TY - JOUR
T1 - Lymph node control in cervical cancer
AU - Grigsby, Perry W.
AU - Singh, Anurag K.
AU - Siegel, Barry A.
AU - Dehdashti, Farrokh
AU - Rader, Janet
AU - Zoberi, Imran
PY - 2004/7/1
Y1 - 2004/7/1
N2 - 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.
AB - 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.
KW - Cervical cancer
KW - FDG
KW - Irradiation
KW - Lymph nodes
KW - PET
UR - http://www.scopus.com/inward/record.url?scp=2942567735&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2003.12.038
DO - 10.1016/j.ijrobp.2003.12.038
M3 - Article
C2 - 15183474
AN - SCOPUS:2942567735
SN - 0360-3016
VL - 59
SP - 706
EP - 712
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 3
ER -