High Control Rate for Lymph Nodes in Cervical Cancer Treated with High-Dose Radiotherapy using Helical Tomotherapy

The purpose of this study was to evaluate whether bulky lymphadenopathy located in the abdominopelvic cavity in cervical cancer can be controlled without severe toxicity by increasing radiation dose using helical tomotherapy. From January 2007 to December 2010, 26 patients with cervical cancer with metastatic lymph nodes (LNs) having at least one short diameter > 1.5 cm were treated with helical tomotherapy. A total of 58 LN sites were treated and the largest LN of each site was evaluated for response. Median follow-up time was 28 months (4–50 months). Median short diameter of the LNs was 1.7 cm (0.7–4.2 cm) with median radiation dose of 62.6 Gy10 in 2 Gy equivalent dose (53.3–77.9 Gy10). Initial LN response was evaluated on imaging obtained within 4 months after radiotherapy. Initial complete response (CR), partial response (PR), and stable disease (SD) were observed in 54, 2 and 2 lesions, respectively. Recurrence occurred in two with CR and progression in one with PR. Therefore, final CR, PR, SD, and p...