Zhang X, Zhang X, Liu A
Cancer Hospital of Shandong Providence, Jinan.
Zhonghua Fu Chan Ke Za Zhi. 1995 Oct;30(10):611-3.
To investigate the prognostic factors in relation to retreatment modalities in patients with recurrent cervical carcinoma.
According to initial therapy, 194 patients with recurrence were grouped as: (1) surgery, 22 cases; (2) surgery and radiotherapy, 24 cases, and (3) radiotherapy alone, 148 cases. Factors such as clinical stage, sites of recurrence, time of diagnosis of recurrence after initial therapy and modalities of retreatment were analyzed.
There were 19 cases alloted to stage I, 51 cases to stage II (IIa 23 and IIb 28) and 124 cases to stage III (IIIa 21 and IIIb 103); histopathologically confirmed squamous cell carcinoma in 181 cases and adenocarcinoma 13 cases. Central recurrences were found in 91 cases and lateral or pelvic recurrences in 103 cases. Time of diagnosis of recurrence within 2 years from initial treatments was shown in 118 patients and above 2 years in 76 patients. In 147 of the 194 patients retreated, those of the group 1 obtained a median survival rate of 24 months, which was significantly longer than that of group 2, and group 3. The sites of recurrence did not significantly affect the survival.
Radiotherapy remains the treatment of choice for patients with pelvic recurrence after surgery. Previously irradiated patients retreated for recurrence by radiotherapy and (or) chemotherapy had lower response rates. The optimal therapy for these patients should be comprehensive managements including surgery, radiotherapy and chemotherapy.
探讨复发性宫颈癌患者再治疗方式的预后因素。
根据初始治疗情况，将194例复发患者分为：（1）手术组，22例；（2）手术加放疗组，24例；（3）单纯放疗组，148例。分析临床分期、复发部位、初始治疗后复发诊断时间及再治疗方式等因素。
Ⅰ期19例，Ⅱ期51例（Ⅱa期23例，Ⅱb期28例），Ⅲ期124例（Ⅲa期21例，Ⅲb期103例）；组织病理学确诊为鳞状细胞癌181例，腺癌13例。中央复发91例，侧方或盆腔复发103例。初始治疗后2年内复发诊断时间的有118例患者，2年以上的有76例患者。194例接受再治疗的患者中，147例患者中，第1组患者的中位生存率为24个月，明显长于第2组和第3组。复发部位对生存率无明显影响。
放疗仍是手术后盆腔复发患者的首选治疗方法。既往接受过放疗的患者复发后再行放疗和（或）化疗的缓解率较低。这些患者的最佳治疗应包括手术、放疗和化疗的综合管理。
