Podczaski E, Stryker J A, Kaminski P, Ndubisi B, Larson J, DeGeest K, Sorosky J, Mortel R
Department of Obstetrics and Gynecology, M. S. Hershey Medical Center, Pennsylvania State University 17033.
Cancer. 1990 Jul 15;66(2):251-8. doi: 10.1002/1097-0142(19900715)66:2<251::aid-cncr2820660210>3.0.co;2-e.
The survival of cervical carcinoma patients with paraaortic/high common iliac nodal metastases was evaluated by retrospective chart review during a 13-year interval. Thirty-three patients with cervical carcinoma and surgically documented nodal metastases received primary, extended-field radiation therapy. Overall 2-year and 5-year actuarial survival rates after diagnosis were 37% and 31%, respectively. Survival was analyzed in terms of the variables patient age, clinical stage, tumor histologic type, the presence of enlarged paraaortic/high common iliac lymph nodes, the extent of nodal involvement (microscopic versus macroscopic), the presence of intraperitoneal disease, and whether intracavitary brachytherapy was administered. The use of intracavitary radiation therapy was associated with improved local control and survival (P = 0.017). None of the other variables were statistically related to patient survival. Twenty-two of the patients died of cervical cancer and five are surviving without evidence of cancer. Four patients died of intercurrent disease. Two patients developed bowel-related radiation complications; both patients received chemotherapy concurrent with the radiation therapy. One of the two patients died of radiation enteritis. The use of extended-field radiation therapy does benefit a small group of patients and may result in extended patient survival.
通过回顾性病历审查，对13年间患有主动脉旁/髂总淋巴结高位转移的宫颈癌患者的生存情况进行了评估。33例经手术证实有淋巴结转移的宫颈癌患者接受了原发性扩大野放射治疗。诊断后的总体2年和5年精算生存率分别为37%和31%。根据患者年龄、临床分期、肿瘤组织学类型、主动脉旁/髂总淋巴结高位肿大情况、淋巴结受累程度（微观与宏观）、腹腔内疾病情况以及是否进行腔内近距离放射治疗等变量对生存情况进行了分析。腔内放射治疗的使用与局部控制和生存率的提高相关（P = 0.017）。其他变量均与患者生存无统计学关联。22例患者死于宫颈癌，5例存活且无癌症迹象。4例患者死于并发疾病。2例患者出现与肠道相关的放射并发症；这两名患者在放射治疗期间均接受了化疗。两名患者中有一名死于放射性肠炎。扩大野放射治疗的使用确实使一小部分患者受益，并可能延长患者生存期。
