Matched-case comparison for the efficacy of neoadjuvant chemotherapy before surgery in FIGO stage IB1-IIA cervical cancer
Matched-case comparison for the efficacy of neoadjuvant chemotherapy before surgery in FIGO stage IB1-IIA cervical cancer
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DOI：
10.1016/j.ygyno.2010.06.017
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发表时间：
2010-11-01
影响因子：
4.7
通讯作者：
Kang, Soon-Beom
中科院分区：
文献类型：
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作者：
Kim, Hee Seung;Kim, Ju Yeong;Kang, Soon-Beom
Objective.评估术前新辅助化疗（NCS）是否比初次手术治疗（PST）更有效地改善FIGO IB 1-IIA期宫颈癌的临床结局。我们进行了匹配病例比较，其中61例NCS治疗患者与183例PST治疗患者相匹配。我们比较了NCS和PST之间的中高危因素、辅助放疗的需要、疾病复发和生存率。有>= 2个中度危险因素或>= 1个高危因素的患者接受以顺铂为基础的辅助同步放化疗。在IIA期疾病中，NCS比PST更明确地减少了中高危因素，尽管在IB期疾病中这些因素的差异很小（大肿瘤大小，25%对52.4%;深基质浸润，57.1%对82.1%;淋巴血管间隙浸润，35.7%对65.5%;宫旁浸润，17.9%对41.7%; p= 2中危因素在NCS中的发生率低于PST，尽管两种治疗之间的高危因素数量没有差异，但这降低了接受NCS的IIA期疾病患者的辅助放疗需求（46.4% vs. 84.5%，p
Objective. To evaluate whether neoadjuvant chemotherapy before surgery (NCS) is more efficient than primary surgical treatment (PST) for improving clinical outcomes in FIGO stage IB1-IIA cervical cancer.Methods. We conducted a matched-case comparison where 61 patients treated with NCS were matched to 183 treated with PST. We compared intermediate- and high-risk factors, the need of adjuvant radiotherapy, disease recurrence and survivals between NCS and PST. Patients with >= 2 intermediate- or >= 1 high-risk factors received adjuvant concurrent chemoradiation using cisplatin-based chemotherapy.Results. NCS reduced more definitely intermediate- and high-risk factors than PST in stage IIA disease in spite of little difference of them in stage IB disease (large tumor size, 25% vs. 52.4%; deep stromal invasion, 57.1% vs. 82.1%; lymphovascular space invasion, 35.7% vs. 65.5%; parametrial invasion, 17.9% vs. 41.7%; p= 2 intermediate-risk factors were less common in NCS than PST despite no difference of the number of high-risk factors between the 2 treatments, which decreased the need of adjuvant radiotherapy in patients with stage IIA disease who received NCS (46.4% vs. 84.5%, p