|Table of Contents|

Efficacy and safety of immunotherapy combined with hyperthermia and radiotherapy in the treatment of advanced cervical cancer in the elderly

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 01
Page:
125-129
Research Field:
Publishing date:

Info

Title:
Efficacy and safety of immunotherapy combined with hyperthermia and radiotherapy in the treatment of advanced cervical cancer in the elderly
Author(s):
YANG Mi; ZHANG Jiayong; ZHANG Xinping; DENG Jiaxiu; TANG Zuge; BIE Jun
Department of Oncology,Nanchong Central Hospital，Sichuan Nanchong 637000，China.
Keywords:
immunotherapy; hyperthermia; radiotherapy; cervical carcinoma
PACS:
R737.33
DOI:
10.3969/j.issn.1672-4992.2024.01.022
Abstract:
Objective:To investigate the efficacy and safety of immunotherapy combined with hyperthermia and radiotherapy for middle-advanced cervical cancer in the elderly.Methods:The clinical efficacy of immunotherapy,hyperthermia and radiotherapy in elderly patients with middle-advanced cervical cancer during the period from January 2020 to June 2021 in our hospital was prospectively analyzed,and the related side effects were compared with the efficacy of hyperthermia plus standard concurrent radiotherapy and chemotherapy.Results:A total of 56 patients were analyzed.The ORR rates of the thermoimmunoradiotherapy group and the thermoradiochemotherapy group were 73.08%（19/26） and 86.67%（26/30）,respectively.PFS were 53.8%(14/26) and 56.7%(17/30) respectively.OS were 61.5%(16/26) and 66.7%(20/30) respectively,with no statistical difference.There was no difference between the two groups in gastrointestinal toxicity(nausea,vomiting,constipation,etc.),liver function damage,renal function damage,and radiation cystitis(P＞0.05).The incidence of hematological toxicity(granulocytopenia,anemia,thrombocytopenia) in the thermoimmunotherapy group was significantly lower than that in the thermoradiochemotherapy group(P＜0.05).The incidence of radiation proctitis>grade 1 in the thermoimmunotherapy group was significantly lower than that in the thermoradionchemotherapy group(P＜0.05).Conclusion:The combination of immunotherapy and hyperthermia with radiation therapy has a significant therapeutic effect in elderly patients with advanced cervical cancer,and does not increase treatment-related toxic side effects.It is effective and safe.Perhaps it can become a new choice for the treatment of advanced cervical cancer in the elderly.

References:

