期刊
RADIOTHERAPY AND ONCOLOGY
卷 134, 期 -, 页码 185-190出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.radonc.2019.02.007
关键词
Cervix cancer; Lymph nodes metastases; Nodal boost; Nodal failure; Para-aortic; Pelvis
资金
- Elekta
- Varian Medical System
- Medical University of Vienna
- Danish Cancer Society
- Danish Cancer Research Foundation
- Austrian Federal Ministry for Digital and Economic Affairs
- National Foundation for Research, Technology and Development
Purpose/Objective(s): To investigate the patterns of nodal failure in patients enrolled in the international multicentre EMBRACE study. Materials/Methods: Nodal disease at diagnosis (N-, N+) and nodal failure were analysed per region (NF) (pelvic (parametrial, common iliac, internal/external iliac), inguinal and para-aortic (PAO)) in 1338 patients. Treatment consisted of chemo-radiation and MRI guided brachytherapy. PAO radiotherapy and/or nodal boost was left to the treating centre. At time of diagnosis 52% of patients had pathologic nodes. Frequency analyses were performed in relation to patient, primary tumour and nodal disease characteristics, and treatment related factors. Results: Median follow up was 34 months and 83% of NF occurred within 24 months. At diagnosis 99% of the N+ patients had pathologic nodes in the pelvis and 14% in the PAO. NFpelvic and NFPAO were reported in 55% and 68% of patients with NF, respectively. Overall NF was reported in 152 patients (11%); 7 and 16% for N- and N+ patients. Of the patients with NF, 41% were located outside the elective target (39% PAO), 40% inside and 35% inside the nodal boost target. Twelve percent of N+ patients that received a nodal boost had a NF inside the nodal boost target. Conclusion: Within the EMBRACE study cohort the overall number of patients developing nodal failure is low, significantly lower for N- compared to N+ patients. Pathological nodes at diagnosis are mainly located in the pelvis, whereas nodal failures are more often reported in the PAO region. About 40% of all nodal failures were reported outside the treatment targets. (C) 2019 The Authors. Published by Elsevier B.V.
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