Prognostic analysis of radical radiotherapy for 211 cases of cervical cancer

Objective To investigate the curative effect and prognostic factors of radical radiotherapy for cervical cancer. Methods A total of 211 patients with stage ⅠA-ⅢB cervical cancer who underwent therapy in department of radiotherapy, Tumor Hospital of Jilin province between June 2014 and February 2017, were analyzed retrospectively. All patients received radical radiotherapy with or without concurrent chemotherapy. Short-term and long-term efficacy and related prognostic factors were observed. Kaplan-Meier method was used for survival analysis, Log-rank test was used for univariate analysis, and Cox proportional hazards regression model was used for multivariate analysis. Results The 2-year overall survival (OS) and disease free survival (DFS) were 83.4% and 72.5%, respectively. During the follow-up periods, 46 patients (21.8%) died, including two from non-tumor-related diseases, and one from second primary colon cancer. Totally 57 patients (27%) had recurrence and metastasis, including 16 (28.1%) with local recurrence, 27 (47.4%) with distant metastasis, and 14 with local recurrence and distant metastasis(24.6%). Univariate analysis showed that 2-year OS and DFS were significantly correlated with pathological type, pre-treatment squamous cell carcinoma antigen (SCC) value and FIGO stage (OS: χ2=7.123, 6.014, 8.398, P<0.05; DFS: χ2=11.832, 8.003, 7.731, P<0.05). In addition to the above factors, 2-year DFS was also associated with pelvic lymph node metastasis (χ2=9.286, P<0.05). Multivariate analysis showed that pathological type, pre-treatment SCC value and FIGO stage were independent prognostic factors of OS(HR=2.963, 2.473, 2.574, P<0.05). The independent prognosis factors affecting DFS included pathological type, pre-treatment SCC value and pelvic lymph node metastasis (HR =3.014, 1.988, 1.914, P<0.05). Conclusions By means of radical radiotherapy, cervical cancer patients with adenocarcinoma, pre-treatment SCC levels ≥30 ng/ml and advanced stage have poor prognosis, so more active treatment strategy should be adopted. Key words: Cervical cancer; Radical radiotherapy; Efficacy; Prognosis