放疗前化疗反应对晚期宫颈癌的预后价值。
The prognostic value of a response to chemotherapy given before radiotherapy in advanced cancer of cervix.
作者信息
Symonds R P, Burnett R A, Habeshaw T, Kaye S B, Snee M P, Watson E R
机构信息
Beatson Oncology Centre, Western Infirmary, Glasgow, UK.
出版信息
Br J Cancer. 1989 Mar;59(3):473-5. doi: 10.1038/bjc.1989.98.
Forty patients with stage III and 15 patients with stage IVa carcinoma of cervix have been treated with two pulses of cisplatin, vincristine and bleomycin combination chemotherapy before full dose radical radiotherapy. Twenty-seven of 51 (53%, 95% confidence interval 40-67%) had an objective response to chemotherapy and all chemotherapy responders had a complete response to radiotherapy. The actuarial survival at 24 months of responders to chemotherapy is 71% against 37% for non-responders. The responding patients had an estimated reduction in mortality to 36% (P = 0.014, 95% CI 15-81%) of that of the non-responders to chemotherapy. The incidence of tumour recurrence or distant metastases showed a similar reduction to 34% (P = 0.006, 95% CI 14-73%) of that of the non-responders. The data strongly suggest that response to chemotherapy in the initial treatment of advanced cervical cancer is associated with an improvement in survival following subsequent radical radiotherapy.
51例宫颈癌患者（40例III期和15例IVa期）在接受全剂量根治性放疗前接受了两周期顺铂、长春新碱和博来霉素联合化疗。51例中有27例（53%，95%置信区间40-67%）对化疗有客观反应，所有化疗有反应者对放疗均有完全反应。化疗有反应者24个月的精算生存率为71%，无反应者为37%。有反应患者的死亡率估计降至化疗无反应者的36%（P = 0.014，95%置信区间15-81%）。肿瘤复发或远处转移的发生率也有类似降低，降至化疗无反应者的34%（P = 0.006，95%置信区间14-73%）。数据强烈表明，晚期宫颈癌初始治疗中对化疗的反应与随后根治性放疗后的生存改善相关。
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