There are few clinical studies on Recombinant human endostatin (Endostar) which is a broad-spectrum antiangiogenic agent in the treatment of cervical cancer, and its efficacy in the treatment of cervical cancer has not been confirmed. This study aims to analyze the efficacy, safety and prognostic factors of Endostar combined with chemoradiotherapy in the treatment of local advanced cervical cancer (LACC).
The clinical data of 41 patients with locally advanced cervical cancer admitted to the Department of Radiotherapy of Changzhou Second People's Hospital Affiliated to Nanjing Medical University and the First Affiliated People's Hospital of Soochow University from 2017 to 2020 were retrospectively analyzed. The patients with LACC who received Endostar combined with and chemoradiotherapy were set as the A group. The B group (patients with LACC who received chemoradiotherapy) was set up by the method of 1:1 case-control matching in SPSS software.
The complete response (CR) rate was 48.8% and 26.8% in A group and B group, respectively (χ2=4.20, p<0.05). However, the objective response rate (ORR) and disease control rate (DCR) have no significant difference found in the two groups (82.9% vs.70.7%, 92.7% vs. 80.5%, p>0.05). The 2-year OS rate in the two groups was 73.2% vs. 48.8%, with no significant difference (p=0.154). The 2-year PFS rates were not significantly different between A group and B group 68.3% vs. 46.3%, p=0.323). In terms of safety, acute adverse events such as gastrointestinal reaction, radiation enteritis and radiation cystitis had no significant difference between the two groups（p＞0.05）. Multivariable analysis identified ECOG 0-1 and tumor size < 4cm had a significantly improved OS of cervical cancer (p＜0.05), and staged IIB disease (FIGO 2009), ECOG 0-1 and tumor size < 4cm had a significantly improved PFS (p＜0.05).
Endostar combined with chemoradiotherapy exihibited a higher CR rate and does not increase the incidence of adverse events compared to chemoradiotherapy alone in the treatment of LACC. Additionally, there was a trend favoring the A group in OS and PFS. Disease stage, ECOG score and tumor size were independent predictive factors.