Article Text
Abstract
Introduction/Background Radical chemo radiation is the standard of care in locally advanced cervical cancer. It is often a challenge to implement the same treatment in the elderly women. The data regarding treatment modalities and outcomes for this cohort is scarce in literature.
Methodology We retrospectively analyzed the medical database of previously treated elderly patients diagnosed with carcinoma cervix between January 2013 to December 2018 after approval from the institutional review board.
Results Mean age of patients was 65 years (Range:60 -95). Of the 176 patients, 98 (56%) patients received only RT, 63 (35%) received CRT, five (3%) patients received adjuvant RT, 4(2.8%) patients received chemotherapy and 1 (0.5%) patient received palliative RT. The most common schedule used for EBRT(External beam radiotherapy) was 50 Gy in 25#, five days a week. The mean EBRT dose was 50 Gy (Range:46–54 Gy). Sixty three patients (37%) received concurrent cisplatin (dose of 40 mg/sq.m). Out of 161 patients who completed EBRT, 19 patients received EBRT boost,133 patients underwent intracavitary brachytherapy. LDR was used in 48 patients and HDR was used in 85 patients. Two patients underwent interstitial brachytherapy and mould brachytherapy was used in 8 patients. The median OTT was 69 days (9.8 weeks). Acute grade 3 GI toxicities were found in 21(12.8%) patients. The median follow-up duration was 22 months. Twenty patients had disease progression. The median PFS was 25 (18- 31) months and median OS was 27(18–35) months. The 3 yr PFS was 37% and 5 yr PFS was 20%. The 3 yr OS was 43% and 5 yr OS was 21%.
Conclusion To conclude, definitive radiotherapy comprising both EBRT and brachytherapy should be recommended even in the elderly women with careful assessment of comorbid conditions.