子宫切除术后盆腔复发性宫颈癌的挽救性高剂量率组织间近距离放疗
Salvage High-dose-rate Interstitial Brachytherapy for Pelvic Recurrent Cervical Carcinoma After Hysterectomy.
作者信息
Murakami Naoya, Kato Tomoyasu, Miyamoto Yuichiro, Nakamura Satoshi, Wakita Akihisa, Okamoto Hiroyuki, Tsuchida Keisuke, Kashihara Tairo, Kobayashi Kazuma, Harada Ken, Kitaguchi Mayuka, Sekii Shuhei, Takahashi Kana, Umezawa Rei, Inaba Koji, Ito Yoshinori, Igaki Hiroshi, Itami Jun
机构信息
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
Department of Gynecologic Oncology, National Cancer Center Hospital, Tokyo, Japan.
出版信息
Anticancer Res. 2016 May;36(5):2413-21.
BACKGROUND
The aim of this study was to report the clinical results of salvage high-dose-rate interstitial brachytherapy (HDR-ISBT) for patients with cervical cancer with pelvic recurrence after hysterectomy.
PATIENTS AND METHODS
When there was no indication for total pelvic extenteration (TPE) and the tumor depth was more than 5 mm of invasion in the paracolpium, salvage HDR-ISBT was applied.
RESULTS
A total of 26 patients were included in this study. The median number of fractions and dose per fraction of HDR-ISBT were 5 (range=3-20 fractions) and 6 Gy (range=2.5-6 Gy), respectively. Three-year local control, progression-free survival, and overall survival were 51.1%, 34.4% and 57.1%, respectively. Combination of external-beam radiation therapy, clinical target volume D90 greater than 65 Gy, and dose per fraction greater than 5 Gy were associated with favorable local control.
CONCLUSION
For patients with recurrent cervical cancer post hysterectomy who are not candidates for TPE, salvage HDR-ISBT is a possible curative treatment modality.
背景
本研究的目的是报告挽救性高剂量率组织间近距离放射治疗（HDR-ISBT）对子宫切除术后盆腔复发的宫颈癌患者的临床结果。
患者与方法
当不存在全盆腔脏器切除术（TPE）指征且肿瘤浸润阴道旁组织深度超过5mm时，应用挽救性HDR-ISBT。
结果
本研究共纳入26例患者。HDR-ISBT的中位分次次数和每次剂量分别为5次（范围=3-20次）和6Gy（范围=2.5-6Gy）。三年局部控制率、无进展生存率和总生存率分别为51.1%、34.4%和57.1%。外照射放疗、临床靶体积D90大于65Gy以及每次剂量大于5Gy的联合应用与良好的局部控制相关。
结论
对于子宫切除术后复发的宫颈癌患者，若不适合行TPE，挽救性HDR-ISBT是一种可能的治愈性治疗方式。
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