Tian Zhong-ze1,#, Li Jun2,#, Liu Ming-lu3, Li Sha1, Lu Jun1, Yue Yang-jun1, Fu Hua1, Zhu Xiang-hui1, Yu Yang1 and Zhang Chun-lin4,*
1Department of Radiation Oncology, Lanzhou General Hospital of People’s Liberation Army, China
2Department of Traditional Chinese medicine, Lanzhou General Hospital of People’s Liberation Army, China
3The Second Clinic, National Defence University of People’s Liberation Army, China
4Department of Radiation Oncology, Tumor Hospital of Gansu Province, China
Objective: To investigate the long-term effects, prognostic factors, and radiotherapy complications of radical radiotherapy in cervical cancer patients.
Methods: A total of 855 patients with primary cervical cancer admitted between January 2004 and March 2014 were treated with radical radiotherapy. After three-dimensional conformal radiotherapy (30 Gy to 44 Gy), a bilateral parametrium dose of 46 Gy to 58 Gy was added. Intra-cervical brachytherapy was conducted simultaneously with external radiation therapy, with 6 Gy to7 Gy per fraction for five to six fractions and an average dose of 32.6 Gy. A total of 132 patients received uterine artery chemoembolization (UACE). Most patients received up to four cycles of systemic chemotherapy.
Results: In all patients, the total disease-specific survival (DSS) in 2, 5, and 10 years was 87.6%, 52.4%, and 30.2% respectively. Cox multivariate analysis showed that the independent prognostic factors affecting survival rate from cervical cancer following radical radiotherapy were age, UACE, clinical stage, hemoglobin (Hgb) level, systemic chemotherapy, and total dose at location A. Age and total dose at location A and total dose at location B were the risk factors for delayed rectal injury, while clinical stage and total dose at location B were the risk factors for delayed small bowel injury, and UACE was the only risk factor for delayed bladder injury.
Conclusion: Age at onset, Hgb level, systemic chemotherapy, and total dose at location A were positive factors affecting the prognosis of in cervical cancer patients following radical radiotherapy, while clinical stage and interventional therapy were negative factors.
Cervical cancer; Radiotherapy; Prognostic factor; Complication
Zhong-ze T, Jun L, Ming-lu L, Sha L, Jun L, Yang-Jun Y, et al. Analysis of Clinical Factors Affecting Radical Radiotherapy for Cervical Cancer. Ann Radiat Ther Oncol. 2019; 2(1): 1016.