High-risk group for locoregional recurrence in patients with stage IB-IIB squamous cell carcinoma of the cervix treated with concurrent chemoradiotherapy.
High-risk group for locoregional recurrence in patients with stage IB-IIB squamous cell carcinoma of the cervix treated with concurrent chemoradiotherapy.
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DOI：
10.1200/jco.2010.28.15_suppl.e15519
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发表时间：
2010-05
影响因子：
2
通讯作者：
M. Hirakawa;Y. Nagai;T. Toita;W. Kudaka;M. Inamine;K. Ogawa;S. Murayama;Y. Aoki
中科院分区：
文献类型：
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作者：
M. Hirakawa;Y. Nagai;T. Toita;W. Kudaka;M. Inamine;K. Ogawa;S. Murayama;Y. Aoki
目的探讨FIGO Ⅰ B-Ⅱ B期宫颈癌同期放化疗（CCRT）后局部复发的预测因素。患者和方法分析了1997年至2007年期间123例FIGO IB-IIB期宫颈鳞状细胞癌患者的数据。CCRT的合格性包括肿瘤大小>4 cm和/或淋巴结肿大超过最小直径1 cm。结果多因素分析显示肿瘤大小（≥ 5.2cm）和年龄（<48岁）是局部复发的独立预测因素。根据这两个因素，将患者分为低风险组（n=91）和高风险组（n=32）的局部区域复发。低危组的5年无病生存率为95.3%，明显优于高危组的65.5%（p<0.0001）。高风险组32例患者中有10例出现局部复发，而低风险组91例患者中仅3例出现局部复发。结论为提高高危组的局部控制率，可考虑使用新的放射增敏剂、辅助子宫切除或辅助化疗进行CCRT。
AIM To identify predictive factors for locoregional recurrence in patients with FIGO stage IB-IIB cervical cancer treated with concurrent chemoradiotherapy (CCRT). PATIENTS AND METHODS Data were analyzed for 123 patients with FIGO stage IB-IIB squamous cell carcinoma of the cervix between 1997 and 2007. Eligibility for CCRT included tumor size >4 cm and/or lymph node enlargement over a minimum diameter of 1 cm. RESULTS Tumor size (≥5.2 cm) and age (<48 years) were independent predictive factors for locoregional recurrence by multivariate analysis. Based on these two factors, the patients were divided into low-risk (n=91) and high-risk (n=32) groups for locoregional recurrence. The 5-year disease-free survival for the low-risk group was 95.3%, which was significantly better than 65.5% for the high-risk group (p<0.0001). Locoregional recurrence was noted in 10 out of the 32 patients in the high-risk group compared to only 3 out of the 91 patients in the low-risk group. CONCLUSION To improve locoregional control in the high-risk group, it may be worthwhile to consider CCRT using new radiosensitizing agents, adjuvant hysterectomy or adjuvant chemotherapy.