Neoadjuvant chemotherapy followed by radical surgery reduces radiation therapy in patients with stage IB2 to IIA2 cervical cancer.
Neoadjuvant chemotherapy followed by radical surgery reduces radiation therapy in patients with stage IB2 to IIA2 cervical cancer.
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DOI：
10.1186/s12957-022-02731-x
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发表时间：
2022-08-23
影响因子：
3.2
通讯作者：
Wang, Zehua
中科院分区：
文献类型：
--
作者：
Huang, Yuhui;Chen, Lei;Cai, Jing;Yang, Lu;Sun, Si;Zhao, Jing;Xiong, Zhoufang;Wang, Zehua
探讨卡铂-紫杉醇脂质体新辅助化疗（NACT）能否通过避免或延迟术后放疗而使局部晚期宫颈癌（LACC）患者获益。回顾性队列研究共纳入了414例国际妇产科联盟（FIGO 2009）IB 2-IIA 2期宫颈癌患者，这些患者在2007年至2017年期间在我院接受卡铂-紫杉醇脂质体化疗，随后接受根治性手术（NACT组）或初次根治性手术（PRS组）。比较两组诊断时的基线临床病理学特征、术后病理学风险因素和术后肿瘤学结局，包括术后放疗（作为辅助治疗或复发性疾病的治疗）、无进展生存期（PFS）和总生存期（OS）。治疗前，NACT组患者的肿瘤分期和肿瘤大小均显著高于PRS组。NACT组肿瘤体积明显缩小，有效率为62.4%，根治性手术时NACT组肿瘤体积小于PRS组。此外，术后病理检查显示NACT组的深部间质浸润频率低于PRS组。根据是否存在复发的病理危险因素，NACT组54.82%的妇女需要辅助放疗，而PRS组60.87%的妇女需要辅助放疗，实际上，NACT组33.00%的患者和PRS组40.09%的患者接受了辅助放疗。此外，8.12%的NACT患者和9.68%的PRS患者在复发后接受了放射治疗。NACT组的累积术后放疗率显著较低（P = 0.041），而两组之间的5年OS和PFS差异无统计学意义。NACT减少了LACC患者的病理风险因素和放射使用，而不影响生存率，这可能会保护年轻患者免受放射相关副作用的影响，从而提高生活质量。ISRCTN登记研究，ISRCTN 24104022
To investigate whether carboplatin-liposomal paclitaxel neoadjuvant chemotherapy (NACT) benefits patients with locally advanced cervical cancer (LACC) through avoiding or delaying postoperative radiation. A total of 414 patients with cervical cancer of International Federation of Gynecology and Obstetrics (FIGO 2009) stages IB2–IIA2 were included in the retrospective cohort study, who had received carboplatin-liposomal paclitaxel chemotherapy followed by radical surgery (NACT group) or primary radical surgery (PRS group) between 2007 and 2017 at our hospital. The baseline clinicopathological characteristics at diagnosis, postoperative pathological risk factors, and oncological outcomes after surgery, including postoperative radiation (as adjuvant treatment or treatment of recurrent diseases), progression-free survival (PFS), and overall survival (OS), were compared between the groups. Before treatment, the patients in the NACT group had significantly more advanced tumor stages and larger tumor sizes than those in the PRS group. The NACT reduced the tumor volumes remarkedly with a response rate of 62.4%, and the tumors in the NACT group were smaller than those in the PRS group when the patients were subjected to radical surgery. Furthermore, postoperative pathology examination revealed less frequent deep stromal invasion in the NACT group than in the PRS group. According to the presence of pathological risk factors for recurrence, 54.82% of women in the NACT group needed adjuvant radiotherapy, while 60.87% in the PRS group, and in fact, 33.00% of NACT patients and 40.09% of PRS patients received adjuvant radiation. In addition, 8.12% of NACT patients and 9.68% of PRS patients underwent radiotherapy after relapse. The cumulative postoperative radiation rate was significantly lower in the NACT group (P = 0.041), while the differences in 5-year OS and PFS were not statistically significant between the groups. NACT reduces the pathological risk factors and the use of radiation without compromising survival in patients with LACC, which may protect younger patients from radiation-related side effects and subsequently improve the quality of life. ISRCTN Registry, ISRCTN24104022
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
4.7
作者：
Chen, Huijun;Liang, Chuan;Wu, Xufeng
通讯作者：
Wu, Xufeng
影响因子：
8.8
作者：
Katsumata N;Yoshikawa H;Kobayashi H;Saito T;Kuzuya K;Nakanishi T;Yasugi T;Yaegashi N;Yokota H;Kodama S;Mizunoe T;Hiura M;Kasamatsu T;Shibata T;Kamura T;Japan Clinical Oncology Group
通讯作者：
Japan Clinical Oncology Group
影响因子：
4.7
作者：
Kim, Hee Seung;Kim, Ju Yeong;Kang, Soon-Beom
通讯作者：
Kang, Soon-Beom
DOI：
10.1111/igc.0b013e3181fe8b6e
发表时间：
2011-01-01
影响因子：
4.8
作者：
Yin, Mingzhu;Zhao, Falin;Chen, Xiuwei
通讯作者：
Chen, Xiuwei