Comparison of the Result of Radiation Alone and Chemoradiation in Cervical Cancer

• 발행기관: 대한방사선종양학회
• 저자명: 김재철(Jae Cheol Kim) 박인규(In Kyu Park)
• 간행물 정보: 『대한방사선종양학회지』제13권 제2호, 191~198쪽, 전체 8쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 1995.06.30

국문 초록

목적 : 자궁경부암의 치료에 있어 방사선 단독치료와 비교하여 방사선 및 화학요법 병행치료가 치료에 대한 반응, 생존율, 재발양상, 원격전이 및 부작용의 빈도 등에 영향을 주는가를 보고자 하였다. 방법 : 경북대학교병원 치료방사선과에서 1985년 11월부터 1991년 12월까지 자궁경부암으로 근치적 방사선치료를 받은 135명의 환자를 대상으로 치료에 대한 반응, 생존율, 재발양상, 원격전이 및 부작용의 빈도에 대하여 후양적 분석을 하였다. 방사선 단독으로 치료한 환자는 56명이었고, cisplatin을 포함한 화학요법을 병행한 환자는 79명이었다. 대상 환자들의 추적조사기간은 5개월에서 105개월이었다 (중간값 : 47개월). FIGO 병기별 분류에 의하면, ⅠB가 18명 (13.3%), ⅡA 7명(5.2%), ⅡB가 97명 (71.9%), ⅢB가 9명 (6.7%)이었다. 결과 : 방사선 단독치료군 중 51예 (91.9%), 병행치료군 중 68예 (86.1%)에서 완전관해가 관찰되었다. 전체 환자의 5년생존율은 73.3%였고, 병기별 5년생존율은 ⅠB 88.9%, ⅡA가 85.7%, ⅢB가 73.8%, ⅢB가 37.5%였다. 치료방법에 따른 5년생존율은 방사선 단독치료군에서 81.9%였고, 병행치료군에서 67.0%였다(p=0.22). 5년무병생존율은 방사선 단독치료군에서 70.4%였고, 병행치료군에서 68.5%였다(p=0.85). 5년국소제어율은 방사선 단독치료군에서 76.1%였고, 병행치료군에서 73.8%였다(p=0.70). 5년원격제어율은 방사선 단독치료군에서 83.9%였고, 병행치료군에서 90.3%였다(p=0.59). 치료에 때른 골수억제는 방사선 단독치료군에서 3예 (5.4%), 병행치료군에서 14예 (17.7%)가 관찰되었다(p<0.05). 내과적 치료로 호전되었던 방광염이 방사선 단독치료군에서 14예, 병행치료군에서 10예 관찰되었다. 내과적 치료로 호전되었던 방광염이 방사선 단독치료군에서 14예, 병행치료군에서 10예 관찰되었다. 내과적 치료로 호전되었던 직장염이 방사선 단독치료군에서 2예, 병행치료군에서 4예 관찰되었고, 외과적 치료를 요했던 직장천공이 병행치료군에서 1예 관찰되었다. 보존적 치료로 해결되었던 장폐쇄의 부작용은 방사선 단독치료군에서만 2예 관찰되었다. 양 군간의 방광염, 직장염, 소장폐쇄의 빈도에는 유의한 차이가 없었다. 결론: 방사선 단독치료군과 비교할 때 cisplatin을 포함한 화학요법의 병행은 치료에 대한 반응, 생존율, 재발양상, 원격전이에 영향을 미치지 않았고, 병행치료군에서 골수억제의 빈도가 더 높게 나타났다.

영문 초록

Purpose : This analysis was to compare the result of radiation alone and chemoradiation in cervical cancer in terms of response, survival, failure, and complication. Materials and Methods : A retrospective analysis of 135 cervical cancer patients treated with definitive radiotherapy from November 1985 to December 1991 was performed. Fifty-six patients were treated with radiation alone and 79 patients were treated with cisplatin-based chemotherapy plus radiation. Follow-up period ranged from 5 to 105 months with a median 47 months. According to the FIGO classification, the patients were subdivided in to 18 (13.3%) stage IB. 7 (5.2%) stage ⅡA, 97 (71.9%) stage ⅡB, and 9 (6.7%) stage ⅢB. Results : A complete response was noted in 51 patients (91.1%) of the radiation alone group, and 68 patients (86.1%) of the chemoradiation group. There was no statistical difference in complete response rate between the two groups. Overall survival rate at 5 years was 73.3%. According to stage, overall survival rates at 5 years were 88.9% in stage ⅠB, 85.7% in stage ⅡA, 73.8% in stage ⅡB, and 37.5% in stage ⅢB, respectively. According to treatment modality, overall survival rates at 5 years were 81.9% in the radiation alone group, 67.0% in the chemoradiation group (p=0.22). Disease-free survival rate at 5 years were 70.4% in the radiation alone group, 68.5% in the chemoradiation group (p=0.85). Locoregional control rates at 5 years were 76.1% in the radiation alone group. 73.8% in the chemoradiation group (p=0.70). Distant disease-free survival rates at 5 years were 83.9% in the radiation alone group. 90.3% in the chemoradiation group (p=0.59). Treatment -related bone marrow suppressions were noted in 3 (5.4%) patients of the radiation alone group. 14 patients (17.7%) of the chemoradiation group (p<0.05). Grade 2 vesical complications were noted in 14 patients of the radiation alone group, and 3 patients of the chemoradiation group, and grade 2 small bowel obstructions were noted in 2 patients of the radiation alone group. There were no statistical differences in the incidence of vesical, rectal, and small bowel complications between the two groups. Conclusion : No statistical difference was found between the radiation alone group and the chemoradiation group in terms of response, survival, and failure, but the incidence of bone marrow suppression was higher in the chemoradiation group.

키워드

Cervical cancer Chemoradiation