Barraclough Lisa Helen, Swindell Ric, Livsey Jacqueline E, Hunter Robin D, Davidson Susan E
Department of Clinical Oncology, Christie Hospital, Manchester, UK.
Int J Radiat Oncol Biol Phys. 2008 Jul 1;71(3):772-8. doi: 10.1016/j.ijrobp.2007.10.066. Epub 2008 Jan 22.
To assess the outcome of patients treated with radical radiotherapy for cervical cancer who received an external beam boost, in place of intracavitary brachytherapy (ICT), after irradiation to the whole pelvis.
Case notes were reviewed for all patients treated in this way in a single center between 1996 and 2004. Patient and tumor details, the reasons why ICT was not possible, and treatment outcome were documented.
Forty-four patients were identified. The mean age was 56.4 years (range, 26-88 years). Clinical International Federation of Gynecology and Obstetrics or radiologic stage for Stages I, II, III, and IV, respectively, was 16%, 48%, 27%, and 7%. A total radiation dose of 54-70 Gy was given (75% received > or =60 Gy). Reasons for ICT not being performed were technical limitations in 73%, comorbidity or isolation limitations in 23%, and patient choice in 4%. The median follow-up was 2.3 years. Recurrent disease was seen in 48%, with a median time to recurrence of 2.3 years. Central recurrence was seen in 16 of the 21 patients with recurrent disease. The 5-year overall survival rate was 49.3%. The 3-year cancer-specific survival rate by stage was 100%, 70%, and 42% for Stages I, II, and III, respectively. Late Grades 1 and 2 bowel, bladder, and vaginal toxicity were seen in 41%. Late Grade 3 toxicity was seen in 2%.
An external beam boost is a reasonable option after external beam radiotherapy to the pelvis when it is not possible to perform ICT.
评估接受宫颈癌根治性放疗的患者在全盆腔照射后接受体外照射加量治疗（代替腔内近距离放疗[ICT]）的治疗结果。
回顾了1996年至2004年在单一中心接受这种治疗的所有患者的病历。记录了患者和肿瘤的详细信息、无法进行ICT的原因以及治疗结果。
共确定了44例患者。平均年龄为56.4岁（范围26 - 88岁）。国际妇产科联盟临床分期或放射学分期中，I期、II期、III期和IV期分别为16%、48%、27%和7%。总放射剂量为54 - 70 Gy（75%的患者接受了≥60 Gy）。未进行ICT的原因中，技术限制占73%，合并症或隔离限制占23%，患者选择占4%。中位随访时间为2.3年。48%的患者出现疾病复发，复发的中位时间为2.3年。21例复发患者中有16例出现中心复发。5年总生存率为49.3%。I期、II期和III期的3年癌症特异性生存率分别为100%、70%和42%。41%的患者出现晚期1级和2级肠道、膀胱及阴道毒性反应。2%的患者出现晚期3级毒性反应。
当无法进行ICT时，体外照射加量是盆腔体外照射放疗后的合理选择。
