| Objectives:This study aimed to analyze the clinical characteristics of patients with? B - ?B cervical cancer admitted in our hospital.Objective to compare the long-term efficacy and prognosis of two kinds of Treatment method with concurrent chemoradiotherapy and concurrent chemoradiotherapy after neoadjuvant chemotherapy; To compare the long-term efficacy of concurrent chemoradiotherapy with single drug and concurrent chemoradiotherapy with two drugs; Long term efficacy of patients with or without adjuvant chemotherapy after concurrent chemoradiotherapy.Methods:We retrospectively reviewed the medical records of Patients with locally advanced cervical cancer from ?B to ?B who confirmed by pathological histology, imaging examinationand and gynecological examination results,in the third affiliated hospital of Kunming medical university between 01 February 2005 and 31 December 2015.Follow up included: Medical history, gynecological examination,TCT, HPV, stool routine examination,urine routine,tumor markers, B-mode ultrasonography, Chest, abdomen, pelvic CT or MRI, Colonoscopy or cystoscopy if necessary, The survey includes :the patient's age, gender, combined disease,pathological type, mass type, tumor size, FIGO stage, lymph node metastasis, number cycles of neoadjuvant chemotherapy, radiation therapy technology,programme of concurrent chemotherapy, adjuvant chemotherapy after concurrent chemoradiotherapy,the diagnosis time, time of death, the last follow-up time etc.Statistical methods using SPSS 17.0 statistical software for data processing.Results: 1.Two patients were treated with concurrent chemoradiotherapy (intravenous group of 58 cases) with concurrent chemoradiotherapy (synchronous group of 113 cases), Two groups of patients with or without lymph node metastasis curative effect was equivalent (P >0.05).The effect of ?B group was better than that of the new adjuvant group, there was statistical difference (P < 0.05) , Two groups with lymph node metastasis of curative effect was equivalent (P >0.05) ,The effect of withiout lymph node metastasis,synchronization group was better than that of the new adjuvant group, there was statistical difference (P <0.05) , ? patients with or without lymph node metastasis, two groups of curative effect. Single factor analysis showed,tumor size, lymph node metastasis, synchronous chemotherapy and treatment method were the prognostic factors of patients with cervical cancer(P <0.05), COX multivariate analysis showed,tumor size, lymph node metastasis, synchronous chemotherapy and treatment method is the independent prognostic factor.Two group of patients with lymph node metastasis, the local recurrence rate of neoadjuvant group was higher than that of the control group (P < 0.05) ; Two group of patients withiout lymph node metastasis, the incidence of 3-4 grade myelosuppression in the neoadjuvant group was significantly higher than that in the control group(P < 0.05):?B without lymph node metastasis, the mortality rate in the neoadjuvant group was higher than that in the control group (P < 0.05) ; ? patients with lymph node metastasis, Death rate, local recurrence rate, distant metastasis rate, near and long term side effects were similar in the two groups(P >0.05) ; ? patients without lymph node metastasis, the local recurrence rate of neoadjuvant group was higher than that of the control group (P < 0.05) .2.For single drug concurrent chemoradiotherapy(single drug group 124 cases) and concurrent chemoradiotherapy with two drugs (47 cases in two groups), The survival rate of the single drug group was better than that of the double drug group (P < 0.05 ) ; For patients with lymph node metastasis, stage ?B, stage ? and concurrent chemoradiotherapy after neoadjuvant chemotherapy, the concurrent chemotherapy and radiotherapy with concurrent chemotherapy and radiotherapy were equivalent (P >0.05) , but for patients of Without lymph node metastasis and concurrent chemoradiotherapy,the survival status of concurrent chemoradiotherapy was significantly better than that of concurrent chemoradiotherapy,there was statistical difference (P < 0.05).3.Whether adjuvant chemotherapy was performed after concurrent chemoradiotherapy (There were 66 cases in the adjuvant chemotherapy group and no adjuvant chemotherapy group (n =93)),two groups of curative effect was equivalent (P >0.05).For patients with concurrent chemoradiotherapy after neoadjuvant chemotherapy , No adjuvant chemotherapy was better than adjuvant chemotherapy,there was no statistical difference (P >0.05).Conclusions: 1. ?B??B cervical squamous cell carcinoma patients,With or without lymph node metastasis,The effect of concurrent chemoradiotherapy and Concurrent chemoradiotherapy after neoadjuvant chemotherapy is equivalent, But for patients with stage ?B without lymph node metastasis,Neoadjuvant chemotherapy leads to poor prognosis; patients with length of tumor,lymph node metastasis,simultaneous use of two drugs in concurrent chemoradiotherapy,concurrent chemoradiotherapy after neoadjuvant chemotherapy have a poor prognosis,Neoadjuvant chemotherapy increases the risk of moderate and severe bone marrow suppression during concurrent chemoradiotherapy, prolonged irradiation time,increased risk of local recurrence, and increases the risk of death in patients with stage?B lymph node metastasis.2. ?B??B cervical squamous cell carcinoma patients,The effect of concurrent radiotherapy and chemotherapy with single drug was better than that of concurrent radiotherapy and chemotherapy with Double medicine .3. ?B??B cervical squamous cell carcinoma patients,With or without lymph node metastasis > whether ?B or ?,whether concurrent chemoradiotherapy or neoadjuvant chemotherapy followed by concurrent chemoradiotherapy, With or without adjuvant chemotherapy after concurrent chemoradiotherapy,the curative effect was the same. |
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