Influencing factors in remission effect of patients with advanced cervical cancer after concurrent chemoradiotherapy and prediction model construction
Objective To explore the factors influencing the remission effect of concurrent chemoradiotherapy in patients with advanced cervical cancer,and constructing a predictive model,in order to provide more reference basis for clinical efficacy prediction and treatment plan.Methods A total of 131 patients with advanced cervical cancer who underwent concurrent chemoradiotherapy in our hospital from January 2020 to January 2023 were retrospectively included.They were divided into a remission group(90 cases)and an unrelieved group(41 cases)based on whether they achieved remission after concurrent chemoradiotherapy.Using univariate and multivariate methods to evaluate the independent influencing factors of remission effect in patients with advanced cervical cancer after concurrent chemoradiotherapy,and based on the independent risk factors mentioned above,constructing a partial regression coefficient model equation,the clinical efficacy of the model in predicting remission effect in patients with advanced cervical cancer after concurrent chemoradiotherapy is analyzed.Results The results obtained from univariate analysis indicate that the maximum tumor diameter,parametrial infiltration,platelet/lymphocyte ratio,neutrophil/lymphocyte ratio,and monocyte/lymphocyte ratio may all be related to the remission effect of concurrent chemoradiotherapy in patients with advanced cervical cancer(P＜0.05).The results of multivariate analysis using logistic regression model showed that tumor maximum diameter,parametrial infiltration,platelet/lymphocyte ratio,neutrophiUlymphocyte ratio,and monocyte/lymphocyte ratio were all independent influencing factors(P＜0.05)on the effect of concurrent chemoradiotherapy in patients with advanced cervical cancer.According to the logistic regression model,it was confirmed that there are independent influencing factors on the remission effect of concurrent chemoradiotherapy in patients with advanced cervical cancer.An independent variable partial regression coefficient model equation was constructed,and the likelihood of achieving remission in patients with advanced cervical cancer after concurrent chemoradiotherapy was obtained as Logit(Y)=1.84-1.16 × maximum tumor diameter(cm)-2.72 × parametrial infiltration+0.08 × platelet/lymphocyte ratio-1.09 × neutrophil/lymphocyte ratio-1.13 × monocyte/lymphocyte ratio.The predictive area under the curve for the remission effect of concurrent chemoradiotherapy in patients with advanced cervical cancer using this clinical model is 0.88(95％CI:0.83～0.94),with a specificity of 75.90％,sensitivity of 87.36％,and an optimal cut-off value of 0.65.Conclusions The remission effect of concurrent chemoradiotherapy in patients with advanced cervical cancer is related to many factors,such as tumor maximum diameter,paracentral infiltration and immunoinflammatory indexes.The prediction model based on the above indicators is helpful to guide clinicians to early identify the poor clinical effect after concurrent chemoradiotherapy.
cervical cancerconcurrent chemoradiotherapyremissioninfluencing factorsprediction model
万方数据
维普
