早期高危宫颈癌术后同期放化疗研究进展

doi:10.3760/cma.j.issn.1004-4221.2017.12.025

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Abstract Cervical cancer is one of the most common gynecologic malignancy,ranking fourth in new cases and deaths in 2012.High-risk early stage cervical cancer after operative need adjuvant treatment. Compared with postoperative radiotherapy alone,CCRT can reduce the pelvic recurrence rates and improve survival rates. And CCRT can extend median survival time and survival rates than sequential CRT after operative. CCRT plus consolidation chemotherapy may play a potential role in further improving survival outcomes for high-risk early stage cervical cancer patients compared with CCRT alone. Retrospective studies show that CCRT had equivalent effects with postoperative chemotherapy alone,but further research is needed. Factors influencing the efficacy of postoperative CCRT include chemotherapy regimens,radiotherapy technology,the interval time between surgery and CCRT,multiple pelvic lymph node metastasis and number of pelvic lymph node dissection. Toxicities mainly include hematologic and gastrointestinal toxicity. Hematologic toxicity is the most common. The incidence of toxicity can be reduced by improving radiotherapy techniques.

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	Nie Fangfang
	Chen Xiaoqin
	Fu Jie

Key words： Cervical neoplasms/concurrent chemoradiotherapy High-risk Untoward effect

Received: 18 July 2017

Fund:Shanghai Shenkang Hospital Development Center Funds for Three Year Action Plan for Promoting Clinical Skills and Clinical Innovation Capacity in Municipal Hospitals (16CR3112B)

Corresponding Authors: Fu Jie,Email:fujie74@sjtu.edu.cn

Cite this article:

Nie Fangfang,Chen Xiaoqin,Fu Jie. Research advances in postoperative concurrent chemoradiotherapy (CCRT) for high-risk early stage cervical cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(12): 1470-1474.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2017.12.025 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2017/V26/I12/1470

