Significance of para-aortic node irradiation in the treatment of cervical cancer.
In 1980, we introduced para-aortic node irradiation as a part of our treatment of cervical cancer. Eighty-six patients with cervical cancer were selected for such treatment, based on histologic or radiologic criteria for lymph node involvement. We delivered 45 Gy to the para-aortic nodes in 5 weeks. Comparison studies on the prognosis and on the incidence of side effects with and without para-aortic node irradiation were carried out on a total of 783 patients who had invasive cervical cancer and were treated from 1975 to 1984. For patients in stages Ib and II who met, or before 1980 would have met, our criteria there was no significant difference in survival for those in stage Ib, but in stage II the para-aortic node irradiation group did significantly better (P less than 0.01). For the entire series of patients, for all stages from Ib to IV, the prognosis for the group treated after the introduction of para-aortic node irradiation was superior, with a statistically significant difference from the prognosis for patients treated before the introduction of this mode (Ib, P less than 0.05; II, P less than 0.01; III, P less than 0.01; IV, P less than 0.05). None of the patients had severe complications after para-aortic node irradiation. We conclude that, by irradiating the para-aortic nodes, we can improve the prognosis of cervical cancer patients who may have para-aortic node involvement, a situation which formerly was considered hopeless.
Horii
T
T
Department of Obstetrics and Gynecology, Kinki University School of Medicine, Osaka, Japan.
Mitsumoto
T
T
Noda
K
K
D005260:Female; D006801:Humans; D015182:Lymphatic Irradiation; D008207:Lymphatic Metastasis / Q000517:prevention & control*; D010388:Pelvis; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*