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化放疗与巩固化疗治疗局部晚期宫颈癌:一项回顾性单中心研究。

Chemobrachyradiotherapy and consolidation chemotherapy in treatment of locally advanced cervical cancer : A retrospective single institution study.

机构信息

Department of Oncology, University Clinical Hospital Mostar, Bijeli brijeg bb, 88000, Mostar, Bosnia and Herzegovina.

Medical Physics and Radiation Protection Office, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.

出版信息

Wien Klin Wochenschr. 2021 Nov;133(21-22):1155-1161. doi: 10.1007/s00508-021-01958-0. Epub 2021 Oct 21.

Abstract

BACKGROUND

Given the lack of primary and secondary prevention programs and cancer awareness in general, cervical cancer remains one of the main causes of cancer-related death in developing countries, such as Bosnia and Herzegovina. Optimization of combinations of external radiation therapy (ERT), brachytherapy and chemotherapy is still needed to improve outcomes in the treatment of advanced cervical cancer.

PATIENTS AND METHODS

We retrospectively analyzed 48 consecutive patients with Fédération Internationale de Gynecologie et d'Obstetrique (FIGO) 2009 stage IB2-IVA, who were treated with primary concomitant chemobrachyradiotherapy (CCBRT) and consolidation chemotherapy at the Department of Oncology, University Hospital Mostar, Bosnia and Herzegovina between December 2012 and June 2020. Patients were treated with ERT plus two cycles of concomitant chemobrachytherapy with ifosfamide and cisplatin and low-dose rate (LDR) brachytherapy followed by four cycles of consolidation chemotherapy at 3‑week intervals. We evaluated local control rate (LCR), disease-free survival (DFS), overall survival (OS), disease-specific survival (DSS) and toxicity.

RESULTS

After 45.5 months (interquartile range, IQR = 47 months) of median follow-up, 5‑year DFS was 72.8% (95% confidence interval. CI 59-78%), OS was 76.6% (95% CI 60-79%), and DSS was 88% (95% CI 71-86%) with acceptable toxicity. LCR was 94%.

CONCLUSION

Primary CCBRT and consolidation chemotherapy applied in standard clinical practice in the treatment of locally advanced cervical cancer (LACC) produce respectable outcomes.

摘要

背景

由于缺乏初级和二级预防计划以及普遍的癌症意识,宫颈癌仍然是发展中国家(如波斯尼亚和黑塞哥维那)癌症相关死亡的主要原因之一。优化外部放射治疗(ERT)、近距离放射治疗和化疗的组合仍然是提高晚期宫颈癌治疗效果的需要。

患者和方法

我们回顾性分析了 2012 年 12 月至 2020 年 6 月期间,在波斯尼亚和黑塞哥维那莫斯塔大学医院肿瘤科接受原发同期放化疗(CCBRT)和巩固化疗的 48 例连续 FIGO 2009 期 IB2-IVA 期患者。患者接受 ERT 加顺铂和异环磷酰胺两周期同期放化疗,随后低剂量率(LDR)近距离放射治疗,再间隔 3 周进行四周期巩固化疗。我们评估了局部控制率(LCR)、无疾病生存率(DFS)、总生存率(OS)、疾病特异性生存率(DSS)和毒性。

结果

在中位随访 45.5 个月(四分位距 IQR=47 个月)后,5 年 DFS 为 72.8%(95%CI 59-78%),OS 为 76.6%(95%CI 60-79%),DSS 为 88%(95%CI 71-86%),毒性可接受。LCR 为 94%。

结论

标准临床实践中应用的原发 CCBRT 和巩固化疗治疗局部晚期宫颈癌(LACC)可获得令人满意的结果。

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