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EP307 The role and optimal regimen of radiation therapy for patients with bone metastasis from uterine cervical cancer
  1. M Hata1,
  2. I Koike1,
  3. M Asai-Sato2,
  4. H Kaizu1,
  5. Y Mukai1,
  6. S Takano1,
  7. E Ito1,
  8. M Sugiura1,
  9. M Sato1,
  10. R Taniuchi1 and
  11. E Miyagi2
  1. 1Department of Radiation Oncology
  2. 2Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan


Introduction/Background Patients with bone metastasis from uterine cervical cancer usually have a poor prognosis and are candidates for palliative care. We therefore carried out a review to determine the role of radiation therapy for patients with bone metastasis from uterine cervical cancer and to identify the optimal radiation regimen.

Methodology A total of 21 patients with bone metastasis from uterine cervical cancer received radiation therapy to the pelvis. All patients received external irradiation and 13 patients also received high-dose-rate intracavitary brachytherapy. The median total dose of 60.4 Gy (range, 32.4-76.2 Gy) was delivered to cervical tumors of all patients and corresponded to 62.1 Gy (range, 31.9-83.3 Gy) in the 2 Gy per fraction-equivalent dose (EQD2). Thirteen patients underwent chemotherapy during and/or following radiation therapy.

Results In 19 of 21 patients, the primary tumors disappeared or were markedly reduced after radiation therapy. In all but one of 18 patients with pelvic pain and bleeding, these symptoms disappeared or were remarkably relieved. However, three patients had primary tumor progression at 7, 9, and 15 months after irradiation with total doses of 56.8, 58.4, and 68.3 Gy in EQD2, respectively. Two of these patients had relapses of bleeding and pain. The primary progression-free rates in all patients were 73% at 1 year, and 37% at 2 years. The overall survival rates were 38% at 1 year, and 9% at 2 years, with an estimated median survival time of 7 months. The number of metastatic bone sites (p=0.016) and administration of chemotherapy (p<0.001) were significant prognostic factors for survival.

Conclusion Radiation therapy is very effective for relief of pelvic symptoms in patients with bone metastasis from uterine cervical cancer. For patients who are expected to survive for more than 1 year, almost curative-dose irradiation to primary tumors is recommended.

Disclosure Nothing to disclose.

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