The Analysis Of Efficacy For The Concomitant Chemoradiotherapy Of The Medium-term And Advanced Ccrvical Cancer

Objective: Studying the efficacy,toxicity and prognostic factors of theconcomitant chemoradiotherapy in the treatment of the medium-term andadvanced cervical cancer,in order to provide the clinical basis.Methods: From January2006to January2010,at the department ofradiotherapy of the second affiliated hospital of Dalian MedicalUniversity,the137patients with cervical cancer treated with radiotherapyalone or concomitant chemoradiotherapy were reviewed and analyzed,whichwere confirmed by pathology.The137patients were randomly divided intotwo groups. Radiotherapy was used to concurrent chemoradiotherapy group,including68cases,and concurrent radiotherapy and chemotherapy witheisplatin was used to the radiotherapy alone group, including69cases.Comparing the efficacy,OS of three years, side effects between the twogroups,analyzing the related risk factors at the same time.Results:1. After three months of the treatment,complete remission rates andefficacy rates of the concurrent chemoradiotherapy group (42.7%,91.2%)were better than those of the radiotherapy alonegroup(26.1%,78.3%),and the result had the statistical significance(P<0.05).2. The result that comparing the OS of three years of two groups were75%and58%among the concurrent chemoradiotherapy group and theradiotherapy alone group, had the statistical significance(P<0.05).3. Acute adverse reactions: The incidence of hematologic toxicities, gastrointestinal side effects in the group of concurrent’chemotherapyplus radiotherapy(60.3%,63.2%) were found to be higher than the onlyradiotherapy group(40.6%,30.4%), P<0.05.Most of them were tolerable.The incidence of rectal side reactions, urogenital tractreactions(30.9%,16.2%,21.7%,11.6%) in the two groups were not havestatistical significance, P>0.05. Late adverse reactions: The incidence ofradiation proctitis(7.4%,4.4%) and radiation cystitis(4.4%,2.9%), had nostatistical significance(P>0.05).4. Single factor analysis showed that the tumor size,pathological types,clinical gross types, with/without lymph node metastasis or anemiabefore the treatment, affected the OS of the three years with prognosticfactors for the medium-term and advanced cervical cancer withconcomitant chemoradiotherapy, P<0.05.5. Multivariate analysis showed that the tumor size,pathological typesand,hemoglobin value at start of radiotherapy were the independentfactors to determine the OS of the of3years foe the medium-term andadvanced cervical cancer with concomitant chemoradiotherapy, P<0.05.Conclusion:1. The concomitant chemoradiotherapy can improve the short-term efficacyand the long-term survival rate of the medium-term and advancedcervical cancer,and the toxicity of concurrent radiochemotherapy ishigher than that of radiotherapy alone.However, the adverse reactionscould be tolerated, and that can be endured. The incidence of thelong-term adverse reactions were not increased.2. The clinicopathologic factors including the tumor size,pathologicaltypes, clinical gross types, with/without lymph node metastasis oranemia before the treatment, are predictors of the OS of three years forthe medium-term and advanced cervical cancer.3. The tumor size,pathological types, with/without lymph node metastasisbefore the treatment were the independent prognostic factors to determine the OS of three years of the concomitant chemoradiotherapyfor the medium-term and advanced cervical cancer.