Investigation of radiation therapy for gynecologic cancer patients with supraclavicular lymph node metastases

Purpose: The aim of this study was to retrospectively investigate the benefit of radiotherapy for supraclavicular lymph nodes by determining the characteristics and survival of patients with recurrent gynecologic cancer after definitive radiotherapy. Material and methods: We reviewed the treatment outcomes of 18 gynecologic cancer patients with supraclavicular lymph nodes metastases treated. Twelve cervical cancer patients, 4 corporeal cancer patients and 2 ovarian cancer patients were investigated. Tumor responses, adverse events and the overall survival were examined. Results: The median overall survival was 12 months. The 1- and 2-year overall survival rates were 48.6% and 9.7%, respectively. The 2-year local control rate was 75.8%. Following therapy, the symptom of pain was relieved in 2 patients (2/2), and edema and swelling were improved in 6 out of 7 symptomatic patients. Eleven asymptomatic patients did not develop any symptoms during the follow-up period. Common Terminology Criteria for Adverse Events grade 2 toxicities were found in 5 patients (2 dermatitis and 4 hematologic toxicities), and grade 3 toxicities were found in 3 patients (3 hematologic toxicities). Conclusion: Radiotherapy for supraclavicular lymph nodes is effective as palliative irradiation. The 2-year local control rate was 75.8% in patients receiving this therapy, their symptoms improved and asymptomatic patients did not become symptomatic during the follow-up period. Radiotherapy for supraclavicular lymph nodes metastases is therefore recommended for preserving the patient's life.