比较局部晚期宫颈癌中鳞癌和腺癌的治疗效果。

Comparison of treatment outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer.

机构信息

Radiation Oncology Unit, Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.

出版信息

Gynecol Oncol. 2012 May;125(2):292-6. doi: 10.1016/j.ygyno.2012.01.034. Epub 2012 Jan 28.

DOI:10.1016/j.ygyno.2012.01.034

PMID:22293041

Abstract

OBJECTIVE

To compare the treatment outcomes between squamous cell carcinoma (SCC) and adenocarcinoma (ACA) in locally advanced cervical cancer patients.

METHODS

All medical records of stages IIB-IVA of cervical cancer patients who had completed treatment between 1995 and 2008 were reviewed. ACA 1 case was matched for SCC 2 cases with clinical stage, tumor size, treatment modalities (radiation therapy (RT) vs concurrent chemoradiation (CCRT)). Treatment outcomes including response to RT/CCRT, time to complete response (CR), patterns of treatment failure and survival outcomes were analyzed.

RESULTS

A total of 423 patients with stages IIB-IVA (141 ACA: 282 SCC) were included. Most of the patients (about 60%) had stage IIB. The overall complete responses (CR) between ACA and SCC were 86.5% and 94.7%, respectively (p=0.004). Median time to clinical CR from RT/CCRT of ACA were 2 months (0-5 months) compared with 1 month (0-4 months) for SCC (p=0.001). Pelvic recurrence and distant failure were found in 2.1% and 14.9% in ACA, and corresponding with 3.9% and 15.6% in SCC. The 5-year overall survival rates of ACA compared to SCC were 59.9% and 61.7% (p=0.191), respectively. When all prognostic factors are adjusted, clinical staging was the only factor that influenced overall survival.

CONCLUSION

ACA in locally advanced cervical cancer had poorer response rate from treatment and also used longer time to achieve CR than SCC. However, these effects were not determinants of survival outcomes.

摘要

目的

比较局部晚期宫颈癌中鳞状细胞癌（SCC）和腺癌（ACA）患者的治疗结果。

方法

回顾分析 1995 年至 2008 年间完成治疗的 IIB-IVA 期宫颈癌患者的所有病历。对 1 例 ACA 与 2 例 SCC 进行临床分期、肿瘤大小、治疗方式（放疗（RT）与同期放化疗（CCRT））匹配。分析治疗结果，包括 RT/CCRT 反应、达到完全缓解（CR）的时间、治疗失败模式和生存结果。

结果

共纳入 423 例 IIB-IVA 期（141 例 ACA：282 例 SCC）患者。约 60%的患者为 IIB 期。ACA 和 SCC 的总完全缓解（CR）率分别为 86.5%和 94.7%（p=0.004）。从 RT/CCRT 开始，ACA 的临床 CR 中位时间为 2 个月（0-5 个月），而 SCC 为 1 个月（0-4 个月）（p=0.001）。ACA 中盆腔复发和远处转移的发生率分别为 2.1%和 14.9%，而 SCC 为 3.9%和 15.6%。ACA 和 SCC 的 5 年总生存率分别为 59.9%和 61.7%（p=0.191）。当调整所有预后因素后，临床分期是唯一影响总生存的因素。