Kou Lingna, Zhang Tao, Yang Xiling, Peng Siyun, Wang Yifei, Yuan Mingyang, Li Minmin
Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
Department of Medical Oncology, Sichuan Cancer Hospital & institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China.
Future Oncol. 2022 May;18(16):1917-1915. doi: 10.2217/fon-2021-0818. Epub 2022 Feb 23.
With the use of concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC), survival outcomes are still not optimal. This study was designed to evaluate the efficacy and safety of adjuvant chemotherapy (ACT) for patients with LACC after treatment with CCRT. Patients diagnosed with stage IIA-IIIB LACC, were retrospectively analyzed. All patients received cisplatin-based CCRT and were divided into two groups: ACT after CCRT (CCRT + ACT group) and observation after CCRT (CCRT group). Overall survival (OS), progression-free survival (PFS) and adverse effects were recorded and analyzed. In total, 375 patients were included; 262 patients accepted ACT after CCRT while the remaining 113 patients chose observation. With a median follow-up of 40 months, no significant differences were found in the OS rates for patients in the CCRT + ACT and CCRT groups at 1 year, 3 years and the end of follow-up. There was also no significant discrepancy in PFS between groups. Subgroup analysis showed the International Federation of Gynecology and Obstetrics (FIGO) stage and age had negligible influence on both OS and PFS. Acute adverse events (grades 3-4) happened more frequently in CCRT + ACT group than in the CCRT group, with significant differences in neutropenia, anemia and creatinine. ACT after CCRT did not show benefit in survival but did induce some adverse effects. Therefore, this regimen is not recommended unless further large-scale randomized controlled trials are executed.
对于局部晚期宫颈癌（LACC）采用同步放化疗（CCRT），生存结局仍不尽人意。本研究旨在评估CCRT治疗后辅助化疗（ACT）对LACC患者的疗效和安全性。对诊断为IIA-IIIB期LACC的患者进行回顾性分析。所有患者均接受了以顺铂为基础的CCRT，并分为两组：CCRT后接受ACT（CCRT + ACT组）和CCRT后观察（CCRT组）。记录并分析总生存期（OS）、无进展生存期（PFS）和不良反应。总共纳入了375例患者；262例患者在CCRT后接受ACT，其余113例患者选择观察。中位随访40个月，CCRT + ACT组和CCRT组患者在1年、3年及随访结束时的OS率无显著差异。两组之间的PFS也无显著差异。亚组分析显示，国际妇产科联盟（FIGO）分期和年龄对OS和PFS的影响可忽略不计。CCRT + ACT组的急性不良事件（3-4级）比CCRT组更频繁发生，在中性粒细胞减少、贫血和肌酐方面存在显著差异。CCRT后进行ACT在生存方面未显示出益处，但确实会引发一些不良反应。因此，除非进行进一步的大规模随机对照试验，否则不推荐这种治疗方案。
