Yoo, Seong Yul ; Kim, Mi Sook ; Yang, Kwang Mo ; Yoo, Hyung Jun ; Seo, Young Seok ; Kang, Jin Kyu ; Lee, Dong Han ; Lee, Kyung Hee ; Lee, Eui Don ; Rhu, Sang Young ; Choi, Suck Chul ; Kim, Moon Hong ; Kim, Beob Jong. / Image-Guided Stereotactic Body Radiation Therapy in Patients With Isolated Para-Aortic Lymph Node Metastases From Uterine Cervical and Corpus Cancer. In: International Journal of Radiation Oncology Biology Physics. 2009 ; Vol. 74, No. 1. pp. 147-153.
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abstract = "Purpose: The aims of this study were to evaluate the role of stereotactic body radiation therapy (SBRT) as a local treatment for isolated para-aortic lymph node (PALN) metastases originating from uterine cervical and corpus cancer. Methods and Materials: We retrospectively enrolled 30 patients with isolated PALN metastases originating from uterine cervical and corpus cancer who had received SBRT using the CyberKnife (CK). All patients were shown to have isolated PALN metastases by computed tomography (CT) and/or positron emission tomography (PET)-CT. The overall survival (OS), local control (LC) rate, and disease progression-free survival (DPFS) rate were calculated according to the Kaplan-Meier method. Comparison between prognosis groups was performed using log-rank analysis. Toxicities were also evaluated. Results: The 4-year OS rate was 50.1{\%}, and the median survival time was not reached. The OS rate among symptomatic patients was significantly lower than that among asymptomatic patients (p = 0.002). The 4-year actuarial LC rate was 67.4{\%}. Patients with a planning target volume of ≤17 ml had significantly higher LC rates (p = 0.009). The 4-year DPFS rate was 45.0{\%}, and the median time to disease progression was 32 months. Small planning target volume was a favorable prognostic factor (p = 0.043). Grade 3 or 4 complications requiring hospitalization were reported in 1 patient at 20 months after SBRT. Conclusion: The OS and LS rates were promising, and the incidence of toxicities was low. Use of SBRT with the CyberKnife is an effective modality for treating isolated PALN metastases in patients with uterine cervical and corpus cancer.",
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AU - Yoo, Seong Yul

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AU - Lee, Kyung Hee

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