Concurrent chemoradiation for vaginal cancer.
Concurrent chemoradiation for vaginal cancer.
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DOI：
10.1371/journal.pone.0065048
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Viswanathan AN
中科院分区：
文献类型：
--
作者：
Miyamoto DT;Viswanathan AN
目前尚不清楚在放射治疗的基础上增加化疗是否能改善原发性阴道癌的预后。在这里，我们回顾了原发性阴道癌患者接受放射治疗（RT）或同步放化疗（CRT）的临床结果。71例原发性阴道癌患者在同一家机构接受了明确的放射治疗，同时有或没有化疗，并对他们的记录进行了回顾。共有51例患者单独接受RT治疗；20例患者行CRT治疗。分析复发情况。使用Kaplan-Meier法估计总生存期（OS）和无病生存期（DFS）。进行Cox回归分析。诊断时的中位年龄为61岁（范围18-92岁），幸存者的中位随访时间为3.0年。Kaplan-Meier估计的OS和DFS在RT组和CRT组之间差异显著（3年OS = 56% vs. 79%, log-rank p = 0.037； 3年DFS = 43% vs. 73%, log-rank p = 0.011）。放疗组有23例（45%）复发，CRT组有3例（15%）复发（p = 0.027）。就首次复发部位而言，仅局部复发10例（14%），局部和局部合并复发4例（6%），局部合并复发9例（13%），局部和远处合并复发1例（1%），远处合并复发2例（3%）。在单变量分析中，同时使用化疗、FIGO分期、肿瘤大小和诊断日期是DFS的重要预测因素。在多变量分析中，同时使用化疗仍然是DFS的重要预测因子（风险比0.31 (95% CI, 0.10-0.97; p = 0.04)）。阴道癌的预后很差。适当的辐射剂量是确保治疗管理的必要条件。阴道癌患者应考虑同期化疗。
It is not known whether the addition of chemotherapy to radiation therapy improves outcomes in primary vaginal cancer. Here, we review clinical outcomes in patients with primary vaginal cancer treated with radiation therapy (RT) or concurrent chemoradiation therapy (CRT). Seventy-one patients with primary vaginal cancer treated with definitive RT with or without concurrent chemotherapy at a single institution were identified and their records reviewed. A total of 51 patients were treated with RT alone; 20 patients were treated with CRT. Recurrences were analyzed. Overall survival (OS) and disease-free survival (DFS) rates were estimated using the Kaplan-Meier method. Cox regression analysis was performed. The median age at diagnosis was 61 years (range, 18–92 years) and the median follow-up time among survivors was 3.0 years. Kaplan-Meier estimates for OS and DFS differed significantly between the RT and CRT groups (3-yr OS = 56% vs. 79%, log-rank p = 0.037; 3-yr DFS = 43% vs. 73%, log-rank p = 0.011). Twenty-three patients (45%) in the RT group had a relapse at any site compared to 3 (15%) in the CRT group (p = 0.027). With regard to the sites of first relapse, 10 patients (14%) had local only, 4 (6%) had local and regional, 9 (13%) had regional only, 1 (1%) had regional and distant, and 2 (3%) had distant only relapse. On univariate analysis, the use of concurrent chemotherapy, FIGO stage, tumor size, and date of diagnosis were significant predictors of DFS. On multivariate analysis, the use of concurrent chemotherapy remained a significant predictor of DFS (hazard ratio 0.31 (95% CI, 0.10–0.97; p = 0.04)). Vaginal cancer results in poor outcomes. Adequate radiation dose is essential to ensure curative management. Concurrent chemotherapy should be considered for vaginal cancer patients.
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影响因子：
2.5
作者：
Kapur, Tina;Egger, Jan;Damato, Antonio;Schmidt, Ehud J.;Viswanathan, Akila N.
通讯作者：
Viswanathan, Akila N.
DOI：
10.1111/j.1048-891x.2004.014066.x
发表时间：
2004-01-01
影响因子：
4.8
作者：
Dalrymple, JL;Russell, AH;Smith, LH
通讯作者：
Smith, LH
DOI：
10.1016/s0360-3016(98)00193-x
发表时间：
1998-08-01
影响因子：
7
作者：
Moore, DH;Thomas, GM;Olt, G
通讯作者：
Olt, G
影响因子：
4.7
作者：
Tran, Phuoc T.;Su, Zheng;Kapp, Daniel S.
通讯作者：
Kapp, Daniel S.
影响因子：
7.2
作者：
Shah CA;Goff BA;Lowe K;Peters WA 3rd;Li CI
通讯作者：
Li CI