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新辅助化疗不能改善局部晚期宫颈鳞状细胞癌的预后及淋巴结转移率:一项中国的回顾性队列研究

Neoadjuvant chemotherapy does not improve the prognosis and lymph node metastasis rate of locally advanced cervical squamous cell carcinoma: A retrospective cohort study in China.

作者信息

Yan Wenxing, Si Lihui, Ding Yaming, Qiu Shuang, Zhang Qi, Liu Linlin

机构信息

Department of Radiotherapy.

Department of Obstetrics and Gynecology, The Second Hospital of Jilin University.

出版信息

Medicine (Baltimore). 2019 Sep;98(39):e17234. doi: 10.1097/MD.0000000000017234.

DOI:10.1097/MD.0000000000017234
PMID:31574835
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6775422/
Abstract

Locally advanced cervical carcinoma has a poor prognosis. Neoadjuvant chemotherapy (NACT) can reduce tumor size and improve tumor resection rate, but its use in large locally advanced cervical carcinoma is controversial. This study aimed to evaluate the treatment and prognosis of NACT in patients with cervical carcinoma stage IB2 or IIA2.This was a retrospective cohort study of patients who underwent type-C radical surgery and pelvic lymphadenectomy due to cervical carcinoma stage IB2/IIA2 between 2/2014 and 12/2016 at the Second Hospital of Jilin University. The patients were grouped according to whether they received NACT (paclitaxel and a platinum salt) or not. Overall survival (OS) and progression-free survival (PFS) were compared between the 2 groups.Of the 144 patients, 60 (41.7%) received NACT. A total of 119 patients underwent postoperative radiation therapy, of which 97 received radiation therapy alone and 22 received concurrent chemoradiotherapy. The adverse reactions in the NACT group were mainly hematologic toxic reactions, but were tolerated. No grade ≥III adverse reactions were observed. NACT did not significantly affect the PFS (P = .453) and OS (P = .933) between the 2 groups. No factor was found to be independently associated with OS or PFS (all P > .05).Compared with patients who underwent surgery with/without radiotherapy and/or chemotherapy, NACT using paclitaxel and a platinum salt does not improve the prognosis and lymph node metastasis rate of locally advanced cervical carcinoma in Chinese patients.

摘要

局部晚期宫颈癌预后较差。新辅助化疗(NACT)可缩小肿瘤大小并提高肿瘤切除率,但其在大型局部晚期宫颈癌中的应用存在争议。本研究旨在评估NACT在IB2期或IIA2期宫颈癌患者中的治疗效果及预后。

这是一项回顾性队列研究,研究对象为2014年2月至2016年12月期间在吉林大学第二医院因IB2/IIA2期宫颈癌接受C型根治性手术及盆腔淋巴结清扫术的患者。根据患者是否接受NACT(紫杉醇和铂盐)将其分组。比较两组的总生存期(OS)和无进展生存期(PFS)。

144例患者中,60例(41.7%)接受了NACT。共有119例患者接受了术后放疗,其中97例仅接受放疗,22例接受同步放化疗。NACT组的不良反应主要为血液学毒性反应,但患者可耐受。未观察到≥III级不良反应。NACT对两组之间的PFS(P = 0.453)和OS(P = 0.933)无显著影响。未发现有因素与OS或PFS独立相关(所有P>0.05)。

与接受手术联合/不联合放疗和/或化疗的患者相比,使用紫杉醇和铂盐的NACT并不能改善中国局部晚期宫颈癌患者的预后及淋巴结转移率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e89/6775422/6aa25f325324/medi-98-e17234-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e89/6775422/6aa25f325324/medi-98-e17234-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e89/6775422/6aa25f325324/medi-98-e17234-g002.jpg

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