Kawaguchi Ryuji, Nakamura Haruki, Morioka Sachiko, Ito Huminori, Tanase Yasuhito, Haruta Shoji, Kanayama Seiji, Yosida Shozo, Furukawa Naoto, Oi Hidekazu, Kobayashi Hiroshi
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
World J Oncol. 2013 Dec;4(6):221-229. doi: 10.4021/wjon720w. Epub 2014 Jan 16.
The purpose of this study was to compare the long-term survival of patients with stage IIIB squamous cell carcinoma of the cervix treated with neoadjuvant intraarterial chemotherapy (IA-NAC) versus those treated with concurrent chemoradiotherapy (CCRT).
We retrospectively reviewed the clinical records of 38 patients with stage IIIB squamous cell carcinoma of the cervix admitted between January 1994 and December 1999 who received IA-NAC followed by abdominal radical hysterectomy (ARH) or radiotherapy (RT). IA-NAC consisted of bilateral infusion via the internal iliac artery of cisplatin, bleomycin and pirarubicin for 2-3 courses. A historical control group of 64 patients who underwent primary CCRT from January 2000 to September 2007 was used for comparison.
In the IA-NAC group, 12 patients (31.6%) with operable tumors underwent ARH, and the remaining 26 patients (68.4%) received RT. The response rates were 86.8% (12 complete response + 21 partial response) for IA-NAC and 98.4% (26 complete response + 37 partial response) for CCRT (P = 0.077), respectively. The 5-year overall survival and disease-free survival rates were 62.4 and 44.5% for IA-NAC and 51.1 and 46.9% for CCRT (P = 0.247 and 0.776), respectively. The 5-year overall survival and disease-free survival rates were 75.0 and 58.3% for the patients receiving IA-NAC followed by ARH, and 55.3 and 37.6% for the patients receiving IA-NAC followed by RT (P = 0.368 and 0.262), respectively.
In the present study, IA-NAC followed by ARH or RT and primary CCRT showed similar survival rates for stage IIIB squamous cell carcinoma of the cervix.
本研究的目的是比较接受新辅助动脉内化疗（IA-NAC）与同步放化疗（CCRT）治疗的IIIB期宫颈鳞状细胞癌患者的长期生存率。
我们回顾性分析了1994年1月至1999年12月期间收治的38例IIIB期宫颈鳞状细胞癌患者的临床记录，这些患者接受了IA-NAC，随后进行了腹式根治性子宫切除术（ARH）或放射治疗（RT）。IA-NAC包括通过双侧髂内动脉灌注顺铂、博来霉素和吡柔比星，共2-3个疗程。将2000年1月至2007年9月期间接受原发性CCRT的64例患者作为历史对照组进行比较。
在IA-NAC组中，12例（31.6%）可手术切除的肿瘤患者接受了ARH，其余26例（68.4%）接受了RT。IA-NAC的缓解率为86.8%（12例完全缓解+21例部分缓解），CCRT的缓解率为98.4%（26例完全缓解+37例部分缓解）（P=0.077）。IA-NAC组的5年总生存率和无病生存率分别为62.4%和44.5%，CCRT组分别为51.1%和46.9%（P=0.247和0.776）。接受IA-NAC后行ARH的患者5年总生存率和无病生存率分别为75.0%和58.3%，接受IA-NAC后行RT的患者分别为55.3%和37.6%（P=0.368和0.262）。
在本研究中，IA-NAC后行ARH或RT与原发性CCRT治疗IIIB期宫颈鳞状细胞癌的生存率相似。
