查詢結果分析
來源資料
相關文獻
- Implications of a Failed Prospective Trial of Adjuvant Therapy after Radical Hysterectomy for Stage Ib-IIa Cervical Carcinoma with Pelvic Node Metastases
- A Phase Ⅱ Trial of Concurrent Chemoradiation with Weekly Cisplatin and Glutathione for Bulky Advanced Cervical Cancer
- 子宮頸癌的預後因素及化學治療在子宮頸癌治療的角色
- Prophylactic Para-Aortic Radiotherapy and Concomitant Chemotherapy for Patients with Cervical Carcinoma: Preliminary Analysis of Outcome and Toxicity
- Preoperative Concurrent Chemotherapy and Radiotherapy in Rectal Cancer Patients
- 子宮頸癌放射治療的結果及直腸後遺症的分析(新光醫院的五年經驗)
- 子宮頸癌的化學治療
- Malignant Primary Extragonadal Germ Cell Tumors of Mediastinum--An Analysis of Clinical and Radiological Features in 15 Cases
- Radiation Therapy in Primary Central Nervous System Lymphoma
- Definitive Radiotherapy with Or Without Chemotherapy for Resectable Head and Neck Cancer
頁籤選單縮合
題名 | Implications of a Failed Prospective Trial of Adjuvant Therapy after Radical Hysterectomy for Stage Ib-IIa Cervical Carcinoma with Pelvic Node Metastases=早期子宮頸癌合併骨盆淋巴腺轉移的術後輔助性治療:一個失敗的前贍性臨床試驗的啟示 |
---|---|
作者 | 賴瓊慧; 湯國政; 張廷彰; 曾志仁; 周宏學; 黃寬仁; 薛綏; 洪志宏; 黃香蘭; 林政道; 宋永魁; Lai, Chyong-huey; Tang, Simon G.; Chang, Ting-chang; Tseng, Chih-jen; Chou, Hung-hsueh; Huang, Kuan-gen; Hsueh, Swei; Hong, Ji-hong; Huang, Shang-lang; Lin, Jen-daw; Soong, Yung-kuei; |
期刊 | 長庚醫學 |
出版日期 | 19980900 |
卷期 | 21:3 1998.09[民87.09] |
頁次 | 頁291-299 |
分類號 | 417.2832 |
語文 | eng |
關鍵詞 | 子宮頸癌; 骨盆淋巴腺轉移; 輔佐治療; 化學治療; 放射治療; Cervical carcinoma; Pelvic node metastases; Adjuvant therapy; Chemotherapy; Radiotherapy; |
中文摘要 | 背景:骨盆淋巴腺轉移在接受根治性子宮切除術的子宮頸癌已是公認的不良預後 因素,但術後輔助治療的角色一直是意見分岐。 方法:為了釐清術後輔助性治療的功效,長庚醫院的婦科腫瘤科從1989年起開始進行前瞻性 對照研究,要探討術後化學治療、放射治療或合併化學放射治療對存活率、再發時間、再發 部位及治療併發症的影響。 結果:此研究在收不到預期人數達 4年後提前結束,但在追蹤時間中數達61個月的 6年存活 率,在進入研究治療計劃的39位病患之無病存活率為78.2%,而存活率85.2%。在接受化學治 療(單一化學治療和合併化學放射治療)的無病存活率比未接受化學治療(單一放射治療或 無輔助治療)的顯著增加。但是因樣本數太小,且因為背景的預後因素不平均,這樣的結果 並不能下結論。但是用此前瞻性治療的病患來印證過去本院回溯性研究所設計的淋巴腺轉移 之早期子宮頸癌預後分類,倒是十分吻合。因為根治手術後的放射治療之併發症比化學治療 或無輔助治療者高,所以一定要用於再發率高的病患才合適,病患及醫師才能認同治療計劃 去執行。 結論:由本失敗的前瞻性臨床試驗,我們知道將來在早期子宮頸癌合併淋巴腺轉移之病患的 前瞻性研究一定要多中心治療計劃,且應依據再發率之高低設計不同的臨床試驗。在低危險 群,比較術後觀察或術後化學治療:在高危險群比較化學治療或合併化學放射治療。 |
英文摘要 | Background: Lymph node metastasis is established as a poor prognostic factor in cervical carcinoma patients undergoing primary surgery. However the optimal postoperative therapy for node-positive patients remains to be defined. Materials and Methods: To determine the role of adjuvant therapy in stage Ib-IIa cervical carcinoma patients who had pelvic node metastases after radical hysterectomy, a single institutional randomized controller trial with factorial design, comparing concurrent chemo-radiotherapy (CT+RT) versus chemotherapy (CT) or radiotherapy (RT) alone was conducted. Study endpoints included site of recurrence, time to recurrence, relapse- free and overall survivals, and toxicity of treatment. Results: At a median follow-up of 61 months, the 6-year relapse-free and overall survival rates of the 39 patients entered into this trial were 78.2% and 85.2%, respectively. This trial was prematurely closed due to suboptimal accrual and protocol violation. It is inconclusive regarding the efficacy of CT because of the limitation of the sample size and the imbalance of prognostic features by actual treatment. A model for risk group classification of patients with stage Ib-II cervical carcinoma with pelvic node metastases from a retrospective analysis was validated by this prospective cohort. The results of this failed trial suggest that adjuvant CT alone seemed comparable to RT alone or CT+RT in survival but was associated with significantly less morbidity. Conclusion: It is warranted to consider a CT alone arm in comparison with either observation or CT+RT according to risk of recurrence in future prospective trials. However, this important issue can only be addressed by a large multicenter trial. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。