Mock Ulrike, Kucera Herwig, Fellner Claudia, Knocke Thomas Hendrik, Pötter Richard
Department of Radiotherapy and Radiobiology, University Hospital Vienna, Vienna, Austria.
Int J Radiat Oncol Biol Phys. 2003 Jul 15;56(4):950-7. doi: 10.1016/s0360-3016(03)00217-7.
To report toxicity, prognostic factors, and outcome of HDR brachytherapy in the primary management of vaginal carcinoma.
A total of 86 patients receiving radiotherapy for primary vaginal carcinoma were analyzed. FIGO stages 0-IV were found in 6, 17, 38, 20, and 5 patients, respectively. Early stages of disease (Stages 0-II) were treated with intravaginal HDR brachytherapy alone (n = 26/86), whereas locally advanced diseases (Stages II-IV) received HDR brachytherapy combined with external beam therapy (n = 55/86). Teletherapy only was used in 5 of 86 cases, all of which were treated with palliative intent (i.e., advanced stage, poor general status). Recurrence-free intervals as well as overall- and disease-specific survival rates were determined for all patients. Frequencies of side effects and the influence of prognostic factors and treatment modalities on outcome were analyzed.
Five-year overall survival rates for Stages 0-IV diseases were 83%, 41%, 43%, 37%, and 0%, respectively. Corresponding 5-year disease-specific survival rates were 100%, 92%, 57%, 59%, and 0%. Regarding 5-year recurrence-free intervals, values of 100%, 77%, 50%, 23%, and 0% (Stages 0-IV) were found, respectively. Tumor stage was the most significant prognostic factor. Chronic side effects G 1-4 were observed in <or=2% (bladder, rectum) and 1%-6% (vagina).
In the treatment of primary vaginal carcinoma, HDR brachytherapy appeared to be well-tolerated and as effective as LDR brachytherapy techniques.
报告高剂量率近距离放射治疗在原发性阴道癌初始治疗中的毒性、预后因素及治疗结果。
共分析了86例接受原发性阴道癌放射治疗的患者。国际妇产科联盟（FIGO）分期0 - IV期的患者分别有6例、17例、38例、20例和5例。疾病早期（0 - II期）仅采用阴道内高剂量率近距离放射治疗（n = 26/86），而局部晚期疾病（II - IV期）接受高剂量率近距离放射治疗联合外照射治疗（n = 55/86）。86例患者中有5例仅接受远距离治疗，所有这些患者均采用姑息性治疗（即晚期、一般状况差）。确定了所有患者的无复发生存期以及总生存率和疾病特异性生存率。分析了副作用的发生率以及预后因素和治疗方式对治疗结果的影响。
0 - IV期疾病的5年总生存率分别为83%、41%、43%、37%和0%。相应的5年疾病特异性生存率分别为100%、92%、57%、59%和0%。关于5年无复发生存期，分别为100%、77%、50%、23%和0%（0 - IV期）。肿瘤分期是最显著的预后因素。在膀胱、直肠中观察到1 - 4级慢性副作用的发生率≤2%，在阴道中为1% - 6%。
在原发性阴道癌的治疗中，高剂量率近距离放射治疗似乎耐受性良好，且与低剂量率近距离放射治疗技术效果相当。
