Takahashi M, Mitsuhashi N, Sakurai H, Hayakawa K, Niibe H
Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Japan.
Anticancer Res. 1997 May-Jun;17(3C):2265-8.
A retrospective analysis of para-aortic lymph node (PALN) metastasis in patients with cervical squamous cell cancer who received prophylactic postoperative irradiation to the pelvis, was carried out.
Sixty-seven patients had no intra-pelvic lymph node (IPLN) metastasis (n 0), whereas 33 had IPLN (n 1). All patients received prophylactic external beam irradiation with a total dose of 50 Gy to the entire pelvis followed by intravaginal boost. Only 5 patients received a prophylactic PALN irradiation with a total dose of 30-50 Gy.
No patients with n 0 developed para-aortic recurrence. However, 6 of 33 patients with n 1 developed PALNs recurrence but only 3 patients developed isolated PALN recurrence. There was no difference in survival between patients with PALNs irradiation and patients without PALNs irradiation.
Routine prophylactic irradiation to PALNs is not necessary even for patients with IPLN metastasis except for the selected patients in the management of cervical cancer.
对接受盆腔术后预防性放疗的宫颈鳞状细胞癌患者的主动脉旁淋巴结（PALN）转移情况进行了回顾性分析。
67例患者无盆腔内淋巴结（IPLN）转移（n = 0），而33例有IPLN转移（n = 1）。所有患者均接受全盆腔预防性外照射，总剂量为50 Gy，随后进行阴道内补量照射。仅5例患者接受了预防性PALN照射，总剂量为30 - 50 Gy。
n = 0的患者均未发生主动脉旁复发。然而，33例n = 1的患者中有6例发生了PALN复发，但仅有3例发生孤立性PALN复发。接受PALN照射的患者与未接受PALN照射的患者生存率无差异。
即使对于有IPLN转移的患者，除了宫颈癌管理中选定的患者外，常规预防性照射PALN并非必要。
