Chatani M, Teshima T, Inoue T
Department of Radiation Therapy, Center for Adult Diseases, Osaka, Japan.
Strahlenther Onkol. 1991 Dec;167(12):701-7.
From January 1983 through December 1987, a total of 138 patients with previously untreated carcinoma of the uterine cervix were entered into the prospective randomized study concerning the two different schedules of point A dose of remote afterloading high-dose rate intracavitary therapy (RALS) and external irradiation dose at the Center for Adult Diseases, Osaka. Group A consisted of 71 patients who were treated with fraction size of point A dose of 7.5 Gy and group B included 67 patients treated with fraction size of 6 Gy. According to the staging system of UICC (1978), 33 patients were classified into stage I, 50 patients stage II, 45 patients stage III, and ten patients stage IV. Three-year survival rates by stage and RALS schedule were in group A 80% and in group B 100% in stage I, 57% and 68% in stage II, 62% and 60% in stage III and 2/8 and 0/2 in stage IV. Survival curves showed no statistically significant difference in each stage. Late rectal and bladder complications requiring treatment (Kottmeier's grade 2 or more) after RALS developed 1.5% (2/138, group A none, group B two) and 1.5% (2/138, group A one, group B one), respectively. This result suggests that this trial is acceptable on survival as well as complication rates.
从1983年1月至1987年12月，大阪成人疾病中心对138例未经治疗的子宫颈癌患者进行了前瞻性随机研究，比较高剂量率腔内后装近距离放疗（RALS）A点剂量的两种不同方案以及外照射剂量。A组由71例接受A点剂量分次量为7.5 Gy治疗的患者组成，B组包括67例接受分次量为6 Gy治疗的患者。根据国际抗癌联盟（UICC，1978年）的分期系统，33例患者被分类为I期，50例为II期，45例为III期，10例为IV期。按分期和RALS方案的三年生存率，I期A组为80%，B组为100%；II期分别为57%和68%；III期分别为62%和60%；IV期分别为2/8和0/2。生存曲线显示各期无统计学显著差异。RALS后需要治疗的晚期直肠和膀胱并发症（Kottmeier 2级或更高）发生率分别为1.5%（138例中的2例，A组无，B组2例）和1.5%（138例中的2例，A组1例，B组1例）。该结果表明，本试验在生存率和并发症发生率方面是可以接受的。
