HIGH-DOSE EXTENDED-FIELD IRRADIATION AND HIGH-DOSE-RATE BRACHYTHERAPY WITH CONCURRENT CHEMOTHERAPY FOR CERVICAL CANCER WITH POSITIVE PARA-AORTIC LYMPH NODES
HIGH-DOSE EXTENDED-FIELD IRRADIATION AND HIGH-DOSE-RATE BRACHYTHERAPY WITH CONCURRENT CHEMOTHERAPY FOR CERVICAL CANCER WITH POSITIVE PARA-AORTIC LYMPH NODES
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DOI：
10.1016/j.ijrobp.2008.10.024
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发表时间：
2009-08-01
影响因子：
7
通讯作者：
Choi, Eun Kyung
中科院分区：
文献类型：
--
作者：
Kim, Young Seok;Kim, Jong Hoon;Choi, Eun Kyung
目的：探讨扩大野放疗(RT)联合铂类化疗对腹主动脉旁淋巴结阳性的宫颈癌患者的疗效和不良反应。方法：回顾分析33例IB-IVB期宫颈癌患者的临床资料。所有患者均接受59.4Gy射线照射，包括腹主动脉旁淋巴结三维适形增强和盆腔外照射41.4~50.4Gy.每个患者还接受了6到7次高剂量率近距离放射治疗(中位数，每次5Gy至A点)。结果：存活患者的中位随访期为39个月。最常见的急性毒性是血液毒性，观察到有23名女性。3例出现严重急性胃肠道反应，4例出现晚期胃肠道反应。超过四分之三的患者表现出完全缓解，包括原发肿块、转移的盆腔和腹主动脉旁淋巴结。在33名妇女中，15名没有疾病证据，6名有持续性疾病，4名出现现场失败，6名出现远距离失败。5年总生存率和无瘤生存率分别为47%和42%。结论：同期放化疗配合扩大野放疗对腹主动脉旁淋巴结阳性的宫颈癌患者是可行的，晚期并发症可接受，存活率高，但有较大的急性毒性反应。(C)2009年爱思唯尔公司。
Purpose: To determine the efficacy and toxicity of extended-field radiotherapy (RT) with concurrent platinum-based chemotherapy in patients with uterine cervical carcinoma and positive para-aortic nodes.Methods and Materials: We retrospectively reviewed the results for 33 women with Stage IB-IVB cervical cancer. Each patient had received 59.4 Gy, including a three-dimensional conformal boost to the para-aortic lymph nodes and 41.4-50.4 Gy of external beam radiotherapy to the pelvis. Each patient also underwent six or seven applications of high-dose-rate brachytherapy (median, 5 Gy to point A at each session).Results: The median follow-up period of surviving patients was 39 months. The most common acute toxicity was hematologic, observed in 23 women. Severe acute and late gastrointestinal toxicity was observed in 3 and 4 patients, respectively. More than three-quarters of patients showed a complete response, encompassing the primary mass, metastatic pelvic, and para-aortic lymph nodes. Of the 33 women, 15 had no evidence of disease, 6 had persistent disease, 4 developed in-field failures, and 6 developed distant failures. The 5-year overall and disease-free survival rate was 47% and 42%, respectively.Conclusion: Concurrent chemoradiotherapy with extended-field radiotherapy is feasible in women with uterine cervical carcinoma and positive para-aortic lymph nodes, with acceptable late morbidity and a high survival rate, although it was accompanied by substantial acute toxicity. (C) 2009 Elsevier Inc.