The prognostic factors for locally advanced cervical @entity5 XXXX treated by intensity-modulated radiation therapy with concurrent chemotherapy.

@entity1 @entity137 @entity5 @entity900 @entity189 @entity344 @entity420 @entity3 @entity1168 @entity1349
BACKGROUND/PURPOSE: To identify the prognostic factors for locally advanced cervical @entity5 @entity1 treated by intensity-modulated radiotherapy (IMRT) and concurrent @entity900 -based chemotherapy. METHODS: A total of 125 @entity1 with stage IB2-III cervical @entity189 were treated with IMRT and concurrent @entity900 -based chemotherapy, plus @entity1168 ( @entity1168 ) brachytherapy between January 2004 and November 2010, in our institution. All @entity1 received external irradiation of 45-54  Gy with the IMRT technique and concurrent @entity900 -based chemotherapy monthly or weekly. @entity1168 brachytherapy of 20-30.5  Gy was prescribed to point A, as a local boost. Prognostic factors including age, histology, stage, lymph nodes @entity3 , pretreatment hemoglobin level, serum squamous cell @entity189 antigen (serum SCC-Ag), chemotherapy regimens and the cumulative dose of weekly @entity900 , were analyzed. The endpoints were @entity1349 ( @entity1349 ), local failure-free survival (LFFS) and disease-free survival (DFS). RESULTS: The median follow-up time was 42 months. The 4-year @entity1349 , LFFS and DFS were 73.8%, 77.9% and 67.2%, respectively. Four (3.2%) @entity1 developed >= grade 3 acute @entity344 and 29 (23.2%) @entity1 developed >= grade 3 acute hematological @entity137 . Five (4.0%) @entity1 developed >= grade 3 late GI @entity137 and seven (5.6%) @entity1 developed >= grade 3 late genitourinary system @entity137 . On univariate analysis, @entity420 was a poor prognostic factor for @entity1349 (p  =  0.05), LFFS (p  =  0.01) and DFS (p  =  0.006). @entity1 with lymph nodes  @entity3 at diagnosis had worse @entity1349 (p  =  0.02). The high cumulative dose of @entity900 (>180  mg/m(2)) had better @entity1349 (p  =  0.03) and tended to have better survival on LFFS (p  =  0.13) and DFS (p  =  0.10). On multivariate analysis, @entity420 was a significant independent prognostic factor for @entity1349 (p  =  0.001), LFFS (p  =  0.005) and DFS (p  <  0.001). Initial lymph nodes @entity3 was an independent predictor of @entity1349 (p  =  0.013). Cumulative dose of weekly @entity900 significantly affected @entity1349 (p  =  0.041), and high cumulative dose of @entity900 tended to have better LFFS (p  =  0.083). Higher pretreatment hemoglobin level had better LFFS (p  =  0.034). CONCLUSION: @entity420 and lymph nodes metastases were poor prognostic factors for @entity1 with locally advanced cervical @entity5 . Lower pretreatment hemoglobin level had poorer local control. Chemotherapy with a high cumulative dose of @entity900 tended to result in better survival.
