Long-term outcome of 160 patients with stage Ⅱb cervical carcinoma treated with pre-operative and intra-operative radiotherapy

Objective To investigate the 5-and 10-year survival and complications of patients with stage Ⅱb cervical carcinoma treated by pre-operative photon radiotherapy (POPRT) plus brachytherapy (192Ir) and selective lymphadenectomy hysterectomy (SLH) plus intra-operative electron radiotherapy (IOERT). Methods From February 1997 to May 2007, 160 patients with stage Ⅱb cervical carcinoma were treated by POPRT of 20 Gy in 10 fractions to the whole pelvis, 192Ir brachytherapy of 14 Gy in 2fractions, followed by IOERT of 18 -20 Gy to the whole pelvis during SLH one week after. Results The follow-up rate was 98.1%. The number of patients followed-up for 5 and 10 years was 143 and 135,respectively. The 5-year overall survival rate, disease-free survival rate and local control rate of all patients were 89.4%, 86. 3% and 96. 3%, with the corresponding 10-year rates of 84.4%, 81.0% and 95.0%,respectively. The radiation-induced rectitis and cystitis were 5.0% and 0. 6%, respectivly. The rate of hydronephrosis and lower extremity edema was 6. 3% and 1.3%, respectively. Conclusions Combination of EBRT plus 192Ir brachytherapy and SLH plus IOERT could improve the survival and local control of patiens with cervical carcinoma, with only a few side effects.     

160例Ⅱb期宫颈癌术前光子线+术中电子线照射的远期疗效分析

目的 分析官颈癌Ⅱb期患者应用术前外照射+192Ir腔内照射+手术及术中电子线照射的远期疗效.方法 对160例应用术前外照射+192Ir腔内照射+手术及术中电子线照射的宫颈癌Ⅱb期患者资料进行回顾分析.全部患者术前先全盆腔接受了20 Gy分10次外照射和192Ir近距离腔内放疗,1周后全盆腔接受了12 MeV电子线18～20 Gy照射.结果 随访率为98.1%.随访满5、10年患者分别为143、135例.5年和10年生存率、无瘤生存率、局部控制率分别为89.4%、86.3%、96.3%和84.4%、81.0%、95.0%.放射性直肠炎、膀胱炎发生率分别为5.0%、0.6%.放疗后肾孟积水、下肢水肿发生率分别为6.3%、1.3%.结论 宫颈癌Ⅱb期患者应用术前外照射+192Ir腔内照射+手术及术中电子线照射可提高患者生存率,且对肿瘤原发部位局部控制效果好,放疗副反应少.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients: A phase Ⅰ/Ⅱ clinical trial

目的 探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应.方法 38例高危乳腺癌患者改良根治术后化疗后,同侧胸壁和锁骨上下放疗43.5 Gy分15次3周完成,观察急性放疗反应发生率和肿瘤的局部区域控制率.结果 中位随访13个月,入组38例患者全部生存,无照射野内复发,远处转移率为13%(5例).5例患者出现3级放射性皮炎,均发生在放疗结束后2～3周.3例患者出现2级放射性肺炎.结论 乳腺癌改良根治术后43.5 Gy分15次3周完成的大分割放疗方案的急性副反应可以接受,近期疗效较好.     

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients: A phase Ⅰ/Ⅱ clinical trial

目的 探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应.方法 38例高危乳腺癌患者改良根治术后化疗后,同侧胸壁和锁骨上下放疗43.5 Gy分15次3周完成,观察急性放疗反应发生率和肿瘤的局部区域控制率.结果 中位随访13个月,入组38例患者全部生存,无照射野内复发,远处转移率为13%(5例).5例患者出现3级放射性皮炎,均发生在放疗结束后2～3周.3例患者出现2级放射性肺炎.结论 乳腺癌改良根治术后43.5 Gy分15次3周完成的大分割放疗方案的急性副反应可以接受,近期疗效较好.     

