Abstract

Current consensus guidelines for definitive cervical cancer intensity modulated radiation therapy (IMRT) recommend inclusion of the entire uterus within the clinical target volume, however this is debated. We aimed to evaluate outcomes of patients with cervical cancer who were treated with less than whole uterus irradiation.We identified 109 patients with FIGO Stage IB-IVA cervical cancer treated definitively with concurrent chemoradiation, including IMRT and brachytherapy, from 2010 to 2022 at a single institution where the practice was to include the gross cervix tumor with an internal target volume with differences in bladder filing accounted for, plus additional 5?mm planning target volume (PTV) margin. Local, regional, and distant recurrences were analyzed using competing risk methods, and a Wilcoxon rank sum test was performed to assess differences in dose to organs at risk based on the proportion of the uterus included in the PTV, with the median proportion of the uterus included (75?%) used as the cut-point.The median follow-up time was 65?months (range 3-352?months). The 2-year cumulative incidence of LR for the entire cohort was 4.2?% (95?% confidence interval [CI] 1.3-9.7). Compared with patients who had?=?75?% of the uterus included in the PTV, patients who had?

View details for DOI 10.1016/j.radonc.2024.110199

View details for PubMedID 38438017