Adverse events and prognosis analysis in 422 cervical cancer patients after intensity modulated radiation therapy combined with brachytherapy
10.3760/cma.j.issn.0254-5098.2019.11.002
- VernacularTitle: 422例宫颈癌患者调强放疗加后装治疗的不良反应和预后因素分析
- Author:
Jian WANG
1
;
Lijun HU
2
;
Bo YU
1
;
Jingping YU
2
;
Lili WANG
3
;
Xinchu NI
2
;
Qinghong MENG
2
;
Zhiqiang SUN
2
;
Jianlin WANG
2
;
Bin NIE
2
Author Information
1. Department of Radiotherapy, JiangyinClinical College, Affiliated to Xuzhou Medical University, Jiangyin 214400, China
2. Department of Radiation Oncology, Changzhou Second People′s Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China
3. Deparment of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Publication Type:Journal Article
- Keywords:
Cervical cancer;
Radiotherapy;
Brachytherapy;
Chemotherapy;
Prognosis
- From:
Chinese Journal of Radiological Medicine and Protection
2019;39(11):807-812
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the adverse events and efficacy in cervical cancer patients receiving intensity modulated radiationtherapy (IMRT) plusbrachytherapy with or without chemotherapy, and to indentify the factors that may affect the prognosis.
Methods:In this retrospective analysis, we analyzed the clinical and follow-up data of the 422 cervical cancer patients, who received IMRT plus brachytherapy with or without chemotherapy.Among these patients, 353 cases received concurrent chemoradiotherapy and the other 69 cases received radiotherapy alone. Kaplan-Meier method was utilized to calculate the overall survival (OS) rates. Log-rank-test and Cox regression were performed to executing the univariate and multivariate analysis of the OS, respectively.
Results:The rate of complete response (CR) in the patients receiving concurrent chemoradiotherapy was significantly higher than that of the patients who received single radiotherapy (77.6% vs. 65.2%, χ2=4.812, P<0.05). The 1-, 3-, and 5-year OS rates were 93.4%, 79.4%, and 65.0%, respectively. Univariate analysis showed that age, Federation International of Gynecology and Obstetr(FIGO)2009 staging, lymph node metastasis, pathological type, chemotherapy experiences concurrent with radiotherapy, short-term efficiency, and sequential chemotherapy could affect the OS (χ2=6.375-613.123, P<0.05). Multivariate analysis showed that FIGO staging, lymph node metastasis, pathological type, chemotherapy experiences concurrent with radiotherapy, and the short-term efficacy were the independent determinants for the prognosis (χ2=3.930-42.994, P<0.05). For patients with positive pelvic lymph node, there were no statistical differences in the para-aortic lymph node (PALN) metastasis whether undergoing prophylactic extended field irradiation of the PALN or not(PALN metastasis rates: 6.1% vs. 16.8%, P>0.05). The OS for the patients receiving prophylactic extended field irradiation of the PALN was higher than that of patients without prophylactic radiation (χ2=3.953, P<0.05).
Conclusions:Cervical cancer patients receiving IMRT plus brachytherapy with or without chemotherapy had achieved promising prognosis. Prophylactic extended field irradiation of the PALN contributed to the improved OS in the patients with pelvic lymph node metastasis. FIGO staging, pathology type, lymph node metastasis, radiotherapy concurrent with chemotherapy or not, and short-term efficiency were independent factors for the prognosis.
