TY - JOUR T1 - Predictors of Radiation Field Failure After Definitive Chemoradiation in Patients With Locally Advanced Cervical Cancer JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 737 LP - 742 DO - 10.1097/IGC.0000000000000662 VL - 26 IS - 4 AU - Hyo Sook Bae AU - Yeon-Joo Kim AU - Myong Cheol Lim AU - Sang-Soo Seo AU - Sang-yoon Park AU - Sokbom Kang AU - Sun Ho Kim AU - Joo-Young Kim Y1 - 2016/05/01 UR - http://ijgc.bmj.com/content/26/4/737.abstract N2 - Purpose We identified the predictive factors for locoregional failure after definitive chemoradiation in patients with locally advanced cervical cancer.Methods Altogether, 397 patients with locally advanced cervical cancer (stage IB2–IVA) were treated with definitive chemoradiation between June 2001 and February 2010. Platinum-based concurrent chemotherapy was given to all patients with median radiation dose of external beam radiotherapy 50.4 Gy in 28 fractions and intracavitary radiotherapy 30 Gy in 6 fractions. Competing risk regression analysis was used to reveal the predictive factors for locoregional failure.Results During the median follow-up of 7.2 years, locoregional failure occurred in 51 (12.9%) patients. The estimated 3-year rate of locoregional control was 89%, whereas the overall survival rate was 82%. After univariate and multivariate analyses, large tumor size (>5 cm), young age (≤40 years), nonsquamous histology, positive lymph node on magnetic resonance imaging, and advanced stage (III–IV) were identified as risk factors for locoregional failure (P = 0.003, P = 0.075, P = 0.005, P = 0.055, and P < 0.001, respectively). After risk grouping according to the coefficients from the multivariate model, we identified a high-risk group for locoregional failure after treatment with definitive chemoradiation as follows: (1) tumor size larger than 5 cm, and at least 1 other risk factor or (2) tumor size 5 cm or less, and at least 3 other risk factors. The cumulated estimated 3-year rate of locoregional failure of the high-risk group was 26%, which was significantly higher than that of the low-risk group (7%, P < 0.001). The 3-year overall survival rates of the 2 groups were also significantly different (57% vs 86%, P < 0.001).Conclusions Large tumor size (>5 cm), young age (≤40 years), nonsquamous histology, positive lymph node on magnetic resonance imaging, and advanced stage are all risk factors for locoregional failure after definitive platinum-based chemoradiation in patients with locally advanced cervical cancer. In the high-risk group, further clinical trials are warranted to improve the locoregional control rate. ER -