同步放化疗对伴有盆腹腔淋巴结转移的宫颈癌患者疗效分析

doi:10.3760/cma.j.cn113030-20191030-00447

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Abstract Objective To determine whether postoperative concurrent chemoradiotherapy (CCRT) improves the survival outcomes of cervical cancer patients with pelvic and/or para-aortic lymph node metastasis after radical surgery. Methods Clinical data of 188 cervical cancer patients presenting with pelvic and/or para-aortic lymph node metastasis after radical surgery between February 2008 and November 2011 were retrospectively analyzed. The incidence of pelvic and/or para-aortic lymph node metastasis was confirmed by postoperative pathology. The clinical efficacy of CCRT was evaluated. Results Recurrence/metastasis occurred in 46 patients. In the radiotherapy alone group, 4(57.1%) patients had recurrence/metastasis in the posterior peritoneum subgroup, 5(55.6%) in the iliac subgroup and 11(28.2%) in the pelvic non-iliac subgroup, respectively. In the CCRT group, there were 5(62.5%) cases of recurrence/metastasis in the posterior peritoneum subgroup, 5(25%) in the iliac subgroup and 16(15.2%) in the pelvic non-iliac subgroup, respectively. Compared with the radiotherapy alone, CCRT could significantly improve the 5-year overall survival (OS) rate of patients with pelvic without iliac lymph node metastasis or iliac lymph node metastasis (pelvic without iliac:88.6% vs.76.9%, P=0.003;iliac:80.0% vs.44.4%, P=0.041), whereas failed to improve the 5-year OS of patients with para-aortic lymph node metastasis (50.0% vs.42.9%, P=0.973). The location of lymph node metastasis and CCRT were the independent prognostic factors for OS (para-aortic vs. pelvic without iliac:hazard ratio[HR]=4.259,95%CI=1.700-10.671, P=0.002;iliac vs. pelvic without iliac:HR=2.985,95%CI=1.290-6.907, P=0.011;concurrent chemotherapy vs. radiotherapy alone:HR=0.439,95%CI=0.218-0.885,P=0.021). Conclusions CCRT can improve the survival of patients with pelvic lymph node metastasis, but it fails to enhance the survival rate of patients with para-aortic lymph node metastasis.

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	Tu Yeqiang
	Tang Qiu
	Yan Dingding
	Lyu Xiaojuan
	Chen Jianhong
	Wang fangfang

Key words： Uterine cervical neoplasm/concurrent chemoradiotherapy Lymph node metastasis Uterine cervical neoplasms/chemotherapy Prognosis

Received: 30 October 2019

Fund:General Research Project of Medicine and Health in Zhejiang Province (Surface project)(2016KYA036)

Corresponding Authors: Tang Qiu, Email:tangqiu@zjcc.org.cn

Cite this article:

Tu Yeqiang,Tang Qiu,Yan Dingding et al. Clinical efficacy of concurrent chemoradiotherapy in cervical cancer patients with pelvic and/or para-aortic lymph node metastasis treated with radical surgery[J]. Chinese Journal of Radiation Oncology, 2020, 29(6): 446-450.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20191030-00447 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2020/V29/I6/446

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