Gultekin Melis, Yilmaz Melek Tugce, Yuce Sari Sezin, Yildiz Demet, Ozyigit Gokhan, Yildiz Ferah
Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
J Obstet Gynaecol. 2022 Oct;42(7):3033-3040. doi: 10.1080/01443615.2022.2081790. Epub 2022 Jun 2.
Our aim was to evaluate the oncological outcomes of stereotactic body radiotherapy (SBRT) boost in patients with cervical cancer. The data of 21 patients who received SBRT boost after definitive radiotherapy (RT) or chemoradiotherapy (CRT) between March 2012 and April 2019 were retrospectively evaluated. External beam radiotherapy (EBRT) was applied to patients with a total dose of 50.4 Gy in 28 fractions. Kaplan-Meier method was used for survival analysis (IBM SPSS 23 software) and < .05 value was considered significant. After definitive RT or CRT, there was a complete response in 9 (43%) patients, partial response in 11 (52%) patients and stable disease in 1 (5%) patient. The median follow-up period was 28 months (range, 7.5-88 months). Two-years cancer-specific survival rate was 80%. While 2-year LC rate was 75% in patients with residual tumour size <4 cm, it was 50% when there was ≥4 cm residual tumour after definitive CRT ( = .1). The treatment was well-tolerated and no acute or late toxicity was observed. Although brachytherapy (BRT) is an essential part of the treatment in locally advanced cervical cancer, SBRT may be used in patients with small residual disease who are not candidate for BRT. IMPACT STATEMENTCervical cancer is one of the most common cancers in the world, and external beam radiotherapy (EBRT) and brachytherapy (BRT) are the main treatment options. However, in rare cases where BRT is not feasible, it has been questioned whether stereotactic body radiotherapy (SBRT) as an alternative to BRT. Nowadays, BRT still appears to be the gold standard treatment. However, studies with a small number of patients and short follow-up periods in the literature show that SBRT can be a good alternative in cases where BRT cannot be performed. Our study is one of the series with the largest number of patients in the literature and with the longest follow-up period. In this area where there is no prospective study, we think that retrospective data with high patient numbers are enlightening. Our study shows that SBRT is an alternative option in cases with small residual disease where BRT cannot be applied, and it provides a basis for a prospective randomised study.
我们的目的是评估立体定向体部放疗（SBRT）增敏在宫颈癌患者中的肿瘤学结局。对2012年3月至2019年4月期间21例在根治性放疗（RT）或放化疗（CRT）后接受SBRT增敏的患者数据进行回顾性评估。对患者采用外照射放疗（EBRT），总剂量50.4 Gy，分28次。采用Kaplan-Meier法进行生存分析（IBM SPSS 23软件），P<0.05为有统计学意义。在根治性RT或CRT后，9例（43%）患者完全缓解，11例（52%）患者部分缓解，1例（5%）患者疾病稳定。中位随访期为28个月（范围7.5 - 88个月）。两年癌症特异性生存率为80%。在残留肿瘤大小<4 cm的患者中，两年局部控制率为75%，而在根治性CRT后残留肿瘤≥4 cm的患者中，该率为50%（P = 0.1）。该治疗耐受性良好，未观察到急性或晚期毒性。虽然近距离放疗（BRT）是局部晚期宫颈癌治疗的重要组成部分，但SBRT可用于不适于BRT的小残留病灶患者。影响声明宫颈癌是世界上最常见的癌症之一，外照射放疗（EBRT）和近距离放疗（BRT）是主要的治疗选择。然而，在极少数BRT不可行的情况下，立体定向体部放疗（SBRT）作为BRT的替代方案一直受到质疑。如今，BRT似乎仍是金标准治疗。然而，文献中患者数量少且随访期短的研究表明，在无法进行BRT的情况下，SBRT可能是一个不错的选择。我们的研究是文献中患者数量最多、随访期最长的系列研究之一。在这个没有前瞻性研究的领域，我们认为大量患者的回顾性数据具有启发性。我们的研究表明，SBRT是无法应用BRT的小残留病灶病例的替代选择，并为前瞻性随机研究提供了依据。
