title: Difference in distant failure site between locally advanced squamous cell carcinoma and adenocarcinoma of the uterine cervix after C-ion RT.
abstract: We investigated the first site of distant failure after carbon ion radiotherapy (C-ion RT) for locally advanced cervical cancer in three clinical trials. A total of 91 cases were enrolled in the three trials (Protocol 9702, 9704 and 9902). Histologically, 36 cases had squamous cell carcinoma (SqCC) and 55 cases had adenocarcinoma (AC), including 13 with adenosquamous cell carcinoma. The number of cases with Stage IIB, IIIB and IVA disease was 21, 59 and 11, respectively. Of the 91 cases, 42 had positive pelvic lymph nodes (PLNs). The median tumor size was 6.0 cm (range, 3.0–12.0 cm). The median follow-up duration for all cases was 40 months (range, 7–181 months). A total of 40 cases developed distant failure as the first site of failure: 13 of 36 (36.1%) SqCC cases had distant failure, with 9 of them with para-aortic lymph node (PALN) failure; 27 of 55 (44.0%) AC cases had distant failure, and 23 of them had distant failure excluding PALN metastasis. Distant failure rates of SqCC cases who had positive and negative PLNs before C-ion RT were 61.1% and 11.1%, respectively (P = 0.0045). Those of AC cases were 54.2% and 45.2%, respectively (P = 0.507). In conclusion, there were high rates of distant failure after C-ion RT in AC cases regardless of PLN status, and there were high rates of distant failure after C-ion RT, especially PALN failure, in SqCC cases with positive PLNs.
authors.forename: Masaru
authors.initials: M
authors.lastname: Wakatsuki
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ohno
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kiyohara
authors.forename: Kumiko
authors.initials: K
authors.lastname: Karasawa
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tamaki
authors.forename: Ken
authors.initials: K
authors.lastname: Ando
authors.forename: Daisuke
authors.initials: D
authors.lastname: Irie
authors.forename: Shintaro
authors.initials: S
authors.lastname: Shiba
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tsujii
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kamada
authors.forename: Makio
authors.initials: M
authors.lastname: Shozu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D063193:Heavy Ion Radiotherapy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011879:Radiotherapy Dosage; D017211:Treatment Failure; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology / Q000532:radiotherapy*