Analysis of clinicopathological factors affecting the chemoradiotherapy sensitivity in advanced cervical squamous cell carcinoma treated

Abstract

The average 5-year overall survival (OS) rate of locally advanced cervical cancer (LACC) is unsatisfactory, this study was to investigate the clinical factors of chemoradiotherapy resistance in cervical cancer after chemoradiation and to improve the efficacy. A total of 965 LACC patients treated with radical chemoradiotherapy, the patients were categorized into two groups: chemoradiotherapy-resistant and chemoradiotherapy-sensitive. The survival curve and survival rate were drawn by Kaplan-Meier method using the R language package. Log-rank test was applied to analyze the difference in the survival rate among the different groups, while COX regression models and logistic regression were applied to analyze the clinical factors affecting prognosis. The 5-year survival rate of the radiotherapy-sensitive group was approximately 40% higher than that of the radiotherapy-resistant group. Univariate analysis revealed that chemoradiotherapy sensitivity, tumor diameter, lymph node metastasis, hemoglobin levels, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and total radiotherapy time were prognostic factors for overall survival (OS) and progression-free survival (PFS). Multivariate analysis revealed that chemoradiotherapy sensitivity, age, PLR, and total radiotherapy time >8 weeks were independent prognostic factors for OS and PFS. The main clinical factors that contributed to the difference in the 5-year survival rate included the tumor stage, hemoglobin level, NLR, lymph node metastasis, and total radiotherapy time factors. Prognostic factors analyses revealed that OS and PFS affecting the efficacy of chemoradiotherapy for advanced cervical squamous cell carcinoma were associated with multiple clinical factors, and that chemoradiotherapy sensitivity, age, and PLR were independent prognostic factors for OS and PFS.