The Study Of Related Factors That Affect The Short-term Effect Of Neoadjuvant Chemotherapy For Cervical Cancer

Objective:To explore the factors that affect the short-term effect of neoadjuvant chemotherapy in patients with stage IB2~IIB cervical cancer.Methods:The medical records of 46 patients with cervical cancer admitted to the first affiliated yijishan hospital of wannan medical college from June 2013 to December 2018 were retrospectively analyzed.All patients received different courses of neoadjuvant chemotherapy combined with radical surgery.Preoperatively,chemotherapy sensitivity was evaluated according to WHO solid tumor evaluation criteria,in which CR and PR were the effective group,SD and PD were the ineffective group.The relationship between sensitivity of NACT and clinical stage,course of chemotherapy,squamous cell carcinoma antigen(SCC-Ag),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),maximum diameter of tumors before chemotherapy and age of patients were analyzed.Results:1.Clinical staging: There were 9 cases of IB2 stage,including 6 cases of PR and 3 cases of SD,with an effective rate of 66.7%.There were 33 cases in IIA stage,including 25 cases of PR,7 cases of SD and 1 case of PD.The effective rate was 75.8%.There were 4 cases in IIB stage,including 2 cases of PR and 2 cases of SD,with an effective rate of 50.0%.The results showed that there was no statistically significant difference in the short-term efficacy of NACT among patients with cervical cancer at different clinical staging(P > 0.05).2.Tumor diameter before chemotherapy: The maximum diameter sample data of 46 patients showed normal distribution,with an average maximum diameter of 4.65 cm and a standard deviation of 1.23.The average maximum diameter of tumors in the effective group was 4.58 cm,the standard deviation was 1.03,and the average maximum diameter of tumors in the ineffective group was 4.82 cm,and the standard deviation was 1.66.The results showed that there was no significant difference in the maximum diameter of tumors between NACT-sensitive and NACT-insensitive patients before chemotherapy(P > 0.05).3.Patient age: The average age of the effective group was 52.36 years old,the median was 51 years old,the average age of the ineffective group was 52.38 years old,and the median was 52 years old.The results showed that there was no significant difference in age between sensitive and insensitive patients(P > 0.05).4.Chemotherapy course: A total of 19 cases were treated with 1 course of chemotherapy,including 10 cases of PR and 9 cases of SD,with an effective rate of 52.6%.A total of 27 cases were treated with 2 courses of chemotherapy,including 23 cases of PR,3 cases of SD and 1 case of PD,with an effective rate of 85.2%.The results showed that the effective rate of the two courses of chemotherapy group was higher than that of the one course of chemotherapy group,and the difference was statistically significant(P < 0.05).5.SCC-Ag before chemotherapy: The average SCC-Ag of effective group was 2.7 ng/ml,the median was 1.8 ng/ml;the average of ineffective group was 10.7 ng/ml,the median was 8.3 ng/ml.The results showed that the SCC-Ag values of NACT-sensitive patients before chemotherapy were lower than those of NACT-insensitive patients(P < 0.05).The best cut-off point of SCC-Ag predicted by ROC curve is 3.750 ng/ml.6.NLR before chemotherapy: The average NLR of effective group was 2.1,the median was 1.95,and that of ineffective group was 2.8,the median was 2.54.The results showed that the NLR value of NACT sensitive patients before chemotherapy was lower than that of NACT insensitive patients,and the difference was statistically significant(P < 0.05).The best cut-off point of NLR is 2.235.7.PLR before chemotherapy: The average PLR of effective group was 117.8,the median was 105.5;that of ineffective group was 139.9,and the median was 124.87.The results showed that there was no significant difference in PLR values between NACT sensitive and non-sensitive patients(P > 0.05).Conclusion:1.Clinical staging,tumor diameter before chemotherapy,patient age and PLR before chemotherapy are not factors affecting the short-term efficacy of NACT for cervical cancer.2.Chemotherapy course,SCC-Ag before chemotherapy and NLR before chemotherapy are the factors affecting the short-term efficacy of NACT for cervical cancer.When SCC-Ag < 3.75ng/ml before chemotherapy and/or NLR < 2.235 before chemotherapy,the short-term efficacy of NACT for cervical cancer patients is relatively good.