[1] Torre LA,Bray F,Siegel RL,et al. Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.DOI:10.3322/caac.21262.
[2] Landoni F,Colombo A.Randomized study between radical surgery and radiotherapy for the treatment of stage ⅠB-ⅡA cervical cancer:20-year update[J].J Gynecol Oncol,2017,28(3):e34.DOI:10.3802/jgo.2017.28.e34.
[3] Ryu SY,Kim MH,Nam BH,et al. Intermediate-risk grouping of cervical cancer patients treated with radical hysterectomy:a Korean Gynecologic Oncology Group study[J].Br J Cancer,2014,110(2):278-285.DOI:10.1038/bjc.2013.716.
[4] Sedlis A,Bundy BN,Rotman MZ,et al. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage ⅠB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy:a gynecologic oncology group study[J].Gynecol Oncol,1999,73(2):177-183.
[5] Kinney WK,Alvarez RD,Reid GC,et al. Value of adjuvant whole-pelvis irradiation after Wertheim hysterectomy for early-stage squamous carcinoma of the cervix with pelvic nodal metastasis:a matched-control study[J].Gynecol Oncol,1989,34(3):258-262.
[6] Peters WA,3rd,Liu PY,Barrett RJ,2nd,et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix[J].J Clin Oncol,2000,18(8):1606-1613.
[7] Takekuma M,Kasamatsu Y,Kado N,et al. The issues regarding postoperative adjuvant therapy and prognostic risk factors for patients with stage Ⅰ—Ⅱ cervical cancer:A review[J].J Obstet Gynaecol Res,2017,43(4):617-626.DOI:10.1111/jog.13282.
[8] Whitney CW,Sause W,Bundy BN,et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage ⅡB-IVA carcinoma of the cervix with negative para-aortic lymph nodes:a Gynecologic Oncology Group and Southwest Oncology Group study[J].J Clin Oncol,1999,17(5):1339-1348.
[9] Morris M,Eifel PJ,Lu J,et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer[J].N Engl J Med,1999,340(15):1137-1143.DOI:10.1056/nejm199904153401501.
[10] Rose PG,Bundy BN,Watkins EB,et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer[J].N Engl J Med,1999,340(15):1144-1153.DOI:10.1056/nejm199904153401502
[11] Keys HM,Bundy BN,Stehman FB,et al. Cisplatin,radiation,and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage ⅠB cervical carcinoma[J].N Engl J Med,1999,340(15):1154-1161.DOI:10.1056/nejm199904153401503
[12] 戚世芳,刘华,田晓予.早期高危宫颈癌术后同步放化疗的临床研究[J].中国实用医药,2010(34):5-6.DOI:10.14163/j.cnki.11-5547/r.2010.34.189.
Qi SF,Liu H,Tian XY.Clinical study of postoperative concurrent chemoradiotherapy for early high-risk cervical cancer[J].Chin Pract Med,2010(34):5-6.DOI:10.14163/j.cnki.11-5547/r.2010.34.189.
[13] Qin AQ,Liang ZG,Ye JX,et al. Significant efficacy of additional concurrent chemotherapy with radiotherapy for postoperative cervical cancer with risk factors:a systematic review and meta-analysis[J].Asian Pac J Cancer Prev,2016,17(8):3945-3951.
DOI:10.1097/md.0000000000004801.
[14] 林贵山,程惠华,李东石.早期高危宫颈癌术后同步放化疗和序贯放化疗的对比研究[J].临床肿瘤学杂志,2009(06):541-543.DOI:1009-0460(2009)06-0541-03
Lin GS,Cheng HH,Li DS.Comparative study of concurrent chemoradiotherapy and sequential chemoradiotherapy in the treatment of early high-risk cervical cancer[J].J Clin Oncol,2009(6):541-543.DOI:1009-0460(2009)06-0541-03
[15] 崔月龙,王博,张建华,等.宫颈癌根治术后同步放化疗与放疗序贯化疗效果对比分析[J].转化医学电子杂志,2015(9):58-59.
Cui YL,Wang B,Zhang JH,et al. Comparative analysis of sequential chemoradiotherapy and radiotherapy sequential chemotherapy in radical resection of cervical cancer[J].J Med Elect Trans,2015(9):58-59.
[16] Sehouli J,Runnebaum IB,Fotopoulou C,et al. A randomized phase Ⅲ adjuvant study in high-risk cervical cancer:simultaneous radiochemotherapy with cisplatin (S-RC) versus systemic paclitaxel and carboplatin followed by percutaneous radiation (PC-R):a NOGGO-AGO Intergroup Study[J].Ann Oncol,2012,23(9):2259-2264.DOI:10.1093/annonc/mdr628.
