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Salvage stereotactic body radiotherapy for locally recurrent uterine cervix cancer at the pelvic sidewall: Feasibility and complication
Author(s) -
Seo YoungSeok,
Kim MiSook,
Yoo HyungJun,
Jang WonIl,
Rhu SangYoung,
Choi SuckChul,
Kim MoonHong,
Kim BeobJong,
Lee DongHan,
Cho ChulKoo
Publication year - 2016
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12185
Subject(s) - medicine , cervical cancer , radiation therapy , cervix , surgery , radiology , cancer , urology
Aims To determine the feasibility of stereotactic body radiotherapy ( SBRT ) in patients with pelvic sidewall recurrence of uterine cervical cancer after radical hysterectomy or definitive radiotherapy. Methods We retrospectively reviewed 23 patients with locally recurrent uterine cervical cancer limited to the pelvic sidewall who were treated with SBRT at our institution between J anuary 2003 and M ay 2010. The SBRT dose ranged from 27 to 45 Gy (median, 39 Gy ) in three fractions, and the fractional SBRT dose ranged from 9 to 15 Gy (median, 13 Gy ). Results The 2‐year overall survival, local progression‐free survival and disease progression‐free survival rates were 43%, 65% and 52%, respectively. Patients with small tumors (gross tumor volume <30 cm 3 ) had a significantly longer 2‐year overall survival rate and 2‐year local progression‐free survival rate than did patients with large tumors (overall survival rate: 89% vs 12%; P = 0.0001 and local progression‐free survival: 85% vs 0%; P = 0.0199). There were three cases (13%) of severe toxicities (rectovaginal fistula). Pelvic pain relief was achieved in all patients. In particular, 10 of 14 patients (71%) achieved analgesic (nonsteroidal anti‐inflammatory drug or narcotic) reduction of 50% or more from baseline. Conclusion SBRT is a feasible treatment option for women with pelvic sidewall tumors from recurrent uterine cervical cancer, especially for small recurrent tumors. However, SBRT should be used carefully in the treatment of large tumors, as the incidence of severe late toxicity increases with the size of the tumor.