Influences of Neoadjuvant Chemotherapy on Clinical Indicators, Prognosis and neutrophil/lymphocyte Ratio of Stage IB2-IIB Cervical Cancer

J BUON. Mar-Apr 2020;25(2):757-763.

Abstract

Purpose: To investigate the influence of neoadjuvant chemotherapy on the efficacy, clinical indicators, prognosis and neutrophil/lymphocyte ratio (NLR) of stage IB2-IIB cervical cancer.

Methods: 120 cervical cancer patients were selected and randomly divided into the control group (n=60) and the observation group (n=60). The patients in the observation group were treated with neoadjuvant chemotherapy combined with surgery, while those in the control group received treatment with surgery alone. The serum tumor markers [matrix metalloproteinase-9 (MMP-9), carcino-embryonic antigen (CEA) and cancer antigen 125 (CA-125)], immunoglobulins (Igs) (IgA and IgM), T-lymphocyte subsets [cluster of differentiation (CD) 4+, CD8+ and CD4+/CD8+], NLR, quality of life, change in cancer-related fatigue degree and clinical efficacy were compared before and after treatment between the two groups.

Results: The levels of MMP-9, CEA, CA-125, NLR, IgA, IgM, CD4+ CD8+, CD4+/CD8+ and Cancer Fatigue Scale (CFS) were decreased, while the World Health Organization Quality of Life Scale Brief (WHOQOL-BREF) score was increased in both groups after treatment, and the observation group exhibited more apparent changes in those levels than the control group (p<0.05). The effective rate was higher, but the incidence rates of postoperative lymphatic metastasis, vascular invasion, parametrial invasion and positive margin were lower in the observation group than those in the control group (p<0.05). The observation group had longer survival time than the control group (p<0.05).

Conclusion: Neoadjuvant chemotherapy can effectively lower the levels of serum tumor markers and NLR, reduce the metastasis rate of cancer cells and the degree of cancer-related fatigue after operation, improve the quality of life and prolong the survival time.