Department of Obstetrics and Gynecology, University of the Ryukyus, Okinawa 903-0215, Japan.
Anticancer Res. 2011 Apr;31(4):1437-41.
To identify predictive factors for locoregional recurrence in patients with FIGO stage IB-IIB cervical cancer treated with concurrent chemoradiotherapy (CCRT).
Data were analyzed for 123 patients with FIGO stage IB-IIB squamous cell carcinoma of the cervix between 1997 and 2007. Eligibility for CCRT included tumor size >4 cm and/or lymph node enlargement over a minimum diameter of 1 cm.
Tumor size (≥5.2 cm) and age (<48 years) were independent predictive factors for locoregional recurrence by multivariate analysis. Based on these two factors, the patients were divided into low-risk (n=91) and high-risk (n=32) groups for locoregional recurrence. The 5-year disease-free survival for the low-risk group was 95.3%, which was significantly better than 65.5% for the high-risk group (p<0.0001). Locoregional recurrence was noted in 10 out of the 32 patients in the high-risk group compared to only 3 out of the 91 patients in the low-risk group.
To improve locoregional control in the high-risk group, it may be worthwhile to consider CCRT using new radiosensitizing agents, adjuvant hysterectomy or adjuvant chemotherapy.
确定接受同期放化疗（CCRT）治疗的FIGO 分期 IB-IIB 宫颈癌患者局部区域复发的预测因素。
对 1997 年至 2007 年间 123 例 FIGO 分期 IB-IIB 宫颈鳞癌患者的数据进行了分析。CCRT 的入选标准包括肿瘤大小>4cm 和/或淋巴结最小直径>1cm 肿大。
多因素分析显示肿瘤大小（≥5.2cm）和年龄（<48 岁）是局部区域复发的独立预测因素。根据这两个因素，患者被分为局部区域复发低危（n=91）和高危（n=32）组。低危组 5 年无病生存率为 95.3%，明显优于高危组的 65.5%（p<0.0001）。高危组 32 例患者中有 10 例出现局部区域复发，而低危组 91 例患者中只有 3 例出现局部区域复发。
为了提高高危组的局部区域控制率，考虑使用新的放射增敏剂、辅助性子宫切除术或辅助化疗进行 CCRT 可能是值得的。
