Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China.
Technol Cancer Res Treat. 2023 Jan-Dec;22:15330338231185013. doi: 10.1177/15330338231185013.
To evaluate the clinical outcomes of volumetric modulated arc therapy (VMAT) followed by brachytherapy (BT), combined with chemotherapy, and local hyperthermia (HT) on locally advanced cervical cancer (LACC).
In total, 40 patients with FIGO stage IB1-IVB cervical cancer from January 2016 to December 2018 were selectively enrolled in this study. All patients were treated with VMAT (50.4 Gy/1.8 Gy/28 f) concurrent with cisplatin-based chemotherapy (40 mg/m, q1w, 6 cycles) and local HT (40.5-41°C for 60 min, BIW). BT (30-36 y/5-6 f, 2 f/w) was conducted after VMAT. Objective response rate (ORR), local control (LC) time, LC rate, progression-free survival (PFS) rate, cancer-specific survival (CSS) rate, overall survival (OS), median time to tumor progression and treatment-related toxicity were evaluated.
The median follow-up time was 31 months (8-48). The ORR was 100% at 3 months after treatment and 92.1% at 6 months, respectively. The 1-year, 2-year, and 3-year LC rates were 87.4%, 81.9%, and 70.9%, respectively. The average LC time was 31.50 ± 1.89 months (95% CI 27.79-35.21). The 1-year, 2-year, and 3-year PFS rates were 75.85%, 61.2%, and 51.3%, respectively, while the median PFS was 27.07 months. The 1-year, 2-year, and 3-year OS rates were 95%, 84%, and 79.6%, respectively. In total, 12(30%) patients had grade 3/4 bone marrow suppression. One patient had grade 4 leukopenia. In total, 17 patients had grade 1/2 bone marrow suppression. Two patients had grade 3 nausea and grade 3 vomiting reaction, respectively. No grade 3/4 proctitis and bladder reaction were observed. In the late period of treatment, 1 patient had a rectal hemorrhage. In total, 13 patients had vaginal stenosis.
VMAT concurrent with chemotherapy, BT, and local HT had a favorable short-term efficacy and acceptable toxicity on cervical cancer, which was an alternative option for LACC.
评估容积旋转调强放疗（VMAT）联合近距离放疗（BT）、化疗和局部热疗（HT）治疗局部晚期宫颈癌（LACC）的临床结果。
本研究共纳入 2016 年 1 月至 2018 年 12 月期间 40 例 FIGO 分期 IB1-IVB 宫颈癌患者。所有患者均接受 VMAT（50.4Gy/1.8Gy/28f）同步顺铂为基础的化疗（40mg/m2，q1w，6 周期）和局部 HT（40.5-41°C，60min，BIW）。VMAT 后行 BT（30-36Gy/5-6f，2f/w）。评估客观缓解率（ORR）、局部控制（LC）时间、LC 率、无进展生存期（PFS）率、癌症特异性生存期（CSS）率、总生存期（OS）、中位肿瘤进展时间和治疗相关毒性。
中位随访时间为 31 个月（8-48）。治疗后 3 个月的 ORR 为 100%，6 个月时为 92.1%。1 年、2 年和 3 年的 LC 率分别为 87.4%、81.9%和 70.9%。平均 LC 时间为 31.50±1.89 个月（95%CI 27.79-35.21）。1 年、2 年和 3 年的 PFS 率分别为 75.85%、61.2%和 51.3%，中位 PFS 为 27.07 个月。1 年、2 年和 3 年的 OS 率分别为 95%、84%和 79.6%。共有 12 例（30%）患者出现 3/4 级骨髓抑制。1 例患者出现 4 级白细胞减少症。共有 17 例患者出现 1/2 级骨髓抑制。2 例患者出现 1/2 级恶心和 3 级呕吐反应。未观察到 3/4 级直肠炎和膀胱炎反应。治疗后期，1 例患者出现直肠出血。共有 13 例患者出现阴道狭窄。
VMAT 联合化疗、BT 和局部 HT 对宫颈癌有良好的短期疗效和可接受的毒性，是 LACC 的一种替代治疗选择。
