Clinical significance of intensity-modulated radiotherapy (IMRT) to the distant metastatic lymph nodes for metastatic cervical cancer

BMC Cancer. 2024 Sep 20;24(1):1170. doi: 10.1186/s12885-024-12895-2.

Abstract

Objective: To retrospectively explore the clinical significance of radiotherapy to the distant metastatic lymph nodes (cervical/ clavicular/ mediastinal et al.) in metastatic cervical cancer. Hereinto, these cervicothoracic lymph nodes were metastasized from IB1-IVA (initial stage at first treatment), and IVB initially had metastatic disease in these areas at diagnosis.

Methods: Metastatic cervical cancer only with the distant cervicothoracic metastatic lymph nodes (cervical/ clavicular/ mediastinal et al.), without distant parenchymal organs metastasis such as lung, liver, bone, and peritoneum, were enrolled in the analysis. These patients were classified into IB1-IVA and IVB based on their initial stage of first treatment. All patients received IMRT for the distant metastatic lymph nodes. The progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method.

Results: Overall, the median PFS was 9 months, and the median OS was 27 months. The subgroup analysis showed that for IB1-IVA, the median PFS was 11 months, and the median OS was 30.5 months. For IVB, the median PFS was 8 months, and the median OS was 16 months.

Conclusion: Radiotherapy is beneficial to the distant metastatic lymph nodes (cervical/ clavicular/ mediastinal et al.), and could effectively bring the longer PFS and OS for metastatic cervical cancer.

Keywords: Cervical cancer; Distant metastatic lymph nodes; Intensity-modulated radiotherapy; Survival.

MeSH terms

  • Adult
  • Aged
  • Clinical Relevance
  • Female
  • Humans
  • Lymph Nodes* / pathology
  • Lymphatic Metastasis* / radiotherapy
  • Middle Aged
  • Neoplasm Staging
  • Radiotherapy, Intensity-Modulated* / methods
  • Retrospective Studies
  • Uterine Cervical Neoplasms* / mortality
  • Uterine Cervical Neoplasms* / pathology
  • Uterine Cervical Neoplasms* / radiotherapy