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients: A phase Ⅰ/Ⅱ clinical trial

目的 探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应.方法 38例高危乳腺癌患者改良根治术后化疗后,同侧胸壁和锁骨上下放疗43.5 Gy分15次3周完成,观察急性放疗反应发生率和肿瘤的局部区域控制率.结果 中位随访13个月,入组38例患者全部生存,无照射野内复发,远处转移率为13%(5例).5例患者出现3级放射性皮炎,均发生在放疗结束后2～3周.3例患者出现2级放射性肺炎.结论 乳腺癌改良根治术后43.5 Gy分15次3周完成的大分割放疗方案的急性副反应可以接受,近期疗效较好.     

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients: A phase Ⅰ/Ⅱ clinical trial

目的 探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应.方法 38例高危乳腺癌患者改良根治术后化疗后,同侧胸壁和锁骨上下放疗43.5 Gy分15次3周完成,观察急性放疗反应发生率和肿瘤的局部区域控制率.结果 中位随访13个月,入组38例患者全部生存,无照射野内复发,远处转移率为13%(5例).5例患者出现3级放射性皮炎,均发生在放疗结束后2～3周.3例患者出现2级放射性肺炎.结论 乳腺癌改良根治术后43.5 Gy分15次3周完成的大分割放疗方案的急性副反应可以接受,近期疗效较好.     

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients: A phase Ⅰ/Ⅱ clinical trial

目的 探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应.方法 38例高危乳腺癌患者改良根治术后化疗后,同侧胸壁和锁骨上下放疗43.5 Gy分15次3周完成,观察急性放疗反应发生率和肿瘤的局部区域控制率.结果 中位随访13个月,入组38例患者全部生存,无照射野内复发,远处转移率为13%(5例).5例患者出现3级放射性皮炎,均发生在放疗结束后2～3周.3例患者出现2级放射性肺炎.结论 乳腺癌改良根治术后43.5 Gy分15次3周完成的大分割放疗方案的急性副反应可以接受,近期疗效较好.     

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients: A phase Ⅰ/Ⅱ clinical trial

目的 探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应.方法 38例高危乳腺癌患者改良根治术后化疗后,同侧胸壁和锁骨上下放疗43.5 Gy分15次3周完成,观察急性放疗反应发生率和肿瘤的局部区域控制率.结果 中位随访13个月,入组38例患者全部生存,无照射野内复发,远处转移率为13%(5例).5例患者出现3级放射性皮炎,均发生在放疗结束后2～3周.3例患者出现2级放射性肺炎.结论 乳腺癌改良根治术后43.5 Gy分15次3周完成的大分割放疗方案的急性副反应可以接受,近期疗效较好.     

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients: A phase Ⅰ/Ⅱ clinical trial

目的 探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应.方法 38例高危乳腺癌患者改良根治术后化疗后,同侧胸壁和锁骨上下放疗43.5 Gy分15次3周完成,观察急性放疗反应发生率和肿瘤的局部区域控制率.结果 中位随访13个月,入组38例患者全部生存,无照射野内复发,远处转移率为13%(5例).5例患者出现3级放射性皮炎,均发生在放疗结束后2～3周.3例患者出现2级放射性肺炎.结论 乳腺癌改良根治术后43.5 Gy分15次3周完成的大分割放疗方案的急性副反应可以接受,近期疗效较好.     

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients: A phase Ⅰ/Ⅱ clinical trial

目的 探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应.方法 38例高危乳腺癌患者改良根治术后化疗后,同侧胸壁和锁骨上下放疗43.5 Gy分15次3周完成,观察急性放疗反应发生率和肿瘤的局部区域控制率.结果 中位随访13个月,入组38例患者全部生存,无照射野内复发,远处转移率为13%(5例).5例患者出现3级放射性皮炎,均发生在放疗结束后2～3周.3例患者出现2级放射性肺炎.结论 乳腺癌改良根治术后43.5 Gy分15次3周完成的大分割放疗方案的急性副反应可以接受,近期疗效较好.