Effects of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) on survival benefits and poor prognostic factors in patients with cervical cancer.

Abstract

Objective: This study aimed to explore the influencing factors of survival benefit and poor prognosis of cervical cancer patients under different radiotherapy modalities.

Methods: A total of 186 patients with cervical cancer treated in our hospital from January 2022 to December 2023 were selected for the retrospective analysis. 126 patients received static intensity-modulated radiation therapy (IMRT) combined with cisplatin. Another 60 cases received volumetric modulated arc therapy (VMAT) combined with cisplatin. The occurrence of adverse reactions, overall survival rate, and recurrence rate were compared between the two groups. COX regression model was used to analyze the influencing factors of the poor prognosis.

Results: There was no difference between the disease control rate (DCR) and objective remission rate (ORR), and the overall survival and recurrence rates in the two groups. The incidence of myelosuppression was much higher in the IMRT group than the VMAT group. Compared with the survival group, the percentage of lymph node metastasis (LNM) and positive margins were significantly increased in the patients in the death group. COX multifactorial analysis confirmed that LNM and positive cutting margins were independent risk factors affecting poor prognosis after radiotherapy in cervical cancer patients (P < 0.05).

Conclusion: Both IMRT and VMAT could achieve certain effects in the treatment of cervical cancer and had similar effects in short-term survival recurrence. However, VMAT had a lower incidence of myelosuppression. LNM and positive margins were factors influencing the poor prognosis of patients.