Clinical value of the comprehensive treatment in intermediate and advanced cervical cancer with uterine arterial interventional chemoembolization and radiotherapy / 中华妇产科杂志

ABSTRACT

Objective To investigate the long-term curative effect of the radiotherapy combined uterine arterial interventional chemoembolization for cervical cancer.Methods Records of 632 patients with cervical cancer stage Ⅱ-Ⅳa proved by pathology in Lanzhou Command General Hospital from January 1st,1999 to August 31st.2009 were retrospective analysed.One hundrand and twenty-six cases of them were treated with radical radiothempy combined uterine arterial interventional chemoembolization(arterial chemoembolization+radiotherapy group).506 cases of them were treated with radical radiotherapy only (radiotherapy group);the evaluation of the late radiation injury was done,according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer(RTOG/EORTC)advanced radiation injury criteria.Prognosis and complications were compared between two groups,relative risk factors of radiothempy complications were identified by method of logistic regression.Results (1)Survivalthe total survival mtes of 1-year,2-year,5-year and 8-year were 94.4%,82.3%,48.8%,29.1%,respectively.The survival rates of arterial chemoembolization+radiotherapy group were 96.0%.82.1%,37.2%,25.7%,while the survival rates of radiotherapy group were 94.1%,80.8%,51.1%,31.5%,in which there were significant differences between two groups (x2 = 0.009, P= 0.993; x2 =0. 158, P =0.691;X2 =11. 197,P=0. 001;x2 =9. 649,P =0.002). During the follow-up period, the rate of recurrence and metastasis in arterial chemoembolization + radiotherapy group were 77. 0% (97/126), while 73. 3% (371/ 506) in radiotherapy group ( x2 = 0. 705,P = 0. 401). (2) Radiotherapy complications and relative risk factors; the total incidence of tardive bladder injury higher than RTOG/EORTC stage II was 5.5% (35/632), while it was 11. l%(14/126)in arterial chemoembolization + radiotherapy group, 4.2% (21/506) in the radiotherapy group(x2 =9.344,P =0.002). The results of logistic regression showed that the uterine arterial interventional chemoembolization was relative risk factors of the tardive bladder injury ( x2 =6. 440, OR = 2. 869,P=0. 011). Conclusions Compared with the simple radiotherapy, there are a similar short-term survival rate and significant poor 5-year, 8-year survival rate in the patients treated with the uterine arterial interventional chemoembolization combined with radiotherapy, which also may be strong dangerous factor for the occurrence of tardive bladder injury. The results shown that the uterine arterial interventional chemoem bolization do not recommend to be routine adjuvant therapy for the radical radiotherapy of cervical cancer.