title: Tailored radiotherapeutic strategies for disseminated uterine cervical cancer patients.
abstract: BACKGROUND
  To investigate the role of radiotherapy (RT) in and to suggest radiotherapeutic strategies for patients presenting with disseminated cervical cancer.
  
  
  METHODS
  We retrospectively analyzed 50 patients diagnosed as the disseminated cervical cancer with distant lymph nodal or visceral organ metastasis between September 1980 and August 2012. Patients were divided into two subgroups according to visceral organ metastasis: 35 patients diagnosed with distant lymph node metastasis only (group A) and 15 patients with visceral organ metastasis (group B). All patients received external beam RT to the pelvis (median dose 45 Gy) and high-dose rate intracavitary RT (median dose 30 Gy). Thirty-nine patients (78%) received chemotherapy.
  
  
  RESULTS
  Median follow-up time was 74 months. The 5-year pelvic control rate (PCR) was 85.8%, and the progression-free survival (PFS), and overall survival (OS) rates were 28.7%, and 36.2%, respectively. The major treatment failure was systemic progression (32 patients, 64%). The 5-year PCRs in groups A and B were 87.4% and 74.7%, respectively (p > 0.05). Meanwhile, PFS and OS rates for group A were significantly better than those for group B (35.3% vs. 13.3%, p = 0.010; and 46.3% vs. 13.3%, p = 0.009, respectively).
  
  
  CONCLUSIONS
  Our data revealed considerable prognostic heterogeneity in disseminated cervical cancer. Even though a high PCR was achieved in patients treated with definitive RT, survival outcomes were dependent on progression of visceral organ metastasis. Therefore, personalized RT and chemotherapy treatment strategies according to the presence of visceral organ metastasis in disseminated cervical cancer patients may help improve clinical outcomes.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University, College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. junghosta@naver.com.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Im
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University, College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. yhi0225@yuhs.ac.|Department of Pharmacology, Yonsei University, College of Medicine, Seoul, South Korea. yhi0225@yuhs.ac.
authors.forename: Hong In
authors.initials: HI
authors.lastname: Yoon
authors.affiliation: Women's Cancer Clinic, Yonsei Cancer Center, Yonsei University, College of Medicine, Seoul, South Korea. shkim70@yuhs.ac.
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Kim
authors.affiliation: Women's Cancer Clinic, Yonsei Cancer Center, Yonsei University, College of Medicine, Seoul, South Korea. nahmej6@yuhs.ac.
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Nam
authors.affiliation: Women's Cancer Clinic, Yonsei Cancer Center, Yonsei University, College of Medicine, Seoul, South Korea. san1@yuhs.ac.
authors.forename: Sang Wun
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Women's Cancer Clinic, Yonsei Cancer Center, Yonsei University, College of Medicine, Seoul, South Korea. oceanblu@yuhs.ac.
authors.forename: Ga Won
authors.initials: GW
authors.lastname: Yim
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University, College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. kckeum@yuhs.ac.|Yonsei Song-Dang Institute for Cancer Research, Yonsei University, College of Medicine, Seoul, South Korea. kckeum@yuhs.ac.
authors.forename: Ki Chang
authors.initials: KC
authors.lastname: Keum
authors.affiliation: Women's Cancer Clinic, Yonsei Cancer Center, Yonsei University, College of Medicine, Seoul, South Korea. ytkchoi@yuhs.ac.
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University, College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. gekim@yuhs.ac.
authors.forename: Gwi Eon
authors.initials: GE
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University, College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. ybkim3@yuhs.ac.|Women's Cancer Clinic, Yonsei Cancer Center, Yonsei University, College of Medicine, Seoul, South Korea. ybkim3@yuhs.ac.|Yonsei Song-Dang Institute for Cancer Research, Yonsei University, College of Medicine, Seoul, South Korea. ybkim3@yuhs.ac.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D000328:Adult; D000368:Aged; D001918:Brachytherapy; D018288:Carcinoma, Small Cell / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*