Clinical Analysis Of Concurrent Chemoradiotherapy And Surgery Combined With Adjuvant Therapy For Locally Advanced Cervical Cancer

Objective:To explore the complications,adverse reactions and clinical efficacy of radical hysterectomy(RH)followed by chemotherapy and radiotherapy versus concurrent chemoradiotherapy(CCRT)in patients with locally advanced cervical cancer.Methods:The clinical data of 148 patients with FIGO stage IB2 and IIA2 cervical cancer at Chinese PLA General Hospital from January 2010 to June 2015 were retrospectively analyzed.The patients were divided into two groups according to the treatment method.Totally 73 patients with radical hysterectomy(RH)followed by chemotherapy and radiotherapy were assigned into the surgery combined with adjuvant therapy group,while the other 75 patients with concurrent radiotherapy and chemotherapy were assigned into the concurrent chemoradiotherapy group.Compared with adverse reactions of chemotherapy and radiotherapy including chemotherapy toxicity and radiotherapy toxicity,the complications of intraoperative and postoperative conditions,recurrence and survival in two groups.Results:1.The adverse reactions of the two groups were compared.The incidence of gastrointestinal reactions,acute rectal toxicity and acute bladder toxicity in the surgery combined with adjuvant therapy group was higher than that in the concurrent chemoradiotherapy group(P<0.05).There was no significant difference in the incidence of Grade 2 or higher myelosuppression,liver and kidney dysfunction(P>0.05).2.In the surgery combined with adjuvant therapy group,the intraoperative and postoperative transfusion rate was 53.4%,the incidence of surgical injury was 9.6%,including ureteral injury 4.1%,bladder injury 2.7%,rectal injury 1.4% and vascular injury 1.4%.Postoperative complications were 24.7%,including persistent fever 11.0%,urinary infection 2.7% and pulmonary infection 1.4%,intestinal obstruction 1.4%,lower extremity venous thrombosis 1.4%,abdominal incision dehiscence 1.4% and pelvic lymphocyst 5.5%.3.There was no significant difference in median survival time,3-year progression-free survival and 3-year overall survival(P>0.05).Conclusion:There were similar survival outcomes for FIGO stage IB2 and IIA2 locally advanced cervical cancer with radical hysterectomy followed by chemotherapy and radiotherapy and concurrent chemoradiotherapy,but concurrent chemoradiotherapy avoids surgical complications,reduces gastrointestinal reactions,acute rectal toxicity and acute bladder toxicity.