| 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 Name | Affiliation | E-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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