Does the Radiotherapy Technique Have an Impact on the Survival of Patients with Cervical Cancer?

Abstract

OBJECTIVEConcurrent chemoradiotherapy is the primary treatment for patients with locally advanced cervicalcancer. We evaluated the treatment results and prognostic factors in patients treated with chemoradiation.METHODSWe retrospectively reviewed the records of 150 patients with locally advanced cervical cancer treatedwith curative chemoradiotherapy between 1999 and 2014 at our hospital.RESULTSThe median follow-up period was 37.5 months (range: 5.6–186 months). All patients received both externalbeam radiation therapy (EBRT) and intracavitary brachytherapy. EBRT was delivered with conventional2-dimensional radiotherapy or 3-dimensional conformal radiotherapy (3DCRT). Eighty-sevenpercent of patients received cisplatinum-based chemotherapy during EBRT. Total or nearly total remissionwas achieved in 72% of patients. With a median follow-up duration of 37.5 months, 29% of patientsdied, 13% of patients had local-regional recurrence, and 25% of patients had distant metastasis. The 2-,5-, and 10-year overall survival rates were 76%, 62%, and 47%, respectively, and the progression-freesurvival rates were 68%, 62%, and 58%, respectively. We evaluated prognostic factors for overall survivaland progression-free survival. The most important prognostic factor was the radiotherapy technique. Thesurvival curves were estimated by the Kaplan–Meier method, and differences were assessed using thelog-rank test; a p-value