Department of Oncology, Cancer Centre of Southeastern Ontario, Kingston General Hospital, Kingston, Ontario, Canada.
Clin Oncol (R Coll Radiol). 2011 Dec;23(10):691-5. doi: 10.1016/j.clon.2011.05.002. Epub 2011 Jun 8.
To document the incidence, management and outcome of uterine cervix cancer in the Canadian province of Saskatchewan. To compare provincial results of low dose rate (LDR) and high dose rate (HDR) brachytherapy in this population.
We carried out a retrospective population-based cohort study of all uterine cervix cancer cases in Saskatchewan diagnosed between 1985 and 2001. We used data from the provincial cancer registry for incident cases, the provincial death registry for vital status information and chart reviews for treatment and toxicity information.
In total, 714 cases of uterine cervix cancer were identified. Stage distribution was IA 22.7%, IB 31.8%, II 19.1%, III 18.4%, IV 6.8%; 81.2% were squamous cell carcinoma, 13.4% adenocarcinoma, 1.5% adenosquamous, 0.9% small cell and 3.1% other. The annual crude incidence rate of uterine cervix cancer in Saskatchewan ranged from 6.5 to 12.3% between 1985 and 2001. The 5-year cause-specific survival rate ranged from 100% for stage IA1 to 22% for stage IV. One hundred and seven patients were treated with LDR and 37 with HDR with similar stage distribution. The 5-year cause-specific survival rate was 56% for HDR and 67% for LDR (P = 0.72). For 43 patients managed with external beam radiotherapy alone, outcome was poor for stage IIB to IIIB. The most common acute toxicities of radiation treatment were diarrhoea (60%) and abdominal cramps (12.5%). The common chronic toxicities were vaginal stenosis (5.5%) and small bowel obstruction (4%).
Our population-level outcomes are in keeping with published observed results and provide some of the first Canadian population-level data on HDR and LDR outcomes. We found no significant different in cause-specific survival between patients managed with HDR and LDR, although interpretation is limited by patient numbers. Our results for external beam radiotherapy alone emphasise the vital role brachytherapy plays in the management of cervical cancer.
记录加拿大萨斯喀彻温省宫颈癌的发病率、治疗方法和转归。比较该人群中低剂量率（LDR）和高剂量率（HDR）近距离放疗的省级结果。
我们对 1985 年至 2001 年间在萨斯喀彻温省诊断的所有宫颈癌病例进行了回顾性基于人群的队列研究。我们使用省级癌症登记处的数据来确定发病病例，使用省级死亡登记处的数据来确定生存状态信息，并通过图表审查来获取治疗和毒性信息。
共确定了 714 例宫颈癌病例。分期分布为 IA 22.7%、IB 31.8%、II 19.1%、III 18.4%、IV 6.8%；81.2%为鳞状细胞癌，13.4%为腺癌，1.5%为腺鳞癌，0.9%为小细胞癌，3.1%为其他类型。1985 年至 2001 年期间，萨斯喀彻温省宫颈癌的年粗发病率在 6.5%至 12.3%之间。5 年疾病特异性生存率从 IA1 期的 100%到 IV 期的 22%不等。107 例患者接受 LDR 治疗，37 例患者接受 HDR 治疗，分期分布相似。5 年疾病特异性生存率 HDR 为 56%，LDR 为 67%（P=0.72）。对于仅接受外照射放疗的 43 例患者，IIIB 期至 IIIB 期的预后较差。最常见的放射治疗急性毒性为腹泻（60%）和腹痛（12.5%）。常见的慢性毒性为阴道狭窄（5.5%）和小肠梗阻（4%）。
我们的人群水平结果与已发表的观察结果一致，并提供了一些关于 HDR 和 LDR 结果的加拿大首例人群水平数据。我们发现接受 HDR 和 LDR 治疗的患者在疾病特异性生存率方面没有显著差异，尽管由于患者数量有限，解释受到限制。我们仅接受外照射放疗的结果强调了近距离放疗在宫颈癌治疗中的重要作用。
