Clinical efficacy of concurrent chemoradiotherapy in cervical cancer patients with pelvic and/or para-aortic lymph node metastasis treated with radical surgery
10.3760/cma.j.cn113030-20191030-00447
- VernacularTitle:同步放化疗对伴有盆腹腔淋巴结转移的宫颈癌患者疗效分析
- Author:
Yeqiang TU
1
;
Qiu TANG
;
Dingding YAN
;
Xiaojuan LYU
;
Jianhong CHEN
;
Fangfang WANG
Author Information
1. 中国科学院肿瘤与基础医学研究所中国科学院大学附属肿瘤医院 浙江省肿瘤医院妇瘤放疗科，杭州 310022
- From:
Chinese Journal of Radiation Oncology
2020;29(6):446-450
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine whether postoperative concurrent chemoradiotherapy (CCRT) improves the survival outcomes of cervical cancer patients with pelvic and/or para-aortic lymph node metastasis after radical surgery.Methods:Clinical data of 188 cervical cancer patients presenting with pelvic and/or para-aortic lymph node metastasis after radical surgery between February 2008 and November 2011 were retrospectively analyzed. The incidence of pelvic and/or para-aortic lymph node metastasis was confirmed by postoperative pathology. The clinical efficacy of CCRT was evaluated.Results:Recurrence/metastasis occurred in 46 patients. In the radiotherapy alone group, 4(57.1%) patients had recurrence/metastasis in the posterior peritoneum subgroup, 5(55.6%) in the iliac subgroup and 11(28.2%) in the pelvic non-iliac subgroup, respectively. In the CCRT group, there were 5(62.5%) cases of recurrence/metastasis in the posterior peritoneum subgroup, 5(25%) in the iliac subgroup and 16(15.2%) in the pelvic non-iliac subgroup, respectively. Compared with the radiotherapy alone, CCRT could significantly improve the 5-year overall survival (OS) rate of patients with pelvic without iliac lymph node metastasis or iliac lymph node metastasis (pelvic without iliac: 88.6% vs.76.9%, P=0.003; iliac: 80.0% vs.44.4%, P=0.041), whereas failed to improve the 5-year OS of patients with para-aortic lymph node metastasis (50.0% vs.42.9%, P=0.973). The location of lymph node metastasis and CCRT were the independent prognostic factors for OS (para-aortic vs. pelvic without iliac: hazard ratio[HR]=4.259, 95% CI=1.700-10.671, P=0.002; iliac vs. pelvic without iliac: HR=2.985, 95% CI=1.290-6.907, P=0.011; concurrent chemotherapy vs. radiotherapy alone: HR=0.439, 95% CI=0.218-0.885, P=0.021). Conclusions:CCRT can improve the survival of patients with pelvic lymph node metastasis, but it fails to enhance the survival rate of patients with para-aortic lymph node metastasis.
