Clinical effects of IMRT and simultaneous integrated boost-intensity modulated radiation therapy: a comparative study of 277 patients with advanced cervical cancer

Abstract

Objective To explore the toxicity, long-term overall survival (OS) , and prognostic factors in advanced cervical cancer treated with IMRT and simultaneous integrated boost-intensity modulated radiation therapy (SIB-IMRT) . Methods A retrospective analysis was performed on 277 patients with advanced cervical cancer. These patients were admitted from January 2009 to June 2015. Among the 277 patients, 70 patients received IMRT, and 207 patients received SIB-IMRT. Toxicities, survival rates, and prognostic factors were compared between the two groups. The Kaplan-Meier method was used to calculate the survival rates, and the Cox model was used for multivariate prognostic analysis. Results The follow-up rate was 100% in both the IMRT and SIB-IMRT groups. Compared with IMRT, SIB-IMRT showed no significant differences in acute proctitis and cystitis toxicities (χ2=0.306, 0.971, both P>0.05) , as well as in long-term toxicity (χ2=0.014, 0.381, both P>0.05) . The 1-year OS rates for the IMRT and SIB-IMRT groups were 100% and 99.5%, respectively, and the 3-year OS rates were 75.0% and 84.7%, correspondingly (χ2=0.339, 0.674, both P>0.05) . The age and status of the pretreatment lymph nodes were the prognostic factors for all patients (χ2=7.971, 15.938, both P<0.05) , including the SIB-IMRT group (χ2=7.503, 10.048, both P<0.05) in terms of OS. Conclusion Results indicated that SIB-IMRT can feasibly treat advanced cervical cancer. SIB-IMRT is a promising alternative treatment for patients who are not fit for brachytherapy treatment; this method also helps to reduce treatment fractions. Hence, SIB-IMRT is a recommended external beam technology for cervical cancer treatment. Key words: Uterine cervical neoplasms; Prognosis; Intensity-modulated radiation therapy; Simultaneous integrated boost-intensity modulated radiation therapy