Treatment Outcomes of Radiation Therapy for Locally Advanced Cervical Cancer

Abstract

Treatment Outcomes of Radiation Therapy for Locally Advanced Cervical Cancer

Thanatip Tantivattana MD

Kanyarat Katanyoo MD

Marisa Jongthanakorn MD

Radiation Oncology Section, Department of Radiology, BMA Medical College and Vajira Hospital

Objective: To study the results of radiation therapy in locally advanced cervical cancer (IIB-IVA) in terms of 2- and 5- year survival rates. Prognostic factors and complications of radiation therapy were also evaluated.

Study design: Descriptive study.

Subjects: A total of 420 patients with locally advanced cervical cancer (IIB-IVA), who were treated by radiation with or without concurrent chemotherapy at Radiation Oncology section, BMA Medical College and Vajira Hospital between January 1998 and December 2005.

Methods: Medical records of the patients including radiation oncology records, out-patient charts and computerized data base of the institution were reviewed. Patients' age, histologic type, size of tumor, stage, computed tomography of whole abdomen results, anemia during treatment, types of radiation therapy, complications and results of treatment were recorded.

Main outcome measures: Overall 2-and 5-year survival rates.

Results: Mean age of 420 patients was 51.8 ± 11.7 years. Cervical cancer histopathology were squamous cell carcinoma in 78.8%, while the rest were adenocarcinoma or adenosquamous cell carcinoma. Clinical stage of diseases were stage IIB 51.4%, IIIA 1.0%, IIIB 45.0% and IVA 2.6%. The overall 2-and 5-year survival rates for all patients were 78.4% and 64.8% respectively. The only significant prognostic factor associated with survival rate from multivariable analysis was tumor stage. Patients in stage IIB had higher survival rate than the patients in stage III (IIIA and IIIB) and IVA with the 5-year survival rate of 72.2%, 56.2% and 47.0% respectively (p-value = 0.001). The late complication of bowel and bladder grade 3-4 were 4.1% and 0.7% respectively.

Conclusion: The overall 2- and 5-year survival rates of patients with locally advanced cervical cancer treated with radiation therapy were 78.4% and 64.8% respectively. Tumor stage was the only significant prognostic factor for survival.

Vajira Med J 2009 ; 53 : 121-129