Efficacy Analysis Of Concurrent Chemoradiotherapy Followed By Adjuvant Chemotherapy In Patients With Stage Ⅲ Squamous Cell Carcinoma Of The Cervix

ObjectivesTo evaluate the efficacy of concurrent chemoradiotherapy(CCRT)followed by adjuvant chemotherapy(AC)in patients with stage III squamous cell carcinoma of the cervix,explore the benefit population of concurrent chemoradiotherapy followed by adjuvant chemotherapy,and provide some reference value for clinical decision-making.MethodsThe Collection in March 2015 to March 2016,Fujian Provincial Cancer Hospital accepted radical radiation and chemotherapy of patients with stage III cervical squamous cell carcinoma of the clinical data,according to its whether to continue the line of adjuvant chemotherapy after concurrent chemoradiotherapy,were divided into concurrent chemoradiotherapy group and concurrent chemoradiotherapy group.Statistical analysis was performed on the clinical baseline data of the patients.The short-term efficacy after the end of radical concurrent chemoradiotherapy was assessed,and the 1-year,3-year,and 5-year overall survival rates and progression-free survival rates of the included study patients were calculated.Overall survival and progression-free survival were analyzed using Kaplan-Meier survival curves,and survival curves were plotted.The toxicity of patients after chemoradiotherapy was statistically analyzed.To explore the benefit population of adjuvant chemotherapy after concurrent chemoradiotherapy through analysis.P < 0.05 was considered statistically significant.ResultsA total of 69 patients met the inclusion criteria,of whom 34 patients received concurrent chemoradiotherapy(CCRT group)and 35 patients received concurrent chemoradiotherapy followed by 3 cycles of adjuvant chemotherapy(CCRT + AC group).The difference between the two groups was not statistically significant.After receiving concurrent chemoradiotherapy,59 patients achieved a complete response and 10 patients achieved a partial response.The 1-year,3-year and 5-year overall survival rates were 94.1%,79.4% and 67.5% in CCRT group and 94.28%,85.7% and 71.1% in CCRT + AC group,respectively,The difference between the two groups was not statistically significant.The 1-year,3-year,and 5-year progression-free survival rates were 91.2%,73.5%,and 58.8% in the CCRT group and 91.3%,75.4%,and 59.4% in the CCRT + AC group,respectively,and there was no statistically significant difference between the two groups.There was no statistically significant difference in chemoradiotherapy toxicity between the two groups of patients.The subgroup analysis showed that the level of Squamous Cell Carcinoma(SCC)before treatment and after concurrent chemoradiotherapy had statistically significant influence on the prognosis between the CCRT group and the CCRT+AC group(P < 0.05).There were no significant differences in age,FIGO stage,lymph node metastasis,tumor maximum diameter,number of concurrent chemotherapy cycles and pre-treatment hemoglobin level between the CCRT group and the CCRT+AC group(P > 0.05).There was no significant difference in the overall survival time and progression-free survival time between the CCRT group and the CCRT+AC group(P > 0.05).However,in patients with partial response in short-term efficacy,the survival time of the CCRT + AC group was better than that of the CCRT group(P < 0.05).ConclusionsThrough subgroup analysis,it is concluded that in patients with high level of squamous cell carcinoma antigen(SCC > 13.7ng/ ml)before treatment,SCC is still above the normal range after concurrent chemoradiotherapy,or in patients who have not achieved complete remission in the near future,adjuvant chemotherapy after radical concurrent chemoradiotherapy can benefit the survival of patients.However,in patients with recent complete remission,adjuvant chemotherapy followed by radical concurrent chemoradiotherapy does not benefit patients’ survival.