VALUE OF ADJUVANT WHOLE-PELVIS IRRADIATION AFTER WERTHEIM HYSTERECTOMY FOR EARLY-STAGE SQUAMOUS CARCINOMA OF THE CERVIX WITH PELVIC NODAL METASTASIS - A MATCHED-CONTROL STUDY
VALUE OF ADJUVANT WHOLE-PELVIS IRRADIATION AFTER WERTHEIM HYSTERECTOMY FOR EARLY-STAGE SQUAMOUS CARCINOMA OF THE CERVIX WITH PELVIC NODAL METASTASIS - A MATCHED-CONTROL STUDY
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DOI：
10.1016/0090-8258(89)90156-x
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发表时间：
1989-09-01
影响因子：
4.7
通讯作者：
SHINGLETON, HM
中科院分区：
文献类型：
--
作者：
KINNEY, WK;ALVAREZ, RD;SHINGLETON, HM
在一项回顾性研究中，185例既往未经治疗的IB或IIA期（国际妇产科联合会）宫颈鳞状细胞癌患者在Wertheim子宫切除术和双侧盆腔淋巴结切除术时发现盆腔淋巴结转移。在这些患者中，103例接受了辅助性全骨盆照射，82例未接受辅助治疗。盆腔照射的中位剂量为5000 cGy。在接受放射治疗的患者中，75%的剂量为5000 cGy或更高。根据分期、肿瘤大小、阳性淋巴结的数量和位置，将接受过放疗和未接受过放疗的患者配对，共产生60对。60名接受过放射治疗的患者平均随访时间为3.9年，未接受过放射治疗的患者平均随访时间为5.8年。两组的Kaplan-Meier总体和癌症特异性生存率估计值无显著差异（P> 0.30）。在随访期间，21名仅接受手术的患者和22名接受辅助放疗的患者出现复发，但辅助放疗降低了仅发生在骨盆的复发比例--27%，而仅接受手术的患者为67%（P= 0.01）。
In a retrospective study, 185 patients with previously untreated stage IB or IIA (International Federation of Gynecology and Obstetrics) squamous cell carcinoma of the cervix were found to have pelvic nodal metastasis at the time of Wertheim hysterectomy and bilateral pelvic lymphadenectomy. Of these patients, 103 received adjuvant whole-pelvis irradiation and 82 received no adjuvant therapy. Median dose of pelvic irradiation was 5000 cGy. Among the irradiated patients, in 75% the dose was 5000 cGy or greater. Matching irradiated and nonirradiated patients according to stage, tumor size, and number and location of positive nodes yielded 60 pairs. Mean length of follow-up was 3.9 years for the 60 irradiated patients and 5.8 years for the nonirradiated patients. Kaplan-Meier overall and cancer-specific survival estimates for the two groups were not significantly different (P> 0.30). During the follow-up period, 21 surgery-only patients and 22 patients treated with adjuvant radiotherapy had recurrence, but adjuvant radiotherapy decreased the proportion of recurrences occurring in the pelvis alone—27% compared with 67% in the surgery-only group (P= 0.01).