Clinical study of concurrent chemoradiotherapy combined with gamma knife therapy for cervical cancer with positive pelvic lymph node / 中国肿瘤临床

ABSTRACT

Objective:To evaluate therapeutic efficacy and adverse reactions of synchronous chemoradiotherapy combined with gamma knife therapy for pelvic lymph node metastasis of cervical cancers. Methods:Data of 42 cervical cancer patients who suffered from residual pelvic lymph node metastasis and received concurrent chemoradiotherapy were retrospectively analyzed. Intensity-modu-lated radiotherapy was used in the treatment. The prescribed doses of planning target volume and pelvic metastasized lymph node of the planned gross tumor volume were 50.4 Gy/28 F and 59.92 Gy/28 F, respectively. The combined internal irradiation dose was 6 Gy/6 F. Concurrent chemotherapy was administered with 40 mg/m2·w cisplatin. Three months after chemoradiotherapy was completed, the pa-tients with residual pelvic positive lymph node received additional dose ranging from 10 Gy to 15 Gy at three or four fractions by using a gamma knife. Results:Near-term efficacy was 83.3%(35/42) in three months. Local control rates were 88.1%(37/42), 83.3%(35/42), and 76.2%(32/42) in 6, 9, and 12 months, respectively. The 1-and 2-year survival rates were 77.5%(31/40) and 70.0%(28/40), re-spectively. The incidence rates of radiation enteritis, proctitis, cystitis, gut toxicity, and neutrocytopenia were 11.9%(5/42), 38.1%(16/42), 7.1%(3/42), 90.5%(38/42), and 85.7%(36/42), respectively, and the majority of these conditions were classified as grades I and II. Conclusion:Synchronous chemoradiotherapy combined with gamma knife therapy is an effective and feasible treatment method for pelvic lymph node metastasis of cervical cancer;this method exhibits a minimal adverse reaction.