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243例ⅡB期宫颈癌术前同期放化疗加根治术与根治性放疗同期化疗预后比较
王宁, 魏丽春, 李围围, 胡静, 刘隽悦, 李剑平, 周咏春, 张莹, 石梅
710032 西安,第四军医大学西京医院肿瘤放疗科
Clinical effects of concurrent radiochemotherapy followed by radical surgery and radical radiotherapy with concurrent chemotherapy:a comparative study of 243 patients with FIGO stage ⅡB cervical cancer
WANG Ning, WEI Li-chun, SHI Mei, LI Wei-wei, Hu Jing, LIU Juan-yue, LI Jian-ping, ZHOU Yong-chun, ZHANG Ying
Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi′an 710032, China
Abstract：Objective To compare concurrent radiochemotherapy (CRCT) followed by radical surgery and radical radiotherapy (RT) with concurrent weekly cisplatin in terms of survival rates and long-term toxicities in patients with FIGO stage ⅡB cervical cancer. Methods A retrospective analysis was performed on 243 patients with FIGO stage ⅡB cervical cancer who were admitted to our hospital from November 2004 to November 2011. Of the 243 patients, 121 patients received CRCT followed by radical surgery (group 1), and 122 received radical RT with concurrent chemotherapy (weekly cisplatin, 40 mg/m2)(group 2). The Kaplan-Meier method wasused to calculate survival rates, and the log-rank test wasused for survival difference analysis;the Cox model was used for multivariate prognostic analysis.ResultsThe follow-up rate was 100% in groups 1 and 2. 34 and 33 patients were followed up for at least 3 years in groups 1 and 2. The 3-year progression-free survival (PFS) rates, overall survival (OS) rates, and local control rates for groups 1 and 2 were 91.5% vs 82.0%(P=0.013), 95.5% vs 89.2%(P=0.085), and 96.7% vs 93.4%(P=0.375), respectively. In group 1, the patients with a tumor diameter of ≥6 cm and an age of ≤35 years had a significantly lower 3-year PFS rate than those with a tumor diameter of<6 cm and an age of>35 years (68.2% vs 93.8%, P=0.004;74.1% vs 93.2%, P=0.037). In group 2, the patients with non-squamous cell carcinoma and a tumor diameter of ≥6 cm had a significantly lower 3-year PFS rate than those with squamous cell carcinoma and a tumor diameter of<6 cm (50.0% vs 83.0%, P=0.013;25.0% vs 86.0%, P=0.002). In groups 1 and 2, the patients with a tumor diameter of ≥6 cm had a significantly lower 3-year OS rate than those with a tumor diameter of<6 cm (78.8% vs 97.0%, P=0.033;46.9% vs 92.6%, P=0.007). Leg edema occurred more frequently in group 1 than in group 2(33.1% vs 8.2%, P=0.000), while radiation enteritis more frequently in group 2 than in group 1(31.2% vs 5.0%, P=0.000). Conclusions CRCT followed by radical surgery may lead to better PFS than radical RT with weekly cisplatin in patients with FIGO stage ⅡB cervical cancer. Tumor diameter is the common prognostic factor for PFS in patients who receive the two treatments.
WANG Ning,WEI Li-chun,SHI Mei et al. Clinical effects of concurrent radiochemotherapy followed by radical surgery and radical radiotherapy with concurrent chemotherapy:a comparative study of 243 patients with FIGO stage ⅡB cervical cancer[J]. Chinese Journal of Radiation Oncology, 2013, 22(4): 274-277.
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