Clinical Efficacy and Prognostic Factors in Locally Advanced Cervical Cancer Patients Treated With Concurrent Chemoradiotherapy

Objective: To analyze the clinical efficacy and toxic & adverse effects of radiotherapy combined with concurrent chemoradiotheray on locally advanced cervical cancer patients, and analyze the prognostic factors. Methods: The clinical data of 125 patients with locally advanced cervical cancer who underwent radiotherapy and concurrent chemoradiotherapy between September 2008 and December 2013 were retrospectively analyzed in the Second Xiangya Hospital of Central South University. Kaplan-Meier method was used to calculate the survival rate. In univariate analysis, log-rank test was used to calculate the intergroup difference, and in multivariate analysis, Cox proportional risk model was used to screen the independent prognostic factors influencing the overall survival rate. Results: As of March 1, 2016, the overall survival rates of the patients were 89.6 %, 74.4 % and 71.2 % in years 1, 3 and 5, respectively. The results of univariate analysis showed that the survival rates of stage-II, stage-III and stage-IVa patients for PIGO staging were 92.6 %, 79.4 %, and 77.9 %; 88.7 %, 66.0 %, and 64.2 %; and 50.0 %, 25.0 %, and 0.0 % in years 1, 3 and 5, respectively. The overall survival rates of the patients in concurrent chemoradiotherapy group and radiotherapy group were 91.8 %, 78.6 %, and 77.6 %; 81.5 %, 61.2 %, and 58.5 % in years 1, 3 and 5, respectively. The overall survival rates of the patients with pre-treatment hemoglobin Hb level < 110 g/L and Hb ≥ 110g/L were 78.4 %, 59.8 %, and 58.2 %; 92.9 %, 79.8 %, and 78.9 % in years 1, 3 and 5, respectively. The overall survival rates of the patients with total radiotherapy duration ≤ 9 cycles and > 9 cycles were 91.2 %, 81.7 %, and 80.0 %; 87.8 %, 64.6 %, and 59.8 % in years 1, 3 and 5, respectively. These differences were statistically significant. Multivariate analyses showed that the clinical staging, concurrent chemoradiotherapy, pretreatment hemoglobin Hb level, and radiotherapy duration were the independent prognostic factors significantly affecting the survival rate of patients with locally advanced cervical cancer. Conclusion: 1. the concurrent chemoradiotherapy of locally advanced cervical cancer patients showed more obvious advantages over the simple radiotherapy, and the acute toxicity was tolerable and the long-term toxicity was not significantly increased; 2. FIGO staging, anemia and radiotherapy completion time were the important prognostic factors affecting the treatment of patients with locally advanced cervical cancer