Prognosis of Stage ⅠB-ⅡA Cervical Squamous Cell Carcinoma Patients with Intermediate Risk Factors Treated with Adjuvant Chemotherapy Versus Concurrent Chemoradiotherapy: A Prospective Randomized Controlled Trial

Abstract

Objective To compare the prognosis of stage ⅠB-ⅡA cervical squamous cell carcinoma patients with intermediate risk factrs between adjuvant chemotherapy and concurrent chemoradiotherapy, and to explore the safety and effectiveness of adjuvant chemotherapy after surgery. Methods A total of 190 patients treated at the Affiliated Cancer Hospital of Guangxi Medical University were selected and randomly divided into two groups: chemotherapy group (CT group, n=95) and concurrent chemoradiotherapy group (CCRT group, n=95). Ten patients lost to follow-up. Kaplan-Meier method and Log rank test were used for OS calculation and survival curve comparison. Cox proportional-hazards regression model was used for multivariate analysis. Results After a median follow-up of 36.7 months, 190 patients were evaluable. The incidence of G3/G4 blood system toxicity were 3.3% in CT group and 10.11% in CCRT group (P=0.019), the incidence of severe gastrointestinal toxicity were 4.4% in CT group and 17.98% in CCRT group, the incidence of radiation-related response was 22.48%. There was no significant difference in the local recurrence rate or distant recurrence rate between two groups (P > 0.05). There was no statistically significant difference in PFS and OS between two groups (P > 0.05). Conclusion There is no significant difference between postoperative chemotherapy and concurrent chemoradiotherapy on stage ⅠB-ⅡA cervical squamous cell carcinoma patients with intermediate risk facfors, but the adverse reactions of postoperative chemotherapy are significantly reduced compared with concurrent chemoradiotherapy.

Keywords

• cervical squamous cell carcinoma
• intermediate risk factors
• chemotherapy
• concurrent chemoradiotherapy