Busch M, Dühmke E, Kuhn W, Teichmann A
Klinik und Poliklinik für Strahlentherapie, Georg-August-Universität, Göttingen.
Strahlenther Onkol. 1991 Nov;167(11):628-37.
219 patients suffering from cervix carcinoma received definitive radiation therapy using moderate doses of external beam therapy and high dose-rate afterloading brachytherapy from 1979 to 1986. At five years, the actuarial survival (AS) for stage Ib patients was 81%, for stage IIa 53%, for stage IIb 56%, for stage IIIa 25%, for stage IIIb 33% and for stages IVa and IVb 0%. Significant prognostic factors for actuarial survival were FIGO stage, histological type, grading and, marginally, age of the patient at the time of diagnosis. The survival data censored for death caused by intercurrent disease (tumor related survival, TUS) at five years were: 90% (Ib), 66% (IIa), 63% (IIb), 50% (IIIa), 41% (IIIb) and 0% (IVa and IVb). The prognostic factors were stage and grading. Age and histology failed to be a significant prognostic factor. The disease-free survival (DFS) according to FIGO stage at five years were: Ib 84%, IIa 64%, IIb 59%, IIIa 50%, IIIb 38%, IVa and IVb 0%. Prognostic factors for disease-free survival were limited to FIGO stage and grading. The five-year local control results (LC) according to stage were 90% (Ib), 64% (IIa), 67% (IIb), 43% (IIIb) and 0% (IVa and IVb) with stage as prognostic factor. High dose-rate afterloading therapy for cervix carcinoma yields good results for local control and survival with a low ratio of severe side effects (6%). Radiation therapy eliminates the prognostic influence of histological type and grading of the tumor on local control. External beam and afterloading doses, however, are relevant factors for prognosis, if the patients are stratified by FIGO stage.
1979年至1986年期间，219例宫颈癌患者接受了中等剂量外照射和高剂量率后装近距离放疗的根治性放射治疗。五年时，Ⅰb期患者的精算生存率（AS）为81%，Ⅱa期为53%，Ⅱb期为56%，Ⅲa期为25%，Ⅲb期为33%，Ⅳa期和Ⅳb期为0%。精算生存的显著预后因素为国际妇产科联盟（FIGO）分期、组织学类型、分级，以及在诊断时患者的年龄（影响较小）。五年时因并发疾病导致死亡而删失的生存数据（肿瘤相关生存，TUS）为：90%（Ⅰb期）、66%（Ⅱa期）、63%（Ⅱb期）、50%（Ⅲa期）、41%（Ⅲb期）和0%（Ⅳa期和Ⅳb期）。预后因素为分期和分级。年龄和组织学未能成为显著的预后因素。根据FIGO分期的五年无病生存率（DFS）为：Ⅰb期84%，Ⅱa期64%，Ⅱb期59%，Ⅲa期50%，Ⅲb期38%，Ⅳa期和Ⅳb期0%。无病生存的预后因素仅限于FIGO分期和分级。根据分期的五年局部控制结果（LC）为：90%（Ⅰb期）、64%（Ⅱa期）、67%（Ⅱb期）、43%（Ⅲb期）和0%（Ⅳa期和Ⅳb期），分期为预后因素。宫颈癌的高剂量率后装治疗在局部控制和生存方面取得了良好效果，严重副作用发生率较低（6%）。放射治疗消除了肿瘤组织学类型和分级对局部控制的预后影响。然而，如果根据FIGO分期对患者进行分层，外照射剂量和后装剂量是预后的相关因素。
