Mayadev Jyoti, Li Chin-Shang, Lim Jihoon, Valicenti Richard, Alvarez Edwin A
Departments of *Radiation Oncology ‡Gynecology Oncology, UC Davis Cancer Center †Department of Public Health Sciences, Division of Biostatics, University of California Davis, Sacramento, CA.
Am J Clin Oncol. 2017 Oct;40(5):451-457. doi: 10.1097/COC.0000000000000187.
We examined the incidence and the effect of alcohol abuse on pelvic control (PC), disease-free survival (DFS), and overall survival (OS) in locally advanced cervical cancer patients undergoing definitive radiation therapy (RT).
Between 2007 and 2013, 95 patients treated with RT were reviewed, and the tumor characteristics, the RT dose, the treatment time, chemotherapy, and the number of cycles were recorded. The association between alcohol abuse and DFS, OS, and the duration of PC was analyzed using multivariable Cox proportional hazards models.
Of the 95 patients with an average age of 54.8 years (range, 27 to 91 y), 30% were FIGO stage 1B1, 1B2, 2A, 52% stage 2B, 3A; and 18% stage 3B; 86% of the patients were treated with weekly cisplatin chemotherapy. Alcohol history showed that 10 (10.5%) patients met the CDC criteria for heavy alcohol use. With a mean follow-up time of 2 years, 85 patients (88.5%) achieved PC and 86 patients (90.5%) were free of distant metastasis. A total of 82 patients (86.3%) were alive at the last follow-up. When controlling for the total treatment time, excessive alcohol abuse was significantly associated with a decrease in DFS (P=0.005; hazard ratio [HR], 6.19; 95% confidence interval [CI]: 1.73, 22.18), OS (P=0.001; HR, 6.68; 95% CI: 2.10, 21.26), and PC (P=0.029; HR, 3.10; 95% CI: 1.13, 8.56) on univariable analysis. On multivariable analysis, excessive alcohol abuse was significantly associated with a decrease in DFS (P=0.005; HR, 10.57; 95% CI: 2.07, 53.93) and OS (P=0.001; HR, 10.80; 95% CI: 2.57, 45.40).
In this small hypothesis-generating series of patients with heavy alcohol use, the data support the association that heavy alcohol use increases the risk of cancer recurrence and mortality. Additional research is required to better define the patient- and treatment-related factors that may be targeted for intervention.
我们研究了酗酒对接受根治性放射治疗（RT）的局部晚期宫颈癌患者盆腔控制（PC）、无病生存期（DFS）和总生存期（OS）的发生率及影响。
回顾了2007年至2013年间接受RT治疗的95例患者，记录其肿瘤特征、RT剂量、治疗时间、化疗及周期数。使用多变量Cox比例风险模型分析酗酒与DFS、OS及PC持续时间之间的关联。
95例患者平均年龄54.8岁（范围27至91岁），30%为国际妇产科联盟（FIGO）1B1、1B2、2A期，52%为2B、3A期，18%为3B期；86%的患者接受了每周顺铂化疗。饮酒史显示，10例（10.5%）患者符合美国疾病控制与预防中心（CDC）重度饮酒标准。平均随访时间为2年，85例（88.5%）患者实现了PC，86例（90.5%）患者无远处转移。最后一次随访时共有82例（86.3%）患者存活。在控制总治疗时间后，单变量分析显示，过度酗酒与DFS降低显著相关（P = 0.005；风险比[HR]，6.19；95%置信区间[CI]：1.73，22.18）、OS降低显著相关（P = 0.001；HR，6.68；95% CI：2.10，21.26）以及PC降低显著相关（P = 0.029；HR，3.10；95% CI：1.13，8.56）。多变量分析显示，过度酗酒与DFS降低显著相关（P = 0.005；HR，10.57；95% CI：2.07，53.93）和OS降低显著相关（P = 0.001；HR，10.80；95% CI：2.57，45.40）。
在这个关于重度饮酒患者的小型探索性系列研究中，数据支持重度饮酒会增加癌症复发和死亡风险的关联。需要进一步研究以更好地确定可能作为干预靶点的患者及治疗相关因素。
