Introduction: Current consensus guidelines for definitive cervical cancer intensity modulated radiation therapy (IMRT) recommend inclusion of the entire uterus within the clinical target volume, however this is debated. We aimed to evaluate outcomes of patients with cervical cancer who were treated with less than whole uterus irradiation.
Methods: We identified 109 patients with FIGO Stage IB-IVA cervical cancer treated definitively with concurrent chemoradiation, including IMRT and brachytherapy, from 2010 to 2022 at a single institution where the practice was to include the gross cervix tumor with an internal target volume with differences in bladder filing accounted for, plus additional 5 mm planning target volume (PTV) margin. Local, regional, and distant recurrences were analyzed using competing risk methods, and a Wilcoxon rank sum test was performed to assess differences in dose to organs at risk based on the proportion of the uterus included in the PTV, with the median proportion of the uterus included (75 %) used as the cut-point.
Results: The median follow-up time was 65 months (range 3-352 months). The 2-year cumulative incidence of LR for the entire cohort was 4.2 % (95 % confidence interval [CI] 1.3-9.7). Compared with patients who had ≥ 75 % of the uterus included in the PTV, patients who had < 75 % of the uterus included in the PTV had significantly lower bowel D200cc (p = 0.02). The cumulative incidence of local failure (LR) was not significantly different between the two groups.
Conclusions: Including less than the whole uterus for definitive cervix cancer IMRT does not seem to compromise local control. Less than whole uterus irradiation could be considered for carefully selected cervix cancer patients to decrease bowel dose and possible treatment-related toxicity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.radonc.2024.110199 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Exploring the Interplay Between Cervicovaginal Microbiome, HPV Infection, and Cervical Intraepithelial Neoplasia in Taiwanese Women.
J Med Virol
February 2025
Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan.
This study examined the relationship between the vaginal microbiome, HPV infection, and cervical intraepithelial neoplasia (CIN) in 173 women. Subjects were grouped by HPV status and cervical lesion severity, ranging from HPV-negative to CIN Grade 2 or higher. Using VALENCIA classification, the study identified different community state types (CSTs) of vaginal microbiota, with CST IV subtypes (Staphylococcus dominated) showing high diversity and increased pathogenic bacteria.
View Article and Find Full Text PDFMulti-center evaluation of the Alinity m HR HPV assay with liquid-based cytology cervical specimens in the United States.
Microbiol Spectr
January 2025
PathAI Diagnostics, Memphis, Tennessee, USA.
Incorporating molecular testing for human papillomavirus (HPV) into the screening of cervical specimens can improve risk stratification and, in turn, patient management. Infection with a high-risk (HR) HPV genotype is associated with greater risk for persistent infection, viral integration, and progression of cervical neoplasia. Current guidelines consider HPV 16 or HPV 18 clinically actionable with referral to colposcopy; however, 12 Other HR HPV genotypes have been associated with cervical cancer risk, suggesting a benefit of extended genotyping.
View Article and Find Full Text PDFSearch for Healthcare and Breast/Gynecological Cancer Prevention Among Brazilian Lesbian Cisgender Women.
Cancer Invest
January 2025
Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto-SP, Brazil.
Although breast, cervical, endometrial, and ovarian cancers account for more than 43% of new cases in 2023 in Brazilian women, no national studies were found on the incidence, risk factors, and prevention of breast and gynecological neoplasms in lesbian women, causing the health needs of non-heterosexual women to go unnoticed by professionals. This study aims to identify and analyze the search for healthcare related to the prevention of breast/gynecological cancer among Brazilian lesbian cisgender women who have not had the disease. Seven lesbian women participated in this qualitative study.
View Article and Find Full Text PDFHistological Type-Specific Behavior in Sarcomas: Analysis of Head and Neck Cancer Registry of Japan.
Laryngoscope
January 2025
Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.
Objective: The goal of this study was to better understand the epidemiology, clinical characteristics, and treatment outcomes of head and neck sarcomas using real-world data from Japan.
Methods: Using the Japanese Head and Neck Cancer Registry, we identified 438 patients who were pathologically diagnosed with head and neck sarcoma between 2011 and 2020. We compared epidemiological, clinical, and prognostic data for the different histological types of sarcoma.
Modeling dosimetric benefits from daily adaptive RT for gynecological cancer patients with and without knowledge-based dose prediction.
J Appl Clin Med Phys
January 2025
Department of Radiation Medicine and Applied Sciences, UC San Diego Health, La Jolla, California, USA.
Purpose: Daily online adaptive radiotherapy (ART) improves dose metrics for gynecological cancer patients, but the on-treatment process is resource-intensive requiring longer appointments and additional time from the entire adaptive team. To optimize resource allocation, we propose a model to identify high-priority patients.
Methods: For 49 retrospective cervical and endometrial cancer patients, we calculated two initial plans: the treated standard-of-care (Initial) and a reduced margin initial plan (Initial) for adapting with the Ethos treatment planning system.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!