Gabriele A M, Boidi Trotti A, Fracchia F, Rosmino C, Rovea P, Tardy A
Divisione di Radioterapia, Ospedale San Giovanni Vecchio, Torino.
Radiol Med. 1989 May;77(5):521-3.
From 1980 through 1984, 41 patients with squamous cell cervix carcinoma and 1 with adenosquamous carcinoma were treated with preoperative irradiation. Clinical stages were Ib in 6 patients, IIa in 24, and IIb in 12. At surgery, lymph node metastases were found in 5 cases, and residual tumors in 8. The latter risk patients were given further external radiotherapy after surgery. Overall three-year survival rates for FIGO stage Ib was 100%; 91.6% for stage IIa, and 83% for stage IIb (minimum follow-up: 3 years). Two patients died from locoregional recurrence of the disease 12-24 months after the treatment, and 2 from distant metastases; 5 patients have showed signs of local improvement. Our results seem to point to pelvic lymph node involvement as the major prognostic factor: in fact, 40% only of the patients with involved lymph nodes is alive. Actuarial survival rates show 90.4% of patients to be alive at 5 years. Tolerance to the combined use radiotherapy and surgery was fair: no severe side-effects were observed. Even though our results are encouraging, a randomized study is still recommended to verify the actual value of this treatment versus combined surgery and radiotherapy or radiotherapy alone.
1980年至1984年期间，41例宫颈鳞状细胞癌患者和1例腺鳞癌患者接受了术前放疗。临床分期为Ib期6例，IIa期24例，IIb期12例。手术时，发现5例有淋巴结转移，8例有残留肿瘤。后一组高危患者术后接受了进一步的体外放疗。FIGO分期Ib期的总体三年生存率为100%；IIa期为91.6%，IIb期为83%（最短随访时间：3年）。2例患者在治疗后12 - 24个月死于疾病的局部区域复发，2例死于远处转移；5例患者有局部改善迹象。我们的结果似乎表明盆腔淋巴结受累是主要的预后因素：事实上，只有40%的淋巴结受累患者存活。精算生存率显示5年时90.4%的患者存活。放疗与手术联合使用的耐受性尚可：未观察到严重副作用。尽管我们的结果令人鼓舞，但仍建议进行随机研究，以验证这种治疗相对于手术与放疗联合或单纯放疗的实际价值。
