Objective： The aim of this study was to explore the difference of long-term prognosis of different treatment regimens in patients with stage IB2, IIA2 cervical Cancer. Methods： From August 1995 to September 2005, ra...Objective： The aim of this study was to explore the difference of long-term prognosis of different treatment regimens in patients with stage IB2, IIA2 cervical Cancer. Methods： From August 1995 to September 2005, radical hysterectomy was chosen as primary treatment regimen for 122 patients （group A）, 85 patients underwent radical hysterectomy after ef- fective neoadjuvant therapy （group B）, and 98 patients received surgery after ineffective preoperative therapy （group C）. All patients received postoperative therapy. Results： Atotal of 305 patients were analyzed. The maximum diameter of tumor was largest in group B, while the pathological risk factors （cervical infiltration, positive surgical margins） were in the lowest propor- tion. The 5-year mortality rate and relapse rate of group B were the highest, and the overall survival （OS） and progression-free survival （PFS） were the shortest （P 〈 0.05）. No significant difference of long-term survival was found in group C and group A. No difference was found in the surgical of three groups. Large tumor more than 5.5 cm had higher effective ratio of treatment than those 5.5 cm or less. Patients received effective preoperative radiotherapy had better long-term prognosis than those received chemotherapy or radiochemotherapy. Conclusion： neoadjuvant treatment using for patients with IB2, IIA2 cervical cancer is effective in reducing risk factors of pathological, but it could not improve the long-term survival. The indications of adjuvant therapy after surgery should be reconsidered. Those tumors of diameter 5.5 cm or less response poor to neoadjuvant treatment, and no improvement of survival was found, so direct surgical treatment is suggested for these patients. Radiotherapy is a better choice of preoperative treatment.展开更多
Objective： To compare the 5-year survival rates and complications of internal and external irradiation therapy combined with operation in patients with Ⅱ-Ⅲ period of cervical cancer. Methods： 162 cervical cancer p...Objective： To compare the 5-year survival rates and complications of internal and external irradiation therapy combined with operation in patients with Ⅱ-Ⅲ period of cervical cancer. Methods： 162 cervical cancer patients after the whole palace resection pelvic lymphadenectomy were divided into three groups, and then accepted radiotherapy. The first group with 91 cases was accepted internal and external irradiation therapy before operation; the second group with 37 cases was given internal irradiation therapy before operation; the third group with 34 cases was given routine postoperative radiotherapy. External irradiation used ^60Co irradiation or a linear accelerator, to the whole basin, and the irradiation dose of ＂B＂ point in preoperative radiotherapy was 26-30 Gy, in postoperative radiotherapy was 46-50 Gy; intraluminal brachytherapy used ^192lr, the dose of ＂A＂ point was 5-15 Gy. Results： The 5-year survival rate of preoperative combined radiotherapy group was 78.0% （71/91）, preoperative intracavitary radiotherapy group 64.9% （24/37）, and postoperative radiotherapy group 35.3% （12/34）. Comparing the 5-year survival rates of the preoperative combined and postoperative irradiation groups, there was significant difference （P 〈 0.05）. The major complications were radioactive proctitis and cystitis, the complication incidences of three groups were 35.2% （32/91）, 32.4% （12/37）, 38.2% （13/34）, respectively, and the differences were not statistically significant （P 〉 0.05）. Conclusion： The intraluminal brachytherapy plus external irradiation can significantly increase the 5-year survival rate of patients with Ⅱa-Ⅲa stages, and the incidence of complications was not significant difference.展开更多
文摘Objective： The aim of this study was to explore the difference of long-term prognosis of different treatment regimens in patients with stage IB2, IIA2 cervical Cancer. Methods： From August 1995 to September 2005, radical hysterectomy was chosen as primary treatment regimen for 122 patients （group A）, 85 patients underwent radical hysterectomy after ef- fective neoadjuvant therapy （group B）, and 98 patients received surgery after ineffective preoperative therapy （group C）. All patients received postoperative therapy. Results： Atotal of 305 patients were analyzed. The maximum diameter of tumor was largest in group B, while the pathological risk factors （cervical infiltration, positive surgical margins） were in the lowest propor- tion. The 5-year mortality rate and relapse rate of group B were the highest, and the overall survival （OS） and progression-free survival （PFS） were the shortest （P 〈 0.05）. No significant difference of long-term survival was found in group C and group A. No difference was found in the surgical of three groups. Large tumor more than 5.5 cm had higher effective ratio of treatment than those 5.5 cm or less. Patients received effective preoperative radiotherapy had better long-term prognosis than those received chemotherapy or radiochemotherapy. Conclusion： neoadjuvant treatment using for patients with IB2, IIA2 cervical cancer is effective in reducing risk factors of pathological, but it could not improve the long-term survival. The indications of adjuvant therapy after surgery should be reconsidered. Those tumors of diameter 5.5 cm or less response poor to neoadjuvant treatment, and no improvement of survival was found, so direct surgical treatment is suggested for these patients. Radiotherapy is a better choice of preoperative treatment.
文摘Objective： To compare the 5-year survival rates and complications of internal and external irradiation therapy combined with operation in patients with Ⅱ-Ⅲ period of cervical cancer. Methods： 162 cervical cancer patients after the whole palace resection pelvic lymphadenectomy were divided into three groups, and then accepted radiotherapy. The first group with 91 cases was accepted internal and external irradiation therapy before operation; the second group with 37 cases was given internal irradiation therapy before operation; the third group with 34 cases was given routine postoperative radiotherapy. External irradiation used ^60Co irradiation or a linear accelerator, to the whole basin, and the irradiation dose of ＂B＂ point in preoperative radiotherapy was 26-30 Gy, in postoperative radiotherapy was 46-50 Gy; intraluminal brachytherapy used ^192lr, the dose of ＂A＂ point was 5-15 Gy. Results： The 5-year survival rate of preoperative combined radiotherapy group was 78.0% （71/91）, preoperative intracavitary radiotherapy group 64.9% （24/37）, and postoperative radiotherapy group 35.3% （12/34）. Comparing the 5-year survival rates of the preoperative combined and postoperative irradiation groups, there was significant difference （P 〈 0.05）. The major complications were radioactive proctitis and cystitis, the complication incidences of three groups were 35.2% （32/91）, 32.4% （12/37）, 38.2% （13/34）, respectively, and the differences were not statistically significant （P 〉 0.05）. Conclusion： The intraluminal brachytherapy plus external irradiation can significantly increase the 5-year survival rate of patients with Ⅱa-Ⅲa stages, and the incidence of complications was not significant difference.
