Local Control and Overall Survival of Patients with Stage IIB–IVA Cervical Cancer after Definitive External Beam Chemoradiation and High-Dose-Rate Cobalt-60 Intracavitary Brachytherapy

Abstract

The present study aimed to assess the local control and overall survival of patients with stage IIB–IVA cervical cancer after definitive external beam chemoradiation and high-dose-rate miniaturized Cobalt-60 (Co-60) intracavitary BT. This was a cross-sectional study that prospectively enrolled patients with cervical squamous cell carcinoma referred for BT as a part of their definitive treatment to Reza Radiotherapy & Oncology Center of Mashhad, Razavi Khorasan, Iran, between 2017 and 2018. The optimal dose of treatment was determined, and survival analysis was performed using the log-rank test at the level of p ≤ 0.05. A total of 65 patients were enrolled, and most of them had stage IIB (76.9%). With a median follow-up of 18 months, the 6-, 12-, 18-, and 24-month overall survival was 98%, 86%, 75%, and 50%, respectively. The optimal cutoff dose of high-risk clinical target volume (HR-CTV) was 85.06 gray (Gy). There was a trend in the reduction of survival in patients with higher stages and receiving lower doses to tumor; however, the results were not significant. Based on the results of this study, a minimum total dose of 85 Gy to high-risk clinical tumor volume is essential to achieve an optimal local control.