Kornovski Y, Ismail E, Kaneva M
Akush Ginekol (Sofiia). 2012;51(4):24-9.
To establish the overall and disease-free survival and the role of surgery as well as in cervical cancer stage IIB (FIGO) patients submitted to combined radiotherapy and surgery.
Between 2003-2011 86 patients with cervical cancer stage IIB had been operated on. Five patients were operated on after neoajuvant chemotherapy. Thirty one women (group 3) had primary pelvic surgery (radical hysterectomy class III and lymphonodulectomy) and adjuvant RT until 52 Gy and 50 women were operated on after preoperative RT (30 Gy) and were submitted to adjuvant RT until 52 Gy (group 4).
After median follow of 45 months the acturial overall and disease-free survival (OS and DFS) were estimated as 75.6% and 77.9% respectively for all patients staged IIB (FIGO). In group 3 the incidence of local relapses and distant metastases was 9.7% and 12.9%, respectively and in group 4--local and distant recurrences were 6% and 14%, respectively. The acturial OS and DFS for group 3 were 80.6% and 77.5%, respectively and for group 4--76% and 80% (NS).
Combinated treatment (RT and pelvic surgery) produce reliable local control of the disease (cervical cancer IIB stage) but is ineffective for metastases outside the small pelvis which is the cause of worse survival of patients with cervical cancer stage IIB (FIGO). Preoperative RT (group 4) doesn't change the OS and DFS significantly. The main indication for surgery in patients with cervical cancer stage IIB is the surgical staging (pelvic and paraaortic lymph node dissection) which enables the appropriate individual treatment planning.
确定接受放化疗联合手术治疗的国际妇产科联盟（FIGO）IIB期宫颈癌患者的总生存率和无病生存率，以及手术的作用。
2003年至2011年间，86例IIB期宫颈癌患者接受了手术治疗。5例患者在新辅助化疗后接受手术。31名女性（第3组）接受了原发性盆腔手术（III级根治性子宫切除术和淋巴结清扫术），并接受辅助放疗至52 Gy；50名女性在术前放疗（30 Gy）后接受手术，并接受辅助放疗至52 Gy（第4组）。
中位随访45个月后，所有IIB期（FIGO）患者的实际总生存率和无病生存率（OS和DFS）分别估计为75.6%和77.9%。第3组局部复发和远处转移的发生率分别为9.7%和12.9%，第4组局部和远处复发率分别为6%和14%。第3组的实际OS和DFS分别为80.6%和77.5%，第4组为76%和80%（无统计学差异）。
联合治疗（放疗和盆腔手术）能有效实现疾病（IIB期宫颈癌）的局部控制，但对小骨盆以外的转移无效，这是IIB期（FIGO）宫颈癌患者生存率较低的原因。术前放疗（第4组）对OS和DFS无显著影响。IIB期宫颈癌患者手术的主要指征是手术分期（盆腔和腹主动脉旁淋巴结清扫），这有助于制定合适的个体化治疗方案。
