Kim, Jin Hee; Kim, Joo-Young; Yoon, Mee Sun; Kim, Young Seok; Lee, Jong Hoon; Kim, Hak Jae; Kim, Hunjung; Kim, Yeon-Joo; Yoo, Chong Woo; Nam, Byung-Ho; Kim, Tae Hyun; Kim, Suk-Ki; Kim, Sun Ho; Kang, Seokbom; Seo, Sang Soo; Lim, Myong Cheol; Park, Sang-Yoon
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
2016Apr ; 7 ( 4 ) :.
PMID : 27102843
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Kim, Jin Hee - Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.
Kim, Joo-Young - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. Electronic address jooyoungcasa@ncc.re.kr.
Yoon, Mee Sun - Department of Radiation Oncology, Chonnam National University, Hwasun Hospital, Republic of Korea.
Kim, Young Seok - Department of Radiation Oncology, Asan Medical Center, Unviersity of Ulsan, College of Medicine, Seoul, Republic of Korea.
Lee, Jong Hoon - Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Republic of Korea.
Kim, Hak Jae - Department of Radiation Oncology, Seoul National University, College of Medicine, Republic of Korea.
Kim, Hunjung - Department of Radiation Oncology, Inha University Hospital, Inha University, School of Medicine, Incheon, Republic of Korea.
Kim, Yeon-Joo - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Yoo, Chong Woo - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Nam, Byung-Ho - Cancer Control and Policy Department, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
Kim, Tae Hyun - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Kim, Suk-Ki - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Kim, Sun Ho - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Kang, Seokbom - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Seo, Sang Soo - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Lim, Myong Cheol - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Park, Sang-Yoon - Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
ABSTRACT
BACKGROUND AND PURPOSE: The efficacy of prophylactic extended-field irradiation (EFI) plus concomitant cisplatin in patients with locally advanced uterine cervical cancer (LAUCC) is unknown, nor is it known whether tumor carbonic anhydrase IX (CA9) expression level, a hypoxia marker, influences survival outcome. MATERIAL AND
METHODS: We recruited patients with UCC, FIGO stage IB1 with pelvic lymph node (LN) metastases to IVA with negative para-aortic LN on PET/CT. CA9 expression was examined and patients were randomized to either EFI or pelvic only radiotherapy (PRT) in each CA9 group. The primary outcomes were para-aortic recurrence-free survival (PARFS) and disease-free survival (DFS).
RESULTS: Between 2006 and 2011, 79 patients with CA9-positive and 37 with CA9-negative tumors were enrolled, respectively. The median follow-up period was 69.2months (range 6.8-102.1). For CA9-positive patients, 5-year PARFS was 100% and 81.7% for those receiving EFI and PRT (p=0.007), respectively. DFS was 78.6% for EFI and 71.3% for PRT patients (p=0.353). For CA9-negative patients, 5y PARFS was 100% and 94.1% for EFI and PRT (p=0.317), respectively. DFS was 100% for EFI and 70.7% for PRT (p=0.018). CONCLUSION: EFI significantly reduced recurrences in PAN in patients with CA9-positive tumors, but survival outcome was not improved, due to high local recurrence and high distant metastases rates. This study indicates the necessity for new therapeutic strategies for LAUCC patients whose tumors show high CA9 expression. CI - Copyright ??2016 Elsevier Ireland Ltd. All rights reserved.
keyword
Carbonic anhydrase IX (CA9); Extended-field irradiation (EFI); Radiotherapy; Uterine cervical cancer
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