文章：

挽救性组织间插植近距离放疗治疗宫颈和子宫内膜癌孤立性局部复发：按盆腔放疗史类型分层的回顾性分析

Salvage Interstitial Brachytherapy for Isolated Local Recurrence of Cervical and Endometrial Cancer: A Retrospective Analysis Stratified by Type of Pelvic Irradiation History

原文发布日期：14 January 2026

DOI: 10.3390/cancers18020252

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: This study evaluated the efficacy and safety of salvage interstitial brachytherapy (S-ISBT) for isolated local recurrence (ILR) of cervical and endometrial carcinoma, stratifying patients by pelvic irradiation history (PIH).Methods: Patients with ILR treated with S-ISBT were retrospectively reviewed and categorized by initial treatment: Group A (surgery alone); Group B (surgery + postoperative radiotherapy (RT)); and Group C (definitive RT). Overall survival (OS), progression-free survival (PFS), local control (LC) rates, and the cumulative incidence functions (CIFs) for Grade ≥ 3 late adverse events (AEs) were estimated. Multivariate analysis identified prognostic factors.Results: The study included 70 patients (A: 28, B: 17, C: 25) with a median follow-up of 33.4 months. The 3-year OS, PFS, LC, and CIFs for Grade ≥ 3 late AEs for Groups A, B, and C were 80.8%, 66.7%, and 30.4% (p< 0.001); 56.4%, 41.5%, and 11.6% (p< 0.001); 89.1%, 61.4%, and 43.0% (p= 0.002); and 26.4%, 13.3%, and 32.0% (p= 0.40), respectively. Multivariate analysis suggested the type of PIH, disease-free interval, and tumor volume as independent prognostic factors. While no significant differences were observed between Groups A and B (OS: HR = 0.47,p= 0.19; PFS: HR = 0.60,p= 0.28), Group C exhibited a significantly higher risk than Group B (OS: HR = 3.08,p= 0.018; PFS: HR = 3.41,p= 0.004).Conclusions: S-ISBT could be considered for patients with prior postoperative RT, whose outcomes are significantly better than those with prior definitive RT.

摘要翻译： 

背景/目的：本研究评估挽救性组织间近距离放疗（S-ISBT）治疗宫颈癌和子宫内膜癌孤立性局部复发（ILR）的疗效与安全性，并根据盆腔照射史（PIH）对患者进行分层分析。

方法：回顾性分析接受S-ISBT治疗的ILR患者，按初始治疗方案分组：A组（单纯手术）；B组（手术+术后放疗）；C组（根治性放疗）。评估总生存期（OS）、无进展生存期（PFS）、局部控制率（LC）以及≥3级晚期不良事件（AEs）的累积发生率函数（CIFs）。通过多变量分析确定预后因素。

结果：本研究纳入70例患者（A组28例，B组17例，C组25例），中位随访时间33.4个月。A、B、C组的3年OS、PFS、LC及≥3级晚期AEs的CIFs分别为：80.8% vs 66.7% vs 30.4%（p<0.001）；56.4% vs 41.5% vs 11.6%（p<0.001）；89.1% vs 61.4% vs 43.0%（p=0.002）；26.4% vs 13.3% vs 32.0%（p=0.40）。多变量分析提示PIH类型、无病间隔期和肿瘤体积是独立预后因素。虽然A组与B组间未见显著差异（OS：HR=0.47，p=0.19；PFS：HR=0.60，p=0.28），但C组风险显著高于B组（OS：HR=3.08，p=0.018；PFS：HR=3.41，p=0.004）。

结论：对于既往接受术后放疗的患者，可考虑采用S-ISBT治疗，其疗效显著优于既往接受根治性放疗的患者。

原文链接：

Salvage Interstitial Brachytherapy for Isolated Local Recurrence of Cervical and Endometrial Cancer: A Retrospective Analysis Stratified by Type of Pelvic Irradiation History