合并症是否会影响接受辅助放疗加近距离放疗的老年子宫内膜癌患者的急性毒性和结局？
Do comorbidity influences acute toxicity and outcome in elderly patients with endometrial cancer treated by adjuvant radiotherapy plus brachytherapy?
机构信息
Department of Radiation Oncology, IRCCS-CROB, Via S. Pio 1, 85028, Rionero in Vulture, PZ, Italy.
出版信息
Clin Transl Oncol. 2013 Aug;15(8):665-9. doi: 10.1007/s12094-012-0986-9. Epub 2013 Jan 29.
PURPOSE
To correlate comorbidity and acute radiation toxicity in elderly patients treated with adjuvant external beam radiotherapy (EBRT) plus brachytherapy-high dose rate (HDR-BRT) for endometrial cancer (EC).
METHODS
Endometrial cancer patients over 65 were treated and evaluated for comorbidity assessment with ACE-27 and Charlson comorbidity index (CCI). EBRT total dose was 45-50.4 Gy (1.8 Gy/day). The vault vagina boost of dose was performed by HDR-BRT with 2/3 fractions with a total dose of 10-15 Gy.
RESULTS
From 2008 to 2011, 35 patients were analyzed. Eighteen patients (51.43 %) had not ACE-27 comorbidity; while 27 patients (77.14 %) had CCI lower than three. During treatment, acute toxicity was mild and not influenced by the comorbidity score. Two-year Progression Free and Overall Survival were 69 and 80 %. ACE-27 and CCI did not affect progression-free survival (p = 0.51, p = 0.3) and OS (p = 0.26, p = 0.5).
CONCLUSION
External beam radiotherapy plus BRT-HDR are well tolerated in EC elderly with good performance status and low comorbidity profile.
目的
分析接受辅助外照射放疗（EBRT）加高剂量率近距离放疗（HDR-BRT）治疗的老年子宫内膜癌（EC）患者的合并症与急性放射毒性之间的相关性。
方法
对 65 岁以上的子宫内膜癌患者进行合并症评估，采用 ACE-27 和 Charlson 合并症指数（CCI）评估合并症。EBRT 总剂量为 45-50.4 Gy（1.8 Gy/天）。采用 HDR-BRT 进行阴道穹窿 2/3 部分剂量加量，总剂量为 10-15 Gy。
结果
2008 年至 2011 年，共分析了 35 例患者。18 例（51.43%）患者无 ACE-27 合并症；27 例（77.14%）患者 CCI 低于 3 分。治疗期间，急性毒性反应较轻，与合并症评分无关。2 年无进展生存率和总生存率分别为 69%和 80%。ACE-27 和 CCI 均不影响无进展生存率（p=0.51，p=0.3）和 OS（p=0.26，p=0.5）。
结论
对于体能状态良好且合并症低危的老年 EC 患者，EBRT 联合 BRT-HDR 治疗具有良好的耐受性。
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