Abstract
Purpose
To compare the clinical outcome of cervical cancer patients treated with primary radiotherapy
with and without the addition of brachytherapy.
Methods and Materials
In all, 220 patients with cervical cancer stage I–IV treated between 1993 and 2009
were included. Three or five 6.0 Gy fractions of brachytherapy were given in addition
to the external beam radiotherapy to 134 patients, whereas 86 patients received external
beam radiotherapy alone (EBRTA). In the EBRTA group, the patients received external
boost instead of brachytherapy with a total dose to the tumor of 64–72 Gy.
Results
The 5-year overall survival and cancer-specific survival rates of the complete series
were 42.5% and 55.5%, respectively. The rates of primary complete remission, 5-year
cancer-specific survival, and recurrence were 92.5%, 68.5%, and 31.3% for the brachytherapy
group vs. 73.3%, 35.4%, and 37.2% for the EBRTA group. The survival (all types) of
the patients receiving brachytherapy was significantly (p < 0.0001) better than for the patients treated with external boost, but the difference
was most pronounced in FIGO stage II tumors. Higher FIGO stage, nonsquamous cell carcinoma
histology, treatment with EBRTA, and lower total equal 2-Gy (EQD2) external dose were
significantly associated with poorer survival, lower rate of remission, and higher
recurrence rate in multivariate models.
Conclusions
Primary tumor remission rate, recurrence rate, and all types of survival rates were
improved in the brachytherapy group. Brachytherapy is important to achieve sufficient
doses to the periphery and central part of the tumor and should always be considered
in treatment of cervical carcinomas.
Keywords
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Article info
Publication history
Published online: November 08, 2016
Accepted:
September 28,
2016
Received in revised form:
September 9,
2016
Received:
June 18,
2016
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
