Background

This subgroup analysis of a prospective phase II trial aimed to identify valuable and accessible prognostic factors for overall survival (OS) and progression-free survival (PFS) of patients with locally advanced cervical cancer (LACC).

Methods

Patients with FIGO II to IVA cervical cancer were assessed in this study. All patients underwent concurrent chemoradiotherapy (CCRT) followed by brachytherapy. Tumor parameters based on MRI scans before and during CCRT were evaluated for Overall survival (OS) and Progression-free survival (PFS).

Results

A total of 86 patients were included in this analysis with a median follow-up period of 31.7 months. Three-year OS and PFS rates for all patients were 87.1% and 76.5%, respectively. Univariate Cox regression analysis showed that restaging tumor size (rTS) over 2.55 cm (p < 0.001), initial tumor volume (iTV) over 55.99 cc (p < 0.001), downstaging (p = 0.042), and restaging tumor volume (rTV) over 6.25 cc (p = 0.006) were significantly associated with OS. rTS (p < 0.001), iTV (p < 0.001), downstaging (p = 0.027), and rTV (p < 0.001) were identified as significant prognostic factors for PFS. In the stepwise multivariable analysis, only rTS > 2.55 cm showed statistically significant with OS (HR: 5.47, 95% CI 1.80–9.58, p = 0.035) and PFS (HR: 3.83, 95% CI 1.50–11.45; p = 0.025).

Conclusions

Initial tumor size and restaging tumor volume that are easily accessible during radiotherapy provide valuable prognostic information for cervical cancer. MRI-based measurable volumetric scoring system can be readily applied in real-world practice of cervical cancer.

Clinical trial information: This study is a subgroup analysis of prospective trial registered at ClinicalTrials.gov Identifier: NCT02993653.

中文翻译：

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放化疗前和放化疗期间基于 MRI 的体积肿瘤参数可预测局部晚期宫颈癌的肿瘤复发和患者生存：一项 II 期前瞻性试验的亚组分析

背景

这项前瞻性 II 期试验的亚组分析旨在确定局部晚期宫颈癌 (LACC) 患者总生存 (OS) 和无进展生存 (PFS) 的有价值且可获取的预后因素。

方法

本研究对FIGO II 至IVA 宫颈癌患者进行了评估。所有患者均接受同步放化疗（CCRT），然后进行近距离放射治疗。根据 CCRT 之前和期间的 MRI 扫描的肿瘤参数评估总生存期 (OS) 和无进展生存期 (PFS)。

结果

该分析共纳入 86 名患者，中位随访期为 31.7 个月。所有患者的三年 OS 和 PFS 率分别为 87.1% 和 76.5%。单变量 Cox 回归分析显示，重新分期肿瘤大小 (rTS) 超过 2.55 cm ( p  < 0.001)、初始肿瘤体积 (iTV) 超过 55.99 cc ( p  < 0.001)、降期 ( p  = 0.042) 和重新分期肿瘤体积 (rTV)超过 6.25 cc ( p  = 0.006) 与 OS 显着相关。 rTS ( p  < 0.001)、iTV ( p  < 0.001)、降期 ( p  = 0.027) 和 rTV ( p  < 0.001) 被确定为 PFS 的重要预后因素。在逐步多变量分析中，仅 rTS > 2.55 cm 显示 OS（HR：5.47，95% CI 1.80-9.58，p  = 0.035）和 PFS（HR：3.83，95% CI 1.50-11.45；p  = 0.025）具有统计学显着性。

结论

在放射治疗期间可以轻松获得初始肿瘤大小和重新分期肿瘤体积，为宫颈癌提供有价值的预后信息。基于 MRI 的可测量体积评分系统可以很容易地应用于宫颈癌的现实实践中。

临床试验信息：本研究是在 ClinicalTrials.gov 上注册的前瞻性试验的亚组分析，标识符：NCT02993653。