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放疗治疗阴道鳞状细胞癌患者的结局:来自单一专家中心的 37 例患者系列。

Outcomes of vaginal squamous cell carcinoma of patients treated with radiation therapy: a series of 37 patients from a single expert center.

机构信息

Department of Radiation Oncology, Tenon University Hospital, Hôpitaux Universitaires Est Parisien, Sorbonne University Medical Facult, 4, rue de la Chine, 75020, Paris, France.

Department of Radiation Oncology, Cheikh Zaid International University Hospital, Rabat, Morocco.

出版信息

Clin Transl Oncol. 2020 Aug;22(8):1345-1354. doi: 10.1007/s12094-019-02264-y. Epub 2019 Dec 23.

Abstract

INTRODUCTION

The aim is to assess the outcome of patients treated for vaginal carcinoma with radiation therapy in terms of long-term tolerance and survival.

MATERIALS AND METHODS

This single-center retrospective study included patients with squamous cell carcinoma of the vagina treated with pelvic external beam radiation therapy (EBRT) with or without vaginal brachytherapy (VB) between 1990 and 2013.

RESULTS

Thirty-seven patients were included with stage I (24%), II (60%), III (8%), or IV (8%) vaginal tumors. Median age was 66 years (range 27-86 years). Median tumor size was 4 cm (range 0.7-12 cm). Seven patients underwent first intention surgery. The 37 patients received pelvic EBRT (45 Gy) with inguinal irradiation in 57% of cases. Fifteen (41%) received concurrent chemotherapy. Low-dose supplemental VB was performed in 31 patients (84%) (median dose: 20 Gy). Median follow-up was 59 months (range 7-322 months). Four patients (11%) had late grade 3-4 complications. Relapse occurred in 11 patients (30%), five of them locally. The 5-year relapse-free and cancer-specific survival rates were 68% and 76%, respectively. Surgery and concurrent chemotherapy did not seem to have an impact on the course of the disease.

CONCLUSION

In our experience, pelvic EBRT leads to prolonged survival with acceptable long-term toxicity in patients with squamous cell carcinoma of the vagina.

摘要

简介

本研究旨在评估采用放射疗法治疗阴道癌患者的长期耐受性和生存结局。

材料与方法

本单中心回顾性研究纳入了 1990 年至 2013 年间采用盆腔外照射放疗(EBRT)联合或不联合阴道近距离放疗(VB)治疗的阴道鳞癌患者。

结果

共纳入 37 例患者,肿瘤分期为Ⅰ期(24%)、Ⅱ期(60%)、Ⅲ期(8%)或Ⅳ期(8%)。中位年龄为 66 岁(范围 27-86 岁)。中位肿瘤大小为 4cm(范围 0.7-12cm)。7 例患者接受了初始手术治疗。37 例患者接受了盆腔 EBRT(45Gy),57%的患者接受了腹股沟淋巴结照射。15 例(41%)患者接受了同期化疗。31 例(84%)患者接受了低剂量补充 VB(中位剂量:20Gy)。中位随访时间为 59 个月(范围 7-322 个月)。4 例(11%)患者发生了迟发性 3-4 级并发症。11 例(30%)患者出现了复发,其中 5 例为局部复发。5 年无复发生存率和癌症特异性生存率分别为 68%和 76%。手术和同期化疗似乎并未影响疾病进程。

结论

在我们的经验中,盆腔 EBRT 可延长阴道鳞癌患者的生存时间,且长期毒性可接受。

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