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P08 Treatment outcomes of locally advanced cervical cancer (LACC) after concurrent chemoradiation followed by high-dose-rate brachytherapy (HDR): a sixteen year single institution experience
  1. M Agulto-Mercadal and
  2. G Amparo
  1. Section of Gynecologic Oncology and Trophoblastic Disease, Jose R. Reyes Memorial Medical Center, Manila, Philippines

Abstract

Introduction/Background A retrospective study of patients with LACC, Stage IB2-IVA,treated with concurrent chemoradiation followed by HDR brachytherapy at a single tertiary institution was conducted. This paper assessed the outcomes, prognostic factors, overall disease-free survival (DFS) and overall survival (OS) of cervical cancer after such treatment.

Methodology Patients treated with concurrent chemoradiation followed by HDR brachytherapy for cervical cancer from January 2001 to December 2016 were analysed. Treatment consisted of pelvic external beam radiation therapy with concurrent chemotherapy followed by HDR brachytherapy. DFS, OS and prognostic variables were assessed.

Results A total of 313 cervical cancer patients treated with concurrent chemoradiation followed by HDR brachytherapy was included. Mean age was 50.4±9.7 years, mostly presenting with Stage III disease (67.73%) and squamous cell histology (77.64%). Recurrent disease was seen in 21.09% of patients at a median of 29.32 months during median follow-up of 34.09 months (range: 3–180 months). Most common sites of recurrence were pelvic (12.78%), osseous (2.24%) and nodal (2.24%). DFS at 5 and 10 years were 60% and 53.61%, respectively. OS at 5 and 10 years were at 91.68% and 74.78%, respectively. Tumor size 3 months post-brachytherapy (HR 1.646 (1.164–2.329), p-value: 0.005), and overall treatment time (HR 1.022 (1.007–1.038), p-value: 0.004) were significant prognostic factors for recurrence while age ≤ 40 years (HR 3.497 (1.189–10.282), p-value: 0.023), presence of recurrence (HR 39.906 (5.043–315.785), p-value: 0.000), and tumor size 3 months post-brachytherapy (HR 2.497 (1.271–4.906), p-value: 0.008) were important prognostic factors for survival.

Conclusion This study showed that concurrent chemoradiation followed by HDR brachytherapy for locally advanced cervical cancer has a 5-year DFS and OS of 60% and 91.68%, respectively. Tumor size 3 months post-brachytherapy and overall treatment time were significant prognostic factors for recurrence, while age ≤ 40 years, presence of recurrence and tumor size 3 months post-brachytherapy were important prognostic factors for survival.

Disclosure Nothing to disclose.

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