| Yi Cheng,Nan Huang,Jing Zhao,Jianhua Wang,Chen Gong,Kai Qin. Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis. Oncol Transl Med, 2019, 5: 25-29. |
| 后程与同期加量调强放疗方案治疗宫颈癌合并盆腔淋巴结转移的疗效及安全性比较 |
| Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis |
| Received:February 26, 2019 Revised:February 26, 2019 |
| DOI：10.1007/s10330-019-0338-8 |
| 中文关键词: 同期加量调强放疗；后程加量调强放疗；宫颈癌合并盆腔淋巴结转移；临床疗效；安全性 |
| 英文关键词: simultaneous integrated dose-increasing intensity-modulated radiation therapy; late-course dose-increasing intensity-modulated radiation therapy; cervical cancer complicated with pelvic lymph node metastasis; clinical efficacy; safety |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Yi Cheng | Tongji Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China | yi_chengtj@163.com | | Nan Huang | Allergy Department，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology | | | Jing Zhao | Oncology Department，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology | | | Jianhua Wang | Oncology Department，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology | | | Chen Gong | Oncology Department，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology | | | Kai Qin* | Oncology Department，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology | qinkaitj@126.com |
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| 中文摘要: |
| 目的：对比分析宫颈癌合并盆腔淋巴结转移应用后程与同期加量调强放疗方案治疗的临床疗效与安全性。方法：纳入2013年1月至2015年1月间本院收治60例宫颈癌并盆腔淋巴结转移患者作为研究对象，随机将患者分为后程放疗组与同期放疗组，分别纳入30例。两组均使用顺铂同步增敏，治疗后对比两组患者的临床治疗情况。结果：同期放疗组的症状缓解率相比于后程放疗组显著更高（P<0.05）；随访结果显示，同期放疗组患者生存时间、无进展时间及远处转移时间相比于后程放疗组患者均显著更长，对比差异显著（P<0.05）；同期放疗组患者放射野内的淋巴结复发率相比于后程放疗组显著更低（P<0.05）；两组患者宫颈、阴道复发及远处转移的发生率对比未见显著差异（P>0.05）；同期放疗组患者的小肠Dmax、膀胱D1cc以及直肠Dmax放射剂量相比于后程放疗组均显著更低，对比差异显著（P<0.05）；同期放疗组患者小肠D2cc与后程放疗组相比未见显著差异（P>0.05）；同期放疗组患者的骨髓抑制发生率相比于后程放疗组显著更低，对比差异显著（P<0.05）。结论：应用同期加量调强放疗方案在宫颈癌合并盆腔淋巴结转移患者的治疗上可明显控制肿瘤的进展，改善患者远期生存率，推迟远处转移时间，安全性更高。 |
| 英文摘要: |
| Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and
simultaneous integrated dose-increasing intensity-modulated radiation therapy (IMRT) for cervical cancer
complicated with pelvic lymph node metastasis.
Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were
admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly
divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing
IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with
cisplatin. After treatment, the clinical outcomes of the two groups were compared.
Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group
was significantly higher than that in the late-course dose-increasing IMRT group (P < 0.05). The follow-up
results showed that the overall survival time, progression-free survival time, and distant metastasis time of
patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in
the late-course dose-increasing IMRT group (P < 0.05). The recurrent rate of lymph nodes in the radiation
field in the simultaneous integrated dose-increasing IMRT group was significantly lower (P < 0.05) than in
the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical
and vaginal recurrence and distant metastasis between the two groups (P > 0.05). The radiation doses of
Dmax in the small intestine, D1cc (the minimum dose to the 1 cc receiving the highest dose) in the bladder,
and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly
lower (P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference
in intestinal D2cc (the minimum dose to the 2 cc receiving the highest dose) between the two groups (P
> 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT
group was significantly lower (P < 0.05) than in the late-course dose-increasing IMRT group.
Conclusion The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical
cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression,
improve the long-term survival time, and postpone distant metastasis time with high safety. |
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