Department of Radiotherapy, Pomeranian Medical University, Szczecin, Poland.
Med Oncol. 2010 Mar;27(1):1-8. doi: 10.1007/s12032-008-9159-7. Epub 2009 Jan 7.
To compare effects of concomitant radiochemotherapy (RCTh) and radiotherapy (RTh) alone in patients with cervical carcinoma and with 36-months follow-up analysis.
106 stage IIA-IVA cervical carcinoma women were divided in two groups. RCTh group was treated with teleradiotherapy (50.4 Gy/T), intracavitary brachytherapy (46 Gy), and iv cisplatin (40 mg/m(2)). RTh group was treated with pelvic teletherapy (52-54 Gy/T) and intracavitary brachytherapy (50-55 Gy).
In RCTh group absorbed radiation dose was significantly lower (50.4 vs. 52.7 Gy) and the duration of treatment was significantly shorter (45.1 days vs. 47.8 days). There were no statistical differences in both groups in survival (59% in RCTh group vs. 56% in RTh group), response to treatment (86% vs. 90%), local recurrence (42% vs. 49%) metastasis occurrence (21% vs. 17%), anemia (40% vs. 26%), early postradiation reactions in intestines (77% vs. 65%) and bladder (71% vs. 61%) as well as in incidence of rectovaginal (10% vs. 4%) and vesicovaginal formation of fistulas (6% vs. 4%), respectively. There were significant differences between two groups in: nausea (77% vs. 6%), vomiting (65% vs. 3.7%), leucopenia (69% vs. 26%) and thrombocytopenia (35% vs. 9%), and late postradiation bladder effects (94% vs. 74%). RCTh patients with anemia had lower 36-months survival rates (42% vs. 71%), more frequent local recurrences (77% vs. 31%) and metastasis-free survival rates (61% vs. 90%) than RCTh patients without anemia.
RCTh gives better treatment results in patients without than in patients with anemia and higher overall survival rates than RTh in patients without anemia. The only clinical prognostic factor for advance cervical carcinoma is the clinical stage of the disease.
比较宫颈癌患者同步放化疗（RCTh）和单纯放疗（RTh）的疗效，并进行 36 个月的随访分析。
将 106 例 IIA-IVA 期宫颈癌患者分为两组。RCTh 组接受外照射（50.4Gy/T）、腔内近距离放疗（46Gy）和静脉顺铂（40mg/m²）治疗。RTh 组接受盆腔外照射（52-54Gy/T）和腔内近距离放疗（50-55Gy）治疗。
RCTh 组吸收剂量明显较低（50.4Gy 比 52.7Gy），治疗时间明显较短（45.1 天比 47.8 天）。RCTh 组和 RTh 组的生存（59%比 56%）、治疗反应（86%比 90%）、局部复发（42%比 49%）、转移发生率（21%比 17%）、贫血（40%比 26%）、早期放射性肠炎（77%比 65%）、膀胱（71%比 61%）、直肠阴道瘘（10%比 4%）和膀胱阴道瘘（6%比 4%）的发生率无统计学差异。两组之间的差异有统计学意义：恶心（77%比 6%）、呕吐（65%比 3.7%）、白细胞减少（69%比 26%）和血小板减少（35%比 9%）、晚期放射性膀胱影响（94%比 74%）。RCTh 合并贫血患者的 36 个月生存率（42%比 71%）、局部复发率（77%比 31%）和无转移生存率（61%比 90%）均低于 RCTh 无贫血患者。
RCTh 能改善宫颈癌患者贫血和非贫血患者的疗效，且 RCTh 组的总体生存率高于 RTh 组的非贫血患者。晚期宫颈癌的唯一临床预后因素是疾病的临床分期。
