Evidence map›Paper›PMID 40251799›Full record

ArticleTumori2025

18F-FDG PET/CT guided salvage radiotherapy strategies for lymph-nodal relapses in gynecological cancers: SBRT vs ENRT.

Andrei Fodor, Martina Midulla, Chiara Brombin, Paola M V Rancoita, Alice Bergamini, Paola Mangili, Miriam Torrisi, Lucia Perna, Emanuela Rabaiotti, Italo Dell'Oca and 7 more

Abstract read
In one paragraph

Article in Tumori, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Andrei FodorDepartment of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID 0000-0002-9285-4390
Martina MidullaDepartment of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Chiara BrombinUniversity Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy.
Paola M V RancoitaUniversity Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy.
Alice BergaminiVita-Salute San Raffaele University, Milan, Italy.
Paola MangiliMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Miriam TorrisiDepartment of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Lucia PernaMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Emanuela RabaiottiDepartment of Oncologic Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Italo Dell'OcaDepartment of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Chiara L DeantoniDepartment of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.ORCID 0000-0002-3610-0316
Luca BoccioloneDepartment of Oncologic Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Claudio FiorinoMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Antonella Del VecchioMedical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Mariaclelia S Di SerioUniversity Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy.
Giorgia MangiliDepartment of Oncologic Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Nadia G Di MuzioDepartment of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify outcome differences between extended nodal radiotherapy (ENRT) with simultaneous integrated boost (SIB) and stereotactic body radiotherapy (SBRT), performed with advanced radiotherapy techniques, both of which were 18F-Fluoro-Deoxy-Glucose (FDG) PET/CT guided, for lymph-node (LN) relapses of gynecological tumors, and to identify the most important determining factors.

methodsRecords of gynecologic patients treated in a single-institution with FDG PET/CT guided intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), or SBRT, were reviewed, and only patients at first salvage radiotherapy for LN relapses were considered. Local relapse-free- (LRFS), regional relapse-free- (RRFS), distant metastasis-free- (DMFS), disease-free-(DFS) and overall-survival (OS), as well as acute and late toxicity (with CTCAE v5.0 score), were determined.

resultsFifty-eight patients (23 ENRT+SIB; 35 SBRT) treated for 178 LNs from February 2007-April 2023, were identified. Median biological equivalent dose (BED10) delivered to PET-positive LNs was 76.5 Gy (Interquartile range-IQR- 74.4;78.7) for ENRT, and 72 Gy (IQR 59.5;75.6) for SBRT. Median follow-up was 81.1(IQR 48.5; 117.2) and 37.0 (IQR 21.3; 58.4) months for ENRT and SBRT, respectively. Thirty-six-month estimated LRFS was 90.2% for ENRT and 82.6% for SBRT; RRFS was 69% and 63.4%, DMFS 26.1% and 44.3%, and OS 73.7% and 60.4%; no statistically significant differences were found between the two groups (logrank test, p= 0.29). ENRT recorded more acute (p⩽0.033), but not late, toxicities.

conclusionsENRT+SIB and SBRT for gynecological LN tumor relapses obtain similar results in terms of disease-free and OS, with fair toxicity. Prospective studies with higher patient numbers are needed.

Indexed as

Fluorodeoxyglucose F18Genital Neoplasms, FemaleLymphatic MetastasisNeoplasm Recurrence, LocalPositron Emission Tomography Computed TomographyRadiosurgeryRadiotherapy, Image-GuidedSalvage TherapyAdultAgedAged, 80 and overFemaleHumansLymph NodesMiddle AgedRadiotherapy, Intensity-ModulatedFluorodeoxyglucose F18extended nodal radiotherapy (ENRT)gynecologic tumorsLymph node relapsepositron emission tomography (PET) guidancesimultaneous integrated booststereotactic body radiotherapy

Identifiers

PMID40251799
PMCPMC12163193

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.