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[局部晚期宫颈癌患者的扩大野放射治疗、高剂量近距离放射治疗联合化疗]

[Extended field radiotherapy and high-dose brachytherapy combined with chemotherapy in patients with locally advanced cervical carcinoma].

作者信息

Petera J, Odrázka K, Dolezel M, Zoul Z, Vaculíková M, Sefrová J, Sirák I

机构信息

Klinika onkologie a radioterapie, FN a LF Hradec Králové.

出版信息

Ceska Gynekol. 2007 Apr;72(2):126-30.

Abstract

OBJECTIVE

Evaluation of results of extended field radiotherapy and high-dose rate brachytherapy combined with chemotherapy in patients with locally advanced cervical carcinoma.

TYPE OF THE STUDY

A retrospective study.

SETTING

Department of Oncology and Radiotherapy, University Hospital Hradec Králové.

METHODS

Forty five patients with stage IIB - IVA cervical cancer and radiologically suspicious pelvic and/or paraaortic lymph nodes were treated at the Dept. of Oncology and Radiotherapy Hradec Králové with pelvic and paraaortic radiotherapy, high-dose rate brachytherapy and concomitant chemotherapy with cisplatin or cisplatin and paclitaxel.

RESULTS

The 3-years disease free survival estimate was 64%. Hematological toxicity was the most limiting factor of concomitant chemotherapy. Late toxicity grade III and IV was observed in 7 patients. One patient underwent surgery due to ileus caused by lymphoma.

CONCLUSIONS

Concomitant chemoradiotherapy with paraaortic fields results in high tumor control but also significant acute and late toxicity. New techniques of radiotherapy, such as intensity modulated radiotherapy, may improve the therapeutic ratio.

摘要

目的

评估局部晚期宫颈癌患者接受扩大野放疗、高剂量率近距离放疗联合化疗的效果。

研究类型

回顾性研究。

研究地点

赫拉德茨克拉洛韦大学医院肿瘤与放疗科。

方法

45例IIB-IVA期宫颈癌且放射学检查怀疑有盆腔和/或腹主动脉旁淋巴结转移的患者,在赫拉德茨克拉洛韦大学医院肿瘤与放疗科接受盆腔和腹主动脉旁放疗、高剂量率近距离放疗,并同时接受顺铂或顺铂与紫杉醇联合化疗。

结果

3年无病生存率估计为64%。血液学毒性是同步化疗最主要的限制因素。7例患者出现III级和IV级晚期毒性反应。1例患者因淋巴瘤导致肠梗阻而接受手术。

结论

腹主动脉旁野同步放化疗可实现较高的肿瘤控制率,但也会产生显著的急性和晚期毒性反应。放疗新技术,如调强放疗,可能会提高治疗增益比。

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