Introduction/Background Cervical cancer represents 6% of gynecological malignant tumors. The incidence in Portugal is 8,9/100.000, although it is higher in southern region. Concurrent Chemo-radiotherapy (CCRT) is the cornerstone treatment.
Methodology Retrospective analysis of 109 patients diagnosed with locally advanced cervical cancer in our center between 2010 and 2017. The goal is assessing the efficacy of CCRT overall survival (OS), disease-free survival (DFS) and incidence of toxicity.
Results 109 patients, with median age 56 years old. Mostly admitted through emergency department (79%), being the most common symptom metrorrhagia (46,8%). 65,1% were Stage IIB. Median time from diagnosis to multidisciplinary committee (MC) was 47 days and from MC to beginning of CCRT was 21 days. CCRT was initiated in 87 (79,8%) patients. DFS was 63% and OS 64% at 5 years. From 522 chemotherapy sessions, only 9 presented severe toxicities, especially haematological grade 3. No relation with OS or DFS was found. 46% (n=40) presented radiotherapy toxicity, especially chronic (n=31). Proctitis (n=24) was the most prevalent. A change was observed in 2015, patients diagnosed before presented an alarming 36,7% of proctitis versus 20% after 2015. A significant difference was observed between radiotherapy toxicity and OS (p=0,018), especially fistulas and proctitis. Median radiation dose was 73Gy. A positive correlation was observed in the incidence of toxicity when exposed to doses ≥75 Gy (p=0,007; HR 4,73 [95% CI: 1,52–14,71]), especially diarrhea and proctitis.
Conclusion The OS and DFS are in concordance with results around European countries.
A high incidence of radiation toxicity was evident, although an improvement was observed since 2015. Our radiation clinic has an intensity-modulated radiation therapy (IMRT) since 2018 and we are eager to evaluate the effect in toxicity in the years to come.
Disclosure Nothing to disclose.
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