Scholarlink

Background <p>This study aimed to identify key risk factors in locally advanced cervical cancer (LACC) patients receiving radical radiotherapy and to evaluate the prognostic significance of MRI-determined tumor volume regression (TVR) among varying risk groups.</p> Methods <p>We retrospectively analyzed a cohort of 176 cervical cancer patients (stages IIA-IVA) treated with intensity-modulated radiotherapy from January 2012 to December 2020. Three-dimensional MRI scans were utilized to measure TVR and lymph node volume regression (NVR). Kaplan-Meier analysis was employed to assess overall survival (OS), progression-free survival (PFS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS). Prognostic factors were further analyzed using Cox proportional hazards models.</p> Results <p>A tumor TVR of ≥ 94% was significantly associated with improved 5-year overall survival (OS; 82.7% vs. 49.8%, <i>p</i> &lt; 0.001) and progression-free survival (PFS; 82.5% vs. 51.1%, <i>p</i> &lt; 0.001). Patients with TVR ≥ 94% also demonstrated superior LRFS and DMFS compared to those with TVR &lt; 94% (<i>p</i> &lt; 0.001 and <i>p</i> = 0.012, respectively). In the concurrent chemoradiotherapy (CCRT) subgroup, higher TVR correlated with better prognosis, whereas in patients receiving radiotherapy alone, an increased TVR did not significantly impact OS. Notably, the prognostic value of TVR was most evident in patients with CYFRA21-1 levels below 7.7 ng/ml. In the NVR ≥ 94% subgroup, OS, PFS, and LRFS were significantly better than in patients with NVR &lt; 94% (<i>p</i> &lt; 0.01), with a trend towards improved DMFS observed (<i>p</i> = 0.138).</p> Conclusion <p>TVR serves as a pivotal prognostic marker in LACC patients with CYFRA21-1 levels below 7.7 ng/ml undergoing CCRT. Additionally, within the lymph node metastasis subgroup, patients achieving a NVR of ≥ 94% demonstrated a notably improved prognosis.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prognostic implications of tumor volume reduction during radiotherapy in locally advanced cervical cancer: a risk-stratified analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年3月31日

查看全文
  • Canyang Lin,
  • Nan Xiao,
  • Qin Chen,
  • Dongxia Liao,
  • Fengling Yang,
  • Pengfei Liu,
  • Yunshan Jiang,
  • Dan Zhao,
  • Baoling Guo,
  • Xiaolei Ni

摘要

Background

This study aimed to identify key risk factors in locally advanced cervical cancer (LACC) patients receiving radical radiotherapy and to evaluate the prognostic significance of MRI-determined tumor volume regression (TVR) among varying risk groups.

Methods

We retrospectively analyzed a cohort of 176 cervical cancer patients (stages IIA-IVA) treated with intensity-modulated radiotherapy from January 2012 to December 2020. Three-dimensional MRI scans were utilized to measure TVR and lymph node volume regression (NVR). Kaplan-Meier analysis was employed to assess overall survival (OS), progression-free survival (PFS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS). Prognostic factors were further analyzed using Cox proportional hazards models.

Results

A tumor TVR of ≥ 94% was significantly associated with improved 5-year overall survival (OS; 82.7% vs. 49.8%, p < 0.001) and progression-free survival (PFS; 82.5% vs. 51.1%, p < 0.001). Patients with TVR ≥ 94% also demonstrated superior LRFS and DMFS compared to those with TVR < 94% (p < 0.001 and p = 0.012, respectively). In the concurrent chemoradiotherapy (CCRT) subgroup, higher TVR correlated with better prognosis, whereas in patients receiving radiotherapy alone, an increased TVR did not significantly impact OS. Notably, the prognostic value of TVR was most evident in patients with CYFRA21-1 levels below 7.7 ng/ml. In the NVR ≥ 94% subgroup, OS, PFS, and LRFS were significantly better than in patients with NVR < 94% (p < 0.01), with a trend towards improved DMFS observed (p = 0.138).

Conclusion

TVR serves as a pivotal prognostic marker in LACC patients with CYFRA21-1 levels below 7.7 ng/ml undergoing CCRT. Additionally, within the lymph node metastasis subgroup, patients achieving a NVR of ≥ 94% demonstrated a notably improved prognosis.