Efficacy and Tolerance of Extended Field Radiation Therapy in Uterine Cervical Cancer Patients with Para-Aortic Lymph Node Metastasis

Abstract

Aim: To determine the response and toxicity of extended field radiation therapy and concurrent chemotherapy on uterine cervical cancer patients with para - aortic lymph node metastasis. Methods: Forty patients with cervical cancer with para -aortic lymphadenopathy metastasis were treated by photons on LINAC with extended field radiotherapy (46-50Gy/23-25#) along with weekly concurrent cisplatin (35mg/m2) followed by 3 sessions of weekly intracavitory brachytherapy (7Gy per session by HDR Ir-192) at our institution. The primary endpoint was to assess efficacy in terms of response to the treatment. The secondary endpoint was to assess tolerance of treatment in terms of toxicities (hematological and non-hematological). Results: Complete clinical response in pelvis and para-aortic disease were observed in 28(70%) and 27(67.5%) patients. Partial clinical response in pelvis and para-aortic disease were observed in 11(27.5%) and 12(30%) of patients. One patient did not respond to the treatment and had progression of disease. Anemia grade 1-2 was seen in 22(55%) patients. Neutropenia grade 1-2 was seen in 10(25%) of patients. Thrombocytopenia grade 1 was seen in only 2(5%) of patients. None of the patient had grade 4 hematological