目的探讨顺铂累积剂量对接受根治性放化疗的局部晚期宫颈癌患者临床结局的影响。对654例接受根治性放化疗的IB3-IVA期患者进行回顾性分析。放射治疗采用骨盆外照射，有或没有主动脉旁放射治疗和近距离放射治疗。伴随化疗采用每周或每 3 周顺铂的形式。收集有关人口统计学、治疗方案、累积顺铂剂量、不良反应和生存结果的数据。采用包括单变量和多变量 Cox 回归模型在内的统计分析来评估影响无进展生存期和总生存期的因素。 503 名 (76.9%) 患者的中位累积顺铂剂量为 210mg（范围 40-320），≥200mg。 。中位随访时间为 35 个月（范围 1-150）。 5年无进展生存率和总生存率分别为66.9%和77.1%。多变量分析发现，不良体能状态、非鳞状细胞组织学、淋巴结转移以及放化疗前血红蛋白<10g/dL是整个组无进展生存期和总生存期的不良预后因素。当单独评估III期病例时，发现累积顺铂剂量<200mg是总生存期的显着不良预后因素（风险比1.79，95%置信区间1.1至3.0，p=0.031）。我们的研究表明，累积顺铂剂量>200mg，特别是在有淋巴结转移的患者中，显着改善了总生存期。贫血、毒性相关挑战和合并症等因素被确定为治疗计划中的关键考虑因素。这些发现强调了最大化治疗效果和管理毒性之间的平衡，指导局部晚期宫颈癌的个性化治疗方法。© IGCS 和 ESGO 2024。不得商业重复使用。请参阅权利和权限。由英国医学杂志出版。

To investigate the impact of cumulative cisplatin dose on clinical outcomes in locally advanced cervical cancer patients undergoing definitive chemoradiotherapy.A retrospective analysis was conducted on 654 patients with stage IB3-IVA disease treated with definitive chemoradiotherapy. Radiotherapy was applied as external beam pelvic with or without para-aortic radiotherapy and brachytherapy. Concomitant chemotherapy was in the form of weekly or 3 weekly cisplatin. Data on demographics, treatment protocols, cumulative cisplatin dose, adverse effects, and survival outcomes were collected. Statistical analyses, including univariate and multivariate Cox regression models, were used to assess factors influencing progression free survival and overall survival.The median cumulative cisplatin dose was 210 mg (range 40-320), and ≥200 mg in 503 (76.9%) patients. Median follow-up was 35 months (range 1-150). The 5 year progression free survival and overall survival rates were 66.9% and 77.1%, respectively. Multivariate analysis identified poor performance status, non-squamous cell histology, presence of lymph node metastases, and hemoglobin <10 g/dL before chemoradiotherapy as poor prognostic factors for both progression free survival and overall survival in the whole group. When stage III cases were evaluated separately, the cumulative cisplatin dose <200 mg was found to be a significant poor prognostic factor in overall survival (hazard ratio 1.79, 95% confidence interval 1.1 to 3.0, p=0.031).Our study showed that a cumulative cisplatin dose >200 mg, particularly in patients with lymph node metastases, significantly improved overall survival. Factors such as anemia, toxicity related challenges, and comorbidities were identified as critical considerations in treatment planning. These findings emphasize the balance between maximizing therapeutic efficacy and managing toxicity, guiding personalized treatment approaches for locally advanced cervical cancer.© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.