Jae Sung Heo

Ajou University

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Oyeon Cho

Ajou University

Mison Chun

Ajou University

Suk‐Joon Chang

Ajou University

Hae Jin Park

Hanyang University

Young Taik Oh

Yonsei University

Hyunsoo Jang

Ajou University

O Kyu Noh

Ajou University

Mi Hwa Kim

Ajou University

Hee‐Sug Ryu

Ajou University

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Ajou University

Ajou University Hospital

Asan Medical Center

Seoul National University

Suwon Research Institute

Yonsei University

University of Ulsan

AstraZeneca (Brazil)

The University of Texas MD Anderson Cancer Center

Korea University Medical Center

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Prognostic factors and treatment outcome after radiotherapy in cervical cancer patients with isolated para-aortic lymph node metastases

Journal of Gynecologic Oncology (2013)

Hyunsoo Jang Mison Chun Oyeon Cho Jae Sung Heo Hee‐Sug Ryu

The purpose of the present study was to evaluate treatment outcomes and prognostic factors in cervical cancer patients with isolated para-aortic lymph node (PALN) metastases. We especially tried to evaluate PALN factors such as size, site and number.From August 1994 to December 2009, 40 cervical cancer patients with isolated PALN node metastases at initial diagnosis were selected for analysis. Patients underwent both extended field external beam and intracavitary brachytherapy. Fourteen patients received 5-fluorouracil and cisplatin (FP) and 16 patients received weekly concurrent cisplatin. Information of PALN, such as size, site, and number, was founded before PALN radiotherapy.The median follow-up time after primary treatment was 28.5 months (range, 2 to 213 months). The 3-year overall and progression-free survival rate after primary treatment was 44.3% and 31.3%, respectively. In multivariate analysis including tumor stage, performance status, and chemotherapy, FP regimen concurrent chemoradiotherapy was more effective than radiotherapy alone (p=0.030). The 3-year progression-free survival rate was 41.9% and 11.1% in patients with PALN numbers of ≤1 and ≥2, respectively (p=0.008). The 3-year progression-free survival rate was 42.1% and 19.2% in patients with PALN size of <1.5 cm and ≥1.5 cm, respectively (p=0.031).The radiologic features of PALN, such as number or size, can be used to determine prognosis in PALN metastatic cervical cancer patients. Furthermore, FP regimen concurrent chemoradiotherapy was associated with better patient survival than radiotherapy alone. However, more studies are required to confirm possible different treatment outcomes between FP and weekly cisplatin regimens.

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Chemoradiotherapy

10.3802/jgo.2013.24.3.229

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Can initial diagnostic PET-CT aid to localize tumor bed in breast cancer radiotherapy: feasibility study using deformable image registration

Radiation Oncology (2013)

Oyeon Cho Mison Chun Young Taik Oh Mi Hwa Kim Hae Jin Park

Abstract Background Localization of the tumor bed of breast cancer is crucial for accurate planning of boost irradiation. Lumpectomy cavity and surgical clips provide localizing information about tumor bed. However, defining the tumor bed is often difficult because of presence of unclear lumpectomy cavity and lack of certain information such as absence of surgical clips. In the present study, we evaluated the feasibility of initial diagnostic PET-CT in localization of the tumor bed using deformable image registration (DIR). Methods We selected twenty-five patients who had an initial diagnostic PET-CT performed and underwent breast-conserving surgery with surgical clips in tumor bed. In every individual patient, two target volumes were separately delineated on planning CT; 1) target volume based on surgical clips with a margin of 1 cm (TV clip ) and 2) tumor volume based on 90% of maximum SUV on PET-CT registered by DIR (TV PET ). The percent of TV PET in TV clip (V in ) was calculated and distance between center points of two volumes (D center ) was also measured. Results Mean D center between two volumes was 1.4 cm (range, 0.33 – 2.53). Mean V in was 94.8% (range, 60.9-100) and 100% in 18 out of 25 patients. When compared to the center of TV clip , the center of TV PET tended to be located posteriorly (mean 0.3 cm, standard deviation 0.6), laterally (mean 0.3 cm, standard deviation 0.8) and inferiorly (mean 0.4 cm, standard deviation 0.9). Conclusion Initial diagnostic PET-CT can be one of the possible references to localize the tumor bed in breast cancer radiotherapy.

Lumpectomy

CLIPS

Image registration

10.1186/1748-717x-8-163

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