Miyauchi Rise, Itoh Yoshiyuki, Kawamura Mariko, Hirakawa Akihiro, Shibata Kiyosumi, Kajiyama Hiroaki, Nakahara Rie, Kubota Seiji, Ito Junji, Okada Tohru, Kikkawa Fumitaka, Naganawa Shinji
Department of Radiology, Nagoya University Graduate School of Medicine, Aichi, Japan.
Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, Aichi, Japan.
Nagoya J Med Sci. 2017 Feb;79(2):211-220. doi: 10.18999/nagjms.79.2.211.
The purpose of this retrospective study was to analyze data in patients with stage IB-IIB uterine cervical cancer who were treated with concurrent chemoradiotherapy (CCRT) with high dose cisplatin and fluorouracil as postoperative adjuvant therapy. Between February 2003 and November 2011, 76 patients with FIGO stage IB-IIB cervical cancer were analyzed. Seventy patients were treated with postoperative CCRT and 6 patients were treated with radiation therapy alone. Data related to overall survival (OS), disease-free survival (DFS), toxicity, and failure pattern were analyzed. The median patient age was 45 years (range, 20-80 years). The median follow-up duration was 63 months (range, 10-125 months). Fifty-eight patients (76.3%) had a squamous cell histologic type, 55 patients (72.4%) had lymphovascular invasion, 31 patients (40.8%) had parametrial invasion, and 28 patients (36.8%) had lymph node metastases. Five-year OS and DFS were 96% and 92%, respectively. Five-year DFS in stage IB1 patients was significantly higher than in stage IB2-IIB patients (p = 0.022). Nineteen patients (25%) had grade 3 or 4 neutropenia, 13 patients (17.1%) had grade 3 anemia, and 2 patients (2.6%) had grade 3 thrombocytopenia, but none of these patients died from the disease. Three patients experienced chronic toxicity: one had bladder perforation, one had hydronephrosis, and one experienced ileus. CCRT as postoperative adjuvant therapy resulted in good survival and outcome without severe toxicity.
本回顾性研究的目的是分析接受高剂量顺铂和氟尿嘧啶同步放化疗(CCRT)作为术后辅助治疗的IB-IIB期子宫颈癌患者的数据。2003年2月至2011年11月期间,对76例国际妇产科联盟(FIGO)IB-IIB期宫颈癌患者进行了分析。70例患者接受了术后CCRT,6例患者仅接受了放射治疗。分析了与总生存期(OS)、无病生存期(DFS)、毒性和失败模式相关的数据。患者中位年龄为45岁(范围20-80岁)。中位随访时间为63个月(范围10-125个月)。58例患者(76.3%)为鳞状细胞组织学类型,55例患者(72.4%)有脉管浸润,31例患者(40.8%)有宫旁浸润,28例患者(36.8%)有淋巴结转移。5年总生存率和无病生存率分别为96%和92%。IB1期患者的5年无病生存率显著高于IB2-IIB期患者(p = 0.022)。19例患者(25%)出现3级或4级中性粒细胞减少,13例患者(17.1%)出现3级贫血,2例患者(2.6%)出现3级血小板减少,但这些患者均未死于该疾病。3例患者出现慢性毒性:1例膀胱穿孔,1例肾积水,1例肠梗阻。CCRT作为术后辅助治疗可带来良好的生存率和结局,且无严重毒性。