Prognostic analysis of patients with Ⅳ B stage hematogenous metastatic cervical squamous cell carcinoma
10.3760/cma.j.cn113030-20210512-00188
- VernacularTitle:80例ⅣB期血道转移宫颈鳞癌预后分析
- Author:
Zhuomin YIN
1
;
Huarong TANG
;
Shuhui YUAN
;
Shan LIU
;
Ming CHEN
;
Hanmei LOU
Author Information
1. 中国科学院大学附属肿瘤医院（浙江省肿瘤医院）/中国科学院基础医学与肿瘤研究所/浙江省放射肿瘤重点实验室/浙江省子宫恶性肿瘤诊治技术研究中心，妇瘤放疗科，杭州 310022
- Keywords:
Cervical neoplasm/radiotherapy;
Cervical neoplasm/chemotherapy;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2021;30(12):1262-1267
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the prognostic factors and the value of definitive pelvic radiotherapy in patients with stage Ⅳ B hematogenous metastatic cervical squamous cell carcinoma. Methods:Clinical data of 80 patients with Ⅳ B stage squamous cell carcinoma admitted to Zhejiang Cancer Hospital from 2006 to 2016 were retrospectively analyzed. The survival analysis was conducted by Kaplan- Meier method. Prognostic factors were analyzed by Cox models. Results:The 1-, 2-and 5-year overall survival (OS) and progression-free survival (PFS) rates were 52.5%, 26.3%, 16.8% and 25%, 13.8%, 8.8%, with a median OS of 13.8 months and a median PFS of 5.6 months, respectively. The most common site of metastasis was bone (51.3%), followed by lung (36.3%) and liver (26.3%). Univariate analysis revealed that chemotherapy combined with definitive pelvic radiotherapy and ≥6 cycles of chemotherapy were positively correlated with OS and PFS, whereas ECOG performance status score of 3-4 and liver metastasis were negatively correlated with OS and PFS. In multivariate analysis, liver metastasis ( HR=2.23, 95% CI: 1.01-4.91, P=0.048) and ECOG performance status score of 3-4( HR=2.01, 95% CI: 1.03-3.91, P=0 0.040) were significantly correlated with poor OS. Subgroup multivariate analysis showed that compared with chemotherapy±palliative radiotherapy, systemic chemotherapy combined with definitive pelvic radiotherapy significantly improved OS ( HR=0.39, 95% CI: 0.18-0.84, P=0.016). Compared with double drugs combined with<4 cycles of chemotherapy, double drugs in combination with ≥4 cycles of chemotherapy significantly improved OS ( HR=0.32, 95% CI: 0.15-0.68, P=0.003). Conclusions:Patients with low ECOG performance status score or liver metastasis obtain poor prognosis. Definitive pelvic radiotherapy combined with chemotherapy can enhance clinical prognosis of patients with Ⅳ B stage hematogenous metastatic cervical squamous cell carcinoma.
