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Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies.

Publication ,  Journal Article
Salama, JK; Mundt, AJ; Roeske, J; Mehta, N
Published in: Int J Radiat Oncol Biol Phys
July 15, 2006

PURPOSE: The aim of this article is to report a preliminary analysis of our initial clinical experience with extended-field intensity-modulated radiotherapy for gynecologic malignancies. METHODS AND MATERIALS: Between November 2002 and May 2005, 13 women with gynecologic malignancies were treated with extended-field radiation therapy. Of the women, 7 had endometrial cancer, 4 cervical cancer, 1 recurrent endometrial cancer, and 1 suspected cervical cancer. All women underwent computed tomography planning, with the upper vagina, parametria, and uterus (if present) contoured within the CTV. In addition, the clinical target volume contained the pelvic and presacral lymph nodes as well as the para-aortic lymph nodes. All acute toxicity was scored according to the Common Terminology Criteria for Adverse Events (CTCAE v 3.0). All late toxicity was scored using the Radiation Therapy Oncology Group late toxicity score. RESULTS: The median follow-up was 11 months. Extended-field intensity-modulated radiation therapy (IMRT) for gynecologic malignancies was well tolerated. Two patients experienced Grade 3 or higher toxicity. Both patients were treated with concurrent cisplatin based chemotherapy. Neither patient was planned with bone marrow sparing. Eleven patients had no evidence of late toxicity. One patient with multiple previous surgeries experienced a bowel obstruction. One patient with bilateral grossly involved and unresectable common iliac nodes experienced bilateral lymphedema. Extended-field-IMRT achieved good local control with only 1 patient, who was metastatic at presentation, and 1 patient not able to complete treatment, experiencing in-field failure. CONCLUSIONS: Extended-field IMRT is safe and effective with a low incidence of acute toxicity. Longer follow-up is needed to assess chronic toxicity, although early results are promising.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

July 15, 2006

Volume

65

Issue

4

Start / End Page

1170 / 1176

Location

United States

Related Subject Headings

  • Uterine Cervical Neoplasms
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiography
  • Oncology & Carcinogenesis
  • Middle Aged
  • Humans
  • Female
  • Endometrial Neoplasms
  • Aged
 

Citation

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Salama, J. K., Mundt, A. J., Roeske, J., & Mehta, N. (2006). Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies. Int J Radiat Oncol Biol Phys, 65(4), 1170–1176. https://doi.org/10.1016/j.ijrobp.2006.02.041
Salama, Joseph K., Arno J. Mundt, John Roeske, and Neil Mehta. “Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies.Int J Radiat Oncol Biol Phys 65, no. 4 (July 15, 2006): 1170–76. https://doi.org/10.1016/j.ijrobp.2006.02.041.
Salama JK, Mundt AJ, Roeske J, Mehta N. Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies. Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):1170–6.
Salama, Joseph K., et al. “Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies.Int J Radiat Oncol Biol Phys, vol. 65, no. 4, July 2006, pp. 1170–76. Pubmed, doi:10.1016/j.ijrobp.2006.02.041.
Salama JK, Mundt AJ, Roeske J, Mehta N. Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies. Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):1170–1176.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

July 15, 2006

Volume

65

Issue

4

Start / End Page

1170 / 1176

Location

United States

Related Subject Headings

  • Uterine Cervical Neoplasms
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiography
  • Oncology & Carcinogenesis
  • Middle Aged
  • Humans
  • Female
  • Endometrial Neoplasms
  • Aged