title: Outcomes of uterine cervical cancer patients with pelvic lymph node metastases after radiotherapy without boost irradiation of metastases.
abstract: OBJECTIVE
  The aim of this study was to evaluate the outcomes of uterine cervical cancer patients with pelvic lymph node (PLN) metastases after radiotherapy without boost irradiation of the metastases and to clarify the necessity of the boost irradiation of metastatic lesions.
  
  
  METHODS
  Thirty-two patients with uterine cervical cancer metastasizing only to the PLN were treated with definitive radiotherapy without boost irradiation of the metastases between 2008 and 2012 at our institution and were selected for this study. The pattern of progression, overall survival, and progression-free survival were analyzed.
  
  
  RESULTS
  Ninety percent of the PLN metastases were controlled by radiotherapy. Twenty-two of 32 patients (69%) experienced progression. Distant metastases as initial progression were observed in 21 of these 22 patients (95%). Only two patients experienced failures in pre-treatment metastatic PLN as initial progression, along with other failures. Severe late lower gastrointestinal toxicities were not observed in any patients. Two-year cumulative overall survival and progression-free survival were 74% and 31%, respectively.
  
  
  CONCLUSIONS
  Boost irradiation of PLN metastases is not necessarily indispensable. Further studies to examine the necessity of boost irradiation of PLN metastases in radiotherapy for uterine cervical cancer patients with metastases are required.
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Yoshizawa
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Koiwai
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Ina
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: Ayumu
authors.initials: A
authors.lastname: Fukazawa
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Sakai
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: Takesumi
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Matsushita
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan.
authors.forename: Masumi
authors.initials: M
authors.lastname: Kadoya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000532:radiotherapy*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010388:Pelvis / Q000473:pathology*; D011879:Radiotherapy Dosage; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy*
keywords: boost irradiation; cancer of the cervix; pelvic lymph node metastasis; radiation therapy in gynecologic cancers