Abstract：
OBJECTIVE: To report the results of a multicenter cohort of preoperative brachytherapy (PBT) for treatment of early-stage cervical cancer (ESCC).
METHODS: A retrospective analysis was conducted among five French comprehensive cancer centers on behalf of the SFRO Brachytherapy Group to examine the outcome of patients with ESCC who received PBT between 2001 and 2019 because of adverse prognostic factors (tumor size >2 cm, presence of lymphovascular invasion, adenocarcinoma).Brachytherapy was followed 4-8 weeks later by surgery. Local relapse free, distant metastasis-free survival, disease-free, and overall survival and adverse effects were examined. Uni- and multivariate analyses were conducted looking for oncological prognostic factors.
RESULTS: A total of 451 patients were identified, with a mean tumor size of 24.7 mm. Adenocarcinoma accounted for 43.5% of cases, and lympho-vascular space invasion (LVSI) was present in 15.7%. A complete histological response was observed in 69.6%. With a mean follow-up of 75.4 months, DFS, LRFS, and OS rates at five years were 88% [95% CI (84-91), 98% [95% CI (96-99), and 92% [95% CI (87-95)], respectively. At the last follow-up, 8.2% of patients had died, including 31 (6.8%) from cervical cancer. Severe side effects range from 1.1% to 2%. At multivariate analysis, adenocarcinoma histological type, tumor size ≥2 cm, and the presence of residual tumors were prognosticators for DFS and DMFS.
CONCLUSIONS: PBT shows excellent oncological outcomes in this cohort of patients with adverse histoprognostic factors. Favorable survival rates and low complications rates were observed, supporting this strategy in the management of ESCC.
METHODS: A retrospective analysis was conducted among five French comprehensive cancer centers on behalf of the SFRO Brachytherapy Group to examine the outcome of patients with ESCC who received PBT between 2001 and 2019 because of adverse prognostic factors (tumor size >2 cm, presence of lymphovascular invasion, adenocarcinoma).Brachytherapy was followed 4-8 weeks later by surgery. Local relapse free, distant metastasis-free survival, disease-free, and overall survival and adverse effects were examined. Uni- and multivariate analyses were conducted looking for oncological prognostic factors.
RESULTS: A total of 451 patients were identified, with a mean tumor size of 24.7 mm. Adenocarcinoma accounted for 43.5% of cases, and lympho-vascular space invasion (LVSI) was present in 15.7%. A complete histological response was observed in 69.6%. With a mean follow-up of 75.4 months, DFS, LRFS, and OS rates at five years were 88% [95% CI (84-91), 98% [95% CI (96-99), and 92% [95% CI (87-95)], respectively. At the last follow-up, 8.2% of patients had died, including 31 (6.8%) from cervical cancer. Severe side effects range from 1.1% to 2%. At multivariate analysis, adenocarcinoma histological type, tumor size ≥2 cm, and the presence of residual tumors were prognosticators for DFS and DMFS.
CONCLUSIONS: PBT shows excellent oncological outcomes in this cohort of patients with adverse histoprognostic factors. Favorable survival rates and low complications rates were observed, supporting this strategy in the management of ESCC.
摘要：
目的：报告术前近距离放射治疗（PBT）治疗早期宫颈癌（ESCC）的多中心队列研究结果。
方法：代表SFRO近距离放射治疗小组对法国五个综合癌症中心进行了回顾性分析，以检查2001年至2019年因不良预后因素（肿瘤大小>2厘米，淋巴管浸润的存在，腺癌)。4-8周后通过手术进行近距离放射治疗。局部无复发，无远处转移生存率，无病,并检查总生存期和不良反应。进行单因素和多因素分析以寻找肿瘤预后因素。
结果：共确定451例患者，平均肿瘤大小为24.7毫米。腺癌占43.5%,15.7%存在淋巴血管间隙侵犯(LVSI)。在69.6%中观察到完全的组织学反应。平均随访75.4个月，DFS,LRFS,五年的OS率为88%[95%CI（84-91），98%[95%CI（96-99），和92%[95%CI（87-95）]，分别。在最后一次随访中，8.2%的病人已经死亡,包括31（6.8％）宫颈癌。严重的副作用范围从1.1%到2%。在多变量分析中，腺癌组织学类型，肿瘤大小≥2厘米，残留肿瘤的存在是DFS和DMFS的预后因素。
结论：PBT在这一具有不良组织预后因素的患者队列中显示出优异的肿瘤学结局。观察到良好的生存率和低并发症率，在ESCC的管理中支持这一战略。
方法：代表SFRO近距离放射治疗小组对法国五个综合癌症中心进行了回顾性分析，以检查2001年至2019年因不良预后因素（肿瘤大小>2厘米，淋巴管浸润的存在，腺癌)。4-8周后通过手术进行近距离放射治疗。局部无复发，无远处转移生存率，无病,并检查总生存期和不良反应。进行单因素和多因素分析以寻找肿瘤预后因素。
结果：共确定451例患者，平均肿瘤大小为24.7毫米。腺癌占43.5%,15.7%存在淋巴血管间隙侵犯(LVSI)。在69.6%中观察到完全的组织学反应。平均随访75.4个月，DFS,LRFS,五年的OS率为88%[95%CI（84-91），98%[95%CI（96-99），和92%[95%CI（87-95）]，分别。在最后一次随访中，8.2%的病人已经死亡,包括31（6.8％）宫颈癌。严重的副作用范围从1.1%到2%。在多变量分析中，腺癌组织学类型，肿瘤大小≥2厘米，残留肿瘤的存在是DFS和DMFS的预后因素。
结论：PBT在这一具有不良组织预后因素的患者队列中显示出优异的肿瘤学结局。观察到良好的生存率和低并发症率，在ESCC的管理中支持这一战略。
