eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
1/2023
vol. 15
 
Share:
Send email
Share:
abstract:
Original paper

Prognostic factors of local control and progression-free survival in AJCC stages T1 and T2 cervical cancer patients treated with adjuvant brachytherapy after chemoradiotherapy

Jean-Christophe Faivre
1
,
Paul Jung
1
,
Julia Salleron
2
,
Florian Baumard
2
,
Florent Courrech
3, 4
,
Frédéric Marchal
5
,
Didier Peiffert
1
,
Sophie Renard
1
,
Claire Charra-Brunaud
1

  1. Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
  2. Department of Biostatistics and Data Management, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
  3. Department of Biophysic, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
  4. Department of Biophysic, Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France
  5. Department of Surgery, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
J Contemp Brachytherapy 2023; 15, 1: 27–36
DOI: https://doi.org/10.5114/jcb.2023.124936
Online publish date: 2023/02/09
View full text Get citation
 
Purpose:
We assessed prognostic factors of local control and progression-free survival (PFS) of patients treated for AJCC stages T1 and T2 cervical cancer using utero-vaginal brachytherapy after chemoradiotherapy.

Material and methods:
This retrospective single-institution analysis included patients who underwent brachytherapy after radiochemotherapy between 2005 and 2015 at the Institut de Cancérologie de Lorraine. Adjuvant hysterectomy was optional. A multivariate analysis of prognostic factors was carried out.

Results:
Of 218 patients, 81 (37.2%) were AJCC stage T1, and 137 (62.8%) were AJCC stage T2. 167 (76.6%) patients had squamous cell carcinoma, 97 (44.5%) patients had pelvic nodal disease, and 30 (13.8%) patients had para-aortic nodal disease. One hundred eighty-four patients (84.4%) underwent concomitant chemotherapy, while adjuvant surgery was performed in 91 patients (41.9%) and 42 (46.2%) patients had pathological complete response. Median follow-up was 4.2 years, and local control was reported in 87.8% (95% CI: 83.0-91.8) and 87.2% (95% CI: 82.3-91.3) of patients at 2 and 5 years, respectively. In multivariate analysis, T stage (hazard ratio [HR] = 3.65, 95% CI: 1.27-10.46, p = 0.016) was associated with local control. PFS was reported in 67.6% (95% CI: 60.9-73.4) and 57.4% (95% CI: 49.3-64.2) of patients at 2 and 5 years, respectively. In multivariate analysis, para-aortic nodal disease (HR = 2.03, 95% CI: 1.16-3.54, p = 0.012), pathological complete response (HR = 0.33, 95% CI: 0.15-0.73, p = 0.006), and intermediate-risk clinical tumor volume of > 60 cc (HR = 1.90, 95% CI: 1.22-2.98, p = 0.005) were associated with PFS.

Conclusions:
Lower dose brachytherapy may benefit AJCC stages T1 and T2 tumors, whereas higher doses are required for larger tumors and para-aortic nodal disease involvement, respectively. Pathological complete response should be associated with better local control and not surgery.

keywords:

uterine cervical neoplasms, brachytherapy, radiotherapy, toxicity, surgery

  
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2024 Termedia Sp. z o.o.
Developed by Bentus.