Roy Soumyajit, Ko Jenny J, Bahl Gaurav
University of British Columbia, British Columbia, Canada.
Department of Radiation Oncology, British Columbia Cancer Agency, Abbotsford Cancer Center, Abbotsford, BC V2S 0C2, Canada.
Gynecol Oncol Rep. 2019 Jan 9;27:54-59. doi: 10.1016/j.gore.2019.01.003. eCollection 2019 Feb.
To describe the patient characteristics, patterns of treatment, and outcome of patients with small cell carcinoma of Cervix (SmCC) treated with radical radiotherapy from a provincial cancer registry database.
Overall 25 patients with SmCC were treated with radical radiotherapy (with or without chemotherapy) from January 1, 1994 to December 31, 2013. Nineteen patients had pure SmCC while 6 had additional neuroendocrine component. Patients were treated with combined chemo-radiotherapy using multi-agent chemotherapy with pelvic or combined pelvic and para-aortic radiotherapy. All patients received brachytherapy. Use of prophylactic cranial irradiation was dependent on physician discretion. Survival was estimated using Kaplan-Meier method and compared using log-rank test.
We report a median overall survival of 53.8 months for our cohort. After a median follow-up of 54 months for surviving patients, the overall survival (OS) and progression free survival (PFS) at 5-years were 48% and 46.4% respectively. Patients with stage I-IIA disease had superior 5-year PFS (67.3% vs. 11.1%; = .004) and 5-year OS (62.5% vs. 22.2%; = .006). Patients with node-negative disease had a trend towards better 5-year PFS (55.7% vs. 19%; = .07) and OS (61.1% vs. 14.3% at 5-years; = .06) Distant metastasis was the predominant site of disease progression ( = 12; 48%).
Distant metastasis is the predominant pattern of failure for patients with SmCC treated with radical chemo-radiotherapy. With modern chemo-radiotherapy protocols we can expect a 5 year survival of around 50%. Early stage and node-negative status appear to be favorable prognostic factors with survival rates at 5-year over 60%.
通过省级癌症登记数据库描述接受根治性放疗的宫颈小细胞癌（SmCC）患者的特征、治疗模式及预后。
1994年1月1日至2013年12月31日期间，共有25例SmCC患者接受了根治性放疗（联合或不联合化疗）。19例为单纯SmCC，6例伴有其他神经内分泌成分。患者接受多药联合化疗同步盆腔或盆腔加腹主动脉旁放疗的综合放化疗。所有患者均接受近距离放疗。预防性颅脑照射的使用取决于医生的判断。采用Kaplan-Meier法估计生存率，并使用对数秩检验进行比较。
我们报告该队列的中位总生存期为53.8个月。存活患者中位随访54个月后，5年总生存期（OS）和无进展生存期（PFS）分别为48%和46.4%。I-IIA期疾病患者的5年PFS（67.3%对11.1%；P = 0.004）和5年OS（62.5%对22.2%；P = 0.006）更佳。无淋巴结转移疾病患者的5年PFS（55.7%对19%；P = 0.07）和OS（5年时61.1%对14.3%；P = 0.06）有改善趋势。远处转移是疾病进展的主要部位（n = 12；48%）。
远处转移是接受根治性放化疗的SmCC患者主要的失败模式。采用现代放化疗方案，我们预计5年生存率约为50%。早期和无淋巴结转移状态似乎是有利的预后因素，5年生存率超过60%。
