[Analysis of clinical efficacy of intensity-modulated radiation therapy and the prognosis factors in advanced cervical cancer]

Abstract

Objective: To investigate the efficacy of intensity-modulated radiation therapy(IMRT) and the prognosis factors in advanced cervical cancer.

Methods: A total of 218 cases of cervical cancer patients treated in Affiliated Tumor Hospital,Guangxi Medical University, between July 2007 and July 2012, were divided into IMRT group and routine radiotherapy group (conventional group, 94 vs 124 cases). To compare the short-term effects of two groups by Chi-square test, and the incidence rate of 1, 3, 5-year survival by rank sum test;to compare the acute and chronic toxicity of the two groups by rank sum test. And to analysis prognostic factors by log-rank test and Cox proportional hazard model and multiple linear regression analysis.

Results: (1) The effective rate in IMRT group was 95.7% (90/94), which in the conventional group was 86.3% (107/124; P < 0.01). The 1, 3, 5-year overall survival rates in IMRT group were not significant difference than those in conventional group (87.6% vs 90.1%, 73.4% vs 81.5%, and 72.3% vs 75.7%;all P > 0.05). The rate of acute gastrointestinal toxicity was 41.5% (39/94) in IMRT group , vs 42.7% (53/124) in conventional group(P < 0.01); and the incidence of acute hematopoietic toxicity in IMRT group was 76.6% (72/94), which was 78.2% (97/124) in conventional group(P < 0.01); the incidence of acute genitourinary toxicity was 12.8% (12/94 ) in IMRT and 8.1% (10/124) in conventional group(P = 0.248). The late gastrointestinal, genitourinary and hematopoietic toxicities were 18.1% (17/94), 16.0% (15/94) and 25.5% (24/94), which were lower than those in conventional group 91.9% (114/124), 47.6% (59/124) and 56.4% (70/124), respectively (all P < 0.01). (2) Univariate analysis showed that the International Federation of Gynecology and Obstetrics (FIGO) stage, histological grade and tumor size were closely associated with 5 years disease-free survival rates and overall survival rates (all P < 0.05) . Multivariate analysis showed that FIGO stage and histological grade were closely associated with 5 year overall survival rates ( all P < 0.01). FIGO stage and histological grade were independent factors to patients' 5-year overall survival rates in cervical cancer (P < 0.01).

Conclusion: IMRT would be to reduce the acute and chronic toxicity, and to improve the quality of patients' life, but did not improve the 5 years survival rate in advanced cervical carcinoma.