IVB 期宫颈癌的治疗结果和毒性。

Outcomes and toxicities for the treatment of stage IVB cervical cancer.

机构信息

Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 323 Illsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.

出版信息

Arch Gynecol Obstet. 2012 Jun;285(6):1685-93. doi: 10.1007/s00404-011-2173-6. Epub 2011 Dec 16.

DOI:10.1007/s00404-011-2173-6

PMID:22173823

Abstract

OBJECTIVE

The prognosis of stage IVB cervical cancer is generally poor. In the current study, treatment outcomes were evaluated in patients with International Federation of Gynecologic Oncology stage IVB cervical cancer treated with radiotherapy and chemotherapy for progression-free survival (PFS) and treated-related toxicities.

STUDY DESIGN

The medical records of the patients with stage IVB cervical cancer who were treated at the National Cancer Center, South Korea were reviewed retrospectively. From February 2002 to February 2010, 45 patients were diagnosed with FIGO stage IVB cervical cancer. Survival and toxicities were compared between the 13 patients with concomitant chemoradiotherapy (CCRT) with weekly cisplatin versus 20 patients with CCRT with 5-fluorouracil/cisplatin.

RESULTS

Initial treatment included weekly cisplatin-CCRT, 5-fluorouracil/cisplatin-CCRT, neoadjuvant chemotherapy, and radiotherapy with subsequent combination chemotherapy in 13, 20, 4, and 5 patients, respectively. Overall survival (OS) and PFS were 26.2 and 6.7 months, respectively. There was no statistical difference in OS (p = 0.47) and PFS (p = 0.64) between the weekly cisplatin-CCRT and 5-fluorouracil/cisplatin-CCRT groups; however, the incidence of anemia >grade 3 as an acute toxicity was higher in the 5-fluorouracil/cisplatin-CCRT chemotherapy regimen group than the weekly cisplatin-CCRT group (p = 0.03). Acute toxicity >grade 2 showed a tendency to be higher in the 5-fluorouracil/cisplatin-CCRT group. Based on multivariate analysis, poor performance status was the only independent prognostic factor of OS (p = 0.03, 9.77; 95% CI 1.3-73.3) and PFS (p = 0.04, 9.58; 95% CI 1.14-81.26).

CONCLUSIONS

CCRT using combination chemotherapeutic agents may not have survival advantage over single agent cisplatin-based CCRT. Further improvement in treatment is needed to increase survival outcomes and to decrease treatment-related toxicities in patients with stage IVB cervical cancer.

摘要

目的

IVB 期宫颈癌的预后通常较差。在本研究中，我们评估了接受放疗和化疗治疗的 IVB 期宫颈癌患者的无进展生存期（PFS）和治疗相关毒性的治疗结果。

研究设计

回顾性分析韩国国家癌症中心 IVB 期宫颈癌患者的病历。2002 年 2 月至 2010 年 2 月，共诊断出 45 例 FIGO 期 IVB 宫颈癌患者。将 13 例接受每周顺铂联合放化疗（CCRT）的患者与 20 例接受 5-氟尿嘧啶/顺铂联合 CCRT 的患者的生存和毒性进行比较。

结果

初始治疗包括每周顺铂 CCRT、5-氟尿嘧啶/顺铂 CCRT、新辅助化疗和随后的联合化疗，分别有 13、20、4 和 5 例患者接受了这些治疗。总生存期（OS）和 PFS 分别为 26.2 个月和 6.7 个月。每周顺铂 CCRT 与 5-氟尿嘧啶/顺铂 CCRT 两组间 OS（p = 0.47）和 PFS（p = 0.64）无统计学差异；然而，5-氟尿嘧啶/顺铂 CCRT 组贫血 >3 级的发生率高于每周顺铂 CCRT 组（p = 0.03）。5-氟尿嘧啶/顺铂 CCRT 组急性毒性 >2 级的发生率有增高趋势。多因素分析显示，较差的体能状态是 OS（p = 0.03，9.77；95%CI 1.3-73.3）和 PFS（p = 0.04，9.58；95%CI 1.14-81.26）的唯一独立预后因素。