局部晚期宫颈癌预后影响因素OA

Objective To investigate the prognostic factors affecting disease-free survival(DFS)and overall survival(OS)in patients with locally advanced cervical cancer(LACC).Methods A retrospective analysis was performed on clinical data from 136 patients with LACC who received radical radiotherapy between January 2016 and December 2021.The following variables were assessed:combination with Chinese medicine treatment,tumor size,International Federation of Gynecology and Obstetrics(FIGO)stage,pathological grade,lymph node metastasis,pre-radiotherapy hemoglobin(Hb)level,pre-radiotherapy neutrophil-to-lymphocyte ratio(NLR),and pre-radiotherapy platelet-to-lymphocyte ratio(PLR).Independent prognostic factors were identified using Kaplan-Meier survival analysis and Cox multivariate regression analysis.A nomogram prediction model was subsequently developed using R software.Results Independent risk factors for DFS:FIGO stageⅣa(HR=5.030),moderate/low differentiation(HR=3.532/5.216),pre-radiotherapy Hb＜120 g/L(HR=1.848),pre-radiotherapy NLR＞2.985(HR=2.631),and without combined Chinese medicine treatment(HR=1.744).Independent risk factors for OS:FIGO stage Ⅳa(HR=2.388),low differentiation(HR=3.292),pre-radiotherapy Hb＜120 g/L(HR=2.139),pre-radiotherapy NLR＞3.55(HR=1.895).The nomogram models constructed based on the above factors demonstrated favorable predictive performance.The areas under the curve(AUC)for predicting poor prognosis in the validation cohort were 0.809 for the DFS model and 0.781 for the OS model.Conclusions FIGO staging,pathological grade,pre-radiotherapy Hb level,and pre-radiotherapy NLR are common prognostic factors for DFS and OS in LACC patients.Notably,without combined Chinese medicine treatment is an independent risk factor for DFS.This suggests that combining Chinese medicine treatment with standard treatment regimen can be considered a clinical option for improving DFS of LACC patients.