[17] Mabuchi S,Isohashi F,Yokoi T,et al. A phase Ⅱ study of postoperative concurrent carboplatin and paclitaxel combined with intensity-modulated pelvic radiotherapy followed by consolidation chemotherapy in surgically treated cervical cancer patients with positive pelvic lymph nodes[J].Gynecol Oncol,2016,141(2):240-246.DOI:10.1016/j.ygyno.2016.02.011.
[18] Zhao H,Li L,Su H,et al. Concurrent paclitaxel/cisplatin chemoradiotherapy with or without consolidation chemotherapy in high-risk early-stage cervical cancer patients following radical hysterectomy:preliminary results of a phase Ⅲ randomized study[J].Oncotarget,2016,7(43):70969-70978.
[19] Takekuma M,Kasamatsu Y,Kado N,et al. Adjuvant chemotherapy versus concurrent chemoradiotherapy for high-risk cervical cancer after radical hysterectomy and systematic lymphadenectomy[J].Int J Clin Oncol,2016,21(4):741-747.
DOI:10.1007/s10147-016-0955-3.
[20] Argenta PA,Ghebre R,Dusenbery KE,et al. Radiation therapy with concomitant and adjuvant cisplatin and paclitaxel in high-risk cervical cancer:long-term follow-up[J].Eur J Gynaecol Oncol,2006,27(3):231-235.
[21] 朱朝勇,李志燕,郭生梅,等.FP与TP方案在早期高危宫颈癌术后同步放化疗中的有效性和安全性的临床研究[J].青海医药杂志,2012(4):5-7.
Zhu CY,Li ZY,Guo SM,et al. Efficacy and safety of FP and TP in postoperative concurrent chemoradiotherapy for early high-risk cervical cancer[J].Qinghai Med J,2012(04):5-7.
[22] Lee TS,Kang SB,Kim YT,et al. Chemoradiation with paclitaxel and carboplatin in high-risk cervical cancer patients after radical hysterectomy:a Korean Gynecologic Oncology Group study[J].Int J Radiat Oncol Biol Phys,2013,86(2):304-310.DOI:10.1016/j.ijrobp.2013.01.035.
[23] Takekuma M,Hirashima Y,Ito K,et al. Phase Ⅱ trial of paclitaxel and nedaplatin in patients with advanced/recurrent uterine cervical cancer:a kansai clinical oncology group study[J].Gynecol Oncol,2012,126(3):341-345.DOI:10.1016/j.ygyno.2012.05.010.
[24] Omura GA,Blessing JA,Vaccarello L,et al. Randomized trial of cisplatin versus cisplatin plus mitolactol versus cisplatin plus ifosfamide in advanced squamous carcinoma of the cervix:a Gynecologic Oncology Group study[J].J Clin Oncol,1997,15(1):165-171.
[25] Moore DH,Blessing JA,McQuellon RP,et al. Phase Ⅲ study of cisplatin with or without paclitaxel in stage ⅠVB,recurrent,or persistent squamous cell carcinoma of the cervix:a gynecologic oncology group study[J].J Clin Oncol,2004,22(15):3113-3119.DOI:10.1200/jco.2004.04.170.
[26] Long HJ,3rd,Bundy BN,Grendys EC,Jr., et al. Randomized phase Ⅲ trial of cisplatin with or without topotecan in carcinoma of the uterine cervix:a Gynecologic Oncology Group Study[J].J Clin Oncol,2005,23(21):4626-4633.DOI:10.1200/jco.2005.10.021.
[27] 郑建清,黄碧芬.宫颈癌术后紫杉醇联合顺铂同步放化疗的临床研究[J].中国实用医药,2015(1):11-13.DOI:10.14163/j.cnki.11-5547/r.2015.01.005.
Zheng JQ,Huang BF.Clinical study of paclitaxel and cisplatin concurrent radiotherapy and chemotherapy in patients with cervical cancer after operation[J].Chin Pract Med,2015(1):11-13.DOI:10.14163/j.cnki.11-5547/r.2015.01.005.
[28] Pu J,Qin SS,Ding JX,et al. A randomized controlled study of single-agent cisplatin and radiotherapy versus docetaxel/cisplatin and radiotherapy in high-risk early-stage cervical cancer after radical surgery[J].J Cancer Res Clin Oncol,2013,139(4):703-708.DOI:10.1007/s00432-013-1373-9.
[29] 杨心凤,娄俊,戴菱蔓,等.宫颈癌术后容积旋转调强治疗与三维适形调强放疗的临床研究[J].实用癌症杂志,2016(10):1703-1705.DOI:10.3969/j.issn.1001-5930.2016.10.040.
Yang XF,Lou J,Daiso LM,et al. Clinical study of volume rotation intensity modulated radiotherapy and three dimensional intensity modulated radiotherapy for postoperative cervical cancer[J].J Pract Cancer,2016(10):1703-1705.DOI:10.3969/j.issn.1001-5930.2016.10.040.
