CLINICAL RESULTS OF CERVIX CANCER USING VARIOUS TECHNOLOGIES IN RADIATION THERAPY

Russian Journal of Oncology Pub Date : 2023-12-25 DOI:10.17816/onco568572

O. Kravets, Anara A. Kurmanova, V. N. Bogatyrev

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Abstract

Background: clinical results of patients with cervical cancer (CC) who treated with different methodological approaches of radiotherapy (RT) in the transforming from conventional to conformal RT and brachytherapy (BT). Purpose: to evaluate long-term results of treatment, locoregional and distant control. Methods: 137 patients with CC IIb - IIIb in 2013-2016 were analysed: 70 (51%) - conventional gamma therapy and brachytherapy (BT) with two-dimensional planning (2D) 60Сo alone or in combination with cisplatin 40 mg/m2 two groups of n=35. The total dose (TD) for point A 75.08 0.57 Gy, point B 57.9 0.43 Gy. In 67 (49%) with conform radiotherapy following BT with three-dimensional planning (3D) 192Ir alone or in combination with cisplatin 40 mg/m2 - two groups n = 35 and 32, respectively. TD CTV-HR D90 95.0 Gy 0.67 EQD2. Results: 3 and 5-year overall survival with 3D RT versus 2D RT was 84.6 4.5% and 63.1 6.0%; 84.6 4.5% versus 56.1 6.0%, respectively (p = 0.030). It was revealed that modern technologies are important in improving overall survival with image-guided RT: 88.2 6.6% of patients are alive for 3 years versus 59.0 8.4%, respectively (p=0.027). The use of chemoradiotherapy (CRT) showed an advantage of 3-year event-free survival in groups with 2D RT - 67.9 8.4% versus 55.2 8.6% (p = 0.042) in 3D RT - no statistically significant differences. Locoregional control was higher in the 3D RT groups at 3 years follow-up: 97.0 2.9% versus 82.9 5.3%, p = 0.050. CRT allows to reduce the number of local failures in the pelvis in the follow-up period up to 6 months, regardless of the RT technologies. The number of relapses and metastases in pelvis is lower in 3D RT - 3.0 2.1% versus 2D - 15.7 4.4% (p = 0.05). The frequency of metastases did not show statistically significant differences: 2D RT - 5.7 2.8% versus 3D RT - 9.0 3.5% (p 0.05). Conclusion: the study proves the improvement of local control in the treatment of cervical cancer in cases of conformal RT and 3D BT.

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使用各种放射治疗技术治疗宫颈癌的临床结果

背景：从传统放疗到适形放疗和近距离放疗，宫颈癌（CC）患者接受不同放疗方法治疗的临床结果。目的：评估长期治疗效果、局部和远处控制情况。方法：对2013-2016年的137例CC IIb - IIIb患者进行分析：70例（51%）--常规伽马治疗和近距离放射治疗（BT），二维规划（2D）60Сo单独或与顺铂40 mg/m2联合，两组n=35。A点的总剂量（TD）为75.08 0.57 Gy，B点为57.9 0.43 Gy。在 67 例（49%）符合放疗条件的 BT 患者中，采用三维计划（3D）192Ir 单独或与顺铂 40 mg/m2 联合治疗--两组分别为 n=35 和 32。TD CTV-HR D90 95.0 Gy 0.67 EQD2。结果三维 RT 与二维 RT 相比，3 年和 5 年总生存率分别为 84.6 4.5% 和 63.1 6.0%；84.6 4.5% 和 56.1 6.0%（P = 0.030）。结果显示，现代技术对提高图像引导 RT 的总生存率非常重要：88.2 6.6% 的患者存活 3 年，而 59.0 8.4% 的患者存活 3 年（P=0.027）。化放疗（CRT）的使用显示出二维 RT 组 3 年无事件生存率的优势：67.9 8.4% 对 55.2 8.6%（P=0.042），三维 RT 组 3 年无事件生存率的差异无统计学意义。随访3年后，3D RT组的局部控制率更高：97.0 2.9%对82.9 5.3%，p = 0.050。无论采用哪种 RT 技术，CRT 都能在随访 6 个月内减少盆腔局部失败的次数。盆腔复发和转移的数量在三维 RT 中为 3.0 2.1%，而在二维 RT 中为 15.7 4.4%（P = 0.05）。转移的频率在统计学上没有显著差异：二维 RT - 5.7 2.8%，三维 RT - 9.0 3.5%（P 0.05）。结论：该研究证明，适形 RT 和 3D BT 治疗宫颈癌的局部控制效果有所改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Russian Journal of Oncology

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