Objective To investigate the long-term
efficacy and
prognosis of
concurrent chemoradiotherapy alone and
concurrent chemoradiotherapy after
neoadjuvant chemotherapy for stage ⅡB-ⅢB cervical
squamous cell carcinoma .
Methods A retrospective
analysis was performed among 171
patients with stage ⅡB-ⅢBcervical
squamous cell carcinoma who were admitted to our
hospital and had complete follow-up data from February 1,2005 to October 31,2011. Results The median follow-up
time was 66 months. There were no significant differences in the 3-or 5-year overall
survival rates between the concurrent group and the neoadjuvant group(81.4% vs.75.9%,74.3% vs.67.2%,P=0.469).According to the subgroup
analysis ,there was no correlation between
lymph node metastasis and
survival curve(P=0.310,P=0.151).The univariate and Cox
multivariate analyses showed that
tumor size,
lymph node metastasis ,and concurrent
chemotherapy method were independent
prognostic factors for
cervical cancer (P<0.05).For the
patients with
lymph node metastasis , the neoadjuvant group had a significantly higher pelvic local
recurrence rate than the concurrent group (P=0.047),while there were no significant differences in
mortality ,distant
metastasis ,or long-term adverse reactions between the two groups(all P>0.05).For the
patients without
lymph node metastasis ,the neoadjuvant group had a significantly higher
incidence of grade 3-4
bone marrow suppression than the concurrent group (P=0.016), while there were no significant differences in
mortality ,local
recurrence ,distant
metastasis ,or long-term adverse reactions between the two groups (all P>0.05). Conclusions
Concurrent chemoradiotherapy alone and
concurrent chemoradiotherapy after
neoadjuvant chemotherapy achieve
similar treatment outcomes in
patients with stage ⅡB-ⅢBcervical
squamous cell carcinoma ,no matter whether they have
lymph node metastasis or not.
Tumor size,
lymph node metastasis ,and concurrent
chemotherapy method are independent
prognostic factors .
Neoadjuvant chemotherapy increases the
risk of grade 3-4
marrow suppression during
concurrent chemoradiotherapy ,prolongs irradiation
time ,and increases the
risk of local
recurrence .