Intensity-Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy Combined with Intracavitary Posterior Radiotherapy for the Treatment of Medium-Term and Advanced Cervical Cancer: Efficacy, Safety and Prognostic Factors

Abstract

ObjectiveTo explore the efficacy, safety, and prognostic factors of intensity modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) combined with intracavitary posterior radiotherapy for medium-term and advanced cervical cancer.MethodsRetrospectively analyze the clinical data of 104 patients with medium-term and advanced cervical cancer who were treated in the radiotherapy department of our hospital from September 2015 to March 2017. According to the different radiotherapy techniques, they were divided into the IMRT combined with intracavitary posterior radiotherapy group (n = 52) and the 3D-CRT combined with intracavitary posterior radiotherapy group (n = 52). Observe and compare the short-term efficacy, occurrence of adverse reactions and overall survival rate of the two groups. The clinicopathological characteristics of the survival group and the death group were compared, and univariate analysis and multiple logistic regression models were used to analyze the relationship between the clinicopathological characteristics and the patient’s prognosis.ResultsThe total effective rate of IMRT combined with intracavitary posterior radiotherapy group was 96.15%, which was higher than that of 3D-CRT combined with intracavitary posterior radiotherapy group (88.46%), but the difference was not statistically significant (p > 0.05). The incidence of digestive system injury, thrombocytopenia, and radiation proctitis in the IMRT combined intracavitary posterior radiotherapy group was lower than that of the 3D-CRT combined intracavitary posterior radiotherapy group, and the differences were statistically significant (p < 0.05). The prognosis and survival of the two groups of patients were similar, and the difference was not statistically significant (p > 0.05). Pathological classification, clinical stage, and lymph node metastasis are independent influencing factors of 3-year prognosis in patients with medium-term and advanced cervical cancer (p < 0.05).ConclusionIMRT combined with intracavitary posterior radiotherapy is equivalent to 3D-CRT combined with intracavitary posterior radiotherapy, but it can reduce the incidence of adverse reactions in patients with medium-term and advanced cervical cancer, and has higher safety. Pathological typing, clinical staging, Lymph node metastasis were independent factor affecting the prognosis of patients. In clinical treatment, IMRT combined with intracavitary posterior radiotherapy is more recommended as a treatment plan for patients with medium-term and advanced cervical cancer.

Neoadjuvant Chemotherapy, a Treatment Possibility in Locally Advanced Cervical Cancer, Analysis Focusing on The Outcomes of FIGO Stage III Cervical Carcinoma- a Literature Review

“…The clinical outcomes from diverse studies underscore the imperative for tailored treatment strategies contingent on patient characteristics and tumor staging. Ongoing trials, such as INTERLACE, aim to further scrutinize the relative efficacy of diverse treatment modalities, encompassing standard chemoradiation and induction chemotherapy utilizing paclitaxel [17]. Furthermore, retrospective studies posit that combining intensity-modulated radiation therapy with intracavitary posterior radiotherapy may represent a secure and recommended approach for individuals with medium-and advanced-stage cervical cancer [18].…”

Chinese clinical practice guidelines for the prevention and treatment of radiation‐induced rectal injury

“…Consequently, the frequency and severity of radiation‐induced intestinal injuries are reduced to some degree. In patients with locally advanced cervical cancer, the incidence of late radiation‐induced rectal injury was reduced from 48% to 19%, when comparing IMRT combined with brachytherapy to 3D‐CRT combined with brachytherapy 44 . This was the result of the comparison between the two treatment modalities.…”