Clinical Application Of Gene Testing In The Individualized Treatment Of Advanced Cervical Cancer

Objective To investigate the clinical significance of MDR1(G26677T/A),GSTP1(Ile105Val A/G)and CDA(A79C)gene detection in the treatment of advanced cervical cancer.Methods Forty-six patients with advanced cervical cancer were randomly divided into experimental group and control group,including 23 in the experimental group and 23 in the control group.By detecting the MDR1(G26677T/A),GSTP1(Ile105Val A/G),and CDA(A79C)polymorphism genotypes in the peripheral blood of the experimental group,the patients in the experimental group were treated with highly sensitive drugs according to the test results.In the control group,paclitaxel combined with cisplatin chemotherapy was used.Both groups underwent three-dimensional conformal intensity-modulated radiotherapy(IMRT)and ?-192 brachytherapy.The radiation dose is the same as the radiotherapy.The observations were compared in terms of short-term efficacy,progression-free survival,and toxicity.Results The short-term efficacy CR of the experimental group was 13(56.52%),PR was 9(39.13%),SD was 0,PD was 1(4.34%),and ORR was 95.65%.The CR in the control group was 6(26.08%),the PR was 11(47.82%),the SD was 3(13.04%),the PD was 3(13.04%),and the ORR was 73.91%.The short-term efficacy of the experimental group was significantly higher than that of the experimental group.In the control group,the difference was statistically significant(P<0.05).The average PFS of the experimental group was(33.12±2.74)months,and the average PFS of the control group was(31.79±2.98)months.The average PFS of the experimental group was longer than that of the control group,but there was no significant difference between the two groups(P>0.05).In terms of adverse reactions,the experimental group had more III to IV degree myelosuppression,the incidence rate was 60.86%,and the incidence of severe myelosuppression in the control group was 39.13%.The incidence of severe myelosuppression in the experimental group was significantly higher than that in the control group,but there was no statistical difference(P>0.05).In the two groups,there were no severe gastrointestinal reactions.In the experimental group,12 patients(52.17%)had a grade I gastrointestinal reaction,and 11 patients(47.82%)had a second degree gastrointestinal reaction.In the control group,16 patients(69.56%)had a grade I gastrointestinal reaction,and 7 patients(30.43%)had a second degree gastrointestinal reaction.There was no statistical difference between the two groups,P>0.05.In the experimental group,15 patients(65.21%)had liver damage,12 patients(12.17%)had grade I liver damage,2 patients(8.69%)had grade II liver damage,and 1 patient had severe liver damage(4.34%).).In the control group,11 patients(47.82%)had liver damage,10 patients(43.47%)had grade I liver damage,and 1 patient(4.34%)had grade II liver damage.There was no statistical difference between the two groups,P>0.05.In the experimental group,14 patients(60.86%)had renal impairment,13 patients(56.52%)had grade I renal impairment,and 1 patient(4.34%)had grade II renal impairment.In the control group,17 patients(73.9%)had renal impairment,6 patients with grade I renal impairment(26.09%),and 16 patients with renal renal dysfunction(69.56%).There was no statistical difference between the two groups,P>0.05.During the radiotherapy,no serious radiation enteritis and radiation cystitis occurred in the two groups.In the experimental group,4 patients with radiation-induced enteritis(17.4%)and 1 patient with grade II acute radiation enteritis(4.34%).In the control group,3 patients with acute radiation enteritis(13.0%)and 1 patient with grade II acute radiation enteritis(4.34%).In the experimental group,2 patients(8.0%) developed grade I radiation cystitis,and 1 patient(4.34%)developed acute radiation cystitis.In the control group,3 patients(13.0%)developed acute radiation cystitis,and 1 patient(4.34%)developed acute radiation cystitis.There was no statistical difference between the two groups.Conclusion In this study,we detected the expression of MDR1(G26677T/A,CDA(A79C),GSTP1(Ile105Val A/G)genes in patients with advanced cervical cancer,and selected sensitive chemotherapy for adaptive chemotherapy.The short-term efficacy showed excellent results in the genetic testing group.Without genetic testing,it is predicted that genetic testing can guide the chemotherapy regimen of patients with advanced cervical cancer,increase the local control rate of advanced cervical cancer,and reduce the risk of distant metastasis.In terms of adverse reactions,there was no significant difference between the genetic testing group and the non-genetic testing group,indicating that genetic testing to guide the treatment of cervical cancer is also safe.