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Outcomes for Patients With Cervical Cancer Treated With Extended-Field Intensity-Modulated Radiation Therapy and Concurrent Cisplatin
  1. Lindsay G. Jensen, MD, MAS*,
  2. Michael D. Hasselle, MD,
  3. Brent S. Rose, MD*,
  4. Sameer K. Nath, MD, MAS*,
  5. Yasmin Hasan, MD,
  6. Dan J. Scanderbeg, PhD*,
  7. Catheryn M. Yashar, MD*,
  8. Arno J. Mundt, MD* and
  9. Loren K. Mell, MD*
  1. *Department of Radiation Oncology, University of California San Diego, La Jolla, CA; and
  2. Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL.
  1. Address correspondence and reprint requests to Loren K. Mell, MD, Department of Radiation Oncology, 3855 Health Sciences Dr, MC0843, La Jolla, CA 92093. E-mail: lmell{at}
  1. This research was presented in part at the 53rd annual meeting of the American Society for Radiation Oncology (ASTRO), Miami Beach, FL, October 2–6, 2011.


Objective To evaluate disease outcomes and toxicity in patients with cervical cancer treated with extended-field intensity-modulated radiotherapy.

Materials and Methods We included all patients treated with extended-field intensity-modulated radiotherapy and concurrent weekly cisplatin from 2003 to 2010 at 2 institutions. Overall survival and disease-free survival were estimated using Kaplan-Meier method. Locoregional failure (LRF), distant failure, and competing mortality were calculated using cumulative incidence functions. Acute and late toxicity were graded using Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group late radiation morbidity scoring criteria, respectively.

Results The study included 21 patients, 14 and 20 of which had positive para-aortic and pelvic nodes, respectively. The median follow-up was 22 months. Eighteen-month overall survival and disease-free survival were 59.7% (95% confidence interval [CI], 41.2%–86.4%) and 42.9% (95% CI, 26.2%–70.2%). Eighteen-month cumulative incidences of LRF, distant failure, and competing mortality were 9.5% (95% CI, 1.5–26.8%), 42.9% (95% CI, 21.3–62.9%), and 4.8% (95% CI, 0.3–20.2%), respectively. Eighteen-month cumulative incidences of late grade 3 or higher-grade genitourinary and gastrointestinal toxicity were 4.8% (95% CI, 0.2%–20.3%) and 0%, respectively.

Conclusions Intensity-modulated extended-field radiotherapy was associated with low rates of late toxicity and LRF. High rates of distant failure indicate that this group of patients could benefit from intensified systemic therapy.

  • Cervical cancer
  • Extended field radiotherapy
  • Intensity-modulated radiation therapy (IMRT)
  • Para-aortic lymph nodes

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  • The authors declare no conflicts of interest.