Tumor shrinkage before intracavitary brachytherapy for cancer of the cervix: radiotherapy alone versus concurrent chemoradiotherapy.
Tumor shrinkage before intracavitary brachytherapy for cancer of the cervix: radiotherapy alone versus concurrent chemoradiotherapy.
复制标题
宫颈癌腔内近距离放射治疗前肿瘤缩小：单独放疗与同步放化疗。
作者：
R. Kim;S. Spencer
目的
本研究的目的是比较腔内近距离放射治疗（ICBT）前单纯放疗和同步放化疗的肿瘤缩小情况。
材料和方法
选择19名连续患者（3名IB2期，9名IIB期，7名IIIB期）用于测量肿瘤消退。10例患者接受单独放疗，9例患者同时接受基于顺铂的放化疗。两组的盆腔放射平均剂量均为45戈伊，持续5周。将治疗前基于计算机断层扫描的肿瘤测量结果与治疗后但腔内近距离放射治疗前的测量结果进行比较。颈部肿块的最大宽度和厚度从轴向CT图像测量。
结果
腔内近距离放射治疗前的肿瘤消退差异很大，范围从15%到65%。然而，接受放化疗的患者的肿瘤消退率较高，范围为41%至65%（平均值为55%），而单纯放疗的范围为15%至52%（平均值为38%）。
结论
我们的研究结果表明，显着的肿瘤缩小发生同步放化疗相比，单独放疗。这一发现支持了近期临床试验的结果，这些临床试验证明了同步放化疗对晚期宫颈癌的盆腔控制和生存率的改善。
PURPOSE
The purpose of this study was to compare the tumor shrinkage between radiotherapy alone and concurrent chemoradiotherapy before intracavitary brachytherapy (ICBT).
MATERIALS AND METHODS
Nineteen consecutive patients (three stage IB2, nine stage IIB, seven stage IIIB) were selected for measurement of tumor regression. Ten patients underwent radiotherapy alone, and nine patients underwent concurrent cisplatin-based chemoradiotherapy. The average dose of pelvic radiation was given at 45 Gy over a 5-week period in both groups. Computed tomography-based tumor measurement before treatment was compared with measurement after treatment but before intracavitary brachytherapy. The largest width and thickness of the cervical mass were measured from the axial computed tomographic images.
RESULTS
Tumor regression before intracavitary brachytherapy varied widely, ranging from 15% to 65%. However, the tumor regression in patients who underwent chemoradiotherapy was higher, ranging from 41% to 65% (mean, 55%), compared with radiotherapy alone, which ranged from 15% to 52% (mean, 38%).
CONCLUSION
Our results show that significant tumor shrinkage occurs with concurrent chemoradiotherapy compared with radiotherapy alone. This finding supports the results of recent clinical trials demonstrating improvement of pelvic control and survival with concurrent chemoradiotherapy for advanced cancer of the cervix.