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辅助性外部光束放射疗法结合手臂疗法用于中等风险的宫癌
Nuria Agusti1, David Viveros-Carreño2,3, Alexander Melamed4
1Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA NAgusti@mdanderson.org.
概括
外部光束放射疗法 (EBRT) 与胸腔疗法在中等风险的宫癌中很常见. 这项研究没有发现整体生存益处,但在没有接受化疗的患者中改善了生存率.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 妇科瘤学 妇科瘤学
背景情况:
- 外部射线疗法 (EBRT) 是对中等风险宫癌的标准辅助治疗方法.
- 支臂疗法经常与EBRT结合使用,但其益处仍未得到证实.
研究的目的:
- 为了评估与EBRT结合使用支臂治疗的频率.
- 为了比较单独使用的EBRT剂量与与支臂疗法一起使用的EBRT剂量.
- 评估支臂治疗对早期宫癌患者整体存活率的影响.
主要方法:
- 使用国家癌症数据库 (2004-2019) 进行回顾性队列研究.
- 包括患有中等风险,早期子宫癌的患者,接受了激进子宫切除和淋巴结分期治疗.
- 仅接受EBRT的患者与EBRT加上支臂治疗的患者进行了比较,使用2:1的倾向性得分匹配.
主要成果:
- 大约26.7%的患者除了EBRT外还接受了支臂治疗.
- 单独使用EBRT和带有支臂治疗的EBRT之间没有观察到总生存时间的显著差异 (HR 0.88).
- 没有接受化疗的患者在添加支臂治疗时,整体存活率有所改善 (HR 0.48).
结论:
- 支臂疗法使用频繁,但与显著的治疗异质性有关.
- 在这个患者队列中,加上EBRT的支臂疗法并没有改善整体存活率.
- 同时的化疗状态是影响支架疗法的生存益处的关键因素.
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