紫杉醇+卡铂化疗方案联合术后放疗治疗高危早期子宫内膜癌的疗效。

Efficacy of postoperative radiotherapy combined with taxol+carboplatin chemotherapy regimens in the treatment of high-risk early-stage endometrial cancer.

机构信息

Department of Oncology, Yanan University Affiliated Hospital, Yanan, China.

出版信息

J BUON. 2021 Mar-Apr;26(2):561-568.

Abstract

PURPOSE

To compare the efficacy and safety of postoperative extrapelvic irradiation intensity-modulated radiotherapy (IMRT)+concurrent chemotherapy and vaginal brachytherapy (VBT)+concurrent chemotherapy in the treatment of patients with high-risk early-stage endometrial cancer, and analyze the influencing factors for the prognosis of patients.

METHODS

A total of 126 patients with high-risk stage Ic-IIa endometrial cancer were divided into extrapelvic irradiation IMRT + concurrent taxol+carboplatin (TC) chemotherapy group (IMRT group, n=63) and VBT + concurrent TC chemotherapy group (VBT group, n=63). Then, the efficacy and the incidence rate of adverse reactions were compared between the two groups of patients. Additionally, the possible influencing factors for the prognosis of patients were analyzed.

RESULTS

In the Functional Assessment of Cancer Therapy-General Version 4 (FACT-G-V4) scale for the quality of life of patients, the scores of physiological status, social/family status, emotional status and functional status were dramatically higher in the VBT group than in the IMRT group at 3 months after treatment. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 87.3% and 73.0% in the IMRT group and 82.5% and 66.7% in the VBT group, respectively. Furthermore, advanced age, lower uterine segment involvement and anemia before treatment were independent risk factors for tumor progression in patients with endometrial cancer.

CONCLUSIONS

For patients with high-risk early-stage endometrial cancer, postoperative VBT + concurrent TC chemotherapy has similar efficacy to postoperative extrapelvic irradiation IMRT + concurrent TC chemotherapy, but patients receiving the former have fewer adverse reactions and high quality of life. Advanced age, lower uterine segment involvement and anemia before treatment are independent risk factors affecting tumor progression in such patients.

摘要

目的

比较盆腔外照射强度调制放疗（IMRT）+同期化疗与阴道近距离放疗（VBT）+同期化疗治疗高危Ⅰ期子宫内膜癌患者的疗效和安全性，并分析患者预后的影响因素。

方法

将 126 例高危Ⅰc-Ⅱa 期子宫内膜癌患者分为盆腔外照射 IMRT+同期紫杉醇+卡铂（TC）化疗组（IMRT 组，n=63）和 VBT+同期 TC 化疗组（VBT 组，n=63）。比较两组患者的疗效和不良反应发生率，分析患者预后的可能影响因素。

结果

在治疗后 3 个月，癌症治疗功能评估一般量表 4 版（FACT-G-V4）中患者生活质量的生理状况、社会/家庭状况、情感状况和功能状况评分，VBT 组明显高于 IMRT 组。IMRT 组的 5 年总生存（OS）率和无进展生存（PFS）率分别为 87.3%和 73.0%，VBT 组分别为 82.5%和 66.7%。此外，治疗前年龄较大、下段子宫受累和贫血是子宫内膜癌患者肿瘤进展的独立危险因素。