Li Xiaojun, An Cunlian, Feng Chunlan, Sun Jieren, Lu Huixiang, Yang Xiaodong, Wang Kaiping, Wang Ruimei
Heavy Ion Radiotherapy Department, Wuwei Cancer Hospital and Institute, Wuwei Academy of Medical Sciences, Gansu, China 733000.
Department of Gynecology and Oncology, Wuwei Cancer Hospital, Gansu, China 733000.
J Oncol. 2022 Sep 30;2022:9578436. doi: 10.1155/2022/9578436. eCollection 2022.
To investigate the value of neoadjuvant chemotherapy combined with 3D-image-guided afterloading intracavitary radiotherapy in locally advanced cervical cancer (LACC).
Patients with cervical cancer admitted to our hospital from January 1, 2020 to January 1, 2021 were retrieved and analyzed. Cases treated with neoadjuvant chemotherapy and 3D-image-guided afterloading intracavitary radiotherapy were assigned into the observation group (OG), while cases with neoadjuvant chemotherapy alone were assigned into the control group (CG). The short-term effects were determined by RECIST 1.1. Total effective rate (TR) = complete remission (CR) + partial remission (PR). The serum levels of squamous epithelial cell carcinoma antigen (SCC-Ag), glycoantigen 125 (CA125), carcinoembryonic antigen (CEA), and vascular endothelial growth factor (VEGF) were assessed. In view of the difference between tumor markers and diameters before and after treatment, the correlation between them was analyzed by Pearson test. The adverse events were compared, and the amount of operative bleeding and operation time were evaluated. Cox regression analysis was conducted to assess the influencing factors of 1-year disease-free survival time.
Sixty-seven patients were retrieved, including 30 cases in the OG and 37 cases in the CG. There were no significant differences in age, pathological type, tumor size, FIGO stage, past medical history, or smoking history between the two groups ( > 0.05). The TR of patients in the OG was higher than that in the CG ( < 0.05). The SCC-Ag, CA125, CEA, and VEGF levels in the OG decreased markedly after treatment ( < 0.001). The difference in SCC-Ag, CA125, CEA, and VEGF was positively correlated with the difference in tumor diameter before and after treatment ( < 0.05). The incidence of adverse events revealed no obvious difference between the OG and CG ( > 0.05). Cox regression analysis showed that FIGO stage and treatment regimens were independent prognostic factors for 1-year disease-free survival ( < 0.05).
Neoadjuvant chemotherapy combined with 3D-image-guided afterloading intracavitary radiotherapy can improve the TR rate and 1-year disease-free survival of LACC patients without increasing the incidence of adverse events.
探讨新辅助化疗联合三维图像引导后装腔内放疗在局部晚期宫颈癌（LACC）中的应用价值。
回顾性分析2020年1月1日至2021年1月1日我院收治的宫颈癌患者。将接受新辅助化疗联合三维图像引导后装腔内放疗的患者纳入观察组（OG），将单纯接受新辅助化疗的患者纳入对照组（CG）。采用实体瘤疗效评价标准（RECIST）1.1评估近期疗效。总有效率（TR）=完全缓解（CR）+部分缓解（PR）。检测血清鳞状上皮细胞癌抗原（SCC-Ag）、糖类抗原125（CA125）、癌胚抗原（CEA）及血管内皮生长因子（VEGF）水平。针对治疗前后肿瘤标志物及直径的差异，采用Pearson检验分析两者的相关性。比较两组不良事件发生情况，评估术中出血量及手术时间。进行Cox回归分析以评估1年无病生存时间的影响因素。
共纳入67例患者，其中观察组30例，对照组37例。两组患者年龄、病理类型、肿瘤大小、国际妇产科联盟（FIGO）分期、既往病史及吸烟史比较，差异均无统计学意义（>0.05）。观察组患者的TR高于对照组（<0.05）。观察组治疗后SCC-Ag、CA125、CEA及VEGF水平均明显降低（<0.001）。SCC-Ag、CA125、CEA及VEGF的差值与治疗前后肿瘤直径的差值呈正相关（<0.05）。两组不良事件发生率比较，差异无明显统计学意义（>0.05）。Cox回归分析显示，FIGO分期及治疗方案是1年无病生存的独立预后因素（<0.05）。
新辅助化疗联合三维图像引导后装腔内放疗可提高LACC患者的TR率及1年无病生存率，且不增加不良事件发生率。
