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对于FIGO IIB期宫颈鳞癌的年轻绝经前患者,新辅助化疗后行根治性手术作为同步放化疗的替代治疗方案。

Neoadjuvant chemotherapy followed by radical surgery as an alternative treatment to concurrent chemoradiotherapy for young premenopausal patients with FIGO stage IIB squamous cervical carcinoma.

作者信息

Yang ShanShan, Gao Ying, Sun Jing, Xia Bairong, Liu TianBo, Zhang HongXia, Li Qi, Xiao Min, Zhang YunYan

机构信息

Department of Gynecological Radiotherapy, The Affiliated Tumor Hospital of Harbin Medical University, Harbin, 150081, China.

出版信息

Tumour Biol. 2015 Jun;36(6):4349-56. doi: 10.1007/s13277-015-3074-2. Epub 2015 Jan 21.

DOI:10.1007/s13277-015-3074-2
PMID:25874487
Abstract

Concurrent chemoradiotherapy (cCRT) is the standard of care for International Federation of Gynecology and Obstetrics (FIGO) stage IIB squamous cervical carcinoma (SCC). However, an increasing number of young patients with stage IIB SCC are concerned with preserving their ovarian and vaginal functions during treatment. This retrospective study aimed to compare clinical prognosis between young patients with stage IIB SCC treated with neoadjuvant chemotherapy (NACT) followed by radical surgery (RS) and those treated with cCRT. Medical records of 244 premenopausal patients aged <45 years with FIGO stage IIB SCC treated with NACT+RS and cCRT between February 2007 and June 2009 were reviewed. All these patients completed the treatment plan. NACT+RS resulted in recurrence (35.9 versus 41.8 %, P = 0.350), progression-free survival (PFS) rate (log-rank, P = 0.456), and overall survival (OS) rate (log-rank, P = 0.637) comparable to cCRT. Compared with cCRT, NACT+RS did not show a significant statistical difference in clinical prognosis of premenopausal patients with stage IIB SCC. Therefore, NACT+RS may be considered as an alternative treatment for the young patients who are concerned with preserving endocrine function, and this alternative treatment may also be administered when radiotherapy is unavailable.

摘要

同步放化疗(cCRT)是国际妇产科联盟(FIGO)IIB期宫颈鳞癌(SCC)的标准治疗方法。然而,越来越多的IIB期SCC年轻患者在治疗期间关注保留其卵巢和阴道功能。本回顾性研究旨在比较接受新辅助化疗(NACT)后行根治性手术(RS)的IIB期SCC年轻患者与接受cCRT的患者的临床预后。回顾了2007年2月至2009年6月期间244例年龄<45岁、FIGO IIB期SCC且接受NACT+RS和cCRT治疗的绝经前患者的病历。所有这些患者均完成了治疗计划。NACT+RS导致的复发率(35.9%对41.8%,P = 0.350)、无进展生存率(PFS)(对数秩检验,P = 0.456)和总生存率(OS)(对数秩检验,P = 0.637)与cCRT相当。与cCRT相比,NACT+RS在IIB期SCC绝经前患者的临床预后方面未显示出显著统计学差异。因此,NACT+RS可被视为关注保留内分泌功能的年轻患者的替代治疗方法,并且在无法进行放疗时也可采用这种替代治疗方法。

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