Mansha Muhammad Atif, Sadaf Tabinda, Waheed Asmara, Munawar Amna, Rashid Asma, Chaudry Samreen Javed
Clinical and Radiation Oncology Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
JCO Glob Oncol. 2020 Oct;6:1639-1646. doi: 10.1200/GO.20.00169.
To report the chronic toxicity and disease outcomes attributable to intensity-modulated radiation therapy (IMRT) in patients with cervical cancer.
Between January 2014 and December 2018, a retrospective review of medical records of patients with cervical cancer who received radiation therapy with IMRT was performed. Disease and treatment-related details were documented. Follow-up notes were reviewed, and severity of late toxicities was recorded. Overall survival (OS) and disease-free survival (DFS) at 3 years were estimated.
A total of 222 patients' records were reviewed. Mean age was 50.7 years. Median follow-up duration was 33 months (range, 2-70 months). The most common toxicity was vaginal stricture (grade 2, n = 59, 26.6%; grade 3, n = 4, 1.80%), followed by proctitis (grade 2, n = 24; 10.8%; grade 3, n = 7; 3.20%). Seven patients (grade 2, n = 5, 2.3%; grade 3, n = 2; 0.90%) developed cystitis, and only 5 (grade 2; 2.3%) were found to have colitis. None of the patients had grade 4 or grade 5 toxicities. There was a significant difference in late complications in patients with nodal disease or those who underwent prior surgery ( < .05). Three-year OS and DFS rates were 79.7% and 81.9%, respectively. Patients with tumor size > 5 cm and those with pelvic lymph node metastasis had poor survival rates ( < .05).
IMRT is an effective and well-tolerated technique that should be considered in patients with lymph node disease and in postoperative patients. There is an inverse relationship between tumor size and nodal involvement with respect to OS and DFS.
报告宫颈癌患者调强放射治疗（IMRT）所致的慢性毒性和疾病转归。
2014年1月至2018年12月，对接受IMRT放射治疗的宫颈癌患者的病历进行回顾性研究。记录疾病及治疗相关细节。查阅随访记录，记录晚期毒性的严重程度。估算3年总生存期（OS）和无病生存期（DFS）。
共查阅了222例患者的记录。平均年龄为50.7岁。中位随访时间为33个月（范围2 - 70个月）。最常见的毒性反应是阴道狭窄（2级，n = 59，26.6%；3级，n = 4，1.80%），其次是直肠炎（2级，n = 24；10.8%；3级，n = 7；3.20%）。7例患者发生膀胱炎（2级，n = 5，2.3%；3级，n = 2；0.90%），仅5例（2级；2.3%）有结肠炎。无患者出现4级或5级毒性反应。有淋巴结疾病或曾接受过手术的患者晚期并发症有显著差异（P <.05）。3年OS率和DFS率分别为79.7%和81.9%。肿瘤大小> 5 cm的患者和有盆腔淋巴结转移的患者生存率较差（P <.05）。
IMRT是一种有效且耐受性良好的技术，对于有淋巴结疾病的患者和术后患者应予以考虑。肿瘤大小与淋巴结受累情况在OS和DFS方面呈负相关。
