Kawase Setsuko, Okuda Takahito, Ikeda Mitsuru, Ishihara Shunichi, Itoh Yoshiyuki, Yanagawa Shigeo, Ishigaki Takeo
Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya city, Japan.
Gynecol Oncol. 2006 Sep;102(3):493-9. doi: 10.1016/j.ygyno.2006.01.009. Epub 2006 Feb 14.
The purpose of this study was to determine the effectiveness of the combination of intraarterial and intravenous concurrent chemoradiation therapy (CIAIV-CCRT) for the treatment of high-risk uterine cervical cancer.
Between January 2000 and November 2004, we reviewed 45 cervical cancer patients treated by CIAIV-CCRT. The numbers of patients with stage IB2, IIA, IIB, IIIA, IIIB, and IVA were 3, 6, 14, 1, 17, and 4, respectively. Patients with stage III and IVA or patients with tumors >3 cm in diameter were enrolled in this study. Two sessions of CCRT were administered every 3 weeks using a combination of 70 mg/m2 x h(-1) cisplatin or 50 mg/m2 x h(-1) nedaplatin via the bilateral uterine artery and 2800 mg/m2 x 96 h(-1) 5-fluorouracil intravenously. Patients concurrently received external beam radiation therapy and brachytherapy. A nonrandomized control group of 47 patients who underwent radiation therapy alone between 1993 and 2000 was used for comparison.
Of the 45 patients, 28 (62%) exhibited complete response and 16 (36%) exhibited partial response. One IIIB patient (2%) did not show any response. The 5-year overall survival (OAS) rates in the CCRT group and control group were 80.6% and 54.9%, respectively. With regard to late toxicities, no statistically significant differences were observed between the two groups. In uni- and multivariate analyses, positive pelvic lymph node showed a statistically significant influence on the OAS in the CIAIV-CCRT group (P = 0.049).
These preliminary results suggest that CIAIV-CCRT can improve the prognosis of patients with high-risk cervical cancer.
本研究旨在确定动脉内和静脉内同步放化疗（CIAIV-CCRT）联合治疗高危子宫颈癌的有效性。
在2000年1月至2004年11月期间，我们回顾了45例接受CIAIV-CCRT治疗的宫颈癌患者。IB2期、IIA期、IIB期、IIIA期、IIIB期和IVA期的患者人数分别为3例、6例、14例、1例、17例和4例。III期和IVA期患者或肿瘤直径>3 cm的患者纳入本研究。每3周进行两个疗程的同步放化疗，通过双侧子宫动脉给予70 mg/m2×h-1顺铂或50 mg/m2×h-1奈达铂，并静脉给予2800 mg/m2×96 h-1 5-氟尿嘧啶。患者同时接受外照射放疗和近距离放疗。将1993年至2000年间仅接受放疗的47例患者作为非随机对照组进行比较。
45例患者中，28例（62%）表现为完全缓解，16例（36%）表现为部分缓解。1例IIIB期患者（2%）未显示任何缓解。同步放化疗组和对照组的5年总生存率（OAS）分别为80.6%和54.9%。关于晚期毒性，两组之间未观察到统计学上的显著差异。在单因素和多因素分析中，阳性盆腔淋巴结对CIAIV-CCRT组的OAS有统计学上的显著影响（P = 0.049）。
这些初步结果表明，CIAIV-CCRT可改善高危宫颈癌患者的预后。
