| Objective:Only effective neo-adjuvant chemotherapy could improve the PFS and OS of patients with locally advanced cervical cancer and decrease the need of postoperative treatment. MRI was regarded as an eligible method for assessment of chemotherapy response. However, MRI imaging usually could not reflecting the truth for some reasons. On the other hand, the change of squamous cell carcinoma antigen (SCC-ag) had been found efficiency in evaluating the neoadjuvant chemotherapy(NACT) response, which would nevertheless be assessed after 2 or 3 cycles of NACT and might delay the best treatment time for non-responders. As a result,we seek to explore whether the change of SCC-ag level after the first cycle of NACT can judge the responsiveness of chemotherapy during early decision-making or not.Methods:The clinical statistics of 1044 patients with cervical squamous cell carcinoma were collected.308 cases followed 2 or 3 cycles of NACT were screened out according to the strict inclusion standard. The correlation between the change of SCC-ag level after the first cycle of NACT (△SCC-ag1) and the chemotherapy response was retrospectively analyzed, which was compared with the change after the second cycle of NACT(△SCC-ag2).Meanwhile, we further analyzed whether chemotherapy response or △SCC-agl was the independent prognostic indicator.Results:Between responders and non-responders, the previous menstruation, age, clinical stage, pathological grade, indicating that they were comparable. SCC-ag level was correlated with tumor size. As expected, the decreasing percentage of SCC-ag during NACT was an independent predictor of assessing chemotherapy response.the level of SCC-ag reduced by 59.6% after the first cycle of NACT, which got the optimal cutoff value, furthermore, the sensitivity and specificity was 65.0%,74.4% respectively, which was better than 55.7%,65.5% after the second cycle of MACT. It suggested that effective neoadjuvant chemotherapy could improve the disease-free survival patients (p=0.02). However, unfortunately, we’ve not found any correlation between ASCC-agl and prognosis (p=0.2).Conclusions:Our study suggests that the change of SCC-ag level after the first cycle chemotherapy was a reliable and effective indicator for early judging neoadjuvant chemotherapy responsiveness in patients with cervical squamous cell carcinoma. Effective neoadjuvant chemotherapy could improve the prognosis, even though the relationship between △SCC-agl and prognosis need further investigation. |
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