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Use of small pelvic field instead of whole pelvic field in postoperative radiotherapy for node-negative, high-risk stages I and II cervical squamous cell carcinoma
  1. K. Ohara*,
  2. H. Tsunoda,
  3. M. Nishida,
  4. S. Sugahara*,
  5. T. Hashimoto*,
  6. Y. Shioyama*,
  7. K. Hasezawa*,
  8. H. Yoshikawa,
  9. Y. Akine and
  10. Y. Itai
  1. * Department of Radiation Oncology, Tsukuba University Hospital, Tsukuba City, Japan
  2. Department of Gynecology, Tsukuba University Hospital, Tsukuba City, Japan
  3. Department of Diagnostic Radiology, Tsukuba University Hospital, Tsukuba City, Japan
  1. Address correspondence and reprint requests to: Kiyoshi Ohara, MD, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City 305–8575, Japan. Email: ki-ohara{at}
  1. Part of this study was presented at the European Cancer Conference 11, Lisbon, October 21–25, 2001. MN is currently affiliated with the department of Gynecology, Kasumigaura National Hospital, Tsuchiura City, Japan.


We investigated whether a small pelvic (SP) field that covers primarily the pericervical regions in postoperative radiotherapy for cervical squamous cell carcinoma is adequate for a subgroup of node-negative patients. Of 84 patients with stage I–II disease treated with postoperative radiotherapy due to pathologic risk factors, 42 node-negative patients received SP-field radiotherapy, whereas remaining 42 node-positive patients were treated with a conventional whole pelvic (WP) field that also covered pelvic lymph nodes, both with 50.0–50.4 Gy/25–28 fractions. The pathologic risk factors included positive nodes, deep stromal invasion (≥2 /3 thickness), parametrial extension, and positive or close surgical margin. Recurrence was identified for 20 patients: three in the SP group and 17 in the WP group. Intrapelvic recurrence accounted for all three recurrences in the SP group and for four in the WP group; 5-year pelvic-control rate did not differ significantly between the SP (93%) and WP (90%) groups. Extrapelvic recurrence (n = 11) was identified exclusively in the WP group. Patterns of recurrence indicate that use of an SP field instead of a WP field may be adequate in postoperative radiotherapy for a subgroup of node-negative, high-risk patients.

  • complication
  • lymph node metastasis
  • pelvic failure
  • prognostic factor

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