Efficacy and prognostic factors of concurrent chemoradiotherapy in patients with stage Ib3 and IIa2 cervical cancer

2020 
Objectives: We investigated the efficacy, side effects, and prognostic factors of concurrent chemoradiotherapy for patients with stage Ib3-IIa2 cervical cancer. Material and methods: We conducted a retrospective analysis of clinicopathologic data from 73 patients with stage Ib3-IIa2 cervical cancer who received concurrent chemoradiotherapy from January 2008 to December 2013 in our hospital. Overall response and disease control rates were used to evaluate short-term outcomes; the 3-year and 5-year disease-free survival and overall survival were used to evaluate long-term efficacy. Toxicity reactions and prognostic factors were recorded. Results: With concurrent chemoradiotherapy, overall response and disease control rates were 91.78% and 97.26%, respectively. The 3-year disease-free and overall survival were 80.82% and 83.56%; the 5-year disease-free and overall survival were 75.34% and 79.45%, respectively. All side effects were tolerated and potentially alleviated by symptomatic treatment. Tumor pathological type, differentiated degree, primary tumor size and squamous cell carcinoma antigen levels before and after treatment were closely related to survival (univariate analysis; p < 0.05). Pathological type, primary tumor size and squamous cell carcinoma antigen levels one month after treatment were independent prognostic factors for long-term outcome (multivariate analysis). Conclusions: Short- and long-term efficacy of concurrent chemoradiotherapy for stage Ib3-IIa2 cervical cancer is well-determined and tolerable. Patients with adenocarcinomas, tumor diameter ≥ 5 cm and squamous cell carcinoma antigen levels ≥ 1.5 ng/mL (one month after treatment) had poor prognosis and should be assessed further.
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