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局部晚期肾盂输尿管癌单纯手术与术后辅助放疗疗效比较
李晓梅, 王庆国, 赵勍, 李洪振, 张敏, 侯栋梁, 秦尚斌, 高献书
100034 北京,北京大学第一医院放疗科
Efficacy of postoperative three-dimensional conformal radiotherapy in transitional cell carcinoma of the renal pelvis or ureter
LI Xiao-mei, WANG Qing-guo, ZHAO Qing, LI Hong-zhen, ZHANG Min, HOU Zhen-liang, QIN Shang-bin, GAO Xian-shu
Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China Corresponding author:WANG Qing-guo, Email:wangqgzone@sohu.com
Abstract：Objective To evaluate the role of postoperative three-dimensional conformal radiotherapy (3DCRT) in transitional cell carcinoma of the renal pelvis or ureter. Methods We retrospectively reviewed a series of 103 patients with transitional cell carcinoma of the renal pelvis or ureter. All patients received surgery without distant metastases and had T3 or T4 disease, or grade 3 disease if T2. No patient received chemotherapy. Thirty-seven patients received three-dimensional conformal radiotherapy (3DCRT) following surgery. Sixty-six patients received surgery alone. The local control rates and survival rates were calculated by Kaplan-Meier method and compared by Logrank test in univariate analysis. Cox regression was used for multivariate analysis. Results The follow-up rates were 89% and 92% in surgery alone and 3DCRT groups. The number of patients who had minimal followed-up time of 5 years were 33,37 in surgery alone and 3DCRT groups. The 1-,3-, and 5-year local control rates were 89% vs. 94%, 74% vs. 90%, and 72% vs. 90% in surgery alone and 3DCRT groups, respectively (χ2=3.90,P=0.048). The 1-,3-, and 5-year bladder tumor-free survival rates were 87% vs. 94%, 60% vs. 79%, and 57% vs. 79% in surgery alone and 3DCRT groups, respectively (χ2=4.50,P=0.037). The 1-,3-, and 5-year overall survival rates were 90% vs. 84%, 71% vs. 65%, and 65% vs. 62% in surgery alone and 3DCRT groups, respectively (χ2=0.32,P=0.573). Univariate and multivariate analyses showed that T stage, lymph node metastasis, positive surgical margin were correlated with overall survival rate (χ2=7.91,64.69,40.20 and 5.08,17.23,8.22,P=0.005,0.000,0.000 and 0.024,0.000,0.004). Conclusions 3DCRT may improve local control and reduce tumor recurrence in bladder in patients with locally advanced transitional cell carcinoma of the renal pelvis or ureter. However, 3DCRT does not improve overall survival in this group of patients.
LI Xiao-mei,WANG Qing-guo,ZHAO Qing et al. Efficacy of postoperative three-dimensional conformal radiotherapy in transitional cell carcinoma of the renal pelvis or ureter[J]. Chinese Journal of Radiation Oncology, 2012, 21(2): 152-155.
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