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421 Clinical response in cervical cancer patients undergoing initial hypofractionated hemostatic radiotherapy for uncontrollable bleeding in curable clinical stages
  1. Issac Vladimir Hernandez Davila1,
  2. Ricardo Mendoza Coronado1,
  3. David Hernadnez Martinez1,
  4. Nubia Wong Arce2,
  5. Ovidio Garcia Oviedo2,
  6. Amado Diaz Guerrer2,
  7. SIlvia Haces Rodriguez1,
  8. Rafael Piñeiro Retid1 and
  9. Oscar Vidal Gutierrez1
  1. 1Centro Universitario Contra el cancer, Monterrey, Mexico
  2. 2Hospital Universitario, Monterrey, Mexico


Introduction/Background Various hypofractionated radiotherapy regimens aiming to achieve a hemostatic outcome more rapidly have been employed as an initial strategy in different scenarios. This raises questions not only about the hemostatic efficacy of the treatment but also about the long-term outcomes for these patients.

Methodology Treatment records of all cervical cancer patients treated at the University Center Against Cancer (CUCC) from 2016 to 2022 were reviewed to identify those who initiated treatment with a hemostatic radiotherapy scheme for cervical cancer stage IVA or lower and were eventually reevaluated for radical dosage. Nineteen patients treated in this manner were identified, and information for evaluation was available for 15 of them. Ten patients showed evidence of disease recurrence or persistence. Seven of them succumbed to the disease, two are undergoing palliative treatment, and the current status of one patient is unknown. Only two patients remain disease-free

Results Only eight out of the 15 patients received brachytherapy. Of the 7 Patients who did not receive brachytherapy, the most common cause was residual tumor hindering device placement. 5 of these patients, who did not receive brachytherapy, are known dead.

The only two patients currently alive and disease-free are among the subgroup of five patients who received two sessions of brachytherapy. The mean treatment duration from the start of the first hemostatic dose to the last radiotherapy sesión was 101 days. Of the 15 patients, three achieved a complete clinical response (20%).

Conclusion The observed results suggest an unfavorable association with survival for patients receiving hypofractionated radiotherapy as an initial hemostatic strategy when brachytherapy is not administered, and if protraction times are prolonged. Although establishing causality between hemostatic radiotherapy and unfavorable outcomes is not possible, it seems prudent to explore other therapeutic options to control bleeding before resorting to radiotherapy.

Disclosures The authors claim that there is no conflict of interest.

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