Survival Analysis Of Patients With Advanced Cervical Cancer Treated With Radical Radiotherapy In A Third Class A Hospital

Objective: To analyze 1-year,2-year,3-year,4-year OS and DFS,recurrence and metastasis rate,recurrence and metastasis mode,incidence of side effects of radiotherapy and factors affecting survival rate in patients with medium-advanced cervical cancer treated with radical radiotherapy,so as to find a more appropriate treatment plan for patients with medium-advanced cervical cancer.Methods: According to the inclusion and exclusion criteria,clinical medical records and follow-up data of 120 patients with stage IIB-IVB cervical cancer who received radical radiotherapy in the Affiliated Hospital of Yan ’an University from June 2015 to June 2018 were collected.OS and DFS,recurrence and metastasis rate,recurrence and metastasis mode,incidence of side effects of radiotherapy and factors affecting survival rate were analyzed in patients with advanced cervical cancer treated with radical radiotherapy at 1,2,3 and 4 years.Independent sample t test was used for comparison between the two groups.The survival rate was calculated by K-M method.Univariate survival analysis was performed by log-rank test.COX proportional regression model was used for multivariate survival analysis.Results: A total of 120 patients were included in this study.The 2009 FIGO stage was IIB-IVB,and the pathological type was squamous cell carcinoma.The mean age was59.6 years and the median age was 57.0 years.The average body mass index was23.0kg/m2.The results showed that 1-year OS was 97.6 percent,2-year OS 96.0 percent,3-year OS 78.5 percent,and 4-year OS 62.0 percent.1-year DFS were 95.2%,2-year DFS 79.0%,3-year DFS 74.3%,and 4-year DFS 63.1%.The 4-year recurrence and metastasis rate was 30.0%,the local recurrence rate was 12.5%,the distant metastasis rate was 14.2%,and the local recurrence and distant metastasis rate was 3.3%.Distant metastasis was most common,followed by local recurrence.The most common site of distant metastasis was pelvic bone,and pelvic and abdominal lymph node metastasis was most common in local recurrence.The side effects of radiotherapy were evaluated by RTOG grading standard.The incidence of side effects of radiotherapy with RTOG≥ grade3 was 57.5%,among which the incidence of myelosuppression was 26.7%,radiation cystitis 14.2% and radiation enteritis 16.7%.The results of single factor analysis on OS showed that tumor size,stage and synchronous chemotherapy were significantly correlated with OS,with statistical significance(P < 0.05).Multivariate analysis showed that tumor size,stage and concurrent chemotherapy were independent factors affecting4-year OS.The univariate analysis showed that tumor size,stage,HB abefore treatment were significantly correlated with DFS,with statistical significance(P < 0.05).Multivariate analysis showed that tumor size and stage were independent factors affecting 4-year DFS.Conclusion: 1.Survival and disease-free survival: 1-year OS was 97.6%,2-year OS was 96.0%,3-year OS was 78.5%,and 4-year OS was 62.0%;1-year DFS were 95.2%,2-year DFS 79.0%,3-year DFS 74.3%,and 4-year DFS 63.1%.2.Recurrence and metastasis rate and mode of recurrence and metastasis: the 4-year recurrence and metastasis rate was 30.0%,including local recurrence rate of 12.5%,distant metastasis rate of 14.2%,and local recurrence + distant metastasis rate of 3.3%.Distant metastasis was most common,followed by local recurrence.The most common site of distant metastasis was pelvic bone,and pelvic and abdominal lymph node metastasis was most common in local recurrence.3.Incidence of side effects of radiotherapy: The incidence of side effects of RTOG≥Grade 3 radiotherapy was 57.5%,among which the incidence of myelosuppression was26.7%,the incidence of radiation cystitis was 14.2% and the incidence of radiation enteritis was 16.7%.4.Factors affecting survival rate: tumor size,stage and synchronous chemotherapy are independent factors affecting 4-year OS.Tumor size and stage were independent factors affecting 4-year DFS.According to the results of this study,the anemia and nutritional status of the patients should be corrected before treatment to maximize the tolerance of the patients to the treatment,and then the synchronous chemoradiotherapy should be selected according to the PS score of the patients.For the patients with large tumors and late stage,whether induction chemotherapy,consolidation chemotherapy or combined targeting therapy should be performed,the sample size will be expanded for further study.