Department of Radiation Oncology, Okmeydani Training and Research Hospital, İstanbul, Turkey.
Department of Radiation Oncology, İstanbul Oncology Hospital, İstanbul, Turkey.
Radiol Med. 2020 Oct;125(10):981-989. doi: 10.1007/s11547-020-01187-x. Epub 2020 Apr 10.
The prognostic effect of human papilloma virus (HPV) on early radioresponse before brachytherapy was evaluated in locally advanced cervix uteri carcinoma patients.
Between 2015 and 2018, 150 patients with locally advanced carcinoma of the cervix uteri from University of Health Sciences Okmeydani Training and Research Hospital and Istanbul Oncology Hospital underwent chemotherapy concomitant with external radiotherapy and brachytherapy after performing fluorodeoxyglucose positron emission tomography (FDG PET) and magnetic resonance imaging (MRI) for purposes of staging and treatment planning. The treatment results of patients analyzed retrospectively.
The median age of 57 patients was 53 years, and the initial tumor volume was 27 cm. The median follow-up period was 22 months. The median tumor volume after external radiotherapy was significantly higher in patients without local control than those who responded to external radiotherapy (p = 0.031). The mean tumor diameter and volume in all HPV-negative patients after external radiotherapy were significantly higher than those of HPV-positive patients (p = 0.011 and p = 0.046, respectively). In a group of patients with poor early responses, local disease control could not be achieved despite the use of recommended higher doses of brachytherapy.
We could not determine the correlation between HPV contamination and patients who had early response intervention. But residual tumor of more than 2 cm in diameter after external radiotherapy may be a predictor of failed local control and development of metastasis within a short time.
评估人乳头瘤病毒(HPV)对局部晚期子宫颈癌患者近距离放疗前早期放射反应的预后影响。
2015 年至 2018 年间,150 例来自健康科学大学奥克梅丹尼训练与研究医院和伊斯坦布尔肿瘤医院的局部晚期子宫颈癌患者在进行氟脱氧葡萄糖正电子发射断层扫描(FDG PET)和磁共振成像(MRI)以进行分期和治疗计划后,接受了化疗联合外放射治疗和近距离放疗。回顾性分析了这些患者的治疗结果。
57 例患者的中位年龄为 53 岁,初始肿瘤体积为 27cm。中位随访时间为 22 个月。在外放疗后无局部控制的患者肿瘤体积中位数明显高于对外放疗有反应的患者(p=0.031)。在外放疗后所有 HPV 阴性患者的平均肿瘤直径和体积均明显高于 HPV 阳性患者(p=0.011 和 p=0.046)。在早期反应较差的患者中,尽管使用了建议的更高剂量的近距离放疗,但仍无法实现局部疾病控制。
我们无法确定 HPV 污染与早期反应干预患者之间的相关性。但外放疗后直径大于 2cm 的残余肿瘤可能是局部控制失败和短时间内转移发展的预测因素。