根据主要治疗方式的 Vulvar 癌症存活率:一个回顾性队列研究
Kelly H Bruce1, Amy Alabaster2, Arthur-Quan M Tran3
1Department of Obstetrics and Gynecology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA, United States of America.
Gynecologic oncology
|August 10, 2023
概括
对于癌,当考虑阶段时,初级放射治疗显示了与初级手术相似的生存率. 用辅助辐射进行手术会增加淋巴风险,这表明辐射可能是一个可行的替代方案.
科学领域:
- 妇科瘤学 妇科瘤学
- 辐射瘤学 辐射瘤学
- 手术瘤学手术瘤学
背景情况:
- 癌治疗传统上涉及手术,放射治疗作为替代或辅助的选择.
- 对比初级辐射和初级手术之间的结果对于优化患者护理和治疗策略至关重要.
研究的目的:
- 为了比较原发性辐射治疗的女性与原发性手术治疗的女性的整体存活率 (OS) 和无进展存活率 (PFS).
- 评估和比较与不同治疗方式相关的并发症率,包括淋巴和伤口感染.
主要方法:
- 一项回顾性队列研究分析了Kaiser Permanente成员在2008年至2018年期间被诊断患有阴道状细胞癌 (SCC).
- 患者被分为三个组:仅进行初级手术 (仅PS),使用辅助辐射进行手术 (PS + RT) 和初级辐射 (PRT).
- 使用多变量回归来调整年龄,阶段,并发症和吸烟状况,分析1年和3年的OS和PFS.
主要成果:
- 在201名女性中,114名仅接受PS,36名接受PS + RT,51名接受PRT. 只有PS患者的疾病进展较慢.
- 只有PS (96.5%,82.6%) 的原始1年和3年的OS显著高于PS+RT (72.2%,48.3%) 和PRT (72.6%,53.9%).
- 然而,在控制阶段和其他因素后,在PRT和PS之间没有发现死亡风险的统计差异 (aHR 1.35),或PS + RT和PS之间没有发现死亡风险的统计差异 (aHR 1.28). 与PS + RT (36.1%) 相比,只有PS (20.2%) 和PRT (9.8%) 观察到增加淋巴瘤风险.
结论:
- 当根据疾病阶段进行调整时, Vulvar 癌症的存活率在初级辐射和初级手术之间是可比的.
- 手术后的辅助放射治疗与淋巴的发病率较高有关.
- 初级辐射疗法对精选患者,特别是那些可能需要辅助治疗的患者来说,是一种潜在的可接受的初级手术替代方案.
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