Aim: To investigate and compare overall survival (OS), disease-free survival (DFS) and toxicity of women who underwent either chemoradiotherapy with or without prior lymph node debulking or upfront chemotherapy followed by radiotherapy and hyperthermia (triple therapy) for locally advanced cervical cancer (LACC) to identify a potential role for triple therapy. Methods: Women with histologically proven LACC and with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB2 and IIA2 to IVA were included. Cox regression analyses were used for calculating hazard ratios and to adjust for confounding variables. A multivariable logistic regression analysis was used to examine the influence of covariates on toxicity. Results: A total of 370 patients were included of whom 58% (n= 213) received chemoradiotherapy (CRT), 18% (n= 66) received node-debulking followed by chemoradiotherapy (LND-CRT) and 25% (n= 91) received triple therapy (TT). Five-year OS was comparable between the three treatment groups, with 53% (95% confidence interval 46–59%) in the CRT group, 45% (33–56%) in the LND-CRT group and 53% (40–64%) in the TT group (p= 0.472). In the adjusted analysis, 5-year OS and DFS were comparable between the three treatment groups. No chemotherapy-related differences in toxicity were observed. Conclusion: This study suggests that the toxicity and survival of TT is similar to CRT or LND-CRT.
目的：本研究旨在调查和比较局部晚期宫颈癌（LACC）患者在接受放化疗（无论是否先行淋巴结减灭术）或先行化疗继以放疗和热疗（三联疗法）后的总生存期（OS）、无病生存期（DFS）及毒性反应，以探讨三联疗法的潜在作用。方法：纳入经组织学证实为LACC且符合国际妇产科联盟（FIGO）2009年分期IB2至IIA2至IVA期的女性患者。采用Cox回归分析计算风险比并调整混杂变量，同时运用多变量逻辑回归分析检验协变量对毒性反应的影响。结果：共纳入370例患者，其中58%（n=213）接受放化疗（CRT），18%（n=66）接受淋巴结减灭术后放化疗（LND-CRT），25%（n=91）接受三联疗法（TT）。三组治疗方案的五年总生存期相当：CRT组为53%（95%置信区间46–59%），LND-CRT组为45%（33–56%），TT组为53%（40–64%）（p=0.472）。经调整分析后，三组间的五年总生存期和无病生存期仍无显著差异。各组间未观察到与化疗相关的毒性差异。结论：本研究表明，三联疗法的毒性反应和生存结局与放化疗或淋巴结减灭术后放化疗相似。
肿瘤(癌症)患者之家