This study aims to evaluate the efficacy of chemoradiotherapy for advanced cervical cancer using heat shock protein 70 (HSP70) combined with multimodal MRI. The protein expressions of HSP70 in biopsy specimens obtained from 101 patients with cervical cancer were detected by immunohistochemistry. Plain MRI scan, DWI, DCE-MR, and MRS were performed before and after a period of 6 months of chemoradiotherapy. All patients were assigned into the complete response (CR) and partial response (PR) groups. HSP70 protein expression, tumor diameter, and tumor volume were lower in the CR group than in the PR group. The rate of tumor shrinkage, relative positive enhancement integral (rPEI), relative maximum slope of decrease (rMSD), relative signal enhancement ratio at 60 s (rSER ) and maximum SER (rSER ), mean apparent diffusion coefficient (ADC ) and minimum ADC value (ADC ) values in the CR group were higher than those in the PR group. Tumor diameter and volume, rSER and rSER were reduced after chemoradiotherapy, while rMSD, rSER , time to peak (TTP), ADC and ADC were higher after the treatment. The receiver operating characteristic (ROC) curves indicated that HSP70 expression, tumor diameter, rPEI, ADC and Cho peak showed the better chemoradiotherapy efficacy. Our data demonstrates that HSP70 protein combined with multimodal MRI may accurately evaluate the chemoradiotherapy efficacy of patients with advanced cervical cancer. The recurrence of cervical cancer significantly decreased in patients with negative expression of HSP70 and HSP70 protein detection provides potential therapy for the prevention, diagnosis, and prognosis of cervical cancer.

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