Magnetic resonance imaging after external beam radiotherapy and concurrent chemotherapy for locally advanced cervical cancer helps to identify patients at risk of recurrence

被引:16
作者
Angeles, Martina Aida [1 ]
Baissas, Pauline [1 ]
Leblanc, Eric [2 ]
Lusque, Amelie [3 ]
Ferron, Gwenael [1 ,4 ]
Ducassou, Anne [5 ]
Martinez-Gomez, Carlos [1 ,6 ]
Querleu, Denis [7 ]
Martinez, Alejandra [1 ,6 ]
机构
[1] Inst Univ Canc Toulouse Oncopole, Inst Claudius Regaud, Dept Surg Oncol, Toulouse, France
[2] Oscar Lambret Canc Ctr, Dept Gynecol Oncol, Toulouse, France
[3] Inst Univ Canc Toulouse, Inst Claudius Regaud, Biostat Unit, Toulouse, France
[4] INSERM CRCT 19, Toulouse, France
[5] Inst Univ Canc Toulouse Oncopole, Inst Claudius Regaud, Dept Radiotherapy, Toulouse, France
[6] INSERM CRCT 1, Toulouse, France
[7] Inst Bergonie, Dept Surg Oncol, Bordeaux, France
关键词
DEFINITIVE CHEMORADIOTHERAPY; COMPUTED-TOMOGRAPHY; TUMOR RECURRENCE; MRI ASSESSMENT; VOLUME; MANAGEMENT; CARCINOMA; SURVIVAL; IMPACT; BRACHYTHERAPY;
D O I
10.1136/ijgc-2018-000168
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective Tumor volume and regression after external beam radiotherapy have been shown to be accurate parameters to assess treatment response via magnetic resonance imaging (MRI). The aim of the study was to evaluate the prognostic value of tumor size reduction rate after external beam radiotherapy and chemotherapy prior to brachytherapy. Methods Patients with locally advanced cervical cancer treated at two French comprehensive cancer centers between 1998 and 2010 were included. Treatment was pelvic external beam radiotherapy with platinum based chemotherapy followed by brachytherapy. Records were reviewed for demographic, clinical, imaging, treatment, and follow-up data. Anonymized linked data were used to ascertain the association between pre-external and post-external beam radiotherapy MRI results, and survival data. Results 185 patients were included in the study. Median age at diagnosis was 45 years (range 26-72). 77 patients (41.6%) were International Federation of Gynecology and Obstetrics stage IB2-IIA disease and 108 patients (58.4%) were stage IIB-IVA. Median tumor size after external beam radiotherapy and chemotherapy was 2.0 cm (range 0.0-8.0) and median tumor size reduction rate was 62.4% (range 0.0-100.0%). Tumor size and tumor reduction rate at 45 Gy external beam radiotherapy MRI were significantly associated with local recurrence free survival (P<0.001), disease free survival, and overall survival (P<0.05). Tumor reduction rate >= 60% was significantly associated with a decreased risk of relapse and death (HR (95% CI) 0.21 (0.09 to 0.50), P=0.001 for local recurrence free survival; 0.48 (0.30 to 0.77) P=0.002 for disease free survival; and 0.51 (0.29 to 0.88), P=0.014 for overall survival). Conclusions Tumor size reduction rate >60% between pre-therapeutic and post-therapeutic 45 Gy external beam radiotherapy with concurrent chemotherapy was associated with improved survival. Future studies may help to identify patients who may ultimately benefit from completion surgery, adjuvant chemotherapy, and closer follow-up.
引用
收藏
页码:480 / 486
页数:7
相关论文
共 50 条
[41]   PARAMETRIAL BOOST USING MIDLINE SHIELDING RESULTS IN AN UNPREDICTABLE DOSE TO TUMOR AND ORGANS AT RISK IN COMBINED EXTERNAL BEAM RADIOTHERAPY AND BRACHYTHERAPY FOR LOCALLY ADVANCED CERVICAL CANCER [J].
Fenkell, Louis ;
Assenholt, Marianne ;
Nielsen, Soren Kynde ;
Haie-Meder, Christine ;
Poetter, Richard ;
Lindegaard, Jacob ;
Tanderup, Kari .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2011, 79 (05) :1572-1579
[42]   Magnetic resonance imaging radiomics-based prediction of severe inflammatory response in locally advanced rectal cancer patients after neoadjuvant radiochemotherapy [J].
