Clinical value of simultaneous boost intensity modulated radiotherapy in high-risk clinical target volume of stage IIb-IVa cervical carcinoma

Background: To compare the clinical efficacy of simultaneous modulated accelerated radiotherapy therapy to high-risk clinical volume (CTV-hr) with conventional intensity modulated radiotherapy therapy for stage IIB-IVA cervical cancer, and investigate the value of defining high-risk clinical target areas for parallel radiation dose simultaneous nudging in patients with locally advanced cervical cancer. Methods Retrospectively analyzed patients with stage IIB-IVA cervical cancer who received radical radiotherapy at the Affiliated Hospital of Qingdao University from November 2014 to September 2019, divided into hr-SMART group and n- SMART group according to whether to set a high-risk clinical target volume(CTV-hr) and push the volume to 54–56 Gy simultaneously. Both groups were given brachytherapy and chemotherapy and compared the efficacy and adverse effects. Results A total of 217 patients were assessed, with 119 and 98 in the hr-SMART and n-SMART groups. Hr-SMART and n-SMART groups had significantly different mortality rate(19.3% vs 41.8%), overall recurrence rates (26.1% vs 50%) with statistically significant differences ( p  < 0.05). According to the KM survival curve, hr-SMART has a better OS (3-year OS rate, 87.4% vs. 71.4% ; P  = 0.001) and PFS (3-year OS rate, 72.3% vs. 51.0% ; P  = 0.000)than n-SMART.The objective remission rates (ORR) in the hr-SMART and n-mart groups were 91.6% and 90.8%, respectively, with no statistically significant differences ( p ༞0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( p  > 0.05). Conclusions Setting up high-risk clinical target volume and undergoing simultaneous modulated accelerated radiotherapy for patients with stage IIB-IVA cervical cancer can reduce recurrence and improve clinical efficacy with comparable adverse effects.