Yamashita Hideomi, Nakagawa Keiichi, Tago Masao, Shiraishi Kenshiro, Nakamura Naoki, Ohtomo Kuni, Oda Katsutoshi, Nakagawa Shunsuke, Yasugi Toshiharu, Taketani Yuji
Department of Radiology, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyou-ku, Tokyo 113-8655, Japan.
Gynecol Oncol. 2005 Jun;97(3):834-9. doi: 10.1016/j.ygyno.2005.03.017.
To compare treatment outcome results of conventional surgery vs. radiotherapy (RT) for carcinoma of the uterine cervix.
A retrospective analysis was conducted of 152 patients with uterine cervical cancer radically treated with surgery or high dose-rate intracavitary brachytherapy (HDR-ICBT) with or without external RT from June 1991 to May 2004. The median follow-up time was 43.5 months (range, 1.0-130.0 months). The median age was 53 years (range, 25-81 years). There were 13 patients (9%) in stage IA, 52 (34%) in stage IB, 24 (16%) in stage IIA, and 63 (41%) in stage IIB. The conventional surgery group included 115 patients (76%) who underwent hysterectomy with pelvic lymph node dissection. Of these, 72 (63%) received postoperative radiotherapy. Thirty-seven patients (24%) were assigned to the RT group. Of these, 14 (38%) received chemoradiotherapy. Three patients with stage I received ICBT-alone without external beam irradiation.
The 5-year cause-specific survival (CSS) rates for surgery and RT were 79.9% and 82.3%, respectively; the difference between these two treatments was not statistically significant (P = 0.8524). The differences in the survival rates between the two treatments for each of the stage I or stage II patients were also not statistically significant (P = 0.8407 for stage I and P = 0.6418 for stage II).
This retrospective study suggests that RT results in compatible survival with conventional surgery for patients with stage I-II cervical carcinoma.
比较子宫颈癌传统手术与放射治疗(RT)的治疗结果。
对1991年6月至2004年5月期间152例接受手术或高剂量率腔内近距离放射治疗(HDR-ICBT)联合或不联合体外放疗的子宫颈癌根治术患者进行回顾性分析。中位随访时间为43.5个月(范围1.0 - 130.0个月)。中位年龄为53岁(范围25 - 81岁)。IA期13例(9%),IB期52例(34%),IIA期24例(16%),IIB期63例(41%)。传统手术组包括115例(76%)接受子宫切除术及盆腔淋巴结清扫术的患者。其中,72例(63%)接受术后放疗。37例(24%)患者被分配至放疗组。其中,14例(38%)接受同步放化疗。3例I期患者仅接受腔内近距离放射治疗,未接受体外照射。
手术组和放疗组的5年病因特异性生存率(CSS)分别为79.9%和82.3%;两种治疗方法之间的差异无统计学意义(P = 0.8524)。I期或II期患者中,两种治疗方法的生存率差异也无统计学意义(I期P = 0.8407,II期P = 0.6418)。
这项回顾性研究表明,对于I - II期子宫颈癌患者,放疗与传统手术的生存率相当。