The Christie NHS Foundation Trust, Clinical Oncology, Manchester.
The Christie NHS Foundation Trust, Clinical Oncology, Manchester; The Clatterbridge Cancer Centre, Clinical Oncology, Liverpool.
Radiother Oncol. 2022 Oct;175:42-46. doi: 10.1016/j.radonc.2022.07.023. Epub 2022 Aug 11.
Metastatic and incurable cancers of the gynaecological tract (FGTC) represent a major global health burden. Systemic treatment has modest efficacy and radiotherapy is often used for local symptoms. This study combines experience from two large UK centres in palliative radiotherapy for gynaecological cancers.
Pooled data from two major centres was analysed. Advanced FGTC patients who received at least one fraction of palliative radiotherapy to the pelvis between 2013 and 2018 were included. Data collected included demographic and tumour details, radiotherapy dose fractionation and details of previous and subsequent treatment. Response was defined in terms of toxicity, symptomatic response and survival. Comorbidities were recorded using a modified ACE 27 score which is adjusted for the presence of uncontrolled FGTC in all the patients.
A total of 184 patients were included for treatment response and toxicity; survival data was available for 165 patients. Subjective response in pre-radiotherapy symptoms was documented in 80.4%. Grade 3 or worse gastrointestinal, urinary and other (vomiting, fatigue, pain) toxicity incidence was 2.2%, 3.8%, and 2.7% respectively. No statistically significant correlation between the prescribed EQD2 and symptom control or toxicity was seen. 1 year overall survival was 25.1% (median 5.9 months). Absent distant metastases, completion of the intended course of radiotherapy, response to radiotherapy, and receipt of further lines of treatment were independent prognostic factors.
Palliative radiotherapy is effective for symptoms of advanced FGTC with low toxicity. The absence of a dose response argues for short low dose palliative radiotherapy schedules to be used.
妇科生殖道转移性和不可治愈癌症（FGTC）是全球主要的健康负担。全身治疗的疗效有限，放疗通常用于局部症状。本研究结合了英国两个大型中心在妇科癌症姑息性放疗方面的经验。
对两个主要中心的数据进行了汇总分析。纳入了 2013 年至 2018 年期间至少接受过一次盆腔姑息性放疗的晚期 FGTC 患者。收集的数据包括人口统计学和肿瘤特征、放疗剂量分割以及之前和之后治疗的详细信息。根据毒性、症状缓解和生存情况来定义反应。共病采用改良的 ACE 27 评分记录，该评分在所有患者中均针对 FGTC 进行了调整。
共纳入 184 例患者进行治疗反应和毒性评估；165 例患者的生存数据可用。80.4%的患者记录了放疗前症状的主观缓解。3 级或更高级别的胃肠道、泌尿系统和其他（呕吐、疲劳、疼痛）毒性发生率分别为 2.2%、3.8%和 2.7%。未观察到处方 EQD2 与症状控制或毒性之间存在统计学显著相关性。1 年总生存率为 25.1%（中位 5.9 个月）。无远处转移、完成计划放疗疗程、对放疗的反应以及接受进一步的治疗线是独立的预后因素。
姑息性放疗对晚期 FGTC 的症状有效，毒性低。没有剂量反应表明应使用短程低剂量姑息性放疗方案。
