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The impact of boost radiation therapy after hysterectomy on cervical cancer patients with close or positive resection margins

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Abstract

Purpose

We investigated the effect of boost radiation therapy (RT) in addition to whole pelvis RT (WPRT) on treatment outcome and safety of cervical cancer patients following hysterectomy with close/positive resection margins (RM).

Methods

We retrospectively analyzed 51 patients with cervical cancer who received WPRT with or without boost-RT as adjuvant treatment between July 2006 and June 2022. Twenty patients (39.2%) were treated with WPRT-alone, and 31 (60.8%) received boost-RT after WPRT using brachytherapy or intensity-modulated RT.

Results

The median follow-up period was 41 months. According to RT modality, the 4-year local control (LC) and locoregional control (LRC) rates of patients treated with WPRT-alone were 61% and 61%, respectively, whereas those in LC and LRC rates in patients who underwent WPRT with boost-RT were 93.2% and 75.3%, with p-values equal to 0.005 and 0.090, respectively. Seven patients (35.0%) had local recurrence in the WPRT-treated group compared to only two out of the 31 patients (6.5%) in the WPRT with boost-RT-treated counterparts (p = 0.025). Boost-RT was a significantly good prognostic factor for LC (p = 0.013) and LRC (p = 0.013). Boost-RT did not result in statistically-significant improvements in progression-free survival or overall survival. The acute and late toxicity rates were not significantly different between groups.

Conclusion

Boost RT following WPRT is a safe and effective treatment strategy to improve LC without increasing toxicity in patients with cervical cancer with close/positive RM after hysterectomy.

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Data availability

Data are available upon reasonable request.

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Authors and Affiliations

  1. Department of Radiation Oncology, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, 56, Dongsuro, Bupyung-gu, Incheon, 21431, Republic of Korea

    So Jung Lee, Myungsoo Kim, Yoo-Kang Kwak & Hye Jin Kang

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  1. So Jung Lee
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Contributions

HJK contributed to the study conception and design. Material preparation, data collection and analysis were performed by HJK, MK, Y-KK, and SJL. The first draft of the manuscript was written by SJL. All authors reviewed and approved the final manuscript.

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Correspondence to Hye Jin Kang.

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This study was approved by the institutional review board of the Catholic Medical Center ethics committee (IRB No.: OC22RASI0154).

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Lee, S.J., Kim, M., Kwak, YK. et al. The impact of boost radiation therapy after hysterectomy on cervical cancer patients with close or positive resection margins. Clin Transl Oncol 26, 689–697 (2024). https://doi.org/10.1007/s12094-023-03283-6

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  • DOI: https://doi.org/10.1007/s12094-023-03283-6

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