[30] Qiao L,Cheng J,Liang N,et al. A comparative dosimetric study of volumetric-modulated arc therapy:.fixed field intensity-modulated radiotherapy in postoperative irradiation of stage ⅠB-ⅡA high-risk cervical cancer[J].Oncol Lett,2016,11(2):959-964.DOI:10.3892/ol.2015.3998.
[31] Lan ML,Yu X,Xiao H,et al. Clinical outcomes and toxicity of postoperative intensity-modulated versus three-dimensional conformal radiation therapy in patients with cervical cancer[J].Asia Pac J Clin Oncol,2016,12(4):430-436.DOI:10.1111/ajco.12476.
[32] Isohashi F,Mabuchi S,Yoshioka Y,et al. Intensity-modulated radiation therapy versus three-dimensional conformal radiation therapy with concurrent nedaplatin-based chemotherapy after radical hysterectomy for uterine cervical cancer:comparison of outcomes,complications,and dose-volume histogram parameters[J].Radiat Oncol,2015,10:180.DOI:10.1186/s13014-015-0486-5.
[33] Kim SW,Chun M,Ryu HS,et al. Long-term results of early adjuvant concurrent chemoradiotherapy for high-risk,early stage uterine cervical cancer patients after radical hysterectomy[J].BMC Cancer,2017,17(1):297.DOI:10.1186/s12885-017-3299-0
[34] Okazawa M,Mabuchi S,Isohashi F,et al. The prognostic significance of multiple pelvic node metastases in cervical cancer patients treated with radical hysterectomy plus adjuvant chemoradiotherapy[J].Int J Gynecol Cancer,2012,22(3):490-497.
DOI:10.1097/IGC.0b013e31823c369b.
[35] Takekuma M,Kasamatsu Y,Kado N,et al. Reconsideration of postoperative concurrent chemoradiotherapy with fluorouracil and cisplatin for uterine cervical cancer[J].J Obstet Gynaecol Res,2015,41(10):1638-1643.DOI:10.1111/jog.12754.
[36] Mell LK,Kochanski JD,Roeske JC,et al. Dosimetric predictors of acute hematologic toxicity in cervical cancer patients treated with concurrent cisplatin and intensity-modulated pelvic radiotherapy[J].Int J Radiat Oncol Biol Phys,2006,66(5):1356-1365.DOI:10.1016/j.ijrobp.2006.03.018
[37] Albuquerque K,Giangreco D,Morrison C,et al. Radiation-related predictors of hematologic toxicity after concurrent chemoradiation for cervical cancer and implications for bone marrow-sparing pelvic IMRT[J].Int J Radiat Oncol Biol Phys,2011,79(4):1043-1047.DOI:10.1016/j.ijrobp.2009.12.025
[38] Klopp AH,Moughan J,Portelance L,et al. Hematologic toxicity in RTOG 0418:a phase 2 study of postoperative IMRT for gynecologic cancer[J].Int J Radiat Oncol Biol Phys,2013,86(1):83-90.DOI:10.1016/j.ijrobp.2013.01.017.
[39] 张艳贤.宫颈癌同步放化疗急性血液学不良反应相关预测因子的研究[D].桂林:广西医科大学,2015.
Zhang YX.The study of cervical cancer radiotherapy and chemotherapy for acute hematologic adverse reactions related predictors[D].Guilin:Guangxi Medical University,2015.
[40] Hui B,Zhang Y,Shi F,et al. Association between bone marrow dosimetric parameters and acute hematologic toxicity in cervical cancer patients undergoing concurrent chemoradiotherapy:comparison of three-dimensional conformal radiotherapy and intensity-modulated radiation therapy[J].Int J Gynecol Cancer,2014,24(9):1648-1652.DOI:10.1097/igc.0000000000000292.
[41] Erpolat OP,Alco G,Caglar HB,et al. Comparison of hematologic toxicity between 3DCRT and IMRT planning in cervical cancer patients after concurrent chemoradiotherapy:a national multi-center study[J].Eur J Gynaecol Oncol,2014,35(1):62-66.
[42] Isohashi F,Mabuchi S,Akino Y,et al. Dose-volume analysis of predictors for chronic gastrointestinal complications in patients with cervical cancer treated with postoperative concurrent chemotherapy and whole-pelvic radiation therapy[J].J Radiat Res,2016,57(6):668-676.DOI:10.1093/jrr/rrw037.