Combined low-dose-rate brachytherapy and external beam radiation for cervical cancer: experience over ten years.

I Han, C Orton, F Shamsa, K Hart, A Strowbridge, G Deppe, A Porter, P J Chuba
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Abstract

Cervical cancer was treated with a combination of external beam and intracavitary radiation during a 10-year period at Wayne State University. Data were collected for 216 patients treated radically with external beam radiation (EBRT) and low-dose-rate brachytherapy for cervical cancer between 1980 and 1991 at Wayne State University. Patient distribution by stage was IB, 20.8%; IIA, 7.4%; IIB, 26.9%; IIIA, 1.8%; IIIB, 40.7%; and IVA, 2.3 %. Survival curves were constructed using Kaplan-Meier methods and differences between groups were tested for significance using the log-rank test. Multivariate analysis was done using the Cox proportional hazards model. With a median follow-up of 114 months, actuarial disease-free survival for all patients was 60% at 5 years and 55% at 10 years. Actuarial 5-year survival for Stage IB was 79%; for Stage II, 59%; and for Stage III, 53%. There were 14/216 (6%) of patients with severe late complications. On univariate analysis, race was found to be statistically significant, with Caucasian patients having better survival than African American (P = 0.03). The survival for patients treated in shorter overall times was significantly higher (P<0.001), especially with treatment completion in under 58 days. The stepwise Cox multivariate analysis provided the following significant results: race (African American vs. Caucasian; P = 0.04, RR = 1.6), Stage (II vs. I, P = 0.004, RR = 2.6), Stage (III vs. I; P = 0.004, RR = 2.5), and overall treatment time (P = 0.006, RR = 1.62). Rates of local control, survival, and complications among women treated with combined external beam and intracavitary radiation for cervix cancer were similar to those of prior retrospective studies.

宫颈癌的低剂量近距离放射治疗和外照射联合疗法:十年来的经验。
在韦恩州立大学的 10 年间,宫颈癌患者接受了外照射和腔内放射的综合治疗。我们收集了韦恩州立大学在1980年至1991年期间采用体外射束辐射(EBRT)和低剂量近距离放射治疗宫颈癌的216名患者的数据。患者的分期分布为:IB,20.8%;IIA,7.4%;IIB,26.9%;IIIA,1.8%;IIIB,40.7%;IVA,2.3%。采用 Kaplan-Meier 方法绘制了生存曲线,并用对数秩检验法检验了组间差异的显著性。采用考克斯比例危险模型进行多变量分析。中位随访时间为114个月,所有患者5年的精算无病生存率为60%,10年的精算无病生存率为55%。IB 期患者的 5 年精算生存率为 79%,II 期为 59%,III 期为 53%。216例患者中有14例(6%)出现严重的晚期并发症。单变量分析发现,种族具有统计学意义,白种人的生存率高于非裔美国人(P = 0.03)。总治疗时间较短的患者的生存率明显更高(P = 0.05)。
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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