Comparison of the effect of intensity-modulated radiotherapy or conventional radiotherapy combined with intracavitary brachytherapy on cervical stump cancer
10.3760/cma.j.issn.1006-9801.2019.01.002
- VernacularTitle:子宫颈残端癌调强放疗或常规放疗联合腔内近距离放疗效果比较
- Author:
Xiangli ZHAO
1
;
Kunpeng YIN
;
Jing ZHAO
;
Fei GU
;
Xinyu ZHAO
;
Guang LI
Author Information
1. 中国医科大学附属第一医院放疗科
- Keywords:
Uterine cervical neoplasms;
Radiotherapy;
intensity-modulated;
Treatment outcome;
Propensity score matching method
- From:
Cancer Research and Clinic
2019;31(1):6-10
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of intensity modulated radiotherapy (IMRT) and conventional radiotherapy (CRT) combined with intracavitary brachytherapy on patients with cervical stump cancer. Methods A total of 47 patients with cervical stump cancer who were admitted to the First Hospital of China Medical University from October 2007 to September 2017 were retrospectively reviewed. Of the 47 patients, 19 patients received CRT combined with intracavitary brachytherapy (CRT group), and 28 patients received IMRT combined with intracavitary brachytherapy (IMRT group). In order to reduce the effects of selection bias and confounding factors, propensity score matching was performed to compare the groups. Results After the propensity score matching, there were 19 patients in each group. The 1-, 3-and 5-year overall survival (OS) rate for matched patients were 100.0％, 85.1％ and 63.8％ in IMRT group, and 84.2％, 57.9％ and 42.1％ in CRT group, respectively, and the difference in survival between the two groups was statistically significant (PLog-rank= 0.029, PCox= 0.043, HR= 3.723, 95％CI 1.044-13.280). The median progression-free survival (PFS) time of the IMRT group was better than that of the CRT group [median PFS time had not been reached (7-72 months) vs. 17 months (2-125 months), PLog-rank= 0.032, PCox= 0.042, HR=2.773, 95％CI 1.037-7.417]. The incidence of late rectal and bladder radiation injury was 15.8％ (3/19) and 0 (0/19) in IMRT group, and 57.9％ (11/19) and 26.3 ％(5/19) in CRT group, respectively, and the difference was statistically significant (P= 0.017, P= 0.046). Conclusion Compared with CRT combined with intracavitary brachytherapy, IMRT combined with intracavitary brachytherapy has a better effect on patients with cervical stump cancer, and the incidence of complications is low, this method is worthy of clinical application.
