SIB-IMRT Combined With Cisplatin Radiotherapy And Chemotherapy For LACC

Objective:To investigate the efficacy of concurrent chemoradiotherapy for locally advanced cervical cancer(LACC)and the levels of hematocrit Index,biochemical indicators,and the positive rate of human papillomavirus(HPV),vascular endothelial growth factor(VEGF),p53 and Ki67 in tumor sample or serum in LACC patients and control group.Methods:From January 2017 to October 2019,40 patients with LACC confirmed by pathology in our hospital were randomly selected as LACC group,and treated with SIB-IMRT and cisplatin,and 36 patients with benign diseases in the same period were selected as benign cervical diseases(BCD)group.HPV infection was detected by PCR-Reverse dot blot hybridization,and GPx4 and SLC7A7 were detected by q PCR.The expression levels of VEGF,CEA,SCC and CA125 in serum were detected by chemiluminescence microparticle immunoassays(CMIA),and p53,Ki67and VEGF in biopsy tissues were detected by immunohistochemistry(IHC).The curative effect of SIB-IMRT combined with cisplatin in patients with LACC was analyzed,and the relationship between the expression levels of serum CA125,CEA,SCC,VEGF,p53,Ki67 and VEGF in cancer tissues and the sensitivity of LACC patients to concurrent chemoradiotherapy was analyzed after survival investigation for 1 year post treatment.Results:The levels of RBC,MCV,MPV,LDL-C and HDL-C in LACC group were significantly lower than those in BCD group(P<0.05).The positive rates of serum VEGF,CEA,SCC,CA125 and HPV in cervical secretions of LACC group were significantly higher than those in BCD group(P<0.05);there was no significant differences in WBC,PLT,triglyceride and total cholesterol between the two groups(P>0.05);the positive expression rates of HPV,VEGF,p53 and Ki67 in cervical tissue of LACC group were significantly higher than those in BCD group(P<0.05).The positive rate of serum VEGF in LACC group was 55.00%(22/40)by CMIA,and 62.50%(25/40)by IHC in LACC group.The results of the two methods are consistent(χ~2=0.464,P=0.496,kappa=0.641).The curative effect evaluation showed that there were 23 cases of CR(57.50%),12 cases of PR(30.00%),5 cases of SD(12.50%).There was no PD cases.The total effective rate was 87.50%(35/40).The relative expression levels of GPx4 and SLC7A7 m RNA in PBMC of LACC patients after chemotherapy were significantly lower than those before chemotherapy(P<0.05);The positive rates of HPV,VEGF,p53,Ki67 in sensitive group(CR patients,23 cases)were significantly lower than those in resistance group(PR+SD+PD patients,17 cases)(P<0.05).Conclusion:CMIA method is consistent with ICH method in detecting VEGF in LACC patients.The positive rates of VEGF in serum and HPV,VEGF,p53 and Ki67 in biopsy tissues of patients with LACC were significantly increased.There was some treatment efficacy of SIB-IMRT combined with cisplatin for LACC.The levels of GPx4 and SLC7A7 m RNA and the expression of VEGF,HPV,VEGF,p53 and Ki67were related to the sensitivity of SIB-IMRT and cisplatin in LACC patients.