Peripheral Blood Markers Predict Prognosis and Treatment-Related Adverse Events of Stage IB–IVA Cervical Squamous Cell Carcinoma Treated with Chemoradiotherapy Combined with Hyperthermia

Abstract This retrospective cohort study evaluated the clinical efficacy and safety of radical concurrent chemoradiotherapy (CCRT) combined with deep microwave hyperthermia in 193 patients with stage IB–IVA cervical squamous cell carcinoma (CSCC). With a median follow-up of 40.6 months, the 3-year overall survival (OS) and progression-free survival (PFS) rates were 81.34% and 81.27%, respectively. Multivariate analysis identified International Federation of Gynecology and Obstetrics (FIGO) stage and serum squamous cell carcinoma antigen (SCC-Ag) levels as independent poor prognostic factors for both OS and PFS. Treatment-related adverse events (TRAEs), predominantly myelosuppression, occurred in 54.9% of patients. Notably, the lymphocyte-to-monocyte ratio (LMR) served as an independent protective factor against TRAEs (odds ratio = 0.405, P = 0.003); patients with LMR ≤ 4 faced a significantly higher toxicity risk. Pretreatment SCC-Ag and LMR are reliable biomarkers for prognosis and safety profiling, supporting personalized risk-stratified management in clinical practice.