越南采用根治性同期放化疗治疗 2018 年 FIGO 分期 III 期宫颈癌患者的治疗结果和预后因素。
Treatment Outcome and Prognosis Factors of FIGO 2018 Stage III Cervical Cancer Patients Treated with Definitive Concurrent Chemoradiation in Vietnam.
机构信息
Department of Medical Oncology 6, Vietnam National Cancer Hospital, Hanoi, Vietnam.
Department of Oncology, Vietnam University of Traditional Medicine, Hanoi, Vietnam.
出版信息
Asian Pac J Cancer Prev. 2021 Mar 1;22(3):853-859. doi: 10.31557/APJCP.2021.22.3.853.
OBJECTIVE
This study aimed to analyze the treatment outcome and toxicities, along with prognosis factors of patients with FIGO 2018 stage III cervical cancer treated with definitive concurrent chemoradiation.
METHODS
A total of 83 stage III cervical cancer patients with good performance status (ECOG PS 0, 1) were treated with three-dimensional conformal radiation therapy (3D-CRT) combined with chemotherapy (weekly cisplatin), followed by high-dose-rate (HDR) brachytherapy between January 2017 and March 2019 at Vietnam National Cancer hospital. Treatment outcomes and prognosis factors were assessed along with acute and late toxicities.
RESULTS
The 3-year DFS was 67.8% and 3-year OS was 80.3%. On multivariate analyses, short axis of pelvic lymph node diameter of ≥ 15mm, invasion of the lower third of vagina and para-aortic lymph node metastasis were identified as adverse prognostic factors for DFS. The cumulative incidence rate of gastrointestinal and genitourinary toxicity (≥ grade 2) at the 3-year follow-up were 29.6% and 11.6%, respectively.
CONCLUSIONS
3D CRT and HDR brachytherapy with concurrent chemotherapy is an effective treatment, with acceptable toxicity for FIGO 2018 stage III cervical cancer in Vietnam.
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目的
本研究旨在分析采用根治性同期放化疗治疗国际妇产科联合会（FIGO）2018 分期 III 期宫颈癌患者的治疗结果和毒性反应，以及预后因素。
方法
2017 年 1 月至 2019 年 3 月，越南国家癌症医院对 83 例一般状况良好（ECOG PS 0、1）的 III 期宫颈癌患者采用三维适形放疗（3D-CRT）联合化疗（每周顺铂）进行治疗，随后进行高剂量率（HDR）近距离放疗。评估治疗结果和预后因素以及急性和晚期毒性反应。
结果
3 年无病生存率（DFS）为 67.8%，3 年总生存率（OS）为 80.3%。多因素分析显示，盆腔淋巴结短径≥15mm、阴道下段侵犯和腹主动脉旁淋巴结转移是 DFS 的不良预后因素。3 年随访时，胃肠道和泌尿生殖系统毒性（≥2 级）的累积发生率分别为 29.6%和 11.6%。
结论
3D-CRT 和 HDR 近距离放疗联合化疗是一种有效的治疗方法，对越南FIGO 2018 分期 III 期宫颈癌具有可接受的毒性。
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