Survival outcome of cervical cancer patients treated by image-guided brachytherapy: a ‘real world’ single center experience in Thailand from 2008 to 2018

Abstract

The objective of our study was to evaluate the survival outcome of cervical cancer patients treated using image-guided brachytherapy (IGBT). From 2008 to 2018, 341 patients with cervical cancer were treated by radical radiotherapy. IGBT (by computed tomography [CT] or transabdominal ultrasound [TAUS]) was used to treat all of these patients. The characteristic data and patient status after treatment were recorded. All data were evaluated for survival outcome analysis. From a total of 341 patients, 295 patients were analyzed and 46 patients were excluded due to data missing in the survival outcomes. At the median follow-up time of 48 months (IQR 30–80 months), The 4-year local control, progression-free survival and overall survival rates were 89.5%, 74.9% and 69.1%, respectively. For overall survival, the size (> 5 cm), pathology (non-SCCA), stage (stage III–IV by FIGO 2009), lymph node (LN) (presented) and overall treatment time (OTT) (> 56 days) showed statistical significance in univariate analysis while non-SCCA pathology, advanced stage, presented LN and longer OTT showed statistical significance in multivariate analysis. In conclusion, our analysis reports a 4-year overall survival rate of 69.1%. Non-SCCA pathology, advanced stage disease, LN presence and longer OTT showed worse prognostic factors in multivariate analysis.

Prediction of Cervical Cancer Patients’ Survival Period with Machine Learning Techniques

“…While some of our findings are consistent with previous research, particularly regarding the importance of tumor stage, there are discrepancies. For example, histopathology shows different outcomes in our study compared to those reported in the study by Tharavichitkul et al [ 22 ]. The insights gained from this research could assist in the planning and resource allocation for patient care.…”

“…Therefore, direct comparisons with our study, which concentrates on predicting survival time, are not feasible. However, based on research results in the same field, the performance of prediction models built for both classification and regression is known to be relatively accurate [9,[18][19][20][21][22].…”

“…The exclusion criteria were as follows: patients who had undergone re-irradiation or radical surgery in the pelvis were not considered for inclusion. The clinical outcomes derived from this dataset have been previously reported in an international publication [ 22 ].…”

High-Dose-Rate Three-Dimensional Image-Guided Adaptive Brachytherapy (3D IGABT) for Locally Advanced Cervical Cancer (LACC): A Narrative Review on Imaging Modality and Clinical Evidence

“…Eight cervical points were defined by TAUS and marked on the orthogonal images to serve as reference points to guide the dose optimization. In their report of 295 patients over ten years who underwent CT-or TAUS-guided BT, there were no significant differences between the two modalities in terms of local control and survival [58].…”

“…This practice has reported very low rates of ≥3 and adverse events, demonstrating the safety of the procedure, and further attempts will be made to apply hybrid applicators to improve target coverage [56]. Tharavichitkul et al [58,75] reported their experiences and excellent outcomes of dose planning using TAUS and orthogonal radiographs. Eight cervical points were defined by TAUS and marked on the orthogonal images to serve as reference points to guide the dose optimization.…”