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接受明确影像学引导放疗的 FIGO IIIC 期宫颈癌患者发生淋巴结失败的风险因素。

Risk Factors for Nodal Failure in Patients with FIGO IIIC Cervical Cancer Receiving Definitive Image-Guided Radiotherapy.

机构信息

Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

出版信息

Curr Oncol. 2023 Dec 8;30(12):10385-10395. doi: 10.3390/curroncol30120756.

Abstract

BACKGROUND

Nodal failure is a major failure pattern for patients with FIGO IIIC cervical cancer, which is further associated with worse survival. This study was designed to investigate risk factors for nodal failure in FIGO IIIC cervical cancer patients.

METHODS

The characteristics of positive lymph nodes (LNs) and relevant clinical factors of 162 FIGO IIIC cervical cancer patients were collected. The chi-square test and logistic regression model were used to identify risk factors for nodal failure.

RESULTS

In total, 368 positive LNs were identified, including 307 pelvic LNs and 61 para-aortic LNs. The nodal failure rates for all LNs, pelvic LNs, and para-aortic LNs were 9.2%, 7.8%, and 16.4%, respectively. After 20 fractions of RT, a nodal short diameter (D) ≥ 0.95 cm and a ratio of nodal shrinkage (ΔV) < 0.435 resulted; <4 cycles of chemotherapy indicated higher nodal failure rates for all LNs. For pelvic LNs, ΔV < 0.435 and <4 cycles of chemotherapy were associated with a higher incidence of nodal failure. For para-aortic LNs, ΔV < 0.435 was the only risk factor for nodal failure.

CONCLUSIONS

Para-aortic LNs were more likely to experience nodal failure than pelvic LNs. Nodal shrinkage during radiotherapy and cycles of chemotherapy were associated with nodal failure in patients with FIGO IIIC cervical cancer.

摘要

背景

对于 FIGO IIIC 期宫颈癌患者,淋巴结失败是一种主要的失败模式,进一步与生存预后不良相关。本研究旨在探讨 FIGO IIIC 期宫颈癌患者淋巴结失败的危险因素。

方法

收集了 162 例 FIGO IIIC 期宫颈癌患者阳性淋巴结(LNs)的特征和相关临床因素。采用卡方检验和逻辑回归模型来确定淋巴结失败的危险因素。

结果

共发现 368 个阳性 LNs,包括 307 个盆腔 LNs 和 61 个主动脉旁 LNs。所有 LNs、盆腔 LNs 和主动脉旁 LNs 的淋巴结失败率分别为 9.2%、7.8%和 16.4%。在接受 20 次放疗后,淋巴结短径(D)≥0.95cm 和淋巴结缩小率(ΔV)<0.435;化疗<4 个周期与所有 LNs 的淋巴结失败率较高相关。对于盆腔 LNs,ΔV<0.435 和化疗<4 个周期与淋巴结失败的发生率较高相关。对于主动脉旁 LNs,ΔV<0.435 是淋巴结失败的唯一危险因素。

结论

主动脉旁 LNs 比盆腔 LNs 更易发生淋巴结失败。放疗期间淋巴结缩小和化疗周期与 FIGO IIIC 期宫颈癌患者的淋巴结失败相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5178/10742234/5d566cb4e856/curroncol-30-00756-g001.jpg

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