Objective　To explore the application value of　contrast-enhanced ultrasound (CEUS) parameters in predicting the early therapeutic effect of concurrent chemoradiotherapy (CCRT) in patients with locally advanced cervical cancer (LACC).Methods A total of 65 patients with LACC treated in the Linyi Tumor Hospital from January 2021 to December 2022 were selected. All the patients underwent CEUS within one week before therapy and after the end of external?radiotherapy. The time-intensity curve (TIC) was drawn and analyzed for each patient to obtain CEUS parameters existing before therapy and after the end of external?radiotherapy

wherein the CEUS parameters include time to peak (TP)

gradient (Grad)

area under the curve (Area) and peak intensity (PI). Meanwhile

the maximum tumor diameters were measured before therapy and after the end of external radiotherapy to calculate the tumour regressive rate.Results According to the response evaluation criteria in solid tumors

the enrolled patients were divided into a sensitive group and an insensitive group

there were 53 patients (81.5%) in the sensitive group and 12 patients (18.5%) in the insensitive group after the end of external radiotherapy

the maximum tumor diameters before therapy and after the end of external radiotherapy were（60.7±14.6) mm and（31.2±16.9) mm respectively

and the tumor regressive rate was（49.2±23.2)%.Before therapy

the values of Grad and PI in the sensitive group were lower than those in the insensitive group

and the differences were statistically significant (all values of P were smaller than 0.05). The pre-therapy Grad and the pre-therapy PI values were in negative correlation with the tumor regressive rate (the values of r were -0.602 and -0.499 respectively

and the values of P are both smaller than 0.05). After the end of the external radiotherapy

in the sensitive group

the values of Grad

Area and PI were all decreased compared with those before therapy

the value of TP was higher than that before therapy

and the differences were statistically significant (all values of P were smaller than 0.05).After the end of the external radiotherapy

the values of Grad

Area and PI in the sensitive group were all lower than those in the insensitive group

the value of TP in the sensitive group was higher than that in the insensitive group

and the differences were statistically significant (all values of P were smaller than 0.05)

wherein the values of Grad and PI after the end of the external radiotherapy were in negative correlation with the tumor regressive rate (the values of r were -0.859 and -0.913 respectively

and the values of P were both smaller than 0.05). The logistic regression analysis result showed that Both the pre-therapy Grad and the pre-therapy PI values could be used as the independent　factors for predicting the early therapeutic effect of the CCRT in the patients with the LACC

the values of B

Wald

odds ratio and P are -2.841、6.496、0.058、0.011 and -1.951、7.484、0.142、0.006 respectively.The area under the curve (AUC) of the ROC curve of the pre-therapy Grad and the pre-therapy PI values for predicting the early therapeutic effect of the CCRT in the patients with the LACC were 0.802 and 0.894 respectively.Conclusion　The pre-therapy Grad and the pre-therapy PI　are independent　factors for predicting the early therapeutic effect of the CCRT in the patients with the LACC

and can be used as an important reference for predicting the early therapeutic effect.