Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100006, China.
Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100006, China.
Int J Surg. 2016 Jun;30:63-7. doi: 10.1016/j.ijsu.2016.04.001. Epub 2016 Apr 12.
The aim of the retrospective study was to investigate the therapeutic efficiency of the preoperative intracavitary radiotherapy combined with radical surgery on postoperative complications and long-term survival in patients with stage IB2 and IIA2 cervical cancer (CC).
From January 1995 to December 2012, a total of 171 patients with stage IB2 or IIA2 CC were recruited into the study. They were divided into two groups according to the treatment modality provided: preoperative radiotherapy followed by radical surgery (n = 80), and radical surgery alone (n = 91). The clinical curative effect, postoperative complications and the postoperative prognosis of patients were evaluated and compared in two groups. The tumor response and survival of patients in two groups were observed in follow-up study.
There were no significant differences in the incidence of postoperative complications, intraoperative blood loss and surgery duration (P > 0.05) between the two groups. Preoperative radiotherapy did not improve the postoperative prognosis yet. Though patients undergoing preoperative radiotherapy showed the similar 1- (92.50% vs. 84.62%), 3- (85.00% vs. 81.32%) and 5-year (80.00% vs. 74.72%) survival rates, the 3- and 5-year locoregional control rates of them were much higher than those undergoing surgery alone (P < 0.05).
Preoperative radiotherapy combined with radical surgery could improve locoregional control rate and would not increase the risk of postoperative complications. It may be a feasible treatment mode for early stage CC carcinoma.
本回顾性研究旨在探讨术前腔内放疗联合根治性手术治疗 IB2 期和 IIA2 期宫颈癌（CC）患者术后并发症和长期生存的疗效。
1995 年 1 月至 2012 年 12 月，共招募了 171 例 IB2 期或 IIA2 期 CC 患者。根据所提供的治疗方式将患者分为两组：术前放疗联合根治性手术（n=80）和单纯根治性手术（n=91）。评估并比较两组患者的临床疗效、术后并发症和术后预后。在随访研究中观察两组患者的肿瘤反应和生存情况。
两组患者术后并发症发生率、术中出血量和手术时间差异无统计学意义（P>0.05）。术前放疗并未改善术后预后。尽管接受术前放疗的患者 1 年（92.50% vs. 84.62%）、3 年（85.00% vs. 81.32%）和 5 年（80.00% vs. 74.72%）生存率相似，但 3 年和 5 年局部区域控制率明显高于单纯手术组（P<0.05）。
术前放疗联合根治性手术可提高局部区域控制率，且不会增加术后并发症的风险。对于早期 CC 癌，这可能是一种可行的治疗模式。
