The Impact of overall treatment time on treatment outcome of radiotherapy in cervical cancer
Keywords:
brachytherapy, local control rate, overall survival rate, overall treatment time, radiotherapyAbstract
Backgrounds The adverse effect on treatment outcome for prolongation of overall treatment time (OTT) in radiotherapy has been reported in some studies. Objective This study aimed to clarify the impact of OTT on the treatment outcome of radiotherapy in cervical cancer. Materials and methods The records of 130 cervical cancer patients with squamous cell carcinoma (stage IB to IVA) underwent definitive radiotherapy in year 2009-2013 were retrospective studied. The patients received the totally EQD2 cumulative dose at point A which consisted of external beam radiotherapy of 44 Gy whole pelvic then midline block to 50 Gy, followed by parametrium boost to 56 Gy and Ir-192 intracavitary brachytherapy with point A dose of 7 Gy for four fractions. The patients were separated into 2 groups based on OTT recommended by American Brachytherapy Society, OTT ≤ 56 day (group 1) and > 56 day (group 2). Kaplan-Meier and Log-rank were used to test for the difference between 2 groups. Cox regression was used for univariate and multivariate analysis (MVA) to identify the prognostic factor. Results For the studied group, OTT ranged 44-88 day and EQD2 ranged 83.6-86.1 Gy. Local control rate (p = 1.000), distant metastasis free survival rate (p = 0.923), disease Free Survival (DFS) (p = 0.734), cause specific survival (p = 0.410) and overall Survival (OS) (p = 1.000) were not significantly different between 2 groups. MVA identified initial tumor size as the prognostic factor of DFS (p = 0.016) and stage for OS (p = 0.007). Conclusions Our results revealed that there was no impact of OTT on the treatment outcome and survival rate. Tumor size greater than 4 cm was the prognostic factor of DFS and stage for OS.
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