Giriş ve 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. Gereç ve Yöntemler: 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.
Objective: More than half of stage IB-IIA cervical carcinoma patients need adjuvant radiotherapy. Especially in cases with large tumors definitive radiotherapy is preferred. In stage III although definitive chemoradiotherapy is accepted as standard of care, surgery has still a non–negligible utilization in clinical practice. In this study we aimed to evaluate and compare the survival outcome of stage IB-III by FIGO 2018 cervical carcinoma patients after definitive or adjuvant radiotherapy. Materials and Methods: 28 patients who underwent definitive radiotherapy (DRT) and 20 patients who underwent adjuvant radiotherapy (ART) in our clinic between 2011-2019 were enrolled in the study. DRT and ART groups were compared with Chi-square test in terms of clinicopathological features. Overall (OS) and progression free survival (PFS) were evaluated via Kaplan-Meier analysis and log-rank test. Multivariate analysis was performed by Cox regression. Results: After a follow up period of median 39,6 (0,5-90,5) months, 33 patients were alive. In the DRT group OS, PFS and 3 years OS were 39,65 months, 26,10 months and 79,6% respectively where in the ART group they were calculated as 42,46 months, 22,93 months and 72,2% respectively. The difference between 2 groups in terms of OS and PFS was not statistically significant (p=0,936 and p=0,756). Multivariate analysis revealed a statistical significance for ECOG on OS and tumor size on PFS (p=0,009, p=0,044). However, the influence of treatment modality was not statistically significant on PFS (p=0,724) or OS (p=0,908). Conclusion: OS, PFS and 3 years OS results of our sample were compatible with previous literature. For stage IB-III cervical cancer, definitive radiotherapy and postoperative adjuvant radiotherapy have similar survival results. Definitive radiotherapy should be considered in patients who would need adjuvant radiotherapy.
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