Long-term outcome and prognostic factors in patients with cervical carcinoma: a retrospective study

Abstract

This study evaluates treatment outcomes and possible prognostic factors of inoperable cervical cancer patients treated with external beam radiotherapy (EBRT) and high-dose rate brachytherapy (HDR BRT). Between 1993 and 2000, 183 patients with cervical cancer were treated at our institute. Radiotherapy was the sole treatment modality until January 1997; after the announcement of National Cancer Institute in 1999, 40 mg/m(2) of cisplatin (49%) was routinely applied every week. Median age was 54 years (32-92 years). Most patients (88%) had advanced-stage disease (IIB-IIIB). With a median follow-up time of 45 months (6-121 months), the 5-year overall survival (OS), local recurrence-free survival, disease-free survival (DFS), and distant metastasis-free survival (DMFS) rates were 55%, 71%, 51%, and 77%, respectively. Univariate analysis revealed that age, tumor size, lymph node status, and concomitant cisplatin were prognostic factors for OS. The DFS rates were lower in young age group. Patients with tumor greater than 4 cm and age greater than 40 were at greater risk for local recurrence. Distant metastases were more frequent in patients with adenocarcinoma. Concurrent cisplatin use increases DMFS rates (91% vs 78%; P= 0.05). In multivariate analysis, extensive stage, parametrial infiltration, young age, adenocarcinoma histopathology, and lymph node metastasis were negative prognostic factors for OS while concomitant cisplatin increases OS. Likewise, patients with extensive stage, adenocarcinoma, and without concurrent cisplatin administration had more risk for distant metastasis. There was no treatment-related mortality. Grade 3-4 morbidity rates were seen only in eight patients (4%). The combination of EBRT and HDR BRT together with concomitant chemotherapy in the treatment of locally advanced carcinoma of cervix is safe and well tolerated with acceptable morbidity.

Efficacy of Cisplatin Based Concurrent Chemoradiation Followed by Intracavitary Brachytherapy in Locally Advanced Carcinoma Cervix: Experience from Northern Pakistan

“…Most of the patients presenting in stage III and IV [21,22]. Tumor grade and stage are the predictors for the response to the treatment proved by many studies [23][24][25]. These findings are consistent with the results of the current study.…”

Protective Effects of Melatonin and Octreotide Against Radiation-Induced Intestinal Injury

“…Higher RT doses may damage the intestine-an important dose-limiting organ during abdominopelvic irradiation-and cause radiation enteritis (RE) [1]. RE may cause several clinically important symptoms, which occur in more than 70% of patients undergoing pelvic irradiation [1,2]. The incidence of diarrhea is 17-46% with chemoradiotherapy [3,4] and 17-34% with RT alone [4].…”

The Increasing Frequency of Cervical Cancer in Korean Women under 35

“…Cervical cancer has several risk factors for recurrence and prognosis (18). Intermediate risk factors are deep stromal invasion, lympho-vascular space invasion, and the size of the tumor, and high risk factors are a positive resection margin, lymph node metastasis and parametrial invasion.…”