Cordoba Abel, Escande Alexandre, Comte Pauline, Fumagalli Ingrid, Bresson Lucie, Mubiayi Ndaye, Lartigau Eric
Department of Radiotherapy, Oscar Lambret Comprehensive Cancer Center, Lille, France.
J Contemp Brachytherapy. 2017 Feb;9(1):71-76. doi: 10.5114/jcb.2017.65640. Epub 2017 Jan 31.
In November 2013, a woman with Herlyn-Werner-Wunderlich (HWW) syndrome was diagnosed with a locally advanced left cervical adenocarcinoma. The patient's malformation consisted of two uteri with two cervixes, a obstructed vagina, and a left renal agenesis. Classification FIGO: stage IIIa because of infiltration of the inferior third of the vagina wall. Locoregional management comprised an infrarenal lateral aortic lymphadenectomy followed by concomitant radio-chemotherapy to the pelvic (inguinal, pelvic, and infrarenal para aortic nodes) volumes. A total of 50.4 Gy were delivered (1.8 Gy/fraction/day) to the node (inguinal, pelvic, and aortic infrarenal) and pelvic volume; a concomitant boost to the primary cervical tumor and macroscopic nodes to 59.92 Gy (2.14 Gy/fraction/day) was performed. 20 Gy were delivered with intracavitary brachytherapy boost with mold technique and a pulsed-dose-rate technique due to the rarity of this uterine malformation. After 30 months of follow-up, there was no evidence of locoregional or distant recurrence.
2013年11月，一名患有赫林-韦纳-温德利希（HWW）综合征的女性被诊断为局部晚期左宫颈腺癌。患者的畸形包括双子宫双宫颈、阴道梗阻和左肾缺如。国际妇产科联盟（FIGO）分期：Ⅲa期，原因是阴道壁下三分之一受侵。局部区域治疗包括肾下水平的主动脉旁淋巴结清扫术，随后对盆腔（腹股沟、盆腔和肾下主动脉旁淋巴结）区域进行同步放化疗。对淋巴结（腹股沟、盆腔和肾下主动脉旁淋巴结）及盆腔区域共给予50.4 Gy（1.8 Gy/分次/天）；对原发性宫颈肿瘤和肿大淋巴结同步加量至59.92 Gy（2.14 Gy/分次/天）。由于这种子宫畸形罕见，采用模具技术和脉冲剂量率技术进行腔内近距离放疗加量，给予20 Gy。随访30个月后，无局部区域或远处复发迹象。
