Analysis Of Factors Related To Recurrence Metastasis And Survival After Radical Radiotherapy Of Locally Advanced Cervical Squamous Cell Carcinoma

Objectives:To analyze the clinical features of patients with squamous squamous cell carcinoma of IB2 to ?B by retrospective study,and to explore the related factors of recurrence and metastasis after radical radiotherapy for locally advanced cervical squamous cell carcinoma.Methods:We retrospectively reviewd the medical records of 250 Patients with locally advanced squamous squamous cell carcinoma from stage IB2 to ?B who underwent radical radiotherapy after radical radiotherapy in the Department of Radiation Therapy,Third Affiliated Hospital of Kunming Medical University from 1 January 2013 to 31 December 2015.For analysis,all statistics were performed using SPSS 22.0 statistical software package.The difference between groups was analyzed by log-rank test.The multivariate analysis was performed by COX regression model.The Kaplan-Meier method was used to calculate the overall survival(OS)and progression-free survival.Period(PFS),P<0.05 was considered to be statistically significant.Results:The optimal threshold values of PLR and SCC under the ROC curve were 171.99 and 3.29,respectively.There was no significant correlation between age,pathological type,lesion size,lymph node maximum short diameter,pre-treatment PLT,CEA,radiotherapy and recurrence and metastasis after radical radiotherapy(P>0.05);clinical stage,palace invasion Hb levels before treatment,PLR,SCC,Hb level one week after radiotherapy,total days of radiotherapy,treatment methods were significantly correlated with adverse events(P<0.05);single factor analysis found that the palace was invaded and the clinical stage was advanced(?,Stage ?),Hb<90g/L before treatment,PLR? 171.99,SCC?3.29ug/L,Hb<90 g/L for one week after radiotherapy,total days of radiotherapy?56 days,plus neoadjuvant or auxiliary on the basis of concurrent radiotherapy and chemotherapy Chemotherapy was a negative factor in PFS and OS at 1,2,and 3 years,and the difference was statistically significant(P<0.05).Multivariate analysis found that the clinical stage was stage II and III(P=0.020),and Hb<90g/L after radiotherapy(P=0.002),pre-treatment PLR?171.99(P=0.048),total days of radiotherapy?56 days(P=0.000)were independent prognostic risk factors for PFS;clinical stage was stage ? and III(P=0.001),uterine body invasion(P=0.024),Hb<90g/L after radiotherapy(P=0.002),and the total number of days of treatment?56 days(P=0.000)were independent prognostic risk factors for OS;pelvic lymph node metastasis accounted for 69.2%(18/26)of pelvic recurrence and metastasis,and the effect of synchronous or sequential addition of pelvic lymph nodes on the occurrence of adverse events(P=0.785)and death(P=0.834)was not significant.Conclusions:1.Influencing factors of advanced clinical stage,intrauterine invasion,Hb<90g/L before treatment,PLR<171.99,SCC<3.29ug/L,Hb<90g/L one week after radiotherapy,neoadjuvant or adjuvant chemotherapy on the basis of concurrent chemoradiotherapy,and total days of radiotherapy>56 days with high incidence of adverse events;2.Advanced clinical stage(stage II and ?),Hb 90g/L after radiotherapy,total days of radiotherapy?56 days,PLR?171.99 before treatment is an independent prognostic risk factor of PFS.3.Advanced clinical stage(?,?),uterine body invasion,Hb<90g/L after radiotherapy,total days of radiotherapy ?56 days is an independent prognostic risk factor for OS;4.Concurrent chemoradiotherapy for patients with locally advanced cervical squamous cell carcinoma have better PFS and OS;5.Pelvic failure was mainly pelvic lymph node metastasi,and pelvic lymph node synchronization or sequential addition was similar for PFS and OS results.