Assessment of Parametrial Response by Growth Pattern in Patients With International Federation of Gynecology and Obstetrics Stage IIB and IIIB Cervical Cancer: Analysis of Patients From a Prospective, Multicenter Trial (EMBRACE).

摘要: Purpose To assess disease response along the parametrial space according to tumor morphology in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIB IIIB cervical cancer at time image-guided adaptive brachytherapy. Methods Materials Patients FIGO registered as November 2013 EMBRACE study were evaluated. Tumors stratified morphologic subtype on magnetic resonance imaging (expansive infiltrative), characteristics those subtypes analyzed. Parametrial involvement diagnosis brachytherapy was evaluated, chemo-radiotherapy classified good, moderate, or poor. The grade compared between 2 groups analyzed regard volumes, dosimetric parameters. Results A total 452 whom 186 had expansive growth type 266 infiltrative morphology. tumors more extensive disease, indicated by a higher rate well radiologic evidence extension into distal pelvic side wall imaging. Cervical necrosis common group. Good group (34% vs 24%; P =.02), poor (11% 19%; =.02). Mean gross volume equal both (51.7 cm 3 ). high-risk clinical target larger (37.9 cm 33.3 cm , =.005). mean D 90 slightly (92.7 Gy 89.4 Gy, Conclusion Infiltrative are advanced presentation respond less favorably when that equivalent size. use allows achieving reasonably high doses groups.