Mancebo G, Gil-Moreno A, Vergés R, Martínez-Palones J M, Checa M A, Carreras J M R, Giralt J, Xercavins J
Gynecology Oncology Unit, Department of Obstetrics and Gynecology, Barcelona, Spain.
Eur J Gynaecol Oncol. 2010;31(1):18-22.
We assessed the feasibility, response rates, and overall survival of patients with locally advanced cervical cancer treated with cisplatin-based chemotherapy during radiation therapy on an out-of-protocol basis.
Sixty-nine consecutive newly diagnosed untreated patients with locally advanced cervical cancer who received chemoradiation between 1999 and 2003 were retrospectively reviewed. Treatment consisted in external beam radiation followed by one 137-cessium intracavitary application. Cisplatin was administered for six weeks during external beam radiation.
Treatment was well tolerated, although 52 patients presented some degree of acute adverse toxicity (gastrointestinal 65%, hematological 48%, genitourinary 10%). The 3-year survival rate was 61.8% (95% CI 54.5-69.0), with a mean 41.8 months (95% CI 35.7-48.3). Overall survival after adjusting by FIGO Stage IB2-IIA and IIB-IVA was 73.9% and 50%, respectively (p = 0.1839). Overall survival according to Stages IB2-IIb and III-IVA was 74.8% and 34.9%, respectively (P = 0.0376).
In patients with locally advanced cervical cancer, adding a weekly regimen of cisplatin to standard pelvic radiation in an out-of-protocol basis is feasible, effective, and showed no unexpected toxicity.
我们评估了局部晚期宫颈癌患者在放疗期间接受基于顺铂的化疗（非按方案进行）的可行性、缓解率和总生存率。
回顾性分析了1999年至2003年间连续69例新诊断的未经治疗的局部晚期宫颈癌患者，这些患者接受了放化疗。治疗包括外照射放疗，随后进行一次铯-137腔内照射。在体外照射放疗期间，顺铂给药6周。
治疗耐受性良好，尽管52例患者出现了一定程度的急性不良反应（胃肠道反应65%，血液学反应48%，泌尿生殖系统反应10%）。3年生存率为61.8%（95%可信区间54.5 - 69.0），平均生存期为41.8个月（95%可信区间35.7 - 48.3）。根据国际妇产科联盟（FIGO）分期IB2-IIA和IIB-IVA调整后的总生存率分别为73.9%和50%（p = 0.1839）。根据分期IB2-IIb和III-IVA的总生存率分别为74.8%和34.9%（P = 0.0376）。
对于局部晚期宫颈癌患者，在非按方案进行的情况下，在标准盆腔放疗基础上加用每周一次的顺铂方案是可行、有效的，且未显示出意外的毒性。
