Radical hysterectomy with adjuvant radiotherapy versus definitive radiotherapy alone for FIGO stage IIB cervical cancer
Radical hysterectomy with adjuvant radiotherapy versus definitive radiotherapy alone for FIGO stage IIB cervical cancer
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DOI：
10.1016/j.ygyno.2011.07.009
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发表时间：
2011-11-01
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;Okazawa, Mika;Kimura, Tadashi
目标。本研究的目的是比较FIGO期BB期宫颈癌根治性子宫切除术后辅助性放疗与单纯放疗的疗效和不良反应。我们回顾了1996年4月至2009年12月期间收治的FIGO IIB期宫颈癌患者的病历。在研究期间，95例患者接受了根治性子宫切除术，所有患者都接受了辅助放射治疗(基于手术的组)。此外，94名患者单独接受了明确的放射治疗(基于RT的组)。比较两组的复发率、无进展生存期(PFS)、总生存期(OS)和治疗相关并发症。根治性子宫切除术后辅助性放疗的复发率(44.2%比41.5%，p=0.77)、PFS(对数等级，p=0.57)和OS率(对数等级，p=0.41)与单纯放疗组相似。两组急性3-4级毒副反应发生率相似(24.2%对24.5%，P=0.048)，而手术组3-4级晚期毒性发生率显著高于放疗组(24.1%对10.6%，P=0.048)。COX多因素分析显示，手术加辅助放射治疗可增加3~4级晚期毒性反应的风险，但差异无统计学意义(优势比2.41，95%CI0.97~5.99，P=0.059)。在FIGO IIB期宫颈癌患者中，明确的放射治疗被发现是一种比根治性子宫切除术后放射治疗更安全的方法，而且与治疗相关的并发症较少，生存结果相似。(C)2011 Elsevier Inc.保留所有权利。
Objectives. The aim of this study was to compare the treatment outcomes and adverse effects of radical hysterectomy followed by adjuvant radiotherapy with definitive radiotherapy alone in patients with FIGO stage BB cervical cancer.Methods. We retrospectively reviewed the medical records of FIGO stage IIB cervical cancer patients who were treated between April 1996 and December 2009. During the study period, 95 patients were treated with radical hysterectomy, all of which received adjuvant radiotherapy (surgery-based group). In addition, 94 patients received definitive radiotherapy alone (RT-based group). The recurrence rate, progression-free survival (PFS), overall survival (OS), and treatment-related complications were compared between the two groups.Results. Radical hysterectomy followed by adjuvant radiotherapy resulted in comparable recurrence (44.2% versus 41.5%, p = 0.77), PFS (log-rank, p = 0.57), and OS rates (log-rank, p = 0.41) to definitive radiotherapy alone. The frequencies of acute grade 3-4 toxicities were similar between the two groups (24.2% versus 24.5%, p = 1.0), whereas the frequencies of grade 3-4 late toxicities were significantly higher in the surgery-based group than in the RT-based group (24.1% versus 10.6%, p = 0.048). Cox multivariate analyses demonstrated that treatment with surgery followed by adjuvant radiotherapy was associated with an increased risk of grade 3-4 late toxicities, although the statistical significance of the difference was marginal (odds ratio 2.41, 95%CI 0.97-5.99, p = 0.059).Conclusions. Definitive radiotherapy was found to be a safer approach than radical hysterectomy followed by postoperative radiotherapy with less treatment-related complications and comparable survival outcomes in patients with FIGO stage IIB cervical cancer. (C) 2011 Elsevier Inc. All rights reserved.