Department of Radiation Oncology, University of California Irvine, Orange, California, USA.
Int J Radiat Oncol Biol Phys. 2013 Mar 1;85(3):714-20. doi: 10.1016/j.ijrobp.2012.05.033. Epub 2012 Jul 3.
The purpose of this study was to determine locoregional control (LRC), disease-free survival (DFS), and toxicity of high-dose-rate interstitial brachytherapy (HDR-ISBT) in the treatment of locally advanced cervical cancer.
Between March 1996 and May 2009, 116 patients with cervical cancer were treated. Of these, 106 (91%) patients had advanced disease (International Federation of Gynecology and Obstetrics stage IIB-IVA). Ten patients had stage IB, 48 had stage II, 51 had stage III, and 7 had stage IVA disease. All patients were treated with a combination of external beam radiation therapy (EBRT) to the pelvis (5040 cGy) and 2 applications of HDR-ISBT to a dose of 3600 cGy to the implanted volume. Sixty-one percent of patients also received interstitial hyperthermia, and 94 (81%) patients received chemotherapy.
Clinical LRC was achieved in 99 (85.3%) patients. Three-year DFS rates were 59%, 67%, 71%, and 57% for patients with stage IB, II, III, and IVA disease, respectively. The 5-year DFS and overall survival rates for the entire group were 60% and 44%, respectively. Acute and late toxicities were within acceptable limits.
Locally advanced cervical cancer patients for whom intracavitary BT is unsuitable can achieve excellent LRC and OS with a combination of EBRT and HDR-ISBT.
本研究旨在确定局部晚期宫颈癌患者接受高剂量率间质近距离放疗（HDR-ISBT）治疗的局部控制率（LRC）、无疾病生存率（DFS）和毒性。
1996 年 3 月至 2009 年 5 月期间，共治疗了 116 例宫颈癌患者。其中，106 例（91%）患者为晚期疾病（国际妇产科联合会分期 IIB-IVA）。10 例为 IB 期，48 例为 II 期，51 例为 III 期，7 例为 IVA 期。所有患者均接受盆腔外照射放疗（EBRT）（5040 cGy）联合 2 次 HDR-ISBT 治疗，植入体积剂量为 3600 cGy。61%的患者还接受了间质热疗，94 例（81%）患者接受了化疗。
99 例（85.3%）患者达到临床 LRC。IB、II、III 和 IVA 期患者的 3 年 DFS 率分别为 59%、67%、71%和 57%。全组患者的 5 年 DFS 和总生存率分别为 60%和 44%。急性和晚期毒性均在可接受范围内。
对于不适合腔内 BT 的局部晚期宫颈癌患者，EBRT 和 HDR-ISBT 联合治疗可获得优异的 LRC 和 OS。
