Comparison on efficacy and safety of concurrent chemoradiotherapy versus radiotherapy alone in patients with middle or late stage cervical cancer

Objective The effect of concurrent chemoradiotherapy on the efficacy, safety and prognosis of advanced cervical cancer was studied comparing with radiotherapy alone. The expression levels of p53 and Bax in tumor tissues were taken as the starting point to discuss the curative effect. Methods Sixty-five patients with advanced cervical cancer (stage Ⅱb~Ⅳ) who were treated by radiotherapy alone in January, 2009 January, 2013 were selected as control group. Sixty-five patients of concurrent chemoradiotherapy were selected for the same period and the same condition as the observation group. The radiotherapy scheme was the same as the control group. The chemotherapy was combined with the PF regimen, 1 times every 3 weeks, and the chemotherapy was 3 times. The short-term effect (nearly 3 months), the incidence of adverse reactions, the prognosis (3, 5 years, local recurrence, distant metastasis) were compared between the 2 groups, and the expression of P53 and Bax before and after the treatment were compared and analyzed. Results The effective rate of the observation group was higher than that of the control group (63.1% to 43.1%, P<0.05). The 3-and 5-year survival rates in the observation group were 78.5% and 63.1%, respectively, higher than those in the control group 61.5% and 40.0% (P<0.05). The local recurrence rate and distant metastasis rate in the observation group were 30.8% and 23.1% respectively, lower than those in the control group 47.7% and 43.1% (P<0.05). The incidence of bone marrow suppression and gastrointestinal reactions in the observation group was significantly higher than that in the control group (P<0.05). There was no significant difference in the incidence of liver and kidney function injury, radiation proctitis and radiation cystitis in the two groups (P>0.05), which could be tolerated in patients with adverse reactions and did not significantly affect the treatment. After the treatment, the positive rates of P53 and Bax in the two groups increased, and the increase in the observation group was higher than that in the control group (P<0.05). Conclusion Compared with radiotherapy alone, synchronous radiotherapy can improve the effectiveness of the treatment of advanced cervical cancer and improve the prognosis of patients. Although the incidence of toxic and side effects is high, the patient can be tolerated after active treatment. The mechanism may be related to the up-regulation of the expression of Bax and the inhibition of P53 process, thus improving the chemosensitivity of the patients.