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ⅡB—ⅢB期宫颈鳞癌同步放化疗与新辅助化疗后同步放化疗疗效比较
郑洁, 吴星娆, 叶岚, 武鹏飞, 艾毅钦
650118 昆明,云南省肿瘤医院 昆明医科大学第三附属医院放疗科
A comparative analysis of the efficacy and prognosis of concurrent chemoradiotherapy alone and concurrent chemoradiotherapy after neoadjuvant chemotherapy for stage ⅡB-ⅢB cervical squamous cell carcinoma
Zheng Jie, Wu Xingrao, Ye Lan, Wu Pengfei, Ai Yiqin
Department of Radiation Oncology,Yunnan Tumor Hospital/Third Affiliated Hospital of KunMing Medical University,Kunming 650118,China
Objective To investigate the long-term efficacy and prognosis of concurrent chemoradiotherapy alone and concurrent chemoradiotherapy after neoadjuvant chemotherapy for stage ⅡB-ⅢB cervical squamous cell carcinoma. Methods A retrospective analysis was performed among 171 patients with stage ⅡB-ⅢB cervical squamous cell carcinoma who were admitted to our hospital and had complete follow-up data from February 1,2005 to October 31,2011. Results The median follow-up time was 66 months. There were no significant differences in the 3-or 5-year overall survival rates between the concurrent group and the neoadjuvant group (81.4% vs. 75.9%,74.3% vs. 67.2%,P=0.469).According to the subgroup analysis,there was no correlation between lymph node metastasis and survival curve (P=0.310,P=0.151).The univariate and Cox multivariate analyses showed that tumor size,lymph node metastasis,and concurrent chemotherapy method were independent prognostic factors for cervical cancer (P<0.05).For the patients with lymph node metastasis,the neoadjuvant group had a significantly higher pelvic local recurrence rate than the concurrent group (P=0.047),while there were no significant differences in mortality,distant metastasis,or long-term adverse reactions between the two groups (all P>0.05).For the patients without lymph node metastasis,the neoadjuvant group had a significantly higher incidence of grade 3-4 bone marrow suppression than the concurrent group (P=0.016),while there were no significant differences in mortality,local recurrence,distant metastasis,or long-term adverse reactions between the two groups (all P>0.05). Conclusions Concurrent chemoradiotherapy alone and concurrent chemoradiotherapy after neoadjuvant chemotherapy achieve similar treatment outcomes in patients with stage ⅡB-ⅢB cervical squamous cell carcinoma,no matter whether they have lymph node metastasis or not. Tumor size,lymph node metastasis,and concurrent chemotherapy method are independent prognostic factors. Neoadjuvant chemotherapy increases the risk of grade 3-4 marrow suppression during concurrent chemoradiotherapy,prolongs irradiation time,and increases the risk of local recurrence.
Zheng Jie,Wu Xingrao,Ye Lan et al. A comparative analysis of the efficacy and prognosis of concurrent chemoradiotherapy alone and concurrent chemoradiotherapy after neoadjuvant chemotherapy for stage ⅡB-ⅢB cervical squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2018, 27(1): 58-62.
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2018, Vol. 27 
