Makino Hiroshi, Nishio Shin, Tsubamoto Hiroshi, Shimada Muneaki, Nishikawa Ryutaro, Kai Kentaro, Ito Kimihiko, Mizuno Tomoko, Ushijima Kimio, Morishige Ken-Ichiro
Department of Obstetrics and Gynecology, Gifu University, Gifu, Japan.
Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
J Obstet Gynaecol Res. 2016 Jun;42(6):701-6. doi: 10.1111/jog.12956. Epub 2016 Mar 2.
The early and precise diagnosis and proper palliative treatment of bone metastasis is important for improving the quality of life of cervical cancer patients. The aim of this study was to clarify the clinical features, treatment modalities and prognosis of bone metastasis in cervical cancer patients in Japan.
The medical records of 75 cervical cancer patients with bone metastasis who were treated between January 2000 and December 2010 were retrospectively analyzed in a multi-institutional study.
Fifty-four patients (72.0%) had a single bone metastasis. Bone metastases were found in the spine (46.7%) and pelvis (42.7%). Forty-three patients (57.3%) also had extra-osseous metastases. Most of the patients received radiotherapy, chemotherapy or both, but 25 patients (33.3%) received palliative care only. Bisphosphonates were given as palliative therapy to 25 patients (33.3%). The median overall survival after the diagnosis of bone metastasis was significantly shorter in patients with extra-osseous metastases than in those without extra-osseous metastases (14 vs 5 months; P < 0.05). The survival of patients who received chemotherapy following radiotherapy or concurrent chemoradiotherapy was significantly longer than that of the patients who received palliative care. On multivariate analysis, the presence of extra-osseous metastasis was an independent predictor of survival in patients with bone metastasis from cervical cancer.
Multidisciplinary treatment might improve the prognosis of patients with bone metastasis who do not have extra-osseous lesions.
骨转移的早期精准诊断及恰当的姑息治疗对于提高宫颈癌患者的生活质量至关重要。本研究旨在阐明日本宫颈癌患者骨转移的临床特征、治疗方式及预后情况。
对2000年1月至2010年12月期间接受治疗的75例宫颈癌骨转移患者的病历进行多机构回顾性分析。
54例患者（72.0%）为单发骨转移。骨转移多见于脊柱（46.7%）和骨盆（42.7%）。43例患者（57.3%）还伴有骨外转移。大多数患者接受了放疗、化疗或两者兼用，但25例患者（33.3%）仅接受了姑息治疗。25例患者（33.3%）接受了双膦酸盐作为姑息治疗。骨转移诊断后的中位总生存期，伴有骨外转移的患者显著短于无骨外转移的患者（14个月对5个月；P<0.05）。放疗后接受化疗或同步放化疗的患者生存期显著长于接受姑息治疗的患者。多因素分析显示，骨外转移的存在是宫颈癌骨转移患者生存的独立预测因素。
多学科治疗可能改善无骨外病变的骨转移患者的预后。
