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早期宫颈癌手术后盆腔复发的近距离放疗疗效及预后因素分析。

Therapeutic effects and prognostic factors of I brachytherapy for pelvic recurrence after early cervical cancer surgery.

机构信息

Department of Oncology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, Guangdong, China.

Department of Gynecology, GuangZhou Red Cross Hospital, Jinan University, Guangzhou, 510220, Guangdong, China.

出版信息

Sci Rep. 2021 May 31;11(1):11356. doi: 10.1038/s41598-021-90007-x.

Abstract

To investigate the efficacy of I seed implantation in the treatment regimen of pelvic recurrence after early cervical cancer surgery and to analyse prognostic factors. To evaluate efficacy and analyse prognostic factors of I seed implantation for pelvic recurrence after early cervical cancer surgery. A prospective study was conducted on 62 patients who experienced pelvic recurrence after early cervical cancer surgery between August 2005 and September 2015. The 62 patients were treated and assessed in 2 groups (n = 30). All 62 patients were randomized into two groups that received two different treatment regimens: the treatment group (n = 30), which received I particle implantation therapy, and the control group (n = 32), which received whole-pelvic irradiation using the anteroposterior/posteroanterior field and cisplatin-based concurrent chemoradiation therapy. The efficacy/efficiency of I seed implantation and prognostic factors were analysed by logistic regression. Overall survival was determined by Kaplan-Meier analysis. Multivariate analysis results were obtained by the Cox proportional hazards regression model. The effective control rates at 1, 3, 6 and 12 months were 76.7%, 80.0%, 83.3%, and 86.7% in the I particle implantation group. The total effective control rates at 1, 3, 6 and 12 months were 65.6%, 65.5%, 62.5%, and 71.9% in the chemoradiotherapy group. Significant differences were observed between the two groups. The overall survival rates at 1, 2, 3, 4, and 5 years and the median overall were 96.7%, 93.3%, 86.7%, 71.9%, 65.6% and 4.34 years, respectively, in the I seed implantation group and 81.3%, 71.9%, 62.5%, 56.3%, 53.1% and 3.59 years, respectively, in the control group. There were statistically significant differences in survival rates depending on the diameter of the largest recurrent pelvic tumour (χ = 6.611, P = 0.010). The multivariate analysis showed that the survival rates were related to the diameter of the largest recurrent pelvic tumour (χ = 4.538, P = 0.033). I implantation is an effective, safe, and promising method for the treatment of pelvic recurrence after early cervical cancer surgery. The diameter of the recurrent pelvic tumour was identified as a significant independent prognostic factor in patients who received I implantation.

摘要

研究目的

探讨 I 粒子植入治疗早期宫颈癌术后盆腔复发的疗效,并分析其预后因素。

方法

对 2005 年 8 月至 2015 年 9 月期间 62 例早期宫颈癌术后盆腔复发患者进行前瞻性研究。将 62 例患者分为两组(n=30),分别接受 I 粒子植入治疗(治疗组)和全盆腔照射联合顺铂同步放化疗(对照组)。采用逻辑回归分析 I 粒子植入的疗效/效率和预后因素,采用 Kaplan-Meier 分析总生存率,采用 Cox 比例风险回归模型进行多因素分析。

结果

治疗组 1、3、6、12 个月的有效控制率分别为 76.7%、80.0%、83.3%和 86.7%,对照组分别为 65.6%、65.5%、62.5%和 71.9%,两组差异有统计学意义。治疗组 1、2、3、4、5 年的总生存率分别为 96.7%、93.3%、86.7%、71.9%、65.6%和 4.34 年,对照组分别为 81.3%、71.9%、62.5%、56.3%、53.1%和 3.59 年,两组生存率差异有统计学意义。根据最大复发盆腔肿瘤直径进行分层分析,结果显示肿瘤直径是影响患者生存率的独立预后因素(χ²=6.611,P=0.010)。

结论

I 粒子植入治疗早期宫颈癌术后盆腔复发是一种有效、安全、有前途的方法,肿瘤最大直径是影响患者生存率的独立预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec91/8166881/f98fbb862be5/41598_2021_90007_Fig1_HTML.jpg

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