Lei Chengzhi, Huang Manni, Li Ning, An Jusheng, Xiong Suiyang, Xu Yingjie
Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
Gynecol Oncol Rep. 2021 Feb 8;36:100724. doi: 10.1016/j.gore.2021.100724. eCollection 2021 May.
The purpose of this study was to investigate the clinical application of intensity-modulated radiotherapy combined with intracavitary radiotherapy for locally advanced cervical cancer complicated with uterus didelphys. We retrospectively reviewed the medical records of six patients with locally advanced cervical cancer associated with uterine malformations treated at the National Cancer Center/Cancer Hospital (Beijing, China) between 2015 and 2018. Six cases, including cervical squamous cell carcinoma (n = 3), cervical adenocarcinoma (n = 2), and clear cell adenocarcinoma (n = 1) were identified by pathological diagnosis. Uterine malformation included uterus didelphys (n = 6), with vaginal subseptum (n = 2). Six cases were treated with pelvic intensity-modulated radiotherapy. Four patients received three- dimensional intracavitary brachytherapy based on computed tomography, and two patients received conventional two-dimensional intracavitary brachytherapy. The acute and delayed responses of gastrointestinal and genitourinary toxicities were ≤grade 2 in 5 patients. Five patients achieved clinical complete remission and four patients had no recurrence during the follow-up period. One patient with cervical adenocarcinoma expired due to progression of the disease. The clinical results suggest that advanced cervical cancer associated with uterus didelphys required individual radiotherapy. The use of intensity-modulated radiotherapy combined with three-dimensional intracavitary brachytherapy is recommended in concurrent chemoradiotherapy.
本研究的目的是探讨调强放疗联合腔内放疗在局部晚期宫颈癌合并双子宫患者中的临床应用。我们回顾性分析了2015年至2018年期间在中国医学科学院肿瘤医院（北京，中国）接受治疗的6例局部晚期宫颈癌合并子宫畸形患者的病历。经病理诊断确定6例患者，包括宫颈鳞状细胞癌（n = 3）、宫颈腺癌（n = 2）和透明细胞腺癌（n = 1）。子宫畸形包括双子宫（n = 6），其中合并阴道纵隔（n = 2）。6例患者均接受盆腔调强放疗。4例患者基于计算机断层扫描接受三维腔内近距离放疗，2例患者接受传统二维腔内近距离放疗。5例患者胃肠道和泌尿生殖系统毒性的急性和迟发性反应≤2级。5例患者达到临床完全缓解，4例患者在随访期间无复发。1例宫颈腺癌患者因疾病进展死亡。临床结果表明，局部晚期宫颈癌合并双子宫需要个体化放疗。在同步放化疗中，建议使用调强放疗联合三维腔内近距离放疗。
