Treatment results of adjuvant chemotherapy after radical hysterectomy for intermediate- and high-risk stage IB-IIA cervical cancer
Treatment results of adjuvant chemotherapy after radical hysterectomy for intermediate- and high-risk stage IB-IIA cervical cancer
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DOI：
10.1016/j.ygyno.2006.04.019
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发表时间：
2006-11-01
影响因子：
4.7
通讯作者：
Hasumi, Katsuhiko
中科院分区：
文献类型：
--
作者：
Takeshima, Nobuhiro;Umayahara, Kenji;Hasumi, Katsuhiko
Objective.确定单纯化疗作为中高危宫颈癌术后辅助治疗的有效性。研究组包括65例IB或IIA期鳞状细胞或腺鳞状宫颈癌患者，他们在1993年至2002年期间接受了根治性子宫切除术和盆腔淋巴结切除术。肿瘤为中危（间质浸润> 50%，n = 30）或高危（手术切缘阳性、宫旁浸润和/或淋巴结受累，n = 35）。在所有病例中，化疗均为非选择性：中危病例使用博来霉素、长春新碱、丝裂霉素和顺铂3个疗程，高危病例使用5个疗程。观察无病生存率和联合治疗的并发症。30例中危肿瘤患者的估计5年无病生存率为93.3%（鳞状细胞癌为100%，腺鳞癌为71.4%），35例高危肿瘤患者的估计5年无病生存率为85.7%（鳞状细胞癌为89.3%，腺鳞癌为71.4%）。中危组局部复发率为3.3%，高危组为8.6%。化疗的副作用和联合治疗的并发症均在可接受的范围内。没有患者发生严重的博莱霉素相关肺毒性。仅1.5%的患者发生小肠梗阻，经保守治疗治愈。治疗结果提示单独辅助化疗对宫颈癌患者的潜在作用。(c)2006年爱思唯尔公司All rights reserved.
Objective. To determine the effectiveness of chemotherapy alone as postoperative adjuvant therapy for intermediate- and high-risk cervical cancer.Methods. The study group comprised of 65 consecutive patients with stage IB or IIA squamous cell or adenosquamous cervical cancer who were initially treated with radical hysterectomy and pelvic lymphadenectomy between 1993 and 2002. Tumors were of intermediate-risk (stromal invasion > 50%, n = 30) or high-risk (positive surgical margin, parametrial invasion, and/or lymph node involvement, n = 35). In all cases, chemotherapy was administered adjuvantly: three courses of bleomycin, vincristine, mitomycin, and cisplatin for intermediate-risk cases and five courses for high-risk cases. Disease-free survival and complications of the combined therapy were investigated.Results. Estimated 5-year disease-free survival was 93.3% for the 30 patients with intermediate-risk tumors (100% for those with squamous cell carcinoma and 71.4% for those with adenosquamous carcinoma) and 85.7% for the 35 patients with high-risk tumors (89.3% for those with squamous cell carcinoma and 71.4% for those with adenosquamous carcinoma). The incidence of locoregional recurrence was 3.3% in the intermediate-risk group and 8.6% in the high-risk group. Side effects of chemotherapy and complications of the combined therapy were within acceptable limits. No patient had severe bleomycin-related pulmonary toxicity. Only 1.5% of patients developed small bowel obstruction, which was cured by conservative therapy.Conclusions. The treatment results suggest the potential role of adjuvant chemotherapy alone for patients with cervical cancer. (c) 2006 Elsevier Inc. All rights reserved.