FIGO 2018子宫颈癌新分期ⅠB2期治疗策略的探讨  被引量:4

Investigation of treatment strategy for FIGO 2018 stageⅠB2 cervical cancer

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作  者:范辉健 黎志强[1] 陈必良 孙立新[3] 崔竹梅[4] 康山 王莉[6] 赵卫东[7] 林丽红[8] 詹雪梅[9] 杜佩妍 倪妍 张伟峰[12] 陈春林[1] 郎景和 FAN Hui-jian;LI Zhi-qiang;CHEN Bi-liang;SUN Li-xin;CUI Zhu-mei;KANG Shan;WANG Li;ZHAO Wei-dong;LIN Li-hong;ZHAN Xue-mei;DU Pei-yan;NI Yan;ZHANG Wei-feng;CHEN Chun-lin;LANG Jing-he(Department of Obstetrics and Gynecology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;不详)

机构地区:[1]南方医科大学南方医院妇产科,广东广州510515 [2]空军军医大学西京医院妇科,陕西西安710032 [3]山西省肿瘤医院妇科,山西太原030013 [4]青岛大学附属医院妇产科,山东青岛266000 [5]河北医科大学第四医院妇科,河北石家庄050000 [6]河南省肿瘤医院妇科,河南郑州450008 [7]中国科学技术大学附属第一医院(安徽省立医院)妇产科,安徽合肥230001 [8]安阳市肿瘤医院妇瘤科,河南安阳455000 [9]江门市中心医院妇科,广东江门529030 [10]广州医科大学附属肿瘤医院妇科,广东广州510095 [11]太原市中心医院妇科,山西太原300009 [12]宁波市妇女儿童医院妇科,浙江宁波315012 [13]中国医学科学院北京协和医院妇产科,北京100730

出  处:《中国实用妇科与产科杂志》2021年第7期766-770,共5页Chinese Journal of Practical Gynecology and Obstetrics

基  金:十二五国家科技支撑计划(2014BAI05B03);广州市科技计划(158100075);广东省教育厅高水平大学建设经费南方医科大学临床研究启动项目(LC2016ZD019)。

摘  要:目的探讨FIGO 2018子宫颈癌新分期中ⅠB2期的适宜治疗策略。方法基于中国子宫颈癌临床诊疗项目数据库,纳入2018年FIGO分期ⅠB2期接受直接手术(PS组)、新辅助化疗后手术(NACT组)及根治性放化疗(CRT组)的子宫颈癌病例,比较不同治疗方式的5年总体生存率(OS)及无病生存率(DFS)。结果(1)从数据库中纳入FIGO 2018分期为ⅠB2期子宫颈癌病例3266例,其中PS组2951例,NACT组251例,CRT组64例。(2)3组间肿瘤学结局比较中,CRT组的5年OS及DFS低于PS组(5年OS:82.8%vs.94.9%,P<0.001;5年DFS:73.8%vs.90.7%,P=0.004)。CRT组的5年OS及DFS低于NACT组(5年OS:82.8%vs.95.4%,P=0.001;5年DFS:73.8%vs.93.8%,P=0.001)。PS组与NACT组5年OS或DFS无差异(5年OS:94.9%vs.95.4%,P=0.564;5年DFS:90.7%vs.93.8%,P=0.191)。(3)Cox多因素分析提示根治性放化疗是患者全因死亡及复发/死亡的独立风险因素。结论对于FIGO 2018分期为ⅠB2期子宫颈癌,根治性放化疗不利于患者长期预后,直接开腹手术为该期别子宫颈癌的最合适治疗方式。Objective To explore the optimal treatment strategy for stage I B2 in FIGO 2018 new staging of cervical cancer.Methods Based on the clinical diagnosis and treatment project database of cervical cancer in China,cervical cancer patients staging FIGO 2018 I B2 who received primary surgery(PS),neoadjuvant chemotherapy plus surgery(NACT)and radical chemoradiotherapy(CRT)were included.The 5-year overall survival(OS)and disease-free survival(DFS)by different strategies were compared.Results(1)A total of 3266 patients with FIGO 2018 stage I B2 cervical cancer were included,including 2951 patients in the PS group,251 patients in the NACT group,and 64 patients in the CRT group.(2)The 5-year OS and DFS of CRT group were lower than those of PS group and NACT group(5-year OS:82.8%vs.94.9%,P<0.001;82.8%vs.95.4%,P=0.001.5-year DFS:73.8%vs.90.7%,P=0.004;73.8%vs.93.8%,P=0.001).There was no difference in 5-year OS or DFS between the PS group and the NACT group(5-year OS:94.9%vs.95.4%,P=0.564;5-year DFS:90.7%vs.93.8%,P=0.191).(3)Cox multivariate analysis suggested that radical chemoradiotherapy was an independent risk factor for allcau se mortality and recurrence/death.Conclusion Radical chemoradiotherapy is not conducive to the longterm prognosis of patients with FIGO 2018ⅠB2 cervical cancer,and radical abdominal surgery is the optimal treatment for this stage of cervical cancer.

关 键 词:子宫颈肿瘤 国际妇产科联盟 治疗策略 肿瘤学结局 

分 类 号:R737.3[医药卫生—肿瘤]

 

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