Efficacy Of Concurrent Chemoradiotherapy Combined With Immunotherapy For Locally Advanced Cervical Cancer

Objective: Observe the clinical efficacy and safety of concurrent chemoradiotherapy combined with immunotherapy for local advanced cervical cancer patients.Methods and Materials: In this study,we reviewed patients with locally advanced cervical cancer who were treated between August 2020 and February 2022 at the Second Norman Bethune Hospital of Jilin University(all had definite pathological diagnosis),they were divided into two groups: one group was concurrent chemoradiotherapy combined with immunotherapy,a total of 28 cases,and the other group was treated with concurrent chemoradiotherapy as control with 32 cases.Radiotherapy uses intensity modulated radiation therapy combined with Brachytherapy.In the first week of intensity modulated radiation therapy,Paclitaxel combined with platinum scheme chemotherapy is given.Every 3 weeks is a chemotherapy cycle for a total of 4-6 cycles.On the basis of concurrent chemoradiotherapy on the first day of each chemotherapy cycle,intravenous sintilimab 200 mg was given,once every 3 weeks,a total of 4-6 cycles.The main research final of this study is the short-term efficacy,the secondary end point was 1-year treatment outcome.Record all patients’ hospital medical records,outpatient records,or follow-up.SPSS 25.0 was used for statistics and analysis,P < 0.05 that the difference was statistically significant.The protocol was approved by the Ethics Committee of our hospital,batch number:(2022)review No.116.Results: All patients have a complete follow-up record.Of the 28 patients in the research group,CR was 21(75.0%),PR was 4(14.3%),SD was 3(10.7%),PD was 0(0.0%),ORR was 89.3%(25/28),DCR Of 100%(28/28);of the 32 patients in the control group,CR is 19(59.4%),PR is 7(21.9%),SD is 2(6.2%),PD is 4(12.5%),ORR is 81.3%(26/32),DCR is 87.5%(28/32).All patients are completed with 4 to 6 cycles of chemotherapy.There was no significant difference between the two groups in shortterm efficacy(P> 0.05).In the study group,the SCC level decreased from 10.00 to 0.79,with a significant difference(P<0.05).The level of CEA in the study group was 5.92 before treatment and decreased to 2.19 after treatment,with a significant difference(P<0.05).During the treatment,patients and non-blood adverse reactions occurred in the research group and the control group,includes white blood cell counting,decreased platelets,and reduced hemoglobin;and liver function abnormalities and abnormal thyroid function,thyroid dysfunction mainly includes hyperthyroidism and hypothyroidism.In this research,there are many hypothyroidism in the research group,and no hyperthyroidism occurs.The specific situation of adverse reactions in the research group is: 12(42.9%)people have reduced white blood cells;15(53.6%)people have anemia;7(25.0%)people have reduced platelets;1(3.6%)people have liver function changes;5(17.9%)person with thyroid function is abnormal.The specific situation of adverse reactions in the control group is: 13(40.6%)people show a reduction of white blood cell counting;18(56.3%)people have anemia;7(21.9%)people have decreased platelets,1(3.1%)people have liver function changes.After statistical analysis,the incidence of abnormal thyroid function in the study group was significantly higher than that in the control group,indicating that there was a significant difference between the two groups(P = 0.013< 0.05),but there was no significant difference in the incidence of other reactions(P> 0.05).In the 28 patients in the study group,the prevalence of thyroid dysfunction was high,but no grade 3-5 disease was found,and for grade 1-2 disease,improvement was achieved after symptomatic treatment,and no major response was found,therefore,the overall efficacy is good.Conclusion: The short-term CR rate,ORR and DCR in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy combined with immunotherapywere higher than those in patients treated with concurrent chemoradiotherapy,suggesting that concurrent chemoradiotherapy combined with immunotherapy has a better short-term effect on locally advanced cervical cancer.The serum levels of SCC and CEA in the study group decreased more significantly than those in the control group,dynamic monitoring of SCC and CEA levels may be of guiding value for the short-term efficacy and even prognosis of immunotherapy for locally advanced cervical cancer.During the period of immunotherapy,thyroid dysfunction and liver dysfunction were common adverse reactions,but no serious adverse events or death occurred,it is suggested that concurrent chemoradiotherapy combined with immunization is safe and effective.