Prophylactic irradiation of para-aortic lymph nodes in XXXX . A prospective randomized study.

@entity1 @entity2622 @entity44198 @entity3
PURPOSE: For assessment of the advantages and side effects of para-aortic lymph nodes irradiation under the evaluation by computer tomography, a prospective randomized study was started in 1986. The results for survival, local control and late complications are presented in the following. @entity1 AND METHODS: From November 1986 to October 1990, 93 @entity1 with @entity2622 were randomly allocated for treatment with either pelvic irradiation (pelvic group) or pelvic plus para-aortic lymph nodes irradiation (para-aortic group). Thirty-six @entity1 underwent external irradiation and intracavitary therapy (RT arm) and 57 @entity1 , extended radical hysterectomy and external irradiation ( @entity44198 arm). Para-aortic lymph nodes irradiation delivered 45 Gy in 1.8 Gy per day for 5 days per week through anterior-posterior fields. RESULTS: The 3-year cause specific survival rates were para-aortic group: 57% and pelvic group: 89% in RT arm group, and para-aortic group: 70% and pelvic group: 86% in @entity44198 arm group. Differences for the 2 groups in each treatment arm were not significant. In pelvic failure, para-aortic lymph nodes @entity3 and distant @entity3 showed no statistically significant differences for the 2 groups in each treatment arm. In the para-aortic group, complications were more frequent than in the pelvic group (13/45 vs. 2/48, p < 0.025). As an enteric complication ileus was found in 7% (3/45) of the para-aortic group while 2% (1/48) in the pelvic group. Compression fractures of the lumber vertebral body were apparent in 9% (4/45) and 0%, respectively. CONCLUSION: Routine para-aortic lymph nodes irradiation delivered through anterior-posterior fields for high risk @entity1 with @entity2622 is of limited value occurring to the high incidence of late complications and this treatment fails to improve no survival rates.
