THE ADVERSE EFFECT OF TREATMENT PROLONGATION IN CERVICAL-CARCINOMA
THE ADVERSE EFFECT OF TREATMENT PROLONGATION IN CERVICAL-CARCINOMA
复制标题
DOI：
10.1016/0360-3016(94)00635-x
复制
发表时间：
1995-07-30
影响因子：
7
通讯作者：
BUCHLER, DA
中科院分区：
文献类型：
--
作者：
PETEREIT, DG;SARKARIA, JN;BUCHLER, DA
目的：在长期放射治疗过程中存活的肿瘤克隆原的增殖可能是宫颈癌局部失败的原因。总治疗时间的影响进行了回顾性分析，在有关盆腔控制和总生存率的鳞状细胞癌的子宫cervical.Methods和材料：209例（阶段IB-IIIB）治疗的组合外束和低剂量率腔内照射进行了评价的研究。采用多因素分析和Kaplan-Meier统计学方法，研究治疗时间对盆腔控制和5年生存率的影响。结果：中位治疗时间为55天。对于所有分期，治疗时间< 55天与大于或等于55天的5年生存率和盆腔控制率有显著差异：分别为65和54%（p = 0.03），87和72%（p = 0.006）。按阶段，较短的治疗持续时间（即，< 55天vs.大于或等于55天）对于IB/IIA和III期的5年总生存率和盆腔控制是显著的，但对于IIIB期：IB/IIA期（81和67%，96和84%），III期疾病（52和42%，76和55%）和IIB期（分别为43和50%，74和80%）则不显著。对于疾病的所有阶段，治疗超过55天后，每增加一天，生存率降低0.6%/天，盆腔控制降低0.7%/天。此外，显着的晚期并发症没有influeuced治疗time.Conclusion：这些结果表明，延长治疗时间与宫颈癌患者的局部控制和生存率下降。这与其他机构的新数据一致。治疗的意义包括避免不必要的治疗中断，设计分割方案，减少治疗时间，并可能在常规放射治疗期间使用肿瘤细胞抑制药物。
Purpose: Proliferation of surviving tumor clonogens during a course of protracted radiation therapy may be a cause of local failure in cervical carcinoma. The affect of total treatment time was analyzed retrospectively in relation to pelvic control and overall survival for squamous cell carcinomas of the uterine cervix.Methods and Materials: Two hundred and nine patients (Stage IB-IIIB) treated with a combination of external beam and low dose rate intracavitary irradiation were evaluable for study. Multivariate analysis and Kaplan-Meier statistical methods were used to del:ermine the effect of treatment time on pelvic control and survival at 5 years.Results: The median treatment duration was 55 days. For all stages combined, the 5-year survival and pelvic control rates were significantly different with treatment times < 55 days vs. greater than or equal to 55 days: 65 and 54% (p = 0.03), 87 and 72% (p = 0.006), respectively. By stage, a shorter treatment duration (i.e., < 55 days vs. greater than or equal to 55 days) was significant for 5-year overall survival and pelvic control for Stages IB/IIA and III, but not for Stage IIIB: Stage IB/IIA (81 and 67%, 96 and 84%), Stage III disease (52 and 42%, 76 and 55%) and Stage IIB (43 and 50%, 74 and 80%, respectively). Survival decreased 0.6%/day and pelvic control decreased 0.7%/day for each additional day of treatment beyond 55 days for all stages of disease. Additionally, significant late complications were not influeuced by treatment time.Conclusion: These results suggest-that prolongation of treatment time is associated with decreased local control and survival in patients with cervical carcinoma. This is consistent with emerging data from other institutions. Therapeutic implications include avoidance of unnecessary treatment breaks, the design of fractionation schemes that decrease treatment duration, and possibly the use of tumor cytostatic drugs during conventional radiation.