Chen, Li ;
Zhu, Wenchao ;
Zhang, Wei ;
Chen, Engeng ;
Zhou, Wei .
LANGENBECKS ARCHIVES OF SURGERY, 2024, 409 (01)
[43]   Risk assessment model for overall survival in patients with locally advanced cervical cancer treated with definitive concurrent chemoradiotherapy [J].
Shim, Seung-Hyuk ;
Lee, Shin-Wha ;
Park, Jeong-Yeol ;
Kim, Young Seok ;
Kim, Dae-Yeon ;
Kim, Jong-Hyeok ;
Kim, Yong-Man ;
Kim, Young-Tak ;
Nam, Joo-Hyun .
GYNECOLOGIC ONCOLOGY, 2013, 128 (01) :54-59
[44]   Concurrent definitive chemoradiation incorporating intensity-modulated radiotherapy followed by adjuvant chemotherapy in high risk locally advanced cervical squamous cancer: a phase II study [J].
Zhang, Gong-yi ;
Zhang, Rong ;
Bai, Ping ;
Li, Shu-min ;
Zhang, Yuan-yuan ;
Chen, Yi-ran ;
Huang, Man-ni ;
Wu, Ling-ying .
BMC CANCER, 2022, 22 (01)
[45]   Durvalumab after concurrent chemotherapy and high-dose radiotherapy for locally advanced non-small cell lung cancer [J].
Landman, Yosef ;
Jacobi, Oded ;
Kurman, Noga ;
Yariv, Orly ;
Peretz, Idit ;
Rotem, Ofer ;
Dudnik, Elizabeth ;
Zer, Alona ;
Allen, Aaron M. .
ONCOIMMUNOLOGY, 2021, 10 (01)
[46]   Tumor recurrence and survival prognosis in patients with advanced gastric cancer after radical resection with radiotherapy and chemotherapy [J].
Nie, Shuang-Fa ;
Wang, Chen-Yang ;
Li, Lei ;
Yang, Cheng ;
Zhu, Zi-Ming ;
Fei, Jian-Dong .
WORLD JOURNAL OF GASTROINTESTINAL SURGERY, 2024, 16 (06)
[47]   Diagnostic significance of magnetic resonance imaging in patients with cervical cancer after brachytherapy: a meta-analysis [J].
Zhang, Ji ;
Tian, Weizhong ;
Bu, Xinhua ;
Wang, Xiulan ;
Tian, Fangzheng ;
Wu, Linyun .
ACTA RADIOLOGICA, 2019, 60 (05) :670-676
[48]   Does external beam radiation boost to pelvic lymph nodes improve outcomes in patients with locally advanced cervical cancer? [J].
Wujanto, Caryn ;
Choo, Bok Ai ;
Tan, David ;
Ilancheran, Arunachalam ;
Ng, Joseph ;
Low, Jeffrey J. H. ;
Shen, Liang ;
Tang, Johann ;
Koh, Vicky .
BMC CANCER, 2019, 19 (1)
[49]   Impact of multiparametric magnetic resonance imaging on risk group assessment of patients with prostate cancer addressed to external beam radiation therapy [J].
Pullini, Serena ;
Signor, Marco Andrea ;
Pancot, Martina ;
Zuiani, Chiara ;
Bazzocchi, Massimo ;
Fongione, Sandro ;
Girometti, Rossano .
EUROPEAN JOURNAL OF RADIOLOGY, 2016, 85 (04) :764-770
[50]   Tracer kinetic model selection for dynamic contrast-enhanced magnetic resonance imaging of locally advanced cervical cancer [J].
Kallehauge, Jesper Folsted ;
Tanderup, Kari ;
Duan, Chong ;
Haack, Soren ;
Pedersen, Erik Morre ;
Lindegaard, Jacob Christian ;
Fokdal, Lars Ulrik ;
Mohamed, Sandy Ismail Mohamed ;
Nielsen, Thomas .
ACTA ONCOLOGICA, 2014, 53 (08) :1064-1072