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[子宫颈癌Ⅱ期晚期和Ⅲ期的单纯放射治疗。居里研究所393例治疗结果及治疗并发症(作者译)]

[Exclusive radiotherapy of late stage II and stage III carcinoma of the uterine cervix. Results and therapeutic complications for 393 cases treated at the Institut Curie (author's transl)].

作者信息

Fenton J, Decroix Y

出版信息

Bull Cancer. 1979;66(5):542-8.

PMID:554682
Abstract

Late stage II and stage III uterine cervix cancers are actual pelvic tumours and their treatment requires high doses. Therefore there is a risk of complications for the neighbouring structures. External and intracavitary irradiation are associated, the latter in a second time. For 141 late stage II and 252 stage III cases treated at the Institut Curie from 1963 to 1971 included, the respective actuarial survival are: 61 and 43 per cent at 5 years; 55 and 35 per cent at 10 years; and 55 and 30 per cent at 15 years. There is a significantly statistical difference between unilateral and bilateral stage III cancers actuarial survival: at 5 years, 52 and 34 per cent; at 10 years, 45 and 29 per cent; at 15 years, 37 and 25 per cent. Likewise, the survival for stage III cases with an abnormal urogram is distinctly poorer than for cases with a normal urogram: 48 and 18 per cent at 5 years; 41 and 13 per cent at 10 years; 38 and 8 per cent at 15 years. The crude cure rate for all the cases remains almost unchanged from the seventh year on. Failures due to cancer are mostly pelvic evolutions or recurrences, excepted a few isolated metastases (about 15 per cent of the overall failures). The majority of the failures occur during the first three years. The treatment complications are mostly moderate (4/5 are mere sequelae); rectum and bladder are the most exposed to the risk; only 5 per cent of the cured patients had severe complications.

摘要

II期晚期和III期宫颈癌实际上是盆腔肿瘤,其治疗需要高剂量。因此,邻近结构存在并发症风险。外照射和腔内照射联合使用,后者在第二次治疗时进行。在居里研究所1963年至1971年收治的141例II期晚期和252例III期病例中,各自的精算生存率分别为:5年时为61%和43%;10年时为55%和35%;15年时为55%和30%。单侧和双侧III期癌症的精算生存率存在显著统计学差异:5年时分别为52%和34%;10年时分别为45%和29%;15年时分别为37%和25%。同样,尿路造影异常的III期病例的生存率明显低于尿路造影正常的病例:5年时分别为48%和18%;10年时分别为41%和13%;15年时分别为38%和8%。所有病例的粗治愈率从第七年起几乎保持不变。癌症导致的失败大多是盆腔进展或复发,少数孤立转移除外(约占总失败病例的15%)。大多数失败发生在头三年。治疗并发症大多为中度(五分之四只是后遗症);直肠和膀胱最易面临风险;只有5%的治愈患者出现严重并发症。

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