Major adverse events and prognostic factors in elderly patients with cervical cancer undergoing intensive-modulated radiotherapy combined with intravaginal brachytherapy
10.3760/cma.j.issn.0254-9026.2019.10.021
- VernacularTitle: 调强放疗联合后装治疗的老年宫颈癌患者不良反应和预后因素分析
- Author:
Jian WANG
1
;
Lijun HU
2
;
Bo YU
1
;
Lili WANG
3
;
Jingping YU
2
;
Qinghong MENG
2
;
Zhiqiang SUN
2
;
Jianlin WANG
2
Author Information
1. Department of Radiation Oncology, Jiangyin People's Hospital, Affiliated Hospital of Southeast University, Jiangyin 214400, China
2. Department of Radiation Oncology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China
3. Department of Radiation Oncology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Publication Type:Journal Article
- Keywords:
Uterine cervical neoplasms;
Radiotherapy;
Prognosis
- From:
Chinese Journal of Geriatrics
2019;38(10):1148-1152
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the adverse effects and clinical efficacy of the intensive modulated radiotherapy(IMRT)and intravaginal brachytherapy combined with versus without chemotherapy in elderly patients with cervical cancer, and to analyze its prognostic factors.
Methods:Clinical data and follow-up results of 214 patients with cervical cancer aged ≥60 years undergoing IMRT and intravaginal brachytherapy combined with or without chemotherapy were retrospectively analyzed.The overall survival(OS)rate was calculated by using the Kaplan-Meier method.Prognostic factors were analyzed by Log-rank single factor test and Cox multivariate analysis.
Results:The rates of myelosuppression(≥grade 3)was higher in the concurrent chemo-radiotherapy group than in simple radiotherapy group(48.6% vs.15.8%, χ2=27.372, P<0.05). The complete response(CR)rate was higher in the concurrent chemo-radiotherapy group than in the simple radiotherapy group(83.0% vs.68.3%, χ2=5.993, P=0.014). The 1-, 3- and 5-year OS rate were 92.2%, 79.3% and 65.6%, respectively in all patients.Univariate analysis showed that the staging, lymph node metastasis status, pathological type and short-term efficacy of cervical cancer(based on FIGO guideline)were influencing factors for the prognosis(χ2=4.321-30.316, all P<0.05). Multivariate analysis showed that the FIGO staging, lymph node metastasis status and short-term efficacy were independent influencing factors for the prognosis(χ2=5.284-14.261, all P<0.05).
Conclusions:The intensive modulated radiotherapy and intravaginal brachytherapy combined with chemotherapy have a good efficacy and favorable long-term survival rate for the treatment of cervical cancer in elderly patients, and its major adverse effects can be tolerated.The FIGO staging, lymph node metastasis status and short-term efficacy are independent influencing factors for the prognosis in elderly patients with cervical cancer.
