Reviewing the role of parametrial boost in patients with cervical cancer with clinically involved parametria and staged with positron emission tomography

Rajasooriyar, Chrishanthi, Van Dyk, Sylvia, Lindawati, Mery, Bernshaw, David, Kondalsamy-Chennakesavan, Srinivas and Narayan, Kailash (2012) Reviewing the role of parametrial boost in patients with cervical cancer with clinically involved parametria and staged with positron emission tomography. International Journal of Gynecological Cancer, 22 9: 1532-1537. doi:10.1097/IGC.0b013e31826c4dee

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Author Rajasooriyar, Chrishanthi
Van Dyk, Sylvia
Lindawati, Mery
Bernshaw, David
Kondalsamy-Chennakesavan, Srinivas
Narayan, Kailash
Title Reviewing the role of parametrial boost in patients with cervical cancer with clinically involved parametria and staged with positron emission tomography
Journal name International Journal of Gynecological Cancer   Check publisher's open access policy
ISSN 1048-891X
1525-1438
Publication date 2012-11
Year available 2012
Sub-type Article (original research)
DOI 10.1097/IGC.0b013e31826c4dee
Volume 22
Issue 9
Start page 1532
End page 1537
Total pages 6
Place of publication New York, United States
Publisher Lippincott Williams & Wilkins
Collection year 2013
Language eng
Formatted abstract
Objective: Primary objective was to validate the practice of not treating clinically involved parametria by parametrial boost. Secondary objective was to validate the adequacy of nodal boost in node-positive patients regardless of parametrial status.
Material and Methods: A retrospective analysis of 193 patients with locoregionally advanced cervical cancer treated with curative intent using external beam radiotherapy and brachytherapy. All patients were staged clinically (International Federation of Gynecology and Obstetrics) and radiologically using magnetic resonance imaging and positron emission tomography. The positron emission tomography positive nodes were boosted to an additional dose of 6 to 10 Gy after 40 Gy to the whole pelvis. Parametrial boost was not used. Patients with stages IB to IIa and stages IIB to IIIB disease were allocated to groups A and B, respectively.
Results: The pelvic failure (P = 0.430) and extrapelvic failure (P = 0.437) did not differ significantly between groups A and B. In multifactor analysis, tumor volume was significantly associated with pelvic failure (P = 0.009) and node positivity was significantly associated with extrapelvic failure (P = 0.002). Clinical parametrial involvement in the absence of parametrial boost was not related to either pelvic or extrapelvic failure. None of the node-positive patients had isolated pelvic nodal failure.
Conclusion: Cervical cancer with clinically involved parametria can be adequately treated without parametrial boost. A dose of 46 to 50 Gy was adequate to avoid isolated pelvic nodal failure.
Keyword Cervical cancer
FIGO stage
Parametrial boost
Lymph node metastasis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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