Mosalaei A, Mohammadianpanah M, Omidvari S, Ahmadloo N
Radiation Oncology Department, Shiraz University of Medical Science, Nemazee Hospital, Shiraz, Iran.
Int J Gynecol Cancer. 2006 May-Jun;16(3):1101-5. doi: 10.1111/j.1525-1438.2006.00554.x.
This retrospective analysis aims to report results of patients with cancer of uterine cervix treated with external-beam radiotherapy (EBR) and high-dose rate (HDR) brachytherapy, using manual treatment planning. From 1975 to 1995, 237 patients with FIGO stages IIB-IVA and mean age of 54.31 years were treated. EBR dose to the whole pelvis was 50 Gy in 25 fractions. Brachytherapy with HDR after-loading cobalt source (Cathetron) was performed following EBR completion with a dose of 30 Gy in three weekly fractions of 10 Gy to point A. Survival, local control, and genitourinary and gastrointestinal complications were assessed. In a median follow-up of 60.2 months, the 10-year overall and disease-free survival rate was 62.4%. Local recurrence was seen in 12.2% of patients. Distant metastases to the lymph nodes, peritoneum, lung, liver, and bone occurred in 25.3% of patients. Less than 6% of patients experienced severe genitourinary and/or gastrointestinal toxicity that were relieved by surgical intervention. No treatment-related mortality was seen. This series suggests that 50 Gy to the whole pelvis together with three fractions of 10 Gy to point A with HDR brachytherapy is an effective fractionation schedule in the treatment of locally advanced cancer of cervix. To decrease the complications, newer devices and treatment planning may be beneficial.
本回顾性分析旨在报告采用手动治疗计划，接受体外照射放疗（EBR）和高剂量率（HDR）近距离放疗的子宫颈癌患者的治疗结果。1975年至1995年期间，共治疗了237例国际妇产科联盟（FIGO）分期为IIB-IVA期、平均年龄54.31岁的患者。全盆腔EBR剂量为50 Gy，分25次给予。EBR完成后，采用HDR后装钴源（卡特龙）进行近距离放疗，每周分3次给予剂量为30 Gy，每次10 Gy至A点。评估患者的生存率、局部控制率以及泌尿生殖系统和胃肠道并发症。中位随访60.2个月，10年总生存率和无病生存率为62.4%。12.2%的患者出现局部复发。25.3%的患者发生远处转移至淋巴结、腹膜、肺、肝和骨。不到6%的患者经历了严重的泌尿生殖系统和/或胃肠道毒性反应，经手术干预后缓解。未观察到与治疗相关的死亡。本系列研究表明，全盆腔50 Gy联合HDR近距离放疗分3次每次10 Gy至A点是治疗局部晚期宫颈癌的有效分割方案。为减少并发症，采用更新的设备和治疗计划可能有益。
