目的:本研究旨在探讨在腔内近距离放射治疗(ICBT)当天插入或不插入顺铂的情况下,外照射放射治疗(EBRT)和连续高剂量腔内近距离放射治疗(HDRICBT)之间的比较临床结果。
方法:在本研究中,2017年1月至2018年7月在印度一家领先的研究所进行,诊断和未治疗的局部晚期宫颈癌患者被随机分为两组。在每个疗程的近距离放射治疗前,1组同时接受顺铂治疗,而2号臂单独接受近距离放射治疗。结果在急性和晚期毒性方面进行了比较,治疗反应,和后续行动。使用SPSS16进行数据分析,统计学显著性设定为p<0.05。
结果:两个研究组的完全缓解(CR)率相似,为73.3%,近距离放射治疗前同步顺铂无明显优势。然而,在后续行动中出现了值得注意的趋势。在并发顺铂组中,CR率从近距离放射治疗1个月后的73.3%增加到3个月时的86.7%和6个月时的83.3%.相反,对照组1个月后CR率为73.3%,3个月时80%,6个月时为76.6%。虽然没有统计学意义,这一观察结果提示顺铂和ICBT联合治疗可能提高缓解率.
结论:未来的研究重点是最佳药物,剂量,调度,建议将顺铂与其他药物联合使用,以进一步探索本研究中观察到的潜在益处。
OBJECTIVE: The current study aimed to delve into the comparative clinical outcomes between external beam radiation therapy (EBRT) and sequential High Dose Rate Intracavitary Brachytherapy (HDRICBT) with or without concurrent cisplatin administration on the day of intracavitary brachytherapy (ICBT) insertion in women with locally advanced cervical cancer.
METHODS: In this study, conducted between January 2017 and July 2018 at a leading institute in India, diagnosed and untreated patients of locally advanced carcinoma cervix were randomized into two groups. Arm 1 received concurrent cisplatin before each course of brachytherapy, while Arm 2 underwent brachytherapy alone. The outcomes were compared in terms of acute and late toxicities, treatment response, and follow-up. Data analysis was performed using SPSS 16, with statistical significance set at p < 0.05.
RESULTS: Both study arms showed similar complete response (CR) rates of 73.3%, with no significant advantage of concurrent cisplatin before brachytherapy. However, a noteworthy trend emerged during follow-up. In the concurrent cisplatin group, the CR rate increased from 73.3% post 1 month of brachytherapy to 86.7% at 3 months and 83.3% at 6 months. Contrastingly, the control group showed CR rates of 73.3% post 1 month, 80% at 3 months, and 76.6% at 6 months. While not statistically significant, this observation suggests a possible enhancement in response rates with concurrent cisplatin and ICBT.
CONCLUSIONS: Future studies focusing on the optimal drug, dosage, scheduling, and combining cisplatin with other agents are recommended to further explore the potential benefits observed in this study.