一项关于使用高剂量率和低剂量率近距离放射疗法对宫颈癌进行根治性放射治疗的单一机构经验。

A single institutional experience with definitive radiotherapy for cervical cancer using both high- and low-dose-rate brachytherapy.

作者信息

Gerszten Kristina, Gooding William E, Lin Yan, Heron Dwight E, Faul Clare

机构信息

University of Pittsburgh Cancer Institute, Department of Radiation Oncology, UPMC Cancer Pavilion, Room 534 Fifth Floor, 5150 Centre Avenue, Pittsburgh, PA 15232, USA.

出版信息

Gynecol Oncol. 2006 Sep;102(3):500-7. doi: 10.1016/j.ygyno.2006.01.021. Epub 2006 Feb 28.

DOI:10.1016/j.ygyno.2006.01.021

PMID:16503346

Abstract

OBJECTIVE

To evaluate outcomes in cervical cancer patients treated with high-dose-rate (HDRB) or low-dose-rate (LDRB) brachytherapy.

METHODS

A retrospective chart review compared control rates, survival, and complications in the two groups.

RESULTS

All patients received pelvic EBRT (45 Gy/5 weeks). 106 patients receiving LDRB were compared to 107 treated with HDRB. The median point A LDRB and HDRB dose was 42 Gy and 25 Gy/5, respectively. Tumor size and stage (I(B) 23% LDRB, 30% HDRB, II(A) 22% LDRB, 11% HDRB, II(B) 44% LDRB, 48% HDRB, III(B) 11% LDRB and HDRB) were similar, but more HDRB patients received chemosensitization (44% versus 6%). After adjusting for lymph node status with cox regression, no difference in 5-year survival (53% HDRB and 61% LDRB P = 0.088) or 5-year DFS (54% both groups, P = 0.089) was found between the two groups. Local recurrences occurred in 19% of the LDRB and 5% of the HDRB cohort. The time to LR was significantly longer in the HDRB group, and this persisted after adjusting for the increased used of chemotherapy in these patients. There was no significant difference in grade III or IV toxicity (6.6% LDRB and 3.7% HDRB).

CONCLUSIONS

This HDRB dose fractionation schedule yielded improved local control but similar survival compared to LDRB.

摘要

目的

评估接受高剂量率（HDRB）或低剂量率（LDRB）近距离放疗的宫颈癌患者的治疗结果。

方法

通过回顾性病历审查比较两组的控制率、生存率和并发症。

结果

所有患者均接受盆腔外照射放疗（45 Gy/5周）。将106例接受LDRB的患者与107例接受HDRB的患者进行比较。LDRB和HDRB组A点的中位剂量分别为42 Gy和25 Gy/5次。肿瘤大小和分期（I（B）期：LDRB组23%，HDRB组30%；II（A）期：LDRB组22%，HDRB组11%；II（B）期：LDRB组44%，HDRB组48%；III（B）期：LDRB组和HDRB组均为11%）相似，但接受化疗增敏的HDRB患者更多（44%对6%）。经Cox回归调整淋巴结状态后，两组间5年生存率（HDRB组53%，LDRB组61%，P = 0.088）或5年无病生存率（两组均为54%，P = 0.089）无差异。LDRB组19%的患者出现局部复发，HDRB组为5%。HDRB组至局部复发的时间明显更长，在调整这些患者化疗使用增加的因素后，这种情况仍然存在。III级或IV级毒性无显著差异（LDRB组6.6%，HDRB组3.7%）。