Ordeanu C, Coza O, Gavris S, Todor N, Szilagy E, Bako M, Cernea V, Ghilezan N, Nagy V
Department of Brachytherapy, Oncological Institute I. Chiricuta, Cluj-Napoca, Romania.
J BUON. 2007 Apr-Jun;12(2):221-6.
To evaluate the overall and disease-free survival of patients with advanced cervical carcinoma (FIGO stages IIB-IIIB) treated with external beam radiotherapy (EBRT) and medium dose rate brachytherapy (MDR-BT) plus/minus surgery.
One hundred and seven patients received preoperative RT (group A) and 154 were treated with definitive RT (group B); 73 patients in both groups also received cisplatin as radiosensitizer. EBRT delivered as preoperative reached a total dose of 44-46 Gy/pelvis, whereas the definitive RT reached a total dose of 62-64 Gy with standard fractionation. MDR-BT was performed with a LDR/MDR Cs-137 Selectron machine; 10 Gy/point A were delivered in the preoperative group A and 14 Gy/point A/, 1-2 fractions in group B. Cisplatin as radiosensitizer was administered during EBRT at a dose of 20 mg/m(2)/day for 5 days with 21 days interval between cycles.
With a median follow-up of 44.4 months (range 3.4-61.6) the overall survival at 3 years in group A was 92% vs. 68% for group B (p<0.01). According to FIGO stages 3-year overall survival was 88% in stage IIB, 79% in IIIA and 60% in IIIB (p<0.01). Three-year local control was 73.5% (192 patients). Thirty-three (13%) patients developed locoregional recurrences, and another 8 (3.07%) locoregional recurrences plus distant metastases.
The association of EBRT with MDR-BT represents an effective treatment in advanced cervical carcinoma. A significant difference in 3-year overall survival was found, favoring preoperative RT, with a very good rate of local control.
评估接受外照射放疗（EBRT）和中剂量率近距离放疗（MDR - BT）加/减手术治疗的晚期宫颈癌（国际妇产科联盟（FIGO）分期IIB - IIIB期）患者的总生存率和无病生存率。
107例患者接受术前放疗（A组），154例接受根治性放疗（B组）；两组中73例患者还接受顺铂作为放射增敏剂。术前进行的EBRT盆腔总剂量达44 - 46 Gy，而根治性放疗采用标准分割，总剂量达62 - 64 Gy。MDR - BT使用LDR/MDR Cs - 137 Selectron机器进行；A组术前给予A点10 Gy，B组给予A点14 Gy，分1 - 2次。在EBRT期间给予顺铂作为放射增敏剂，剂量为20 mg/m²/天，共5天，周期之间间隔21天。
中位随访44.4个月（范围3.4 - 61.6个月），A组3年总生存率为92%，B组为68%（p<0.01）。根据FIGO分期，IIB期3年总生存率为88%，IIIA期为79%，IIIB期为60%（p<0.01）。3年局部控制率为73.5%（192例患者）。33例（13%）患者出现局部区域复发，另外8例（3.07%）出现局部区域复发加远处转移。
EBRT与MDR - BT联合是晚期宫颈癌的一种有效治疗方法。发现3年总生存率有显著差异，术前放疗更具优势，局部控制率非常好。
