Analysis of vaginal elimination combined with radiotherapy and chemotherapy for giant stage IIIB cervical squamous cell carcinoma / 中国肿瘤临床

ABSTRACT

Objective: To assess the efficacy and safety of vaginal elimination in the treatment of giant stage IIIB cervical squamous cell carcinoma (SCC). Methods: From January 2016 to June 2017, clinical data of 49 patients with giant stage IIIB cervical SCC in Chongqing University Cancer Hospital were retrospectively analyzed. Survival and influencing factors were analyzed using the Kaplan-Meier method and multivariable Cox model. Results: After a median 36.0-month follow-up, the complete remission, local recurrence, and distant metastasis rates were 83.7% (41/49), 4.1% (2/49), and 34.7% (17/49), respectively. The overall survival (OS) rate, disease-free survival rate, distant metastasis-free survival (DMFS) rate, and local control rate (LCR) were 76.6%, 26.7%, 26.7%, and 77.8%, respectively. The occurrence rates of acute grade 3-4 adverse hematological events, diarrhea, frequency of urination, late grades 3-4 adverse rectitis events, and cystitis were 40.82% (20/49), 20.41% (10/49), 6.12% (3/49), 20.41% (10/49), and 8.16% (4/49), respectively. Cox analysis showed that the duration of radiotherapy affected OS and LCR (P<0.05), the dose of EQD2 affected DMFS and LCR (P<0.05), and the recurrence rate of SCC that persisted despite concurrent radiotherapy and chemotherapy was 61% (11/18). Conclusions: Patients with giant stage IIIB cervical SCC benefit from vaginal elimination combined with radiotherapy and chemotherapy; however, adverse reactions in the rectum and bladder increase, and thus, individualized treatment is recommended. The duration of radiotherapy is an independent factor for the prognosis of cervical cancer. SCC can be used for follow-up and monitoring cervical cancer recurrence.