Miyoshi Ai, Isohashi Fumiaki, Fujii Makoto, Iwamiya Tadashi, Takemura Masahiko, Nagase Yoshikazu, Yokoi Takeshi, Yoshioka Emi, Ito Kimihiko, Yamabe Eri, Masuhara Kanji, Tsujie Tomoko, Kimura Tadashi, Kodama Michiko
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Gynecology, Kanda Maternity Clinic Annex, Suita, Osaka, Japan.
Int J Gynaecol Obstet. 2025 Aug;170(2):908-915. doi: 10.1002/ijgo.70077. Epub 2025 Mar 22.
Systemic platinum-based chemotherapy is the first-line treatment of choice for metastatic cervical cancer. While subsequent radiotherapy after primary chemotherapy is a potential option, its benefit remains unclear. This multicenter retrospective study aimed to evaluate whether post-chemotherapy radiotherapy improves the prognosis of metastatic cervical cancer.
We retrospectively analyzed 46 eligible patients, including 22 patients receiving chemotherapy-alone and 24 patients receiving chemotherapy followed by subsequent radiotherapy. Medical records were retrospectively reviewed for patient characteristics, subsequent treatment modality, adverse events during the treatment course, metastasis site, recurrence or progression, and recurrence sites. Fisher exact test or chi-squared test, the Mann-Whitney U test, log-rank test, and Cox proportional hazards model were used.
The 2-year overall survival (OS) rate for all patients was 47%, with the median OS of 24.8 months. Patients receiving chemotherapy alone (chemotherapy-alone group) had a 2-year OS rate of 23%, while those receiving subsequent radiotherapy (chemotherapy-radiotherapy group) had a significantly higher OS rate of 67% (HR = 2.83, P = 0.006). The 2-year progression-free survival (PFS) rates were 9% and 33%, respectively (HR = 3.25, P = 0.010). Serious adverse events occurred in 46.2% of the chemotherapy-alone group and 29.2% of the chemotherapy-radiotherapy group during subsequent treatment (P = 0.249).
Post-chemotherapy radiotherapy may improve the prognosis of metastatic cervical cancer without increasing serious adverse events. Further prospective studies are warranted to validate these findings.
基于铂类的全身化疗是转移性宫颈癌的一线治疗选择。虽然原发化疗后进行后续放疗是一种潜在选择，但其益处仍不明确。这项多中心回顾性研究旨在评估化疗后放疗是否能改善转移性宫颈癌的预后。
我们回顾性分析了46例符合条件的患者，其中22例仅接受化疗，24例接受化疗后再进行后续放疗。回顾病历以获取患者特征、后续治疗方式、治疗过程中的不良事件、转移部位、复发或进展情况以及复发部位。使用Fisher精确检验或卡方检验、Mann-Whitney U检验、对数秩检验和Cox比例风险模型。
所有患者的2年总生存率（OS）为47%，中位总生存期为24.8个月。仅接受化疗的患者（单纯化疗组）2年总生存率为23%，而接受后续放疗的患者（化疗-放疗组）总生存率显著更高，为67%（风险比[HR]=2.83，P=0.006）。2年无进展生存率（PFS）分别为9%和33%（HR=3.25，P=0.010）。在后续治疗期间，单纯化疗组46.2%的患者和化疗-放疗组29.2%的患者发生了严重不良事件（P=0.249）。
化疗后放疗可能改善转移性宫颈癌的预后，且不会增加严重不良事件。有必要进行进一步的前瞻性研究来验证这些发现。
