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首页> 外文期刊>European journal of gynaecological oncology >Radiation therapy with concomitant and adjuvant cisplatin and paclitaxel in high-risk cervical cancer: long-term follow-up.
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Radiation therapy with concomitant and adjuvant cisplatin and paclitaxel in high-risk cervical cancer: long-term follow-up.

机译：伴随和辅助治疗的顺铂和紫杉醇对高危宫颈癌的放射治疗：长期随访。

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INTRODUCTION: Chemo-potentiation of radiation improves survival in women with cervical cancer. Our group has previously demonstrated the tolerability of weekly paclitaxel combined with cisplatin during radiation therapy. We sought to determine the efficacy of this regimen in patients with "high risk" cervical cancer, and to determine the short- and long-term toxicity of this approach. METHODS: We prospectively enrolled surgically staged patients with positive peritoneal cytology, resectable nodal metastases, or primary tumor > 6 cm. Patients were treated using external beam radiation with concomitant cisplatin (50 mg/m2) during weeks 1, 4, and 7, and weekly paclitaxel (50 mg/m2), followed by four courses of adjuvant cisplatin (50 mg/m2) and paclitaxel (135 mg/m2). Toxicity, overall, and disease-free survival were evaluated. RESULTS: Twenty-three patients were enrolled, and 21 were evaluable. Patient allotment by FIGO stage was: IB1 - seven, IB2 - five, IIA - two, IIB - four, IIIB - two, IV - three. Twenty patients (95%) completed radiation treatment (median dose to point A was 8278 cGy). Seventeen patients (81%) completed all chemotherapy. At a median follow-up of 58 months the overall survival was 68%. Overall survival for patients with clinical Stage I and II disease was 82% at a median of 64 months. Hematologic toxicity was common but rarely resulted in treatment delays. Late complications requiring intervention (obstruction, fistula, significant lymphocyst) occurred in 11 patients (52%). CONCLUSION: The combination of paclitaxel and cisplatin appears efficacious in "high-risk" cervical cancer patients. Hematologic toxicity was common but tolerable. Long-term survival was common in these patients, however late toxicity was significant. This regimen should be investigated in collaborative phase III trials.
机译：引言：放射线的化学增强作用可提高宫颈癌女性的生存率。我们的小组先前已证明每周紫杉醇联合顺铂在放疗期间的耐受性。我们试图确定该方案对“高危”宫颈癌患者的疗效，并确定该方法的短期和长期毒性。方法：我们前瞻性地对手术分期为腹膜细胞学阳性，可切除的淋巴结转移或原发肿瘤> 6 cm的患者进行了研究。在第1、4和7周使用外部束联合顺铂（50 mg / m2）和每周紫杉醇（50 mg / m2）进行放射治疗，随后接受四个疗程的顺铂（50 mg / m2）和紫杉醇辅助治疗（135毫克/平方米）。评估毒性，总体和无病生存期。结果：23例患者入组，其中21例可评估。 FIGO分期的患者分配为：IB1-七个，IB2-五个，IIA-两个，IIB-四个，IIIB-两个，IV-三个。 20名患者（95％）完成了放射治疗（A点的中位剂量为8278 cGy）。 17名患者（81％）完成了所有化疗。中位随访58个月，总生存率为68％。 I期和II期临床疾病患者的总生存期为82％，中位数为64个月。血液学毒性很常见，但很少导致治疗延迟。 11例患者（52％）发生了需要干预的晚期并发症（阻塞，瘘管，明显的淋巴囊肿）。结论：紫杉醇和顺铂联合治疗对“高危”宫颈癌患者有效。血液学毒性很常见，但可以耐受。这些患者的长期生存很常见，但是后期毒性很明显。该方案应在三期协作试验中进行研究。

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