Lymph node control in cervical cancer

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84 Scopus citations

Abstract

Purpose The aim was to evaluate pretreatment lymph node size, irradiation dose, and failure patterns. Methods Pretreatment PET and CT were performed in 208 patients. Lymph nodes were scored as either positive or negative by PET and lymph node size was measured by CT. Lymph node irradiation dose and sites of failure were recorded. Results The mean pelvic lymph node doses were: PET negative nodes, ≤1 cm, 66.8 Gy, and 0/76 failures; PET positive nodes, ≤1 cm, 66.8 Gy, and 3/89 failures; 1.1-≤2 cm, 66.9 Gy, and 0/21 failures; 2.1-≤3 cm, 69.4 Gy, and 2/15 failures; and 3.1 to ≤4 cm, 74.1 Gy, and 0/5 failures. The mean paraaortic lymph node dose was 43.3 Gy and there were no paraaortic failures for 24 patients with PET positive ≤1 cm nodes, 0/5 failures for 1.1 to ≤2 cm, and 0/4 failures for 2.1 to ≤3 cm. The most common site of failure was distant metastases. Conclusions The irradiation doses given in this study were adequate to control most lymph node metastases. Positive lymph nodes of any size at diagnosis were the most significant predictor for developing distant metastases.

Original languageEnglish
Pages (from-to)706-712
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume59
Issue number3
DOIs
StatePublished - Jul 1 2004

Keywords

  • Cervical cancer
  • FDG
  • Irradiation
  • Lymph nodes
  • PET

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