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首页> 外文期刊>Journal of Gynecologic Oncology >Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma: a multicenter retrospective study (KROG 13-08)
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Clinical significance of radiotherapy in patients with primary uterine carcinosarcoma: a multicenter retrospective study (KROG 13-08)

机译：放射疗法在原发性子宫癌肉瘤中的临床意义：一项多中心回顾性研究（KROG 13-08）

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Objective To investigate the role of radiotherapy (RT) in patients who underwent hysterectomy for uterine carcinosarcoma (UCS). Methods Patients with the International Federation of Gynecology and Obstetrics stage I–IVa UCS who were treated between 1990 and 2012 were identified retrospectively in a multi-institutional database. Of 235 identified patients, 97 (41.3%) received adjuvant RT. Twenty-two patients with a history of previous pelvic RT were analyzed separately. Survival outcomes were assessed using the Kaplan-Meier method and Cox proportional hazards model. Results Patients with a previous history of pelvic RT had poor survival outcomes, and 72.6% of these patients experienced locoregional recurrence; however, none received RT after a diagnosis of UCS. Univariate analyses revealed that pelvic lymphadenectomy (PLND) and para-aortic lymph node sampling were significant factors for locoregional recurrence-free survival (LRRFS) and disease-free survival (DFS). Among patients without previous pelvic RT, the percentage of locoregional failure was lower for those who received adjuvant RT than for those who did not (28.5% vs. 17.5%, p=0.107). Multivariate analysis revealed significant correlations between PLND and LRRFS, distant metastasis-free survival, and DFS. In subgroup analyses, RT significantly improved the 5-year LRRFS rate of patients who did not undergo PLND (52.7% vs. 18.7% for non-RT, p Conclusion Adjuvant RT decreased the risk of locoregional recurrence after hysterectomy for UCS, particularly in patients without surgical nodal staging. Given the poorer locoregional outcomes of patients previously subjected to pelvic RT, meticulous re-administration of RT might improve locoregional control while leading to less toxicity in these patients.
机译：目的探讨放射治疗（RT）在子宫癌肉瘤（UCS）子宫切除术中的作用。方法在多机构数据库中回顾性鉴定1990年至2012年间接受国际妇产科联合会I–IVa UCS分期的患者。在235例确定的患者中，有97例（41.3％）接受了辅助放疗。分别分析了22例有盆腔RT病史的患者。使用Kaplan-Meier方法和Cox比例风险模型评估生存结果。结果有盆腔RT史的患者生存预后较差，其中72.6％的患者发生局部复发;但是，没有人在诊断出UCS后接受了RT。单因素分析表明，盆腔淋巴结清扫术（PLND）和主动脉旁淋巴结取样是局部无复发生存率（LRRFS）和无疾病生存率（DFS）的重要因素。在没有盆腔放疗的患者中，接受辅助放疗的患者局部区域衰竭的百分比低于未接受盆腔放疗的患者（28.5％vs. 17.5％，p = 0.107）。多变量分析显示PLND和LRRFS，无远处转移生存和DFS之间存在显着相关性。在亚组分析中，RT显着改善了未接受PLND的患者的5年LRRFS率（52.7％vs.非RT的18.7％，p结论）辅助RT降低了UCS子宫切除术后局部复发的风险，特别是在患者中鉴于以前接受盆腔放疗的患者局部结局较差，因此，细心再给予局部放疗可改善局部区域控制，同时降低这些患者的毒性。

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