A comparative clinical study of postoperative intensity-modulated radiotherapy combined with concurrent and sequential chemotherapy for high-risk early-stage cervical cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective To evaluate the efficacy and acute toxieities of postoperative intensity-modulated radiotherapy (IMRT) combined with concurrent (C-IMRCT) or sequential chemotherapy (S-IMRCT) in the treatment of high-risk early-stage cervical cancer.Methods A retrospective study was performed on the clinical data of 105 patients with high-risk early-stage (Ⅰ B1-Ⅱ A2) cervical cancer from 2009 to 2017.Those patients were divided into C-IMRCT group (n=73) and S-IMRCT group (n=32).The 5-year disease-free survival (DFS) and overall survival (OS) rates,recurrence rate,metastasis rate,and acute toxicities were compared between the two groups.The survival rates were calculated by the Kaplan-Meier method and analyzed by the log-rank test.Univariate prognostic analysis was performed by the log-rank test.Recurrence,metastasis,and adverse reactions were compared using continuous correction chi-square test.Results The median follow-up time was 20 and 23 months in the C-IMRCT group and the S-IMRCT group,respectively (P=0.813).There were no significant differences in the 5-year DFS and OS rates between the two groups (72.6％ vs.72.5％,P=0.918;82.8％ vs.78.5％,P=0.504).There were no significant differences in the recurrence and metastasis rates between the two groups (P=0.598;P=1.000).The univariate prognostic analysis showed that no pathological factor affected prognosis.There were no significant differences in the incidence rates of grade 1-2 hematological toxicity,diarrhea,and urinary tract infection between the two groups (46.6％ vs.41.9％,P=0.884;P=0.854;P=0.271).Conclusions Further clinical studies are needed in terms of the survival rate in patients with high-risk early-stage cervical cancer receiving C-IMRCT.