Postoperative concurrent nedaplatin-based chemoradiotherapy improves survival in early-stage cervical cancer patients with adverse risk factors
Postoperative concurrent nedaplatin-based chemoradiotherapy improves survival in early-stage cervical cancer patients with adverse risk factors
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DOI：
10.1016/j.ygyno.2009.09.002
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发表时间：
2009-12-01
影响因子：
4.7
通讯作者：
Kimura, Tadashi
中科院分区：
文献类型：
--
作者：
Mabuchi, Seiji;Morishige, Ken-ichirou;Kimura, Tadashi
目标.本研究的目的是评价术后奈达铂为基础的同步放化疗（CCRT）在有不良危险因素的FIGO IA 2-IIB期宫颈癌患者中的疗效。我们回顾性分析了1997年4月至2006年3月间183例接受根治性手术的早期宫颈癌患者的病历。其中，68例患者显示高风险预后因素，如盆腔淋巴结阳性，宫旁受累，或手术切缘阳性。57例患者表现出中等风险的预后因素，包括深部间质浸润，毛细淋巴间隙受累，或大肿瘤直径。这些患者术后接受CCRT或单纯放疗（RT）治疗。58例患者未显示风险因素，因此，术后未接受辅助治疗。比较两组患者的3年复发率、无进展生存期（PFS）和总生存期（OS）。在显示高风险和中风险预后因素的患者中，CCRT在复发率、PFS和OS方面显著优于单独RT，但差异无统计学意义（上级）。CCRT组急性3-4级毒性反应发生率明显高于单纯RT组。然而，在严重的晚期毒性方面没有观察到统计学显著差异。术后基于奈达铂的CCRT安全进行，并改善了具有高危或中危预后因素的FIGO IA 2-IIB期宫颈癌患者的预后。在该患者人群中，该治疗可视为顺铂为主的放化疗的替代治疗。(C)2009 Elsevier Inc. All rights reserved.
Objectives. The aim Of this Study was to evaluate the efficacy of postoperative nedaplatin-based concurrent chemoradiotherapy (CCRT) in patients with FIGO stage IA2-IIB cervical cancer with adverse risk factors.Methods. We retrospectively reviewed the medical records of 183 patients with early-stage cervical cancer who had undergone radical Surgery between April 1997 and March 2006. Of these, 68 patients displayed high-risk prognostic factors Such as positive pelvic lymph nodes, parametrial involvement, or a positive surgical margin. Fifty-seven patients demonstrated intermediate-risk prognostic factors including deep stromal invasion, capillary lymphatic space involvement, or large tumor diameter. These patients were treated postoperatively with CCRT or radiotherapy alone (RT). Fifty-eight patients showed no risk factors and, therefore, received no adjuvant therapy after Surgery. The 3-year recurrence rate, progression free survival (PFS), and overall Survival (OS) were compared between the treatment groups.Results. CCRT was significantly superior to RT alone with regard to recurrence rate, PFS, and OS in patients that displayed high-risk and intermediate-risk prognostic factors. The frequencies Of acute grade 3-4 toxicities were significantly higher in patients treated with CCRT than in those treated with RT alone. However, no statistically significant difference was observed with regard to severe late toxicities.Conclusions. Postoperative nedaplatin-based CCRT was safely performed and improved the prognosis of FIGO stage IA2-IIB cervical cancer patients displaying high-risk or intermediate-risk prognostic factors. This treatment can be considered as an alternative to cisplatin-based chemoradiotherapy in this patient population. (C) 2009 Elsevier Inc. All rights reserved.