Feng Tao, Zhang Yuxin, Zheng Guanghao, Lv Xiaojuan, Yan Dingding, Feng Yue, Lou Hanmei
Zhejiang Chinese Medical University, Hangzhou, China.
Department of Gynecological Radiotherapy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
J Gynecol Oncol. 2025 Jan;36(1):e10. doi: 10.3802/jgo.2025.36.e10.
This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dual-agent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events.
This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching.
Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3-4 acute haematological toxicities was different between the two groups (p<0.05).
Cisplatin combined with paclitaxel CCRT couldn't improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.
本研究旨在比较局部晚期宫颈癌（LACC）患者接受顺铂单药同步放化疗（CCRT）与顺铂联合紫杉醇双药CCRT的疗效和不良事件。主要结局指标为总生存期（OS）、无进展生存期（PFS）、局部复发（LR）、远处转移（DM）及不良事件的发生情况。
本项回顾性队列研究纳入接受根治性CCRT的2009年FIGO IB1-IVA期宫颈鳞状细胞癌患者。将患者分为A组和B组，经1:1比例倾向评分匹配后比较两组的治疗结局。
回顾了1203例患者的病历，最终纳入572例患者进行倾向评分匹配。倾向评分匹配后，选取121对患者进行分析。A组和B组的OS、PFS、LR和DM发生率分别为78.5%和83.5%（p = 0.417）、73.3%和78.5%（p = 0.312）、6.6%和2.5%（p = 0.123）、19%和15.7%（p = 0.497）。根据分期和淋巴结转移状态进行的进一步亚组分析显示，两组生存率无差异。两组3-4级急性血液学毒性发生率不同（p<0.05）。
顺铂联合紫杉醇CCRT不能提高LACC患者的生存率。然而，联合化疗的血液学毒性更严重但可控。顺铂单药治疗仍是CCRT的首选。需要进一步的前瞻性研究为顺铂加紫杉醇双药同步治疗的疗效提供证据。
