Prognosis Of Patients With Cervical Cancer Treated With Radical Concurrent Radiotherapy And Chemotherapy

Objective:Cervical Cancer is one of the most common malignantTumors in gynecology.the age of onset gradually tends to be younger and its incidence increase year by year.At present,concurrent chemoradiotherapy is the main treatment for patients with advanced cervical cancer,But there was little change in survival,and cervical cancer remains the leading cause of cancer death in women.Therefore,it is necessary to analyze and study cervical cancer patients with concurrent chemoradiotherapy,especially to its prognostic fators.This paper aims to analyze the influence of some inflammatory indicators on the prognosis of patients with concurrent radiotherapy and chemotherapy before treatment,and to explore the possibility of using them as prognostic monitoring indicators for patients with cervical cancer with concurrent and chemotherapy.Method: This study collected 179 cases of patients who were admitted to the oncology department of the First People's Hospital of Changde City,Hunan Province,form January 2013 to December2018,and were finally diagnosed with cervical cancer.the generalcharacteristics and tumor characteristics of the study population were described by rank-sum test.Then the survival curve was used to analyze the 5-yeas OS of the subjects.The effects of different pathological types,different pathological types,different degree and FIGO stages of patients with concurrent radiotherapy and chemotherapy and chemotherapy of cervical cancer were investigated.The Receiver operating characteristic curve was plottde to obtain the White Blood Cell,Neutrophil and Lymphocyte before treatment and the best cut-off point value of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio.According t the optimal cut-off point into two groups,high and low.The differences in clinical characteristics between the two groups were then compared for statistical significance.Then.Cox regression analysis was used to obtain the relevant factors that may affect the prognosis of CC,and t test was used to compare the distribution of White Blood Cell,Neutrophil and Lymphocyte in survival and death patients,Finally,the survival curve of WBC,N and L in patients with concurrent chemoradiotherapy for Cervical cancer was drawn.Result: 179 patients with cervical cancer were followed up with concurrent chemoradiotherapy,and the 1-year,3-year and 5-year overall survival rates were 97.93%,87.39%,and 74.23%.Different pathological types may affect the overall survival rate of concurrent radiotherapy and chemotherapy for Cervical cancer,compared with squamous cellcarcinoma and adenocarcinoma,adenosquamous carcinoma has the worst prognosis(p=0.00013).Different FIGO stages were significantly correlated with the prognosis of patients with concurrent chemoradiotherapy for cervical cancer,and the later the stages was,the worst the prognosis was(p<0.0001).Different degrees of differentiation were not correlated with the prognosis of Cervical cancer(p=0.58).The result of ROC curve analysis showed that the areas under the WBC,N,L,NLR and PLR curve were 0.662,0.590,0.642,0.474 and0.577.When the critical value of WBC was 10.31,the sensitivity and specificity were 37.04% and 89.40%,When the N count threshold was12.21,the sensitivity and specificity were 22.22% and95.92%.respectively,When the critical value of L count was 1.42,the sensitivity and specificity were 88.89% and 37.41%.When the critical value of NLR was 1.32,the sensitivity and specificity were 81.48% and37.41%,respectively,When the critical value of PLR was 84.9,the better sensitivity and specificity were 48.15% and 70.34%.According to the obtained optimal cut-off point value,NLR and PLR were divided into two groups:low NLR group(< 1)and high NLR group(> 1),low PLR group(< 85)and high PLR group(> 85).Then,univarite analysis was conducted on the influence of each clinical feature on LNLR and PLR.The results showed that WBC(p=0.04),N(p < 0.0001),L(p <0.0001),HB(p=0.031),PLT(p=0.009),SCC(p=0.035),CEA(p=0.010)andpathological type(p=0.007)and were the influencing factor of NLR.Fertitly unmber(p=0.011),renal history(p=0.013),WBC(p=0.012),N(p=0.040),L(p<0.001)and PLT(p<0.001)were the influencing factor pf PLR.The different clinical characteristic and the influence of the NLR and PLR on death Cox regression analysis,single factor analysis showed the WBC,N,L,SCC,CEA,CA125,tumor size,tumor staging and the induction chemotherapy is a risk factor for OS,HB is the protection factor in OS,had statistical significance(p<0.05),while the NLR and PLR for Cervical cancer OS has no statistical significance(p > 0.05).The significant results in the single-factor analysis were analyzed by multi-factor analysis.The result of multi-factor analysis showed that only WBC,L,HB,and CA125 were independent factor affecting OS.Conclusion:Single factor analysis showed that WBC is higher,the higher the N count,L count,SCC,CEA,CA125,the greater the tumor size,the tumor staging is later,induction chemotherapy,KPS score is lower,the more the lower hemoglobin,pathological types of gland scale cancer are risk factor for the prognosis of patients with Cervical cancer chemoradiation death,multi-factor analysis showed that only WBC,CA125 is independent risk factors with Cervical cancer chemoradiation death.Hemoglobin and L count were independent protective factor for the Cervical cancer prognosis.In this study,it was found that NLR and PLR had no statistical significance in the prognosis and death of patients with concurrent chemoradiotherapy for Cervical cancer,which requires further study.