Severe late toxicities following concomitant chemoradiotherapy compared to radiotherapy alone in cervical cancer: an inter-era analysis.
Severe late toxicities following concomitant chemoradiotherapy compared to radiotherapy alone in cervical cancer: an inter-era analysis.
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DOI：
10.1016/j.ijrobp.2012.01.064
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发表时间：
2012-11-15
影响因子：
7
通讯作者：
Bradley, Kristin A.
中科院分区：
文献类型：
--
作者：
Gondi, Vinai;Bentzen, Soren M.;Sklenar, Kathryn L.;Dunn, Emily F.;Petereit, Daniel G.;Tannehill, Scott P.;Straub, Margaret;Bradley, Kristin A.
比较宫颈癌合并放化疗和单纯放疗后严重晚期毒性的发生率。宫颈癌患者在单一机构接受单纯放疗或同时放化疗治疗。重度晚期毒性定义为≥3级阴道、泌尿系统或胃肠道毒性或任何骨盆骨折，采用不良事件通用术语标准第4.0版（CTCAE），发生于治疗完成后≥6个月且在任何挽救治疗之前。校正相关协变量后，比较重度晚期毒性发生率。3年时，单纯放疗组阴道严重晚期毒性的概率为20.2%，同期放化疗组为35.1%（P= 0.026）。3年时，单纯放疗组骨骼严重晚期毒性的概率为1.6%，合并放化疗组为7.5%（P= 0.010）。调整病例组合后，同步放化疗与较高的阴道（风险比[HR] 3.0，95%置信区间[CI]，1.7-5.2，P<0.01）和骨骼（HR 7.0，95% CI 1.4-34.1，P= 0.016）严重晚期毒性相关。与高扩张器顺应性相比，中度（HR 3.6，95% CI 2.0-6.5，P<0.001）和不良（HR 8.5，95% CI 4.3-16.9，P<0.001）扩张器顺应性与较高的阴道重度晚期毒性相关。年龄>50岁与较高的阴道（HR 1.8，95% CI 1.1-3.0，P= 0.013）和骨骼（HR 5.7，95% CI 1.2-27.0，P= 0.028）严重晚期毒性相关。同步放化疗与胃肠道（P= 0.886）或泌尿系统（未校正，P= 0.053;校正，P= 0.063）重度晚期毒性无关。与单独放疗相比，同步放化疗与更高的严重阴道和骨骼晚期毒性发生率相关。其他预测因素包括严重阴道晚期毒性的扩张器顺应性和严重阴道和骨骼晚期毒性的年龄。
To compare rates of severe late toxicities following concomitant chemoradiotherapy and radiotherapy alone for cervical cancer. Patients with cervical cancer were treated at a single institution with radiotherapy alone or concomitant chemoradiotherapy for curative intent. Severe late toxicity was defined as grade ≥3 vaginal, urologic, or gastrointestinal toxicity or any pelvic fracture, using Common Terminology Criteria for Adverse Events version 4.0 (CTCAE), occurring ≥6 months from treatment completion and predating any salvage therapy. Severe late toxicity rates were compared after adjusting for pertinent covariates. At 3 years, probability of vaginal severe late toxicity was 20.2% for radiotherapy alone and 35.1% for concomitant chemoradiotherapy (P=.026). At 3 years, probability of skeletal severe late toxicity was 1.6% for radiotherapy alone and 7.5% for concomitant chemoradiotherapy (P=.010). After adjustment for case mix, concomitant chemoradiotherapy was associated with higher vaginal (hazard ratio [HR] 3.0, 95% confidence interval [CI], 1.7–5.2, P<001), and skeletal (HR 7.0, 95% CI 1.4–34.1, P=.016) severe late toxicity. Compared to high dilator compliance, moderate (HR 3.6, 95% CI 2.0–6.5, P<.001) and poor (HR 8.5, 95% CI 4.3–16.9, P<.001) dilator compliance was associated with higher vaginal severe late toxicity. Age >50 was associated with higher vaginal (HR 1.8, 95% CI 1.1–3.0, P=.013) and skeletal (HR 5.7, 95% CI 1.2–27.0, P=.028) severe late toxicity. Concomitant chemoradiotherapy was not associated with higher gastrointestinal (P=.886) or urologic (unadjusted, P=.053; adjusted, P=.063) severe late toxicity. Compared to radiotherapy alone, concomitant chemoradiotherapy is associated with higher rates of severe vaginal and skeletal late toxicities. Other predictive factors include dilator compliance for severe vaginal late toxicity and age for severe vaginal and skeletal late toxicities.
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DOI：
10.1016/0360-3016(92)90690-j
发表时间：
1992-01-01
影响因子：
7
作者：
STITT, JA;FOWLER, JF;KINSELLA, TJ
通讯作者：
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DOI：
10.1111/j.1525-1438.2006.00348.x
发表时间：
2006-01-01
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DOI：
10.1016/j.ijrobp.2007.08.005
发表时间：
2008-03-15
影响因子：
7
作者：
Oh, Dongryul;Huh, Seung Jae;Lee, Je Ho
通讯作者：
Lee, Je Ho
影响因子：
45.3
作者：
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DOI：
10.1016/0360-3016(95)00118-i
发表时间：
1995-07-30
影响因子：
7
作者：
EIFEL, PJ;LEVENBACK, C;OSWALD, MJ
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OSWALD, MJ