Construction of Cox regression prediction model for prognosis and its influencing factors in cervical cancer after concurrent chemoradiotherapy
Objective To explore the prognosis and its influencing factors in cervical cancer after concurrent chemoradio-therapy,and to construct Cox regression prediction model.Methods A total of 106 patients with stage Ⅱa-Ⅳ cervical cancer admitted to Nanyang Central Hospitall were enrolled as the research objects between July 2018 and September 2021,and all were treated with volumetric modulated arc therapy and platinum chemotherapy.The patients were fol-lowed up till November 2023 or death.The survival of patients and influencing factors of prognosis were analyzed.The prediction model for prognosis was constructed.Results In the 106 patients with cervical cancer with 26-64 months of follow-up,median follow-up time was 45 months.There were 40 death cases,and overall survival rate was 62.26％.After concurrent chemoradiotherapy,overall survival rate was related to pathological type,differentiation degree,hemo-globin level before treatment,radiotherapy time and clinical staging(P＜0.05).Cox multivariate risk model analysis showed that adenocarcinoma(HR=2.373,P=0.039),low differentiation(HR=2.259,P=0.044),hemoglobin level before treatment＜110 g/L(HR=2.143,P=0.030),radiotherapy time＞9 weeks(HR=2.052,P=0.029)and clinical staging at stage Ⅳa(HR=2.026,P=0.041)were independent risk factors of prognosis(P＜0.05).The re-sults of multivariate Cox proportional risk regression model analysis showed that the prognostic index(PI)was as follow:2.373X1+2.259X2+2.143X3+2.052X4+2.026X5(X1:pathological type,X2:differentiation degree,X3:hemo-globin level before treatment,X4:radiotherapy time,X5:clinical staging).Hosmer-Lemeshow x2=6.235,P=0.621.ROC curves analysis showed that AUC and 95％CI of Cox proportional risk regression model for predicting prog-nosis of cervical cancer were 0.859 and 0.787-0.931,respectively.Conclusion The overall survival rate is related to pathological type,differentiation degree,hemoglobin level before treatment,radiotherapy time and clinical staging in pa-tients with cervical cancer after concurrent chemoradiotherapy.
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