Accelerated hyperfractionated radiotherapy for cervical cancer: Multi-institutional prospective study of forum for nuclear cooperation in Asia among eight Asian countries
Accelerated hyperfractionated radiotherapy for cervical cancer: Multi-institutional prospective study of forum for nuclear cooperation in Asia among eight Asian countries
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DOI：
10.1016/j.ijrobp.2007.08.038
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发表时间：
2008-04-01
影响因子：
7
通讯作者：
Tsujii, Hirohiko
中科院分区：
文献类型：
--
作者：
Ohno, Tatsuya;Nakano, Takashi;Tsujii, Hirohiko
目的：为了评估加速超分割放射治疗（RT）的毒性和疗效局部晚期cervical cancer.Methods和Materials：一个多机构前瞻性单臂研究进行了8个亚洲国家。1999年至2002年，120例（64例IIB期和56例IIIB期）宫颈鳞状细胞癌患者接受加速超分割放射治疗。外照射放射治疗包括全盆腔30戈伊，1.5戈伊/次，每日2次，随后进行20戈伊盆腔放射治疗，中心屏蔽剂量为2-戈伊次，每日1次。患者在俯卧位时使用小肠移位装置。除了中心屏蔽RT外，还开始了腔内近距离放射治疗。根据放射治疗肿瘤组和放射治疗肿瘤组/欧洲癌症研究和治疗组织的标准进行急性和晚期发病率分级。结果：中位总治疗时间为35天。存活患者的中位随访时间为4.7年。所有患者的5年盆腔控制率和总生存率分别为84%和70%。肿瘤直径6 cm的5年盆腔控制率和总生存率分别为78%和69%。未发生治疗相关死亡。分别在1例、1例和2例患者中观察到小肠、大肠和膀胱的3-4级晚期毒性。在任何网站的3-4级晚期毒性的5年精算率为5%.Conclusion：我们的研究结果表明，加速超分割RT实现了足够的盆腔控制和生存，而不会增加严重的毒性。这种治疗方法在没有放化疗的亚洲国家是可行的。(c)2008年爱思唯尔公司
Purpose: To evaluate the toxicity and efficacy of accelerated hyperfractionated radiotherapy (RT) for locally advanced cervical cancer.Methods and Materials: A multi-institutional prospective single-arm study was conducted among eight Asian countries. Between 1999 and 2002, 120 patients (64 with Stage IIB and 56 with Stage IIIB) with squamous cell carcinoma of the cervix were treated with accelerated hyperfractionated RT. External beam RT consisted of 30 Gy to the whole pelvis, 1.5 Gy/fraction twice daily, followed by 20 Gy of pelvic RT with central shielding at a dose of 2-Gy fractions daily. A small bowel displacement device was used with the patient in the prone position. In addition to central shielding RT, intracavitary brachytherapy was started. Acute and late morbidities were graded according to the Radiation Therapy Oncology Group and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.Results: The median overall treatment time was 35 days. The median follow-up time for surviving patients was 4.7 years. The 5-year pelvic control and overall survival rate for all patients was 84% and 70%, respectively. The 5-year pelvic control and overall survival rate was 78% and 69% for tumors :6 cm in diameter, respectively. No treatment-related death occurred. Grade 3-4 late toxicities of the small intestine, large intestine, and bladder were observed in 1, 1, and 2 patients, respectively. The 5-year actuarial rate of Grade 3-4 late toxicity at any site was 5 %.Conclusion: The results of our study have shown that accelerated hyperfractionated RT achieved sufficient pelvic control and survival without increasing severe toxicity. This treatment could be feasible in those Asian countries where chemoradiotherapy is not available. (c) 2008 Elsevier Inc.