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调强放疗（IMRT）对转移性宫颈癌远处转移淋巴结的临床意义。

Clinical significance of intensity-modulated radiotherapy (IMRT) to the distant metastatic lymph nodes for metastatic cervical cancer.

机构信息

Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China.

Department of Digestive Endoscopic Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

出版信息

BMC Cancer. 2024 Sep 20;24(1):1170. doi: 10.1186/s12885-024-12895-2.

DOI:10.1186/s12885-024-12895-2
PMID:39304814
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11414034/
Abstract

OBJECTIVE

To retrospectively explore the clinical significance of radiotherapy to the distant metastatic lymph nodes (cervical/ clavicular/ mediastinal et al.) in metastatic cervical cancer. Hereinto, these cervicothoracic lymph nodes were metastasized from IB1-IVA (initial stage at first treatment), and IVB initially had metastatic disease in these areas at diagnosis.

METHODS

Metastatic cervical cancer only with the distant cervicothoracic metastatic lymph nodes (cervical/ clavicular/ mediastinal et al.), without distant parenchymal organs metastasis such as lung, liver, bone, and peritoneum, were enrolled in the analysis. These patients were classified into IB1-IVA and IVB based on their initial stage of first treatment. All patients received IMRT for the distant metastatic lymph nodes. The progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method.

RESULTS

Overall, the median PFS was 9 months, and the median OS was 27 months. The subgroup analysis showed that for IB1-IVA, the median PFS was 11 months, and the median OS was 30.5 months. For IVB, the median PFS was 8 months, and the median OS was 16 months.

CONCLUSION

Radiotherapy is beneficial to the distant metastatic lymph nodes (cervical/ clavicular/ mediastinal et al.), and could effectively bring the longer PFS and OS for metastatic cervical cancer.

摘要

目的

回顾性探讨转移性宫颈癌远处转移性淋巴结（颈/锁骨/纵隔等）放疗的临床意义。其中，这些颈胸淋巴结转移自 IB1-IVA 期（初治时的初始阶段），IVB 期初治时这些区域已有转移性疾病。

方法

仅患有远处颈胸转移性淋巴结（颈/锁骨/纵隔等）而无肺、肝、骨和腹膜等远处实质器官转移的转移性宫颈癌患者纳入分析。这些患者根据初治时的初始分期分为 IB1-IVA 和 IVB 期。所有患者均接受远处转移性淋巴结的调强放疗。采用 Kaplan-Meier 法分析无进展生存期（PFS）和总生存期（OS）。

结果

总体而言，中位 PFS 为 9 个月，中位 OS 为 27 个月。亚组分析显示，IB1-IVA 期患者的中位 PFS 为 11 个月，中位 OS 为 30.5 个月。IVB 期患者的中位 PFS 为 8 个月，中位 OS 为 16 个月。

结论

放疗对远处转移性淋巴结（颈/锁骨/纵隔等）有益，可为转移性宫颈癌带来更长的 PFS 和 OS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/79b92f1171d4/12885_2024_12895_Figd_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/66821536feb1/12885_2024_12895_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/b2b5c2d880ab/12885_2024_12895_Figb_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/ca0bf23c0b75/12885_2024_12895_Figc_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/79b92f1171d4/12885_2024_12895_Figd_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/66821536feb1/12885_2024_12895_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/b2b5c2d880ab/12885_2024_12895_Figb_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/ca0bf23c0b75/12885_2024_12895_Figc_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/11414034/79b92f1171d4/12885_2024_12895_Figd_HTML.jpg

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