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Magnetic resonance imaging during definitive chemoradiotherapy can predict tumor recurrence and patient survival in locally advanced cervical cancer: A multi-institutional retrospective analysis of KROG 16-01

Title
Magnetic resonance imaging during definitive chemoradiotherapy can predict tumor recurrence and patient survival in locally advanced cervical cancer: A multi-institutional retrospective analysis of KROG 16-01
Authors
Lee S.-W.Lee S.H.Kim J.Kim Y.-S.Yoon M.S.Jeong S.Kim J.H.Lee J.Eom K.-Y.Jeong B.K.Sung S.Y.Lee S.J.Lee J.H.
Ewha Authors
정송미
SCOPUS Author ID
정송미scopus
Issue Date
2017
Journal Title
Gynecologic Oncology
ISSN
0090-8258JCR Link
Citation
vol. 147, no. 2, pp. 334 - 339
Keywords
Cervical cancerChemoradiotherapyEarly responseMRI
Publisher
Academic Press Inc.
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Objective Definitive chemoradiotherapy (CRT) followed by brachytherapy is a standard treatment for locally advanced cervical cancer. During CRT, marked reduction of cervical tumor is often observed in magnetic resonance imaging (MRI). The primary aim of this study was to assess the association between tumor response in MRI using FIGO classification and clinical outcomes. Methods Multi-institutional data were retrospectively reviewed to identify the significance of MR tumor response on tumor recurrence and patient survival. 225 patients with histologically confirmed squamous cell carcinoma of the cervix, staged as FIGO Ib2-IVa on initial pelvic MRI, were included. Post-CRT MRI was performed median 35 days after the beginning of CRT and before brachytherapy. A median 54 Gy of external radiation was given with weekly cisplatin during CRT. Results 112 (49.7%) of the 225 patients showed a positive response in post-CRT MRI and were named the responsive arm. After a median follow-up time of 36.2 months, the responsive arm had significantly lower para-aortic recurrence (7.5% vs. 12.4%; p = 0.04) and distant metastasis (13.2% vs. 27.6%; p = 0.03) rates than did the non-responsive arm. The responsive arm had significantly higher 3-year cause-specific survival rate (94.6% vs. 81.1%, p < 0.01) than did the non-responsive arm. In the multivariate analysis, tumor size (hazard ratio, 1.91 and 95% confidence interval, 1.07–3.43; p = 0.028) and positive MR response (hazard ratio, 1.75 and 95% confidence interval, 1.06–2.27; p = 0.045) were significant factors for recurrence-free survival Conclusion Early tumor response evaluation with MRI using FIGO classification effectively predicted distant tumor metastasis and disease-specific survival in locally advanced cervical cancer. © 2017 Elsevier Inc.
DOI
10.1016/j.ygyno.2017.08.029
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의료원 > 의료원 > Journal papers
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