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Lymph node control in cervical cancer.

Perry W Grigsby1, Anurag K Singh, Barry A Siegel

  • 1Department of Radiation Oncology, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63110, USA. pgrisby@wustl.edu

International Journal of Radiation Oncology, Biology, Physics
|June 9, 2004
PubMed
Summary
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Adequate irradiation doses controlled most lymph node metastases. However, positive lymph nodes at diagnosis, regardless of size, significantly predicted distant metastases, highlighting a critical factor in treatment outcomes.

Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Imaging

Background:

  • Lymph node status is crucial in cancer staging and treatment planning.
  • Positron Emission Tomography (PET) and Computed Tomography (CT) are vital for assessing lymph node involvement.
  • Understanding the relationship between lymph node characteristics, radiation dose, and treatment failure is essential for optimizing patient outcomes.

Purpose of the Study:

  • To evaluate the impact of pretreatment lymph node size and irradiation dose on failure patterns.
  • To determine the predictive value of lymph node characteristics on treatment outcomes.

Main Methods:

  • Pretreatment PET and CT scans were utilized for lymph node assessment in 208 patients.
  • Lymph nodes were categorized as PET-positive or PET-negative, and their sizes were measured via CT.

Related Experiment Videos

  • Lymph node irradiation doses and sites of treatment failure were systematically recorded.

    • Main Results:

    • Pelvic lymph node doses ranged from 66.8 Gy to 74.1 Gy, with higher doses associated with larger or PET-positive nodes.
    • Paraaortic lymph node doses averaged 43.3 Gy.
    • Distant metastases were identified as the most frequent site of treatment failure, particularly in patients with PET-positive lymph nodes.

    Conclusions:

    • The applied irradiation doses were generally sufficient for controlling lymph node metastases.
    • The presence of positive lymph nodes at diagnosis, irrespective of size, emerged as the most significant predictor of distant metastatic disease.