［1］胡尚英，赵雪莲，张勇，等.《预防宫颈癌：WHO宫颈癌前病变筛查和治疗指南（第二版）》解读［J］.中华医学杂志，2021,101(34):2653-2657. HU SY,ZHAO XL,ZHANG Y,et al.Interpretation of "WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention,second edition"［J］.Natl Med J China,2021,101(34):2653-2657.
［2］ANDRE T,SHIU KK,KIM TW,et al.Pembrolizumab in microsatellite-instability-high advanced colorectal cancer［J］.N Engl J Med，2020,383(23):2207-2218.
［3］IJFF M,CREZEE J,OEI AL,et al.The role of hyperthermia in the treatment of locally advanced cervical cancer:A comprehensive review［J］.Int J Gynecol Cancer,2022,32(3):288-296.
［4］宋彬，罗娅红，彭卫军，等.宫颈癌磁共振检查及诊断规范专家共识［J］.肿瘤影像学,2017,26(4):250-254. SONG B,LUO YH,PENG WJ,et al.Expert consensus on MRI examination and diagnostic criteria for cervical cancer［J］.Oncoradiology,2017,26(4):250-254.
［5］THERASSE P,ARBUCK SG,EISENHAUER EA,et al.New guidelines to evaluate the response to treatment in solid tumors［J］.J Natl Cancer Inst,2000,92(3):205-216.
［6］黄留叶，赵雪莲，赵方辉.宫颈癌的发病与死亡变化趋势及其预防策略进展［J］.肿瘤综合治疗电子杂志，2021，7(2):21-25. HUANG LY,ZHAO XL,ZHAO FH.Trend of cervical cancer incidence,mortality,and progress of prevention strategies［J］.China Academic Journal Electronic Publishing House,2021,7(2):21-25.
［7］高庆蕾，马丁.转移性妇科恶性肿瘤的治疗策略及思考［J］.中华转移性肿瘤杂志，2020,3(4):241-246. GAO QL,MA D.Treatment strategy and thinking of metastatic gynecologic malignant tumor［J］.Chin J Metastatic Cancer,2020,3(4):241-246.
［8］SAGEA S,TOITA T,MATSUURA M,et al.Improvement in radiation techniques for locally advanced cervical cancer during the last two decades［J］.Int J Gynecol Cancer,2023,33(8):1295-1303.
［9］MUSUNURU HB,PIFER PM,MOHINDRA P,et al.Advances in management of locally advanced cervical cancer［J］.Indian J Med Res,2021,154(2):248-261.
［10］FRENEL JS,LE TOURNEAU C,ONEIL B,et al.Safety and efficacy of pembrolizumab in advanced，programmed death ligand 1-positive cervical cancer:Results from the phase Ⅰb KEYNOTE-028 trial［J］.J Clin Oncol,2017,35(36):4035-4041．
［11］RODRIGUES M,VANONI G,LOAP P,et al.Nivolumab plus chemoradiotherapy in locally-advanced cervical cancer:The NICOL phase 1 trial［J］.Nat Commun,2023,14(1):3698.
［12］CHEN J,HAN Y,HU Y,et al.Neoadjuvant camrelizumab plus chemotherapy for locally advanced cervical cancer(NACI study):A study protocol of a prospective,single-arm,phase Ⅱ trial［J］.BMJ Open,2023,13(5):e067767.
［13］GRAU JF,FARINAS-MADRID L,GARCIA-DURAN,et al.Advances in immunotherapy in cervical cancer［J］.Int J Gynecol Cancer,2023,33(3):403-413.
［14］VAN DER ZEE J,GONZALEZ GD,VAN ＲHOON GC,et al.Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours:A prospective,randomised,multicentre trial.Dutch Deep Hyperthermia Group［J］.Lancet,2000,355(9210):1119-1125．
［15］GAO XS,BOERE IA,VAN BEEKHUIZEN HJ,et al.Acute and long-term toxicity in patients undergoing induction chemotherapy followed by thermoradiotherapy for advanced cervical cancer［J］.Int J Hyperther,2022,39(1):1440-1448.
［16］LEE SY,LEE NＲ,CHO DH,et al.Treatment outcome analysis of chemotherapy combined with modulated electro-hyperthermia compared with chemotherapy alone for recurrent cervical cancer，following irradiation［J］.Oncol Lett,2017,14(1):73-78.
［17］JIANG P,WEI S,BAI Y,et al.The efficacy of volumetric modulated arc therapy combined with chemotherapy,brachytherapy,and local hyperthermia on patients with locally advanced cervical cancer:A retrospective study［J］.Technol Cancer Rest,2023,22:15330338231185013.
［18］YEA JW,PARK JW,OH SA,et al.Chemoradiotherapy with hyperthermia versus chemoradiotherapy alone in locally advanced cervical cancer:A systematic review and Meta-analysis［J］.Int J Hyperther,2021,38(1):1333-1340.
［19］LI Z,DENG J,SUN J,et al.Hyperthermia targeting the tumor microenvironment facilitates immune checkpoint inhibitors［J］.Front Immunol,2020,11:595207.
［20］陈永发，杨文，唐武兵，等.热疗联合放化疗治疗宫颈癌的临床应用及对机体免疫力的影响［J］.现代肿瘤医学，2016,24（3）:451-454. CHEN YF,YANG W,TANG WB,et al.Clinical application of hyperthermia combined with radiotherapy and chemotherapy on cervical cancer and effect on immunity［J］.Modern Oncology,2016,24（3）:451-454.
［21］NISHIKAWA A,SUZUKI Y,KANEKO M,et al.Combination of magnetic hyperthermia and immunomodulators to drive complete tumor regression of poorly immunogenic melanoma［J］.Cancer Immunol Immun,2023,72(6):1493-1504.
［22］LI L,HU Z,SONG F,et al.Photonic hyperthermia synergizes with immune-activators to augment tumor-localized immunotherapy［J］.Small Methods,2023,7(5):e2300116.
［23］LI R,ZHENG Q,DENG Q,et al.A dual functional drug delivery system that combines photothermal therapy and immunotherapy to treat tumors［J］.Mol Pharmaceut,2022,19(5):1449-1457.
［24］WANG X,LIU G,CHEN S,et al.Combination therapy with PD-1 blockade and radiofrequency ablation for recurrent hepatocellular carcinoma:A propensity score matching analysis［J］.Int J Hyperthermia,2021,38(1):1519-1528.
［25］LIU B.Current status and progress of thermal ablation combined with immunotherapy for lung tumors［J］.Chinese Journal of Lung Cancer,2022,25(4):266-271.
［26］KWON S,JUNG S,BEAK SH,et al.Combination therapy of radiation and hyperthermia,focusing on the synergistic anti-cancer effects and research trends［J］.Antioxidants(Basel),2023,12(4):924.
［27］LIU P,YE M,WU Y,et al.Hyperthermia combined with immune checkpoint inhibitor therapy:Synergistic sensitization and clinical outcomes［J］.Cancer Med,2023,12(3):3201-3221.
［28］VAUPEL P,PIAZENA H,HOTTER M,et al.From localized mild hyperthermia to improved tumor oxygenation:Physiological mechanisms critically involved in oncologic thermo-radio-immunotherapy［J］.Cancers(Basel),2023,15(5):1394.

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Last Update: 2023-11-30