Prognostic Factors after Adjuvant Radiotherapy in Cervical Cancers: A Retrospective Study

子宮頸癌輔助性放射線治療的預後因子－回溯性研究

陳柏均(Po-Chun Chen) ； 劉文山(Wen-Shan Liu) ； 陳建勳(Chien-Hsun Chen) ； 張慶雄(Ching-Hsiung Chang) ； 唐佩玲(Pei-Ling Tang) ； 梁頌文(Chung-Man Leung) ； 胡渝昌(Yu-Chang Hu) ； 張國楨(Kuo-Chen Chang)

《放射治療與腫瘤學》 20卷2期 (2013/06) Pp. 89-96

https://doi.org/10.6316/TRO/201320(2)89

摘要

目的：此回溯性研究針對接受過輔助性放射線治療的子宮頸癌患者，研究影響整體存活率及無病存活率的預後因子。材料與方法：本研究從2000至2006年於高雄榮民總醫院收錄149名接受輔助性放射線治療的子宮頸癌患者。利用單變項與多變項，分析各種可能影響存活率之預後因子。結果：病患之中位數年齡為55歲。子宮頸癌患者依據分期，IB有102位，IIA有33位，IIB-IVA有14位。分期為IB的五年整體存活率及無病存活率分別為75.2%及65.4%。分期為IIA的五年整體存活率及無病存活率分別為69.7%及70.5 %。分期為IIB-IVA的五年整體存活率及無病存活率分別為66.7%及50%。多變項分析顯示子宮旁侵犯以及腺癌顯著影響整體存活率。結論：子宮旁侵犯以及腺癌類型的組織型態為最重要的預後因子。另外，在我們的研究中，輔助性化療並不能提升存活率。

關鍵字

子宮頸癌 ； 輔助性放射線治療 ； 預後因子

並列摘要

Purpose: This retrospective study aimed to investigate the prognostic factors influenced the overall and progression-free survival (PFS) in cervical cancer patients who received radical hysterectomy and Iymphadenectomy and adjuvant radiotherapy.Methods: From 2000 to 2006, there were 149 cervical cancer patients treated with surgery and adjuvant radiotherapy in the Department of Radiation therapy, Kaohsiung Veterans General Hospital, Taiwan. Patient characteristics, treatment characteristics and pathologic factors were analyzed using log rank test. The overall survival (OS) and PFS distribution were calculated by Kaplan-Meier method. Multivariate analysis was performed by the Cox regression model.Result: The median age of this population was 55 years-old (ranged from 25 to 82). There were 102, 33, and 14 patients belonged to FIGO stage 18, IIA and 118 to IVA, respectively. The 5-year OS and PFS were 75.2% and 65.4% in stage 18 cervical cancer, 69.7% and 70.5% in stage IIA cervical cancer, and 66.7% and 50% in stage 118. IVA cervical cancer. In multivariate analysis, the factors of adenocarcinoma (p ＜0.05) and parametrial invasion (p ＜ 0.01) correlated with worse OS and the factors of parametrial invasion (p ＜0.01) and age ＜60 (p ＜0.05) correlated with worse PFS.Conclusion: Parametrial invasion and histology of adenocarcinoma accounted the most important prognostic factors among other clinical and pathological factors in patients receiving adjuvant radiotherapy. Adjuvant chemotherapy didn't achieve better survival in our study.

並列關鍵字

Cervical cancer ； Adjuvant radiotherapy ； Prognostic factors