Lymph node control in cervical cancer.
OBJECTIVE
The aim was to evaluate pretreatment lymph node size, irradiation dose, and failure patterns.


METHODS
Pretreatment PET and CT were performed in 208 patients. Lymph nodes were scored as either positive or negative by PET and lymph node size was measured by CT. Lymph node irradiation dose and sites of failure were recorded.


RESULTS
The mean pelvic lymph node doses were: PET negative nodes, < or =1 cm, 66.8 Gy, and 0/76 failures; PET positive nodes, < or =1 cm, 66.8 Gy, and 3/89 failures; 1.1-< or =2 cm, 66.9 Gy, and 0/21 failures; 2.1-< or =3 cm, 69.4 Gy, and 2/15 failures; and 3.1 to < or =4 cm, 74.1 Gy, and 0/5 failures. The mean paraaortic lymph node dose was 43.3 Gy and there were no paraaortic failures for 24 patients with PET positive < or =1 cm nodes, 0/5 failures for 1.1 to < or =2 cm, and 0/4 failures for 2.1 to < or =3 cm. The most common site of failure was distant metastases.


CONCLUSIONS
The irradiation doses given in this study were adequate to control most lymph node metastases. Positive lymph nodes of any size at diagnosis were the most significant predictor for developing distant metastases.
Grigsby
Perry W
PW
Department of Radiation Oncology, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63110, USA. pgrisby@wustl.edu
Singh
Anurag K
AK
Siegel
Barry A
BA
Dehdashti
Farrokh
F
Rader
Janet
J
Zoberi
Imran
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D008875:Middle Aged; D019275:Radiopharmaceuticals; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18