Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan.
Radiat Oncol. 2009 Dec 10;4:62. doi: 10.1186/1748-717X-4-62.
To review the experience and to evaluate the treatment plan of using helical tomotherapy (HT) for the treatment of cervical cancer.
Between November 1st, 2006 and May 31, 2009, 10 cervical cancer patients histologically confirmed were enrolled. All of the patients received definitive concurrent chemoradiation (CCRT) with whole pelvic HT (WPHT) followed by brachytherapy. During WPHT, all patients were treated with cisplatin, 40 mg/m2 intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0).
The mean survival was 25 months (range, 3 to 27 months). The actuarial overall survival, disease-free survival, locoregional control and distant metastasis-free rates at 2 years were 67%, 77%, 90% and 88%, respectively. The average of uniformity index and conformal index was 1.06 and 1.19, respectively. One grade 3 of acute toxicity for diarrhea, thrombocytopenia and three grade 3 leucopenia were noted during CCRT. Only one grade 3 of subacute toxicity for thrombocytopenia was noted. There were no grade 3 or 4 subacute toxicities of anemia, leucopenia, genitourinary or gastrointestinal effects. Compared with conventional whole pelvic radiation therapy (WPRT), WPHT decreases the mean dose to rectum, bladder and intestines successfully.
HT provides feasible clinical outcomes in locally advanced cervical cancer patients. Long-term follow-up and enroll more locally advanced cervical carcinoma patients by limiting bone marrow radiation dose with WPHT technique is warranted.
回顾使用螺旋断层放疗（HT）治疗宫颈癌的经验并评估治疗方案。
2006 年 11 月 1 日至 2009 年 5 月 31 日期间，共纳入 10 例经组织学证实的宫颈癌患者。所有患者均接受根治性同期放化疗（CCRT），采用全盆腔 HT（WPHT）联合近距离放疗。在 WPHT 期间，所有患者每周接受 40mg/m2 顺铂静脉化疗。毒性反应按照常见不良事件术语标准 3.0（CTCAE v3.0）进行评分。
中位生存时间为 25 个月（范围：3-27 个月）。2 年总生存率、无病生存率、局部区域控制率和无远处转移生存率分别为 67%、77%、90%和 88%。均匀性指数和适形性指数的平均值分别为 1.06 和 1.19。CCRT 期间，有 1 例发生 3 级腹泻、血小板减少症和 3 例 3 级白细胞减少症。仅 1 例发生 3 级亚急性血小板减少症。无 3 级或 4 级亚急性贫血、白细胞减少、泌尿生殖系统或胃肠道毒性。与常规全盆腔放疗（WPRT）相比，WPHT 可成功降低直肠、膀胱和肠道的平均剂量。
HT 为局部晚期宫颈癌患者提供了可行的临床结果。需要长期随访，并通过 WPHT 技术限制骨髓照射剂量，以纳入更多局部晚期宫颈癌患者。
