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ⅡB-ⅢA 期宫颈癌放疗、化疗联合热疗三联模式治疗的长期生存数据 - 更新。

Long-term survival data of triple modality treatment of stage IIB-III-IVA cervical cancer with the combination of radiotherapy, chemotherapy and hyperthermia - an update.

机构信息

Academic Medical Centre, Amsterdam, the Netherlands.

出版信息

Int J Hyperthermia. 2012;28(6):549-53. doi: 10.3109/02656736.2012.673047. Epub 2012 Jul 13.

DOI:10.3109/02656736.2012.673047
PMID:22788973
Abstract

BACKGROUND

Advanced cervical cancer is routinely treated with radiotherapy and cisplatin-containing chemotherapy. Hyperthermia has been shown to improve the results of both radiotherapy and cisplatin. The feasibility of the combination of all three modalities was demonstrated and reported in a study of 68 previously untreated cervical cancer patients in 2005. Long-term follow-up is presented here.

METHODS

Sixty-eight patients with advanced cervical cancer were prospectively registered in the USA, Norway and the Netherlands, and treated with a combination of radiotherapy (external beam radiotherapy and brachytherapy for a biologically effective dose of at least 86.7 Gy), chemotherapy (at least four courses of weekly cisplatin (40 mg/m(2))) and locoregional hyperthermia (four weekly sessions). Long-term follow-up was gathered and recurrence-free survival (RFS) and overall survival (OS) curves and survival estimates were obtained.

RESULTS

Median follow-up was 81 months. Tumours in 28 patients have recurred, 21 of whom have died. Five-year RFS from the day of registration in the study is 57.5% (95%CI: 46.6-71.0) and five-year OS is 66.1% (95%CI: 55.1-79.3). Differences between countries can be explained by patient characteristics.

CONCLUSION

The long-term survival results of the combination of full-dose radiotherapy, chemotherapy and hyperthermia fall well within previous reports for this patient group in randomised trials. The small trial size and lack of randomisation do not permit further interpretation.

摘要

背景

中晚期宫颈癌的常规治疗方法为放疗联合含顺铂的化疗。热疗已被证实可提高放疗和顺铂的疗效。在 2005 年的一项研究中,对 68 例未经治疗的宫颈癌患者进行了三种方式联合治疗的可行性研究,并进行了报道。本研究对该组患者进行了长期随访。

方法

68 例中晚期宫颈癌患者在美国、挪威和荷兰前瞻性登记,接受放疗(外照射放疗和近距离放疗,生物有效剂量至少 86.7Gy)、化疗(至少 4 个疗程的每周顺铂[40mg/m2])和局部热疗(每周 4 次)联合治疗。收集长期随访资料,计算无复发生存率(RFS)和总生存率(OS)曲线和生存率估计值。

结果

中位随访时间为 81 个月。28 例患者肿瘤复发,其中 21 例死亡。研究登记日起的 5 年 RFS 为 57.5%(95%CI:46.6-71.0),5 年 OS 为 66.1%(95%CI:55.1-79.3)。国家间的差异可归因于患者特征的不同。

结论

全剂量放疗、化疗和热疗联合治疗的长期生存结果与随机试验中该患者组的既往报告结果相当。由于试验规模小且缺乏随机分组,故无法进一步解释。

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