Samant Rajiv, Lau Bedy, E Choan, Le Tien, Tam Tiffany
Department of Radiation Oncology, Ottawa Hospital Regional Cancer Centre, Ottawa, ON, Canada.
Int J Radiat Oncol Biol Phys. 2007 Nov 1;69(3):746-50. doi: 10.1016/j.ijrobp.2007.04.015. Epub 2007 May 18.
To evaluate the feasibility of concurrent weekly Cis-platinum chemoradiation (CRT) in the curative treatment of primary vaginal cancer.
A retrospective review was performed of all primary vaginal cancer patients treated with curative intent at the Ottawa Hospital Regional Cancer Centre between 1999 and 2004 using concurrent Cis-platinum CRT.
Twelve patients were treated with concurrent weekly CRT. The median age at diagnosis was 56 years (range, 34-69 years), and the median follow-up was 50 months (range, 11-75 months). Ten patients (83%) were diagnosed with squamous cell carcinoma and 2 patients (17%) with adenocarcinoma. The distribution according to stage was as follows: 6 (50%) Stage II, 4 (33%) Stage III, and 2 (17%) Stage IVA. All patients received pelvic external beam radiotherapy (EBRT) concurrently with weekly intravenous Cis-platinum chemotherapy (40 mg/m(2)) followed by brachytherapy (BT). The median dose of EBRT was 4500 cGy given in 25 fractions over 5 weeks. Ten patients received interstitial BT, and 2 patients received intracavitary BT, with the median dose being 3000 cGy. The 5-year overall survival, progression-free survival, and locoregional progression-free survival rates were 66%, 75%, and 92%, respectively. Late toxicity requiring surgery occurred in 2 patients (17%).
For the treatment of primary vaginal cancer, it is feasible to deliver concurrent weekly Cis-platinum chemotherapy with high-dose radiation, leading to excellent local control and an acceptable toxicity profile.
评估顺铂同步每周化疗放疗(CRT)在原发性阴道癌根治性治疗中的可行性。
对1999年至2004年期间在渥太华医院区域癌症中心接受根治性治疗的所有原发性阴道癌患者进行回顾性分析,采用顺铂同步CRT。
12例患者接受了顺铂同步每周CRT治疗。诊断时的中位年龄为56岁(范围34 - 69岁),中位随访时间为50个月(范围11 - 75个月)。10例患者(83%)诊断为鳞状细胞癌,2例患者(17%)为腺癌。根据分期分布如下:II期6例(50%),III期4例(33%),IVA期2例(17%)。所有患者均接受盆腔外照射放疗(EBRT),同时每周静脉注射顺铂化疗(40mg/m²),随后进行近距离放疗(BT)。EBRT的中位剂量为4500cGy,分25次在5周内给予。10例患者接受组织间BT,2例患者接受腔内BT,中位剂量为3000cGy。5年总生存率、无进展生存率和局部区域无进展生存率分别为66%、75%和92%。2例患者(17%)出现需要手术的晚期毒性反应。
对于原发性阴道癌的治疗,每周同步给予顺铂化疗和高剂量放疗是可行的,可实现良好的局部控制且毒性反应可接受。