Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aortic irradiation for high-risk cervical cancer: An update of radiation therapy oncology group trial (RTOG) 90-01
Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aortic irradiation for high-risk cervical cancer: An update of radiation therapy oncology group trial (RTOG) 90-01
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DOI：
10.1200/jco.2004.07.197
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发表时间：
2004-03-01
影响因子：
45.3
通讯作者：
Mutch, DG
中科院分区：
文献类型：
--
作者：
Eifel, PJ;Winter, K;Mutch, DG
目的报告一项随机试验的成熟结果，比较扩大野放射治疗（EFRT）与盆腔放射治疗伴随氟尿嘧啶和顺铂（CTRT）在妇女局部晚期cancer of the uterine cervix.Patients and Methods 403例宫颈癌妇女被随机分配到接受EFRT或CTRT。如果患者患有IIB至IVA期疾病、IB至IIA期疾病且肿瘤直径大于或等于5 cm或盆腔淋巴结阳性，则患者符合资格。患者按分期和淋巴结评估方法分层。结果228例存活患者的中位随访时间为6.6年。CTRT治疗患者的总生存率明显高于EFRT治疗患者（8年时67% vs41%; P <0.0001）。对于接受CTRT的患者，疾病复发风险总体降低51%（95% CI，36%至66%）。接受CTRT的IB至IIB期疾病患者的总体和无病生存率高于接受EFRT的患者（P <0.0001）; 116例III至IVA期疾病患者的无病生存率更高（P = 0.05），如果随机分配接受CTRT，总生存率有更高的趋势（P = 0.07）。治疗的严重晚期并发症的发生率是相似的两个治疗arms.Conclusion成熟的分析证实，除了氟尿嘧啶和顺铂的放射治疗显着提高了生存率的妇女局部晚期宫颈癌，而不增加晚期治疗相关的副作用的发生率。(C)2004年，美国临床肿瘤学会。
Purpose To report mature results of a randomized trial that compared extended-field radiotherapy (EFRT) versus pelvic radiotherapy with concomitant fluorouracil and cisplatin (CTRT) in women with locoregionally advanced carcinomas of the uterine cervix.Patients and Methods Four hundred three women with cervical cancer were randomly assigned to receive either EFRT or CTRT. Patients were eligible if they had stage IIB to IVA disease, stage IB to IIA disease with a tumor diameter greater than or equal to 5 cm, or positive pelvic lymph nodes. Patients were stratified by stage and by method of lymph node evaluation.Results The median follow-up time for 228 surviving patients was 6.6 years. The overall survival rate for patients treated with CTRT was significantly greater than that for patients treated with EFRT (67% v 41% at 8 years; P < .0001). There was an overall reduction in the risk of disease recurrence of 51 % (95% Cl, 36% to 66%) for patients who received CTRT. Patients with stage IB to IIB disease who received CTRT had better overall and disease-free survival than those treated with EFRT (P < .0001); 116 patients with stage III to IVA disease had better disease-free survival (P = .05) and a trend toward better overall survival (P = .07) if they were randomly assigned to CTRT. The rate of serious late complications of treatment was similar for the two treatment arms.Conclusion Mature analysis confirms that the addition of fluorouracil and cisplatin to radiotherapy significantly improved the survival rate of women with locally advanced cervical cancer without increasing the rate of late treatment-related side effects. (C) 2004 by American Society of Clinical Oncology.