A Prospective Trial Of â… B-â…¡A Cervical Squamous Cancer With Intermediate Risk Factors Treated By Chemotherapy Or Chemoradiation

Objective:The aim of this perspective study is to evaluate the efficacy of adjuvant chemotherapy after radical hysterectomy for intermediate risk of stage â… b-â…¡a squamouse cell cervical cancer.Methods:From January 2009 to Octomber 2015,in all of 190 patients who after radical hysterectomy at Affiliated Cancer Hospital of Guangxi Medical Univercity with stage â… b-â…¡a were randomly assigned to the two groups as follows:adjuvant chemotherapy with TP project at 4-week interval for 4 courses(AC group), and adjuvant concurrent chemoradiation with pelvic EBRT plus platinum chemotherapy after surgery(CCRT group). Establishing follow-up database of Excel, SPSS 16.0 software package was used,the main study endpoint is PFS of three years,OS calculation and survival curve comparision were adopted by Kanplan-meier method and Log-rank test. Multiple regression analysis was assessed by Cox proportional-hazards regression model.Result:After 37 months of median follow-up time, the primary end point were evaluabled because of the 180 patients were enrolled.29 patients had recurrence (15 patients in the chemotherapy group,14 patients in the concurrent chemoradiation group),and 24 patients deaths(12 deaths in the CT group,12 deaths in the CCRT group). The incidence of two groups of patients with moderate-severe blood system toxicity was 3.30%(CT group) and 10.11%(CCRT group), the incidence of gastrointestinal toxicity of grade 3 was 4.40%(CT group) and17.98%(CCRT group),the incidence of radiation related local inflammatory response (radiation rectitis, cystitis, dermatitis, lower limb edema) was 21.34%.Multiple regression analysis had showed that the count of intermediate-risk factors (p=0.01) was the independent risk factor of survival time; and the age was the independent risk factor of overall survival time.Conclusion:There was no difference statistically of prognostic analysis between chemotherapy and concurrent chemoradiation for patients with intermediate risk factors after radical surgery, but the incidence of treatment-related adverse reaction was significantly reduced in CT group, it may be one choice of postoperative adjuvant therapy for the patients. The more counts of intermediate- risk factors, the worse prognosis the patients were. The overall survival time of patients who younger than 45 years old is shorter.