Aggressive multimodality treatment for cervical cancer with paraaortic lymph node metastases

Area of Science:

• Gynecologic Oncology
• Radiation Oncology
• Medical Oncology

Background:

• Cervical carcinoma with paraaortic metastases represents a high-risk patient group.
• Previous trials utilized pelvic radiation with chemotherapy, necessitating evaluation of extended fields.

Purpose of the Study:

• To determine the efficacy and toxicity of weekly cisplatin combined with extended field radiation therapy.
• To assess cisplatin's role as a radiation sensitizer in this cohort.

Main Methods:

• A Phase I/II trial involving 13 patients with cervical carcinoma and paraaortic metastases.
• Treatment consisted of weekly cisplatin and extended field radiation therapy.
• Patient outcomes were monitored for disease recurrence and toxicity.

Main Results:

• Eight out of 13 patients are alive with no evidence of disease.
• Recurrences occurred exclusively outside the treated fields (pelvis and paraaortic nodes).
• Complete local and pelvic tumor control was achieved with acceptable toxicity.

Conclusions:

• The combination of weekly cisplatin and extended field radiation therapy demonstrates encouraging efficacy in controlling cervical carcinoma with paraaortic metastases.
• The observed toxicity profile is acceptable, supporting the continuation of this trial.
• Extended field radiation therapy effectively prevents recurrence in the treated pelvic and paraaortic regions.