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Baden C, Whitley A, López-Araujo J, et al. A novel dynamic field-matching technique for treatment of patients with para-aortic node-positive cervical cancer: Clinical experience. Rep Pract Oncol Radiother. 2015;21(1):37-41doi: 10.1016/j.rpor.2015.09.003.
Baden, C., Whitley, A., López-Araujo, J., Popple, R., Duan, J., & Kim, R. (2016). A novel dynamic field-matching technique for treatment of patients with para-aortic node-positive cervical cancer: Clinical experience. Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 21(1), 37-41. https://doi.org/10.1016/j.rpor.2015.09.003
Baden, Craig, et al. "A novel dynamic field-matching technique for treatment of patients with para-aortic node-positive cervical cancer: Clinical experience." Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology vol. 21,1 (2016): 37-41. doi: https://doi.org/10.1016/j.rpor.2015.09.003
Baden C, Whitley A, López-Araujo J, Popple R, Duan J, Kim R. A novel dynamic field-matching technique for treatment of patients with para-aortic node-positive cervical cancer: Clinical experience. Rep Pract Oncol Radiother. 2016 Jan-Feb;21(1):37-41. doi: 10.1016/j.rpor.2015.09.003. Epub 2015 Nov 21. PMID: 26900356; PMCID: PMC4716408.
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Rep Pract Oncol Radiother. 2016 Jan-Feb;21(1):37-41. doi: 10.1016/j.rpor.2015.09.003. Epub 2015 Nov 21.

A novel dynamic field-matching technique for treatment of patients with para-aortic node-positive cervical cancer: Clinical experience.

Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology

Craig Baden, Alexander Whitley, Javier López-Araujo, Richard Popple, Jun Duan, Robert Kim

Affiliations

  1. Department of Radiation Oncology, University of Alabama-Birmingham, Birmingham, AL, USA.

PMID: 26900356 PMCID: PMC4716408 DOI: 10.1016/j.rpor.2015.09.003

Abstract

AIM: To report outcomes for patients with para-aortic lymph node positive cervical cancer treated with a dynamic field-matching technique.

BACKGROUND: PET staging of cervical cancer has increased identification of patients with para-aortic lymph node metastasis. IMRT enables dose escalation in this area, but matching IMRT fields with traditional whole pelvis fields presents a challenge.

MATERIALS AND METHODS: From 2003 to 2012, 20 patients with cervical cancer and para-aortic lymph node metastasis were treated utilizing the dynamic field-matching technique. As opposed to single-isocenter half-beam junction techniques, this technique employs wedge-shaped dose junctions for the abutment of fields. We reviewed the records of all patients who completed treatment with the technique and abstracted treatment, toxicity, and disease-related outcome data for analysis.

RESULTS: Median prescribed dose to the whole pelvis field was 45 Gy and para-aortic IMRT field 50.4 Gy. All but 3 patients underwent HDR (13 pts) or LDR (4 pts) brachytherapy. All patients developed lower GI toxicity; 10 grade 1, 9 grade 2, and 1 grade 4 (enterovaginal fistula). Median DFS was 12.4 months with 1 and 2-year DFS 60.0% and 38.1%. One-year OS was 83.7% and 2-year OS, 64.4%. A total of 10 patients developed recurrence; none occurred at the matched junction.

CONCLUSIONS: The dynamic field-matching technique provides a means for joining conventional whole pelvis fields and para-aortic IMRT fields that substantially reduces dose deviations at the junction due to field mismatch. Treatment with the dynamic matching technique is simple, effective, and tolerated with no apparent increase in toxicity.

Keywords: Cervical cancer; IMRT; Treatment planning

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