| Author/Editor | Lindegaard, Jacob Christian; Petrič, Primož; Schmid, Maximilian; Nesvacil, Nicole; Haie-Meder, Christine; Fokdal, Lars U.; Sturdza, Alina; Hoskin, Peter J.; Mahantshetty, Umesh; Šegedin, Barbara | |
| Title | Prognostic implications of uterine cervical cancer regression during chemoradiation evaluated by the T-score in the multicenter XXX study | |
| Type | članek | |
| Vol. and No. | Letnik 113, št. 2 | |
| Publication year | 2022 | |
| Volume | str. 379-389 | |
| ISSN | 1879-355X - International journal of radiation oncology, biology, physics | |
| Language | eng | |
| Abstract | Purpose: A simple scoring system (T-score, TS) for integrating findings from clinical examination and MRI of the primary tumor at diagnosis has shown strong prognostic capability for predicting local control and survival in locally advanced cervical cancer (LACC) treated with chemoradiation and MRI guided brachytherapy (BT). The aim was to validate the performance of TS using the multicenter XXXX study and to evaluate the prognostic implications of TS regression obtained during initial chemoradiation. Materials and methods: XXXX recruited 1416 patients of which 1318 were available for TS. Patients were treated with chemoradiation followed by MRI guided BT. A ranked ordinal scale of 0-3 points was used to assess 8 anatomic locations typical for local invasion of cervical cancer. TS was calculated separately at diagnosis (TSD) and at BT (TSBT) by the sum of points obtained from the 8 locations at the two occasions. Results: Median TSD and TSBT was 5 and 4, respectively. TS regression was observed in 71% and was an explanatory variable for BT technique (intracavitary vs intracavitary/interstitial) and major dose volume histogram parameters for BT such as CTVHR, CTVHR D90, D2cm3 bladder and D2cm3 rectum. TS regression (TSBTr5) was associated with improved local control and survival and with less morbidity compared to patients with TSBT remaining high (>5) despite initial chemoradiation. TS-regression was significant in multivariate analysis for both local control and survival when analyzed in consort with already established prognostic parameters related to the patient, disease and treatment. Conclusion: TS was validated in a multicenter setting and proven to be a strong multidisciplinary platform for integration of clinical findings and imaging with the ability to quantitate local tumor regression and its prognostic implications with regard to BT technique, DVH parameters, local control, survival and morbidity. | |
| Keywords | kemoradioterapija rak materničnega vratu zdravljenje chemoradiotherapy cervical cancer treatment |