关键词: 宫颈肿瘤, 抗肿瘤联合化疗方案, 放射疗法, 预后, 影响因素分析

Abstract: Objective　To investigate the clinical efficacy as well as toxicity and side effects of simple radiotherapy and concurrent chemoradiotherapy（CCRT） for local advanced cervical cancer and analyze the influence of different factors on the prognosis.Methods　A total of 125 cases with local advanced cervical cancer from September 2008 to December 2013 with a confirmed pathologic diagnosis who underwent chemoradiotherapy in the Cancer Center at the Second Xiangya Hospital of Central South University were selected.Based on different treatment methods，the patients were classified into radiotherapy（n=27，21.6%） and CCRT（n=98，78.4%） groups.The overall survival（OS） for each patient was recorded at follow-up March 1，2016.The survival curve was drawn with the Kaplan-Meier method and a Log-rank test was performed.A multivariate Cox proportional hazards regression model was applied to analyze the prognostic factors.Results　The general 1-，3-，and 5-year survival rates of the 125 patients were 89.6%，74.4%，and 71.2%，respectively.The difference of 1-，3-，and 5-year survival rates between the radiotherapy and CCRT groups was statistically significant（P<0.05）．The incidence rates of patients with bone marrow suppression，gastrointestinal reactions，rectal reactions，genitourinary reactions，vaginal inflammation，pelvic fluid，radiation enteritis，radiation cystitis，and lower limb venous thrombosis did not exhibit significant differences between the two groups（P>0.05）．The results of the Log-rank test showed that there were significant differences in the total OS of patients with local advanced cervical cancer by comparing FIGO clinical stage，pretreatment hemoglobin level，total duration of radiotherapy，and different treatment methods（P<0.05）．Multivariate Cox hazards regression analysis illustrated that FIGO clinical stage〔HR=0.329，95%CI（0.106，0.770）〕，pretreatment hemoglobin level〔HR=0.937，95%CI（0.925，0.984）〕，total duration of radiotherapy〔HR=1.081，95%CI（1.022，1.095）〕，and treatment methods 〔HR=0.203，95%CI（0.072，0.574）〕exhibited regression correlations with the total OS of patients with local advanced cervical cancer（P<0.05）．Conclusion　Compared with radiotherapy treatment of patients with local advanced cervical cancer，the CCRT have obvious effects.FIGO clinical stage，pretreatment hemoglobin level，total duration of radiotherapy，and treatment methods are important prognostic factors for treatment of patients with local advanced cervical cancer.

Key words: Cervical cancer, Antineoplastic concurrent chemotherapy strategy, Radiotherapy, Prognosis, Root cause analysis