子宫颈腺癌的碳离子放射治疗：日本多中心前瞻性注册研究的临床结果（2016-2020）
Carbon-Ion Radiation Therapy for Adenocarcinoma of the Uterine Cervix: Clinical Outcomes of a Multicenter Prospective Registry-Based Study in Japan (2016-2020)
影响因子:6.50000
分区:医学1区 Top / 肿瘤学2区 核医学2区
发表日期:2025 Mar 01
作者:
Kazutoshi Murata, Noriyuki Okonogi, Ken Ando, Keisuke Tsuchida, Kaori Fukunishi, Daisuke Irie, Yoshiaki Ohyama, Masaru Wakatsuki, Munetaka Takekuma, Shingo Kato, Tatsuya Ohno
摘要
子宫宫颈腺癌（AUC）的预后较差的病例比鳞状细胞癌的预后较差。在回顾性或单机构的前瞻性研究中，已有报道了AUC的碳离子放射疗法（CIRT）结果，但没有前瞻性多中心研究。我们在日本的全国医院注册表中介绍了AUC的CIRT结果。该研究包括在2016年6月至2020年4月之间在4个日本中心接受CIRT的患者。在没有器官功能障碍的情况下，每周40 mg/m2顺铂课程。主要终点是2年的总生存率和局部控制率。次要终点是2年无病生存率和晚期不良事件（AES）。舒适的两名患者的中位年龄为54岁（范围为34-76岁）。患者被诊断为IIB期（n = 26），IIIB（n = 12）或IVA（n = 4）疾病。中位随访期为24个月。 2年的总生存率，局部对照和无病生存率为97.5％（95％CI，92.7％-100.0％），80.9％（95％CI，66.9％-94.8％）和64.3％（分别为48.1％-80.4％）。两名患者患有3级直肠/乙状结肠AE。一名患者需要在打捞手术期间进行尿液转移手术，以进行局部肿瘤复发（3级生殖器AE）。没有其他3级或更差的毒性报告。上升是对局部晚期AUC的有效治疗方法。需要进一步的研究来验证CIRT对AUC的安全性和功效。
Abstract
Cases of adenocarcinoma of the uterine cervix (AUC) have poorer prognoses than those of squamous cell carcinoma. Carbon-ion radiation therapy (CIRT) outcomes for AUC have been reported in retrospective or single-institutional prospective studies but not prospective multicenter studies. We present the results of CIRT for AUC in a prospective multicenter study using a nationwide hospital-based registry in Japan.Patients with locally advanced untreated AUC who received CIRT at 4 Japanese centers between June 2016 and April 2020 were included in this study. In the absence of organ dysfunction, up to 5 weekly 40 mg/m2 cisplatin courses were administered. The primary endpoints were 2-year overall survival and local control rates. The secondary endpoints were 2-year disease-free survival rate and late adverse events (AEs).Forty-two patients were enrolled with a median age of 54 years (range, 34-76 years). Patients were diagnosed with stage IIB (n = 26), IIIB (n = 12), or IVA (n = 4) disease. The median follow-up period was 24 months. The 2-year overall survival, local control, and disease-free survival rates were 97.5% (95% CI, 92.7%-100.0%), 80.9% (95% CI, 66.9%-94.8%), and 64.3% (48.1%-80.4%), respectively. Two patients developed grade 3 rectum/sigmoid AE. One patient required urinary diversion surgery during a salvage operation for local tumor recurrence (grade 3 genitourinary AE). No other grade 3 or worse toxicities were reported.CIRT is an effective treatment for locally advanced AUC. Further research is required to validate the safety and efficacy of CIRT for AUC.