Lamblin G, Rouffiac M, Mathevet P, Martin E, Peignaux-Casasnovas K, Chabert P, Lebail-Carval K, Chene G
Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France.
Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France.
Gynecol Obstet Fertil. 2015 Jul-Aug;43(7-8):485-90. doi: 10.1016/j.gyobfe.2015.04.003. Epub 2015 May 16.
To assess toxicity profile in two stage-IB1 cervical cancer treatment strategies: surgery with and without preoperative uterovaginal pulsed dose-rate brachytherapy.
A retrospective study included 45 patients presenting stage-IB1 cervical cancer without pelvic lymph-node invasion, between 2009 and 2011: 25 treated by colpohysterectomy alone (group A) and 20 with preoperative uterovaginal pulsed dose-rate brachytherapy (group B). The median follow-up was 45 and 39 months (group A and B).
Groups were comparable for age (median, 46.9 vs 47.6 years), histologic type (52% vs 65% squamous cell carcinoma) and tumor size (68% vs 60%, <2cm). In postoperative year 1, rates of urinary, digestive and gynaecological disorder were 39.1%, 8.7% and 15% respectively in group A versus 36.8%, 5.3% and 31.6% in group B and in year 2, 5.9%, 8.4% and 15% versus 5.6%, 5.1% and 27.8%.
The present study comparing two stage-IB1 cervical cancer treatment strategies found no significant difference in early or late complications. In 2 months, there was greater grade-3 urinary toxicity (21.1%) and sexual disorder (15.8%) with preoperative brachytherapy but no significant difference. Exclusive surgery is probably preferable for the patient's quality of life.
评估两种IB1期宫颈癌治疗策略的毒性特征：单纯手术以及术前子宫阴道脉冲剂量率近距离治疗联合手术。
一项回顾性研究纳入了2009年至2011年间45例无盆腔淋巴结转移的IB1期宫颈癌患者：25例仅接受阴道子宫切除术治疗（A组），20例接受术前子宫阴道脉冲剂量率近距离治疗（B组）。A组和B组的中位随访时间分别为45个月和39个月。
两组在年龄（中位数，46.9岁对47.6岁）、组织学类型（52%对65%为鳞状细胞癌）和肿瘤大小（<2cm者分别为68%对60%）方面具有可比性。术后第1年，A组泌尿系统、消化系统和妇科疾病的发生率分别为39.1%、8.7%和15%，而B组分别为36.8%、5.3%和31.6%；术后第2年，A组分别为5.9%、8.4%和15%，B组分别为5.6%、5.1%和27.8%。
本研究比较了两种IB1期宫颈癌治疗策略，发现早期或晚期并发症无显著差异。术前近距离治疗在2个月时3级泌尿系统毒性（21.1%）和性功能障碍（15.8%）更严重，但无显著差异。就患者生活质量而言，单纯手术可能更可取。
