Kadkhodayan Sima, Homaei Shandiz Fatemeh, Seilanian Toussi Mehdi, Afzal Aghaee Monavar, Farshidi Farnoosh, Dehghan Parvane
Women's Health Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Solid Tumor Treatment Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Cancer Prev. 2013 Fall;6(4):195-200.
Concurrent chemoradiotherapy (EBRT + cisplatin) plus intracavitary brachytherapy is the standard of care in patients with advanced cervical cancer. However, a number of patients could not undergone brachytherapy due to massive residual tumor or anatomical distortion. In this study, we have evaluated the treatment outcome in patients with locally advanced cervical cancer, undergone conventional EBRT plus cisplatin based chemotherapy.
IN THIS STUDY, WE HAVE SELECTED PATIENTS WITH LOCALLY ADVANCED CERVICAL CARCINOMA (STAGE: IIB to IIIB) undergone external beam radiotherapy and chemotherapy without brachytherapy at our institute between October of 2007 and October of 2009. The patients have received 50 Gy within 5 weeks to whole pelvic that has followed by a localized boost dose on tumor to 70 Gy concurrently with cisplatin 35 mg/m2 weekly. The treatment has related toxicities, and survival (overall and disease free) have evaluated.
30 cases with a median age of 55 (range; 40 to 73) have been studied. According to FIGO classification, the clinical stages were as follows: stage: IIB 23, IIIA 4, and IIIB 3 cases. Three months after treatment, 19 patients (63.3%) have achieved complete response. With a median follow up time of 18 months (range; 10-33 months), 8/23 cases (34.7%) with stage IIB and 2/7 (28.5%) among stage IIIA-IIIB remained disease free at the end of follow up. Data have shown a 2-year overall survival rate of 58.7% ± 9% and 2- year disease free survival of 37.7% ± 9% . Most toxicities were grade I and II. 2 (6.6%) grade III diarrhea and 4 (13.3%) grade III neutropenia have recorded.
Although a considerable number of patients have achieved complete response using concurrent chemoradiotherapy without brachytherapy, the overall treatment outcomes especially for stage IIIA-IIIB were unsatisfactory. Using modern radiation therapy techniques with increased delivered boost dose could improve treatment results.
同步放化疗（体外放疗+顺铂）联合腔内近距离放疗是晚期宫颈癌患者的标准治疗方案。然而，许多患者由于大量残留肿瘤或解剖结构变形而无法接受近距离放疗。在本研究中，我们评估了接受传统体外放疗联合顺铂化疗的局部晚期宫颈癌患者的治疗结果。
在本研究中，我们选取了2007年10月至2009年10月期间在我院接受体外放疗和化疗且未接受近距离放疗的局部晚期宫颈癌（分期：IIB至IIIB期）患者。患者在5周内接受全盆腔50 Gy的照射，随后对肿瘤进行局部加量至70 Gy，同时每周给予顺铂35 mg/m²。评估了治疗相关毒性以及生存情况（总生存和无病生存）。
研究了30例患者，中位年龄为55岁（范围：40至73岁）。根据国际妇产科联盟（FIGO）分类，临床分期如下：IIB期23例，IIIA期4例，IIIB期3例。治疗后3个月，19例患者（63.3%）达到完全缓解。中位随访时间为18个月（范围：10至33个月），随访结束时，IIB期的8/23例（34.7%）和IIIA-IIIB期的2/7例（28.5%）仍无疾病进展。数据显示2年总生存率为58.7%±9%，2年无病生存率为37.7%±9%。大多数毒性为I级和II级。记录到2例（6.6%）III级腹泻和4例（13.3%）III级中性粒细胞减少。
尽管相当数量的患者使用同步放化疗且未进行近距离放疗已达到完全缓解，但总体治疗结果，尤其是IIIA-IIIB期的结果并不理想。采用提高加量剂量的现代放疗技术可能会改善治疗效果。
