调强放射治疗条件下根治性宫颈癌的长期生存报道

Long ⁃ term clinical outcomes of definitive intensity ⁃ modulated radiotherapy for patients with locally ad⁃vanced cervical cancer

目的回顾分析调强放射治疗条件下根治性宫颈癌患者长期生存和毒性反应情况。方法回顾分析2012年7月至2015年12月期间接受治疗的97例根治性宫颈癌患者的临床病例资料。全组患者均接受了盆腔调强放射治疗与妇科后装放疗。分析报道长期生存结果、毒性反应情况和相关预后因素。结果全组患者中位随访期为65个月。5年总生存率、无病生存率、无远处转移生存率和无局部复发生存率分别为76.0%、65.7%、75.5%和81.4%。腺癌/腺鳞癌的病理类型是总生存的独立危险因素(HR=4.932,95%CI:1.446~16.820,P=0.011)。全组共17例(17.5%)患者出现3级及以上急性毒性反应,共36例(37.1%)患者出现晚期毒性反应。结论调强放射治疗条件下根治性宫颈癌患者取得了较好的长期生存结果,治疗相关的急性毒性反应与晚期毒性反应可接受。

Objective Cervical cancer is one of the most common malignancies in women worldwide.Concurrent chemoradiotherapy followed by high⁃dose⁃rate brachytherapyis the standard treatment for locally advanced cervical cancer(LACC).We aimed to investigate the treatment outcomes and toxicities of these patients who underwent definitive intensity⁃modulated radiotherapy(IMRT).Methods A total of 97 patients who received definitive IMRT for LACC between July 2012 and December 2015 were studied retrospectively.Overall survival(OS),disease⁃free survival(DFS),distant metastasis⁃free survival(DMFS),and local recurrence⁃free survival(LRFS)rates were calculated,and survival hazard ratios(HR)for different demographic and clinicopathological variables,were also calculated to determine their prognostic significance.Patients were assessed and recorded for acute toxicities and late toxicities.Results Mean follow⁃up was 65.0(range 2.2~86.7)months.The 5⁃year OS,DFS,DMFS,and LRFS rates were 76.0%,65.7%,75.5%and 81.4%,respectively.The only negative indepen⁃dent risk factor for OS is histological type(squamous cell carcinoma vs.adenocarcinoma/adenosquamous carcinoma(HR=4.932,95%CI:1.446~16.820,P=0.011).A total of 17(17.5%)patients developed grade 3 or greater acute toxicities,and 36(37.1%)patients developed late toxicities.Conclusion Patients with LACC who underwent definitive IMRT have achieved good outcomes,and tolerated associated toxicities.