Uke Ashish, Dahake Shweta B, Luharia Anurag, Luharia Monika, Mishra Gaurav V, Mahakalkar Chanrashekhar
Radiation Oncology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Medical Physics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jul 25;16(7):e65361. doi: 10.7759/cureus.65361. eCollection 2024 Jul.
The incidence of cervical cancer in India is significantly high, and the average recurrence age is much less. The standard line of treatment consists of concurrent chemoradiotherapy. If a recurrence occurs, the treatment options or set of interventions are limited and suboptimal. Through this review, we have analyzed and classified the possible prognostic factors for cervical cancer into three broad categories, viz., (a) disease-related factors, (b) patient-related factors, and (c) treatment-related factors. Disease-related factors include tumor histology, tumor size, stage, parametrial involvement (PMI), Prognostic Nutritional Index (PNI), lymphovascular space invasion (LVSI), and nodal status. Patient-related factors include overall treatment time (OTT), nutritional status, hemoglobin level, comorbidities, and age. Treatment-related factors include addition of chemotherapy, techniques of external beam radiotherapy (EBRT), techniques of brachytherapy, and quality assurance for radiation therapy delivery. Out of these, extremely significant prognostic factors were tumor size and stage, nodal status, PMI, nutritional status, and addition of chemotherapy. Impactful factors include younger age, histology, LVSI, associated comorbidities, hemoglobin level, OTT, and patient-specific quality assurance. The factor that is not related or significant is the technique used for EBRT and brachytherapy delivery.
印度宫颈癌的发病率显著较高，且平均复发年龄要小得多。标准治疗方案包括同步放化疗。如果出现复发，治疗选择或干预措施有限且效果欠佳。通过本综述，我们已将宫颈癌可能的预后因素分析并归类为三大类，即：(a) 疾病相关因素，(b) 患者相关因素，以及 (c) 治疗相关因素。疾病相关因素包括肿瘤组织学、肿瘤大小、分期、宫旁组织受累情况（PMI）、预后营养指数（PNI）、脉管间隙浸润（LVSI）和淋巴结状态。患者相关因素包括总治疗时间（OTT）、营养状况、血红蛋白水平、合并症和年龄。治疗相关因素包括化疗的添加、外照射放疗（EBRT）技术、近距离放疗技术以及放疗实施的质量保证。其中，极为显著的预后因素为肿瘤大小和分期、淋巴结状态、PMI、营养状况以及化疗的添加。有影响的因素包括较年轻的年龄、组织学、LVSI、相关合并症、血红蛋白水平、OTT以及针对患者的质量保证。与预后无关或不显著的因素是用于EBRT和近距离放疗实施的技术。
