Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
J Med Imaging Radiat Oncol. 2022 Oct;66(7):1014-1021. doi: 10.1111/1754-9485.13443. Epub 2022 Jun 13.
To investigate the association between chemotherapy (CMT) cycles and oncological outcomes in elders with locally advanced cervical cancer (LACC) who treated with concurrent chemoradiotherapy (CCRT).
We retrospective studied 498 elders with LACC who treated with radiotherapy (RT) or CCRT between 2002 and 2018. Patients were divided into three groups: RT, CCRT with 1-4 and CCRT with 5-6 cycles of CMT. We compared progression-free survival (PFS) and overall survival (OS) among the three groups and explored survival prognostic factors via multivariate analysis and time-varying analysis effect.
There were 453 eligible patients; 222, 119 and 112 patients who received RT, CCRT with 1-4 and CCRT with 5-6 cycles of CMT, respectively. Patients in the RT group had older age, poorer performance status, more treatment with conventional RT technique and earlier treatment year comparing with both CCRT groups. Patients who received 5-6 cycles of CMT were less to have underweight, comorbidities and anaemia compared with the RT group. There were patients with lower FIGO stage in 5-6 cycles than in 1-4 cycles of CMT and RT groups. The 5-year PFS and OS between RT, CCRT with 1-4 and CCRT with 5-6 cycles of the CMT group were significantly different. Performance status, comorbidity, histology, FIGO stage and total received 5-6 CMT cycles were significant prognostic factors of PFS and OS. However, the benefits of receiving 5-6 CMT cycles were evidenced only within the first 2.5 years.
Elders with LACC who received 5-6 cycles of CMT concurrently with RT can improve PFS and OS, but the benefit persisted only within the first 2.5 years.
本研究旨在探讨同步放化疗（CCRT）治疗局部晚期宫颈癌（LACC）老年患者中化疗周期数与肿瘤学结局的关系。
本研究回顾性分析了 2002 年至 2018 年间接受放疗（RT）或 CCRT 的 498 例 LACC 老年患者的临床资料。患者分为三组：RT 组、CCRT1-4 周期组和 CCRT5-6 周期组。比较三组患者的无进展生存期（PFS）和总生存期（OS），并通过多因素分析和时变分析效应探讨生存预后因素。
共纳入 453 例患者，其中 RT 组、CCRT1-4 周期组和 CCRT5-6 周期组分别有 222、119 和 112 例患者。与 CCRT 两组相比，RT 组患者年龄较大，体力状况较差，接受常规 RT 技术治疗的比例较高，治疗时间较早。与 RT 组相比，接受 5-6 周期 CMT 的患者体重较轻、合并症和贫血较少。5-6 周期 CMT 组的 FIGO 分期低于 1-4 周期 CMT 组和 RT 组。RT 组、CCRT1-4 周期组和 CCRT5-6 周期组的 5 年 PFS 和 OS 差异有统计学意义。体力状况、合并症、组织学、FIGO 分期和总接受 5-6 周期 CMT 是 PFS 和 OS 的显著预后因素。然而，接受 5-6 周期 CMT 的获益仅在最初 2.5 年内得到证实。
接受同步放化疗的局部晚期宫颈癌老年患者接受 5-6 周期化疗可提高 PFS 和 OS，但获益仅在最初 2.5 年内持续。
