Matsuura K, Tanimoto H, Fujita K, Hashimoto Y, Murakami Y, Kenjo M, Kaneyasu Y, Wadasaki K, Ito K
Department of Radiology, Hiroshima University, Hiroshima, 1-2-3 Kasumi, Hiroshima 7348551, Japan.
Gynecol Oncol. 2007 Jan;104(1):11-4. doi: 10.1016/j.ygyno.2006.06.033. Epub 2006 Aug 7.
PURPOSE/OBJECTIVE: To evaluate the outcome of cervical cancer patients unable to undergo conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT) alone using accelerated hyperfractionation (AHF).
We reviewed the records of 7 patients who had received definitive radiotherapy with 3DCRT alone using AHF for cervical cancer between 2002 and 2005. FIGO stage was IB (1), IIB (2), IIIA (1), IIIB (2), and IVA (1). The reason we did not perform ICBT was due to patient refusal. In 1 patient with stage IB, a total dose of 65.4 Gy was delivered by local irradiation (LI) only. In 1 patient with stage IIIA, a total dose of 60 Gy was delivered by LI only. In 5 patients with Stage IIB-IV, a median total dose of 70.8 Gy was delivered by combination of whole pelvic irradiation (median dose of 45 Gy) with LI. Median overall treatment time was 42 days.
Median follow-up for survival patients was 17 months. Out of 7 patients, 6 patients had CR and 1 patient had PR. The response rate was 100%. The 2-year local control rate was 85.7%. Of these patients, 5 are alive without disease and 1 is alive with lung metastasis.
Our outcomes suggest that 3DCRT using AHF may be a promising as a definitive treatment for cervical cancer when ICBT is not able to be performed.
目的/目标：评估无法接受传统腔内近距离放疗（ICBT）的宫颈癌患者单纯使用三维适形放疗（3DCRT）联合加速超分割放疗（AHF）的治疗效果。
我们回顾了2002年至2005年间7例接受单纯3DCRT联合AHF治疗宫颈癌的患者记录。国际妇产科联盟（FIGO）分期为IB期（1例）、IIB期（2例）、IIIA期（1例）、IIIB期（2例）和IVA期（1例）。未进行ICBT的原因是患者拒绝。1例IB期患者仅通过局部照射（LI）给予总剂量65.4 Gy。1例IIIA期患者仅通过LI给予总剂量60 Gy。5例IIB-IV期患者通过全盆腔照射（中位剂量45 Gy）联合LI给予中位总剂量70.8 Gy。中位总治疗时间为42天。
存活患者的中位随访时间为17个月。7例患者中，6例完全缓解（CR），1例部分缓解（PR）。缓解率为100%。2年局部控制率为85.7%。这些患者中，5例无病存活，1例有肺转移存活。
我们的结果表明，当无法进行ICBT时，使用AHF的3DCRT作为宫颈癌的确定性治疗可能很有前景。
