Yi Cheng,Nan Huang,Jing Zhao,Jianhua Wang,Chen Gong,Kai Qin. Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis. Oncol Transl Med, 2019, 5: 25-29.
Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis
Received:February 26, 2019  Revised:February 26, 2019
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KeyWord:simultaneous integrated dose-increasing intensity-modulated radiation therapy; late-course dose-increasing intensity-modulated radiation therapy; cervical cancer complicated with pelvic lymph node metastasis; clinical efficacy; safety
Author NameAffiliationE-mail
Yi Cheng Tongji Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China yi_chengtj@163.com 
Nan Huang Allergy Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology  
Jing Zhao Oncology Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology  
Jianhua Wang Oncology Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology  
Chen Gong Oncology Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology  
Kai Qin Oncology Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology qinkaitj@126.com 
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Abstract:
      Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy (IMRT) for cervical cancer complicated with pelvic lymph node metastasis. Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared. Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group (P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group (P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower (P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups (P > 0.05). The radiation doses of Dmax in the small intestine, D1cc (the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower (P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2cc (the minimum dose to the 2 cc receiving the highest dose) between the two groups (P > 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT group was significantly lower (P < 0.05) than in the late-course dose-increasing IMRT group. Conclusion The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression, improve the long-term survival time, and postpone distant metastasis time with high safety.
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