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首页> 外文期刊>International journal of hyperthermia: The official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group >Neoadjuvant chemotherapy followed by radiotherapy and concurrent hyperthermia in patients with advanced-stage cervical cancer: A retrospective study
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Neoadjuvant chemotherapy followed by radiotherapy and concurrent hyperthermia in patients with advanced-stage cervical cancer: A retrospective study

机译：晚期宫颈癌患者新辅助化疗后放疗和同时热疗的回顾性研究

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Objective: To evaluate the efficacy of neoadjuvant chemotherapy, followed by radiotherapy and concurrent hyperthermia (triple therapy) in patients with advanced-stage cervical cancer. Methods: We selected 43 patients from our hyperthermia database, who were treated from 1996 to 2010 with triple therapy for large primary tumours (>6cm) or para-aortic lymph node metastases. All patients received platinum-based chemotherapy followed by full-dose radiotherapy, brachytherapy and five hyperthermia treatments. The response was evaluated by gynaecological examination and a CT-scan. Time-to-event variables were estimated using the Kaplan Meier method and the Cox regression method. Results: The mean age of the patients was 50.4 years (range 2980). The median tumour size was 5.6cm at diagnosis (range 2.68.2), positive lymph nodes were present in 90.7. A total of 67 of the patients completed all six planned courses of chemotherapy. After completion of neoadjuvant chemotherapy, 83.7 of patients achieved a complete or partial response. At the end of treatment, the complete response rate was 81.4 (95CI 69.293.5). Grade 2, 3 and 4 acute vascular toxicity occurred in 17 patients. The incidence of grade 34 haematological toxicity did not exceed 10 and no neutropenic fever occurred. For grade 12 renal toxicity, a switch to carboplatin was made (n6). No acute grade 34 renal toxicity was observed. No treatment-related deaths were recorded. The median follow-up time was 29.8 months (range 4.1124.8). Overall survival rate at 12 months was 79 (95CI 57.492.3). Conclusion: The triple therapy seems feasible and effective in the treatment of advanced-stage, high-risk cervical cancer. However, chemotherapy-induced vascular toxicity occurred frequently, which may warrant the use of prophylactic anticoagulants. We recommend a phase II trial for prospective confirmation for comparison with standard chemoradiation and the use of anticoagulants.
机译：目的：评估新辅助化疗，放疗和同时热疗（三联疗法）对晚期宫颈癌的疗效。方法：我们从热疗数据库中选择了43例患者，这些患者在1996年至2010年期间接受了针对大型原发性肿瘤（> 6cm）或主动脉旁淋巴结转移的三联疗法。所有患者均接受了铂类化学疗法，然后进行了全剂量放疗，近距离放射治疗和五种热疗。通过妇科检查和CT扫描评估反应。事件发生时间变量是使用Kaplan Meier方法和Cox回归方法估算的。结果：患者的平均年龄为50.4岁（范围2980）。诊断时中位肿瘤大小为5.6cm（范围2.68.2），阳性淋巴结阳性率为90.7。总共67位患者完成了所有六个计划的化学疗程。新辅助化疗完成后，83.7例患者获得了完全或部分缓解。在治疗结束时，完全缓解率为81.4（95CI 69.293.5）。 17例患者发生了2、3和4级急性血管毒性。血液学毒性34级的发生率不超过10，并且没有发生中性粒细胞减少症。对于12级肾毒性，转用卡铂（n6）。没有观察到急性34级肾毒性。没有记录到与治疗有关的死亡。中位随访时间为29.8个月（范围4.1124.8）。 12个月的总生存率为79（95CI 57.492.3）。结论：三联疗法在晚期高危宫颈癌的治疗中似乎是可行和有效的。但是，化疗引起的血管毒性反应频繁发生，这可能需要使用预防性抗凝剂。我们建议进行II期试验，以进行前瞻性确认，以便与标准化学放疗和使用抗凝剂进行比较。

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