Abstract
OBJECTIVE: To investigate the efficacy of endostar combined with simultaneous chemoradiotherapy versus conventional treatment methods for locally advanced cervical cancer (LACC) and assess the prognosis of these patients. METHODS: A retrospective analysis was conducted on the medical records of 182 LACC patients treated at Shaanxi Provincial Cancer Hospital between January 2017 and February 2021. Of these, 88 patients underwent conventional synchronous chemoradiotherapy (control group), while 94 patients received endostar combined with synchronous chemoradiotherapy (combined group). Treatment efficacy, adverse reactions, and tumor marker levels before and after treatment were compared. The 1-year and 3-year survival rates of the two groups were analyzed. Risk factors for 3-year mortality were identified through Cox regression analysis, and the prognostic predictive value of independent factors was assessed using ROC curve analysis. RESULTS: The objective remission rate (ORR) in the combined group (74.47%) was significantly higher than that in the control group (54.55%, P<0.005). Adverse reactions, including gastrointestinal symptoms, bone marrow suppression, liver and kidney function abnormalities, and skin damage, showed no significant differences between the groups (P>0.05). Post-treatment levels of squamous cell carcinoma antigen (SCC-Ag), carbohydrate antigen 125 (CA125), and carcinoembryonic antigen (CEA) were significantly lower in the combined group (P<0.05). The 1-year and 3-year survival rates were notably higher in the combined group (P<0.05). Cox regression analysis identified FIGO stage, histologic grade, and post-treatment SCC-Ag levels as independent risk factors for 3-year mortality, while endostar combined with chemoradiotherapy was an independent protective factor. ROC curve analysis demonstrated AUC values of 0.614 (FIGO stage), 0.625 (histologic grade), 0.622 (treatment modality), and 0.662 (post-treatment SCC-Ag). CONCLUSION: Endostar combined with synchronous chemoradiotherapy for LACC significantly improves short-term treatment efficacy and long-term survival outcomes compared to chemoradiotherapy alone. This approach is safe and does not increase adverse effects, highlighting its potential as a superior treatment strategy.