对FIGOⅠB～ⅡB期宫颈癌患者行子宫切除术后的放射治疗  

Post-hysterectomy radiotherapy in FIGO stage IB-IIB uterine cervical carcinoma

作　　者：Kim J.H. Kim H.J. 侯巍 

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2005年第6期47-48,共2页Core Journal in Obstetrics/Gynecology

摘　　要：This study is a retrospective analysis of stage Ⅰ B- Ⅱ B cervical carcinoma patients who had received postoperative radiotherapy (PORT). Eight hundred patients with stage Ⅰ B- Ⅱ B cervical carcinomas who received PORT after radical hysterectomy and bilateral pelvic lymph node dissection (PLND) between February 1979 and March 2000 were analyzed. The median follow- up duration was 100 months. The 5- year overall survival (OS) and disease- free survival (DFS) rates were 88% and 81% , respectively. One hundred forty- six patients (18% ) failed, and 103 of these had distant metastases. Multivariate analysis revealed that pelvic lymph node (LN) metastasis significantly compromised OS, DFS, pelvic failure- free survival (PFFS), and distant failure- free survival (DFFS) (P < 0.05). Patients with age < 50 years, deep stromal invasion (DSI), and lymphovascular space invasion (LVSI) were significantly associated with a higher risk of distant metastasis after PORT. The incidences of late rectal, urinary, and small bowel complications of grade 3 or higher were 1.6% , 1.4% , and 1.0% , respectively. PORT achieved good OS and DFS in the patients with risk factors after radical hysterectomy for stage IB- IIB cervical carcinomas. Distant metastasis was the major pattern of treatment failure after PORT. Effective systemic chemotherapy might be a breakthrough in improving the outcome of PORT in patients with cervical carcinomas.This study is a retrospective analysis of stage Ⅰ B- Ⅱ B cervical carcinoma patients who had received postoperative radiotherapy (PORT). Eight hundred patients with stage Ⅰ B- Ⅱ B cervical carcinomas who received PORT after radical hysterectomy and bilateral pelvic lymph node dissection (PLND) between February 1979 and March 2000 were analyzed. The median follow- up duration was 100 months. The 5- year overall survival (OS) and disease- free survival (DFS) rates were 88% and 81% , respectively. One hundred forty- six patients (18% ) failed, and 103 of these had distant metastases. Multivariate analysis revealed that pelvic lymph node (LN) metastasis significantly compromised OS, DFS, pelvic failure- free survival (PFFS), and distant failure- free survival (DFFS) (P < 0.05). Patients with age < 50 years, deep stromal invasion (DSI), and lymphovascular space invasion (LVSI) were significantly associated with a higher risk of distant metastasis after PORT. The incidences of late rectal, urinary, and small bowel complications of grade 3 or higher were 1.6% , 1.4% , and 1.0% , respectively. PORT achieved good OS and DFS in the patients with risk factors after radical hysterectomy for stage IB- IIB cervical carcinomas. Distant metastasis was the major pattern of treatment failure after PORT. Effective systemic chemotherapy might be a breakthrough in improving the outcome of PORT in patients with cervical carcinomas.

关 键 词：子宫切除术 FIGO 放射治疗 间质浸润 淋巴结清扫术 系统化疗 淋巴结转移 多元分析 血管腔 

分 类 号：R737.33[医药卫生—肿瘤]