ABSTRACT
Objective To analyze the clinical outcome and prognostic factors of concurrent radiochemotherapy (CRCT) or radiotherapy (RT) alone followed by radical hysterectomy in cervical cancer.MethodsBetween April 2006 and June 2011,182 patients with FIGO ⅠB2-ⅢB cervical carcinoma were treated with preoperative CRCT ( 123 patients) or RT alone ( 59 patients) followed by radical surgery.Weekly cisplatin (40 mg/m2)were administered during radiotherapy for patients treated with CRCT.Preoperative RT doses were 40-50 Gy in 20-25 fractions.Total hysterosalpingo-oophorectomy and pelvic lymph node dissection was performed 2-3 weeks after neoadjuvant therapy.The prognostic factors were analyzed by Cox-regression method.ResultsSixty-nine patients were followed up for 3 years.For patients with tumor ≥4.5 cm,there were no significant differences in the 3-year progression-free survival (PFS) and overall survival (OS) rates between CRCT and RT alone ( x2 =1.84 and 1.56,P =0.176 and 0.221 ).For patients with tumor ＜ 4.5 cm,CRCT group had higher PFS and OS rates than RT alone ( x2 =5.22 and 4.81,P=0.022 and 0.018).The 3-year PFS and OS rates were 92.0％ and 93.8％.By multivariate analysis,tumor diameter ( ≥6 cm vs.＜ 6 cm) was significant prognostic factor for PFS and OS (x2 =2.56,P =0.011 ;x2 =4.06,P =0.007 ),age ( ＜ 48 vs.≥ 48 years) was significant prognostic factor for OS (x2=4.86,P =0.046),and postoperative lymph node status (positive vs.negative) was significant prognostic factor for PFS ( x2 =1.04,P =0.010).ConclusionsTreatment with CRCT or RT followed by radical surgery has achieved good OS and PFS for patients with FIGOⅠB2-ⅢB cervical cancer.Tumor diameter,age and postoperative lymph node status are important prognostic factors for survival.
ABSTRACT
Objective To investigate the influence of interoperation radiation therapy (IROT) on immunity of patients with cervical cancer at Ⅱ b stage. Methods Before and after radiotherapy, T lymphocyte subsets of 61 cervical cancer patients at Ⅱ b stage including 28 patients with IROT and 31 with simple radiotherapy (SR) were tested by flow cytometry, with 20 normal people as the controls(NC). Results Before radiotherapy, radio CD 4, CD 4/CD 8 decreased obviously in cervical cancer patients. There was no obvious difference in immunity between IROT and SR group. After radiotherapy, radio CD 4, CD 4/CD 8 decreased obviously in 61 cervical cancer patients. But SR group was significantly lower than IROT group. Conclusion The influence of IROT on immunity of patients with cervical cancer at Ⅱ b stage was weaker than that of simple radiotherapy, and IROT contributed to the recovery of patients after radiotherapy.