{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T17:32:50Z","timestamp":1786383170031,"version":"build-2736575974"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Scientific Research Initiation Funding for High-Level Personnel","award":["No. 1027Z20230062"],"award-info":[{"award-number":["No. 1027Z20230062"]}]},{"name":"Guangdong Medical University Special Program for Clinical and Basic Scientific and Technological Innovation","award":["No.GDMULCJC2024025"],"award-info":[{"award-number":["No.GDMULCJC2024025"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Objective<\/jats:title>\n This study evaluated efficacy and safety of concurrent chemoradiotherapy (CCRT) versus CCRT plus adjuvant chemotherapy (CCRT+ACT) in 2018 Federation International of Gynecology and Obstetrics (FIGO) Stage III locally advanced cervical cancer (LACC) patients. This study provides clinical evidence to optimize treatment strategies for stage III LACC.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 72 patients diagnosed with stage III LACC were retrospectively enrolled from the Cancer Hospital of Guangdong Medical University between May 2018 and May 2024. They were divided into the CCRT group (n\u2009=\u200933) and the CCRT+ACT group (n\u2009=\u200939). Survival endpoints were analyzed using the Kaplan\u2013Meier method with log-rank tests, and Cox proportional hazards regression models were applied to identify prognostic factors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The 3-year OS (79.5% vs. 63.6%,\n P<\/jats:italic>\n \u2009=\u20090.238) and PFS (56.4% vs. 45.5%,\n P<\/jats:italic>\n \u2009=\u20090.706) rates showed no significant differences between the CCRT+ACT and CCRT groups. Kaplan\u2013Meier survival analysis suggested that a positive lymph node size\u2009\u2265\u200910 mm (relative to a\u2009<\u200910 mm reference) may be associated with an increased hazard for mortality (HR\u2009=\u20098.235;\n P<\/jats:italic>\n \u2009=\u20090.020) and disease progression (HR\u2009=\u20092.986;\n P<\/jats:italic>\n \u2009=\u20090.020). Furthermore, abnormal post-brachytherapy SCC-Ag levels (> 1.5 ng\/mL vs.\u2009\u2264\u20091.5 ng\/mL reference) appeared to be strongly linked to adverse OS (HR\u2009=\u200913.641;\n P<\/jats:italic>\n \u2009<\u20090.001) and PFS (HR\u2009=\u20094.722;\n P<\/jats:italic>\n \u2009=\u20090.007). Regarding safety, CCRT+ACT did not increase grade 3\u20134 toxicities, suggesting a manageable safety profile.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n While CCRT+ACT did not significantly improve survival in the\u00a0un-selected\u00a0stage III LACC population, a positive lymph node size of \u2265 10 mm and elevated post-brachytherapy SCC-Ag levels may serve as important prognostic indicators for adverse outcomes. These findings are hypothesis-generating, suggesting that integrating these factors into clinical risk assessment might aid in refining the identification of high-risk subsets who could potentially benefit from more personalized, intensified adjuvant strategies in future prospective trials.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0354207","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T17:26:07Z","timestamp":1786382767000},"page":"e0354207","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy comparison of concurrent chemoradiotherapy alone versus concurrent chemoradiotherapy plus adjuvant chemotherapy in stage III Locally Advanced Cervical Cancer: A single-center, retrospective observational cohort 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