Differences in outcome for cervical cancer patients treated with or without brachytherapy
Differences in outcome for cervical cancer patients treated with or without brachytherapy
复制标题
DOI：
10.1016/j.brachy.2016.09.011
复制
发表时间：
2017-01-01
期刊：
影响因子：
1.9
通讯作者：
Sorbe, Bengt
中科院分区：
文献类型：
--
作者：
Karlsson, Johannes;Dreifaldt, Ann-Charlotte;Sorbe, Bengt
目得：比较宫颈癌患者的临床结果与原发性放射治疗，并没有增加brachytherapy.METHODS和MATERIALS：在所有，220例宫颈癌I期电视治疗1993年和2009年之间。134例患者在外照射放疗的基础上加用3 ~ 5次6.0戈伊的近距离放射治疗，86例患者仅接受外照射放疗（EBRTA）。EBRTA组采用外照射替代近距离放射治疗，肿瘤总剂量64-72戈伊。结果：全组5年总生存率和肿瘤特异性生存率分别为42.5%和55.5%。近距离放射治疗组的原发完全缓解率、5年癌症特异性生存率和复发率分别为92.5%、68.5%和31.3%，EBRTA组分别为73.3%、35.4%和37.2%。接受近距离放射治疗的患者的生存率（所有类型）显著（p < 0.0001）优于接受外部加强治疗的患者，但这种差异在FIGO II期肿瘤中最为明显。较高的FIGO阶段，非鳞状细胞癌组织学，EBRTA治疗，和较低的总相等2-戈伊（EQD 2）外部剂量显着相关较差的生存率，缓解率较低，高复发率在多变量models.Conclusions：原发性肿瘤缓解率，复发率，和所有类型的生存率提高了近距离放射治疗组。近距离放射治疗对于肿瘤的周边和中心部分获得足够的剂量是很重要的，并且在宫颈癌的治疗中应该始终考虑。(C)2016年美国近距离放射治疗协会。爱思唯尔公司出版All rights reserved.
PURPOSE: To compare the clinical outcome of cervical cancer patients treated with primary radiotherapy with and without the addition of brachytherapy.METHODS AND MATERIALS: In all, 220 patients with cervical cancer stage I TV treated between 1993 and 2009 were included. Three or five 6.0 Gy fractions of brachytherapy were given in addition to the external beam radiotherapy to 134 patients, whereas 86 patients received external beam radiotherapy alone (EBRTA). In the EBRTA group, the patients received external boost instead of brachytherapy with a total dose to the tumor of 64-72 Gy.RESULTS: The 5-year overall survival and cancer-specific survival rates of the complete series were 42.5% and 55.5%, respectively. The rates of primary complete remission, 5-year cancer specific survival, and recurrence were 92.5%, 68.5%, and 31.3% for the brachytherapy group vs. 73.3%, 35.4%, and 37.2% for the EBRTA group. The survival (all types) of the patients receiving brachytherapy was significantly (p < 0.0001) better than for the patients treated with external boost, but the difference was most pronounced in FIGO stage II tumors. Higher FIGO stage, nonsquamous cell carcinoma histology, treatment with EBRTA, and lower total equal 2-Gy (EQD2) external dose were significantly associated with poorer survival, lower rate of remission, and higher recurrence rate in multivariate models.CONCLUSIONS: Primary tumor remission rate, recurrence rate, and all types of survival rates were improved in the brachytherapy group. Brachytherapy is important to achieve sufficient doses to the periphery and central part of the tumor and should always be considered in treatment of cervical carcinomas. (C) 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.