Radical radiotherapy in patients with cervix uteri carcinoma: experience of Ondokuz Mayis University

Abstract

BackgroundRadical radiotherapy is the standard treatment for patients with locally advanced cervix uteri carcinoma (FIGO stage IB2–IVA). Worldwide, incidence and mortality rates vary among regions because of differences in lifestyles and treatment standards. Herein, we evaluated the outcomes of radical radiotherapy in patients with locally advanced cervix uteri carcinoma from the middle Black Sea region of Turkey.MethodsWe retrospectively reviewed the records of 64 consecutive patients with locally advanced cervix uteri carcinoma who were treated from January 2013 to 2016 in our radiation oncology department. All patients staging and radiotherapy planning were performed with modern imaging techniques including magnetic resonance imaging and positron-emission-tomography/computed tomography before radical radiotherapy. Thereafter, all of them were treated with external beam radiotherapy and concurrent cis-platinum-based chemotherapy followed by three-dimensional intra-cavitary high-dose-rate brachytherapy.ResultsThe median age at diagnosis was 54.5 years. The median follow-up period was 21 months. Acute grade 3 toxicity was detected in 3.1% of patients. Late toxicity was not detected in any patient. The 1- and 3-year progression-free survival rates were 83.6 and 67.5%, respectively. The 1- and 3-year overall survival rates were 95.7 and 76.9%, respectively. The most important prognostic factor was the FIGO stage. Distant metastasis was the most common cause of death in patients with locally advanced cervix uteri carcinoma despite radical radiotherapy.ConclusionsIn patients with locally-advanced cervix uteri carcinoma from the middle Black Sea region of our developing country, acceptable toxicity and survival rates are achieved similar to the recent literature from developed countries with using of modern staging, planning and radical radiotherapy techniques. However, recurrence was mostly in the form of distant metastases and further investigations on systemic therapies are required.

Radical Radiotherapy of Locally Advanced Cervix Uteri Carcinoma

“…Our survival results were compared with the results of 3D-planned radical RT that was published in the literature in Table 1. Additionally, in our study, while grade 3 early adverse effects were detected only in the hematopoietic system at a rate of 3.1% in the early period, no grade 4 and higher early adverse events and any late adverse events were detected [50]. Follow-up and surveillance are as important as treatment.…”

“…Adverse events (early or late) increase with combined treatments such as radical RT of cervix uteri carcinoma that includes EBRT with concomitant CHT followed by BRA. The most commonly seen early adverse events are seen both in hematopoietic and gastrointestinal systems [50]. Most of them are self-limited and are treated symptomatically.…”

A novel nomogram and risk stratification for early metastasis in cervical cancer after radical radiotherapy

“…With the implementation of modern conformal RT techniques and the optimization of the local control rate, DM has become an urgent issue leading to a dismal prognosis in CC 16,21 . As a vital portion of DM, EDM will lead to a worse prognosis, but it has not been attached to great importance in CC.…”

Changes of T Lymphocyte Subsets in Peripheral Blood of Patients with Intermediate and Advanced Cervical Cancer before and after Nimotuzumab Combined with Chemoradiotherapy

“…Considering the sample loss (10-15%) and the fact that patients with IACC will be assigned to the CRT group and the CRT combined with Nimo (CRT + Nimo) group, 136 patients (38-67 years old) with IACC who received treatment in Tianjin Medical University Cancer Institute and Hospital from March 2016 to March 2018 but did not receive surgery for some reasons were selected. Inclusion criteria: (1) patients with cervical squamous carcinoma or adenocarcinoma confirmed by pathological biopsy; (2) this is the first treatment, with no history of cancer and CRT; and (3) The clinical stage was IIIa∼IIIc according to the Federation International of Gynecology and Obstetrics. Exclusion criteria: (1) recurrent CC; (2) a history of cervical surgery; (3) estimated life span <6 months; (4) complicated with immune deficiency diseases; and (5) complicated with other malignant tumors.…”

“…Cervical cancer (CC) is the second most prevalent malignant tumor in the world and the fourth leading cause of death in women [1]. Especially in developing countries, more than 80% of CC patients are diagnosed at an advanced stage [2]. Human papillomavirus (HPV) infection is the leading cause of CC worldwide [3].…”