Abstract
BackgroundThis study assessed the survival outcomes and recurrent patterns in pelvic node-positive IB1-IIA2 cervical cancer patients treated with postoperative external beam irradiation with or without vaginal brachytherapy.MethodsThe records of 1149 cervical cancer patients received radical surgery between February 2008 and March 2010 were retrospectively reviewed. 126 stages IB1-IIA2 patients with positive pelvic lymph node (LN) were included and a total of 113 patients who received different postoperative radiation therapy were identified and analyzed. Of the enrolled patients, 55 patients received pelvic external beam radiotherapy (EBRT) without vaginal brachytherapy and 58 patients received pelvic EBRT with vaginal brachytherapy. Treatment-related toxicities were evaluated. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier estimates and statistical significance was determined using the log-rank test.ResultsWith a median follow-up of 47 months (range: 10–61 months), the group which had pelvic EBRT with brachytherapy had a significantly improved 5-year PFS rate (P = 0.044), but no significant difference in 5-year overall survival was found between the two groups (P = 0.437). In patients treated without brachytherapy, the most common site of relapse was the pelvis. No significant differences were found regards to acute and chronic radiation toxicities, including myelosuppression, dermatitis, enterocolitis, proctitis and cystitis (P = 0.485, 0.875, 0.671, 0.459 and 0.969 respectively) between the groups of pelvic EBRT with and without vaginal brachytherapy.ConclusionsTreated with pelvic EBRT in combination with vaginal brachytherapy, cervical cancer patients with positive pelvic lymph node had a reduced risk of locoregional recurrence without increased side effects compared with patients treated with pelvic EBRT without vaginal brachytherapy.
Highlights
This study assessed the survival outcomes and recurrent patterns in pelvic node-positive IB1-IIA2 cervical cancer patients treated with postoperative external beam irradiation with or without vaginal brachytherapy
Treatment for early-stage disease involves radical hysterectomy (RH) with pelvic and/or para-aortic lymph node (LN) dissection or radiation therapy (RT) [1], the former of which is used for most patients because it has the advantage of removing the primary disease and curing the patient within the shortest time period possible
The aim of this study was to evaluate the long-term outcomes of cervical carcinoma patients with positive pelvic lymph nodes underwent pelvic threedimensional conformal radiotherapy (3D-CRT) with or without vaginal brachytherapy and treatment-related toxicities, as these patients may benefit from these treatments with improved survival
Summary
This study assessed the survival outcomes and recurrent patterns in pelvic node-positive IB1-IIA2 cervical cancer patients treated with postoperative external beam irradiation with or without vaginal brachytherapy. Few studies have evaluated the outcomes of different adjuvant therapy strategies for postoperative node-positive patients with or without vaginal brachytherapy, and standard postoperative adjuvant therapy has not been established [11, 12]. The aim of this study was to evaluate the long-term outcomes of cervical carcinoma patients with positive pelvic lymph nodes underwent pelvic threedimensional conformal radiotherapy (3D-CRT) with or without vaginal brachytherapy and treatment-related toxicities, as these patients may benefit from these treatments with improved survival
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