Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, China.
National Health Commission Key Laboratory of Pulmonary Immune-Related Diseases, Guizhou Province People's Hospital, Guiyang, Guizhou, China.
Front Immunol. 2022 Oct 17;13:995930. doi: 10.3389/fimmu.2022.995930. eCollection 2022.
The treatment of residual/recurrent cervical cancer within a previously irradiated area is challenging and generally associated with a poor outcome. Local treatments such as salvage surgery and re-irradiation are usually traumatic and have limited efficacy. High intensity focused ultrasound (HIFU) treatment can directly ablate solid tumors without damaging neighboring healthy tissue. However, the HIFU studies for these patients are limited. Experience gained over the course of 10 years with the use of HIFU for the management of residual/recurrent cervical cancer after chemoradiotherapy is reported herein.
153 patients with residual/recurrent cervical cancer in a previously irradiated field who received HIFU treatment between 2010 and 2021 were retrospectively analyzed. Adverse effects, survival benefit and factors affecting prognosis were given particular attention.
A total of 36 patients (23.5%) achieved a partial response following HIFU treatment and 107 patients (69.9%) had stable disease. The objective response and disease control rates were 23.5% and 93.5%, respectively. The median progression-free survival (mPFS) and median overall survival (mOS) were 17.0 months and 24.5 months, respectively. Moreover, patients with lesions ≥1.40 cm before HIFU treatment and a shrinkage rate ≥ 30% after treatment had a higher mPFS and mOS, and patients with lesions ≤1.00 cm after HIFU treatment had a higher mPFS (P=<0.05). All the treatment-related adverse events were limited to minor complications, which included skin burns, abdominal pain and vaginal discharge.
HIFU treatment is likely a preferred option for cervical cancer patients with residual disease or recurrence following CRT that can safely improve the local control rate and extend survival.
治疗既往放疗区域内的残留/复发宫颈癌具有挑战性，通常预后较差。挽救性手术和再放疗等局部治疗通常具有创伤性，疗效有限。高强度聚焦超声（HIFU）治疗可以直接消融实体肿瘤，而不会损伤相邻的健康组织。然而，针对这些患者的 HIFU 研究有限。本文报告了 10 年来使用 HIFU 治疗放化疗后残留/复发宫颈癌的经验。
回顾性分析了 2010 年至 2021 年期间接受 HIFU 治疗的 153 例既往放疗区域内残留/复发宫颈癌患者。特别关注不良反应、生存获益和影响预后的因素。
HIFU 治疗后，共有 36 例（23.5%）患者达到部分缓解，107 例（69.9%）患者疾病稳定。客观缓解率和疾病控制率分别为 23.5%和 93.5%。中位无进展生存期（mPFS）和中位总生存期（mOS）分别为 17.0 个月和 24.5 个月。此外，HIFU 治疗前病灶≥1.40cm 且治疗后退缩率≥30%的患者 mPFS 和 mOS 较高，HIFU 治疗后病灶≤1.00cm 的患者 mPFS 较高（P<0.05）。所有与治疗相关的不良反应均局限于轻微并发症，包括皮肤烧伤、腹痛和阴道分泌物。
HIFU 治疗可能是 CRT 后宫颈癌残留或复发患者的首选治疗方法，可安全提高局部控制率并延长生存时间。
