Piver M S, Krishnamsetty R M, Emrich L J
Am J Obstet Gynecol. 1985 Apr 15;151(8):1006-8. doi: 10.1016/0002-9378(85)90370-9.
Twenty patients with Stage IIB carcinoma of the cervix who did not undergo pretherapy para-aortic lymphadenectomy, but who had negative preradiation therapy lymphangiograms, were treated with pelvic radiation plus hydroxyurea. Patients received a median of 5020 rads of pelvic radiation plus 4000 rads of radium to point A. During radiation therapy and for a total of 12 weeks, patients received hydroxyurea administered at a dose of 80 mg/kg of body weight every 3 days if the white blood cell count was greater than or equal to 2,500/mm3 and platelets were greater than or equal to 75,000/mm3. The median follow-up time was 28 months (6 to 83 months). The estimated 5-year survival rate was 92%. Seventeen patients are alive with no evidence of disease (median, 28 months); one died of intercurrent disease with no evidence of disease (17 months); one is alive with no evidence of disease after recurrence (18 months); and one died of cervical cancer (22 months). The survival rate of patients with nonsurgically staged negative pretherapy lymphangiograms who had Stage IIB cervical cancer treated by pelvic radiation therapy plus hydroxyurea approximated the improved survival rate reported for patients with negative pretherapy para-aortic lymphadenectomy who were treated with pelvic radiation therapy plus hydroxyurea. Both studies would suggest that pelvic radiation plus hydroxyurea improves the rate of survival in patients with Stage IIB cervical cancer.
20例IIB期宫颈癌患者未接受治疗前的主动脉旁淋巴结清扫术，但放疗前淋巴管造影结果为阴性，接受了盆腔放疗加羟基脲治疗。患者接受盆腔放疗的中位剂量为5020拉德，A点加用4000拉德镭。在放疗期间及总共12周内，如果白细胞计数大于或等于2500/mm³且血小板计数大于或等于75000/mm³，患者每3天接受一次剂量为80mg/kg体重的羟基脲治疗。中位随访时间为28个月（6至83个月）。估计5年生存率为92%。17例患者存活且无疾病证据（中位时间，28个月）；1例死于并发疾病且无疾病证据（17个月）；1例复发后存活且无疾病证据（18个月）；1例死于宫颈癌（22个月）。对于未接受手术分期且放疗前淋巴管造影结果为阴性的IIB期宫颈癌患者，采用盆腔放疗加羟基脲治疗的生存率接近报告的接受盆腔放疗加羟基脲治疗且治疗前主动脉旁淋巴结清扫术结果为阴性的患者的提高后的生存率。两项研究均提示，盆腔放疗加羟基脲可提高IIB期宫颈癌患者的生存率。
