关键词: 宫颈癌, 调强放射治疗, 毒性反应, 危险因素, 长期生存

Abstract:

Objective Cervical cancer is one of the most common malignancies in women worldwide.Concurrent chemoradiotherapy followed by high⁃dose⁃rate brachytherapyis the standard treatment for locallyadvanced cervical cancer（LACC）. We aimed to investigate the treatment outcomes and toxicities of these patientswho underwent definitive intensity⁃modulated radiotherapy（IMRT）. Methods A total of 97 patients who receiveddefinitive IMRT for LACC between July 2012 and December 2015 were studied retrospectively. Overall survival（OS），disease⁃free survival（DFS），distant metastasis⁃free survival（DMFS），and local recurrence⁃free survival（LRFS）rates were calculated，and survival hazard ratios（HR）for different demographic and clinicopathologicalvariables，were also calculated to determine their prognostic significance. Patients were assessed and recorded foracute toxicities and late toxicities. Results Mean follow⁃up was 65.0（range 2.2～86.7）months. The 5⁃year OS，DFS，DMFS，and LRFS rates were 76.0%，65.7%，75.5% and 81.4%，respectively. The only negative indepen⁃dent risk factor for OS is histological type（squamous cell carcinoma vs. adenocarcinoma/adenosquamous carcinoma（HR = 4.932，95% CI：1.446～16.820，P = 0.011）. A total of 17（17.5%）patients developed grade 3 or greateracute toxicities，and 36（37.1%）patients developed late toxicities. Conclusion Patients with LACC who underwentdefinitive IMRT have achieved good outcomes，and tolerated associated toxicities.

Key words: cervical cancer, intensity?modulated radiotherapy, toxicity, risk factor, long?term clinical cutcomes