Potential for gain in the use of proton beam boost to the para-aortic lymph nodes in carcinoma of the cervix.

Abstract

The management of para-aortic lymph nodes (PALN) in carcinoma of the cervix by surgery and adequate conventional radiotherapy (55 Gy +) is associated with an unacceptably high incidence of major morbidity (greater than 30%) discouraging this therapy. The addition of a proton boost to photon treatment will permit the delivery of 60 to 70 Gy to PALN with a morbidity expected to be equal to that observed with 45 Gy photons (13%). The potential for improved control rates at the increased dose may be of the order of 10 to 20% depending on the initial stage of disease. Suitable selection criteria may increase this further in some subgroups.