Evre IB-III Serviks Kanserinde Definitif ve Adjuvan Radyoterapi Sonuçlarının Karşılaştırmalı Değerlendirilmesi

Year 2020, Volume: 7 Issue: 2, 117 - 122, 30.06.2020

Zümrüt Arda Kaymak Çerkeşli , Emine Elif Özkan

https://doi.org/10.34087/cbusbed.594329

Cited By: 1

Abstract

Amaç: Evre IB-IIA Serviks kanseri tanılı hastaların yarıdan fazlası primer
cerrahi sonrası adjuvan radyoterapiye  ihtiyaç duymaktadır. Özellikle büyük tümör
boyutu varlığında tedavide definitif radyoterapi önerilir.  Evre III hastalarda ise definitif
kemoradyoterapi standart yaklaşım olarak önerilmekte iken klinik uygulamada
primer modalite olarak cerrahi halen kullanılmaktadır. Bu çalışmada
kliniğimizde FIGO 2018’e göre Evre IB-III serviks kanseri tanısı ile definitif
veya adjuvan radyoterapi uygulanmış hastaların tedavi sonuçlarının
karşılaştırmalı değerlendirilmesi amaçlanmıştır.  

Materyal ve Metod: 2011-2019 yıllarında kliniğimizde serviks kanseri tanısı ile definitif
radyoterapi (DRT) uygulanan 28 hasta ve adjuvan radyoterapi (ART)  uygulanan 20 hasta çalışmaya dahil edildi. DRT
ve ART hasta gruplarının özellikleri Ki-Kare testi ile, genel sağkalım (GS) ve
progresyonsuz sağkalım (PSK) değerlendirmeleri Kaplan-Meier analizi ve log-rank
testi ile, çok değişkenli analizler ise Cox regresyon analizi ile yapıldı.  

Bulgular: Medyan 39,6 ay(0,5-90,5) takip süresi sonunda 33 hasta hayattaydı. DRT ve
ART gruplarında GS sırasıyla 39,65 ay ve 42,46 ay; PSK sırasıyla 26,10 ay ve
22,93 ay ve 3 yıllık sağkalım oranları sırasıyla %79,6 ve %72,2 idi. İki grup
arasında GS ve PSK açısından istatistiksel olarak anlamlı fark tespit edilmedi
(p=0.936, p=0,756). Çok değişkenli analiz sonuçlarında ECOG durumunun GS
üzerinde, tümör boyutunun ise PSK üzerinde istatistiksel anlamlı etkisi bulundu
(sırasıyla p=0,009, p=0,044). Tedavi modalitesinin ise PSK (p=0,724) veya GS (p=0,908)
üzerinde istatistiksel olarak anlamlı bir etkisi gösterilmedi. 

Sonuç: Hastaların GS, PSK ve 3 yıllık sağkalım sonuçları literatür ile uyumludur.
Evre IB-III serviks kanserinde definitif radyoterapi ve postoperatif adjuvan
radyoterapi benzer sağkalım sonuçlarına sahiptir. Adjuvan radyoterapiye ihtiyaç
duyacak hastalarda definitif radyoterapi tercih edilmesi düşünülmelidir.

Keywords

servik kanseri, definitif radyoterapi, adjuvan radyoterapi, sağkalım

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