Post-operative small pelvic intensity-modulated radiation therapy for early-stage cervical cancer with intermediate-risk factors: efficacy and toxicity
Post-operative small pelvic intensity-modulated radiation therapy for early-stage cervical cancer with intermediate-risk factors: efficacy and toxicity
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DOI：
10.1093/jjco/hyab047
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发表时间：
2021-04-05
影响因子：
2.4
通讯作者：
Fu, Chunli
中科院分区：
文献类型：
--
作者：
Zhang, Guangyu;He, Fangfang;Fu, Chunli
目的：探讨早期宫颈癌中危因素术后小盆腔调强放疗的毒副反应和疗效。方法：2012-2016年间，对151例具有中危因素的宫颈癌(国际妇产科联合会1-IIA期)患者进行术后小盆腔调强放疗。小剂量盆腔调强放疗的中位剂量为50.4Gy28次，达到计划的靶区体积。调强放射治疗采用常规固定野调强放射治疗或螺旋断层放射治疗。3年无瘤生存率和总生存率分别为89%和96%。末次随访时144例(95.3%)存活。复发6例(3.9%)，其中局部复发3例(2%)，远处转移2例(1.3%)，两者兼有1例(0.6%)。腹泻是最常见的急性毒性反应。无1例发生急性或晚期毒性反应。仅有4例(2.6%)出现晚期Ⅱ度毒副反应。结论：对于有中等危险因素的早期宫颈癌患者，术后小盆腔调强放疗是安全的，耐受性良好。急性毒副作用和晚期毒副作用的发生率相当令人满意。
Objective: The aim of the present study was to retrospectively evaluate the toxicity and efficacy of post-operative small pelvic intensity-modulated radiotherapy in early-stage cervical cancer patients with intermediate-risk factors.Methods: Between 2012 and 2016, 151 patients who had cervical cancer (International Federation of Gynecology and Obstetrics stage 1-IIA) with intermediate-risk factors were treated with postoperative small pelvic intensity-modulated radiotherapy. The median dose of 50.4 Gy in 28 fractions with small pelvic intensity-modulated radiotherapy was prescribed to the planning target volume. The intensity-modulated radiotherapy technique used was conventional fixed-field intensity-modulated radiotherapy or helical tomotherapy.Results: The median follow-up was 37 months. The 3-year disease-free survival and overall survival rates were 89 and 96%, respectively. A total of 144 patients (95.3%) were alive at the last followup. In total, 6 patients (3.9%) had recurrence: locoregional recurrence in 3 patients (2%), distant metastasis in 2 (1.3%), and both in 1 (0.6%). Diarrhoea was the most common acute toxicity. There were no patients suffering from acute or late grade >= 3 toxicity. Only 4 patients (2.6%) had late grade 2 toxicities.Conclusions: For early-stage cervical cancer patients with intermediate-risk factors, post-operative small pelvic intensity-modulated radiotherapy was safe and well tolerated. The rates of acute and late toxicities were quite satisfactory.