Sangkittipaiboon Somphob
J Med Assoc Thai. 2014 Jan;97(1):12-9.
To study the treatment outcomes of concurrent chemoradiotherapy with weekly carboplatin in locally-advanced carcinoma of the uterine cervix patients and the complications resulting from the treatment.
Between August 2005 and July 2007, the author identified 105 patients with carcinoma of the uterine cervix. The International Federation of Gynecology and Obstetrics Clinical Stages were IIB, III, and IVA in 83, 19, and three cases, respectively. Mean age was 51.5 years old, ranging from 33 to 79 years. Carboplatin was prescribed weekly concurrent with external irradiation.
The most acute toxicities were in grade 1-2 (grade 3 hematological toxicities were 3.80%). Complete response was achieved in 95 patients (90.5%). Among the 95 responders, 27 experienced recurrences: local recurrences in eight (8.4%), distant failure in 17 (17.9%), and both local and distant failure in two (2.1%). The follow-up time was ranging from three to 96 months (median 76 months). Significant prognostic factors for disease-free survival in multivariate Cox regression analysis were tumor stage and tumor response. With regard to overall survival, multivariate Cox regression analysis confirmed prognostic significance of patients' age, tumor stage, and tumor response. Five-year disease free survival rate was 52.38% (56.63%, 42.11%, and 0% in stage IIB, III, and IVA, respectively) while five-year overall survival rate was 56.19% (61.45%, 42.11%, and 0% in stage IIB, III, and IVA, respectively). Late grade 3-4 gastrointestinal and genitourinary toxicities were 3.2% and 0%, respectively.
Concurrent weekly carboplatin and radiation therapy yields high response rate with modest disease-free and overall survivals in locally advanced carcinoma of the uterine cervix. The regimen is feasible with minimal toxicities. Prognostic factors identified in the present study are consistent with other reports.
研究每周使用卡铂同步放化疗对局部晚期宫颈癌患者的治疗效果及治疗引发的并发症。
2005年8月至2007年7月期间，作者纳入了105例宫颈癌患者。国际妇产科联盟临床分期为IIB期83例、III期19例、IVA期3例。平均年龄51.5岁，范围为33至79岁。卡铂每周给药，与外照射同步进行。
最常见的急性毒性为1 - 2级（3级血液学毒性为3.80%）。95例患者（90.5%）达到完全缓解。在这95例缓解患者中，27例出现复发：局部复发8例（8.4%），远处转移17例（17.9%），局部和远处均复发2例（2.1%）。随访时间为3至96个月（中位时间76个月）。多因素Cox回归分析中，无病生存的显著预后因素为肿瘤分期和肿瘤反应。关于总生存，多因素Cox回归分析证实患者年龄、肿瘤分期和肿瘤反应具有预后意义。五年无病生存率为52.38%（IIB期、III期和IVA期分别为56.63%、42.11%和0%），而五年总生存率为56.19%（IIB期、III期和IVA期分别为61.45%、42.11%和0%）。3 - 4级晚期胃肠道和泌尿生殖系统毒性分别为3.2%和0%。
每周卡铂同步放疗对局部晚期宫颈癌有较高的缓解率，无病生存率和总生存率尚可。该方案毒性小，可行。本研究确定的预后因素与其他报告一致。
