All authors: Campinas State University, Campinas, São Paulo, Brazil.
J Clin Oncol. 2014 Feb 20;32(6):542-7. doi: 10.1200/JCO.2013.50.1205. Epub 2014 Jan 21.
The benefits of chemoradiotherapy (CRT) for cervical cancer compared with radiation (RT) alone seem to diminish in later-stage disease. However, these modalities have not been directly compared for disease-free interval (DFI) and overall survival (OS) of women with stage IIIB cervical cancer.
We conducted a randomized controlled clinical trial comparing DFI and OS of 147 women with stage IIIB squamous cervical cancer who received either cisplatin plus RT (CRT) or RT alone (72 patients in the CRT group and 75 patients in the RT-only group).
The CRT group had significantly better DFI (hazard ratio [HR], 0.52; 95% CI, 0.29 to 0.93; P = .02). However, patients in the CRT group did not have significantly better OS than those in the RT-only group (HR, 0.67; 95% CI, 0.38 to 1.17; P = .16). Toxicity was graded according to criteria of the Radiation Therapy Oncology Group. The organs affected (excluding hematologic effects) did not differ significantly between groups. Also, late toxicity events and organs affected were not significantly disproportionate between the study groups.
For stage IIIB cervical cancer, the addition of cisplatin offers a small but significant benefit in DFI, with acceptable toxicity.
与单独放疗（RT）相比，宫颈癌的放化疗（CRT）的益处似乎在晚期疾病中减弱。然而，对于 IIIB 期宫颈癌患者，尚未直接比较这些方法的无病间隔（DFI）和总生存期（OS）。
我们进行了一项随机对照临床试验，比较了 147 名接受顺铂联合 RT（CRT）或单独 RT（CRT 组 72 例，仅 RT 组 75 例）的 IIIB 期宫颈鳞癌患者的 DFI 和 OS。
CRT 组的 DFI 明显更好（风险比 [HR]，0.52；95%置信区间，0.29 至 0.93；P =.02）。然而，CRT 组的 OS 并不优于仅 RT 组（HR，0.67；95%置信区间，0.38 至 1.17；P =.16）。毒性根据放射治疗肿瘤学组的标准进行分级。各组之间受影响的器官（不包括血液学效应）没有显著差异。此外，两组之间晚期毒性事件和受影响的器官没有显著不成比例。
对于 IIIB 期宫颈癌，顺铂的加入在 DFI 方面提供了微小但有意义的益处，且毒性可接受。
