Multi-institutional Observational Study of Prophylactic Extended-Field Concurrent Chemoradiation Therapy Using Weekly Cisplatin for Patients With Pelvic Node-Positive Cervical Cancer in East and Southeast Asia
Multi-institutional Observational Study of Prophylactic Extended-Field Concurrent Chemoradiation Therapy Using Weekly Cisplatin for Patients With Pelvic Node-Positive Cervical Cancer in East and Southeast Asia
复制标题
DOI：
10.1016/j.ijrobp.2019.04.039
复制
发表时间：
2019-09-01
影响因子：
7
通讯作者：
Tsujii, Hirohiko
中科院分区：
文献类型：
--
作者：
Wakatsuki, Masaru;Kato, Shingo;Tsujii, Hirohiko
目的：这项在东亚和东南亚11个国家开展的多机构观察性研究旨在评估每周顺铂预防性扩大野同步放化疗治疗局部晚期宫颈癌的临床疗效。方法和材料：2007年10月至2016年5月，106例未经治疗的宫颈鳞癌患者纳入本研究。放射治疗包括盆腔照射(总剂量，共25次，包括中央屏蔽)，预防性腹主动脉旁区域照射(36~40次，共20次)，以及高剂量率或低剂量率的腔内近距离放射治疗(ICBT)。高剂量率ICBT计划A点剂量为21~28Gy3~4次，低剂量率ICBT为40~41Gy1~2次。放射治疗过程中每周5个周期的顺铂(40 mg/m(2))。结果：共纳入106例患者。在这些人中，9人严重违反礼仪，2人因一般情况恶化而未接受治疗。因此，95名患者是可评估的。中位随访时间为56个月。在95例患者中，76例(80%)接受了4个或5个周期的化疗。急性3级白细胞减少20例(21%)，晚期3级胃肠道反应3%。所有患者2年局控率、无进展生存率和总生存率分别为96%、78%和90%。结论：东亚和东南亚地区局部晚期宫颈癌患者采用每周顺铂进行预防性扩大野同步放化疗是可行和有效的。(C)2019 Elsevier Inc.保留所有权利。
Purpose: This multi-institutional observational study conducted among 11 countries in East and Southeast Asia aimed to assess the clinical outcomes of prophylactic extended-field concurrent chemoradiation therapy using weekly cisplatin for patients with locally advanced cervical cancer.Methods and Materials: Between October 2007 and May 2016, 106 patients with untreated squamous cell carcinoma of the cervix were enrolled in the present study. Radiation therapy consisted of pelvic irradiation (total dose, 50 Gy in 25 fractions including central shielding), prophylactic paraortic regional irradiation (36-40 Gy in 20 fractions), and either high- or low-dose-rate intracavitary brachytherapy (ICBT) according to institutional practice. The planned point A dose was 21 to 28 Gy in 3 to 4 fractions for high-dose-rate ICBT and 40 to 41 Gy in 1 to 2 fractions for low-dose-rate ICBT. Five cycles of weekly cisplatin (40 mg/m(2)) were administered during the radiation therapy course.Results: A total of 106 patients were enrolled. Of these, 9 had major protocol violations and 2 did not receive treatment because of worsened general condition. Thus, 95 patients were evaluable. The median follow-up was 56 months. Of the 95 patients, 76 (80%) received 4 or 5 cycles of chemotherapy. Acute grade 3 leukopenia was observed in 20 of the patients (21%), and late grade 3 gastrointestinal toxicity was observed in 3%. The 2-year local control, progression-free survival, and overall survival rate for all patients were 96%, 78%, and 90%, respectively.Conclusions: The results indicated that prophylactic extended-field concurrent chemoradiation therapy using weekly cisplatin is feasible and effective for patients with locally advanced cervical cancer in East and Southeast Asia. (C) 2019 Elsevier Inc. All rights reserved.