Radiotherapy alone in locally advanced cervical cancer: a palliative treatment? Real-world data

ABSTRACT

Objective: To investigate the benefit of radiotherapy alone in patients diagnosed with locally advanced cervical cancer when the addition of chemotherapy was contraindicated. Methods: A single-center cohort study of patients diagnosed with locally advanced cervical cancer as defined by the FIGO 2009 (stage IB2 to IVA) and contraindication for concomitant chemotherapy was retrospectively evaluated. Patients included were treated with radiotherapy in a curative intent and those patients who completed the external beam radiotherapy were considered for brachytherapy. Patient's demographics, reasons for not receiving concomitant chemotherapy and treatment responses were analyzed. Disease-free survival (DFS) and overall survival (OS) were calculated. Results: With a median follow-up of 13.9 months (range 0.10-81.8), the median DFS was 11.6 months (95% CI: 10.2-13.1), and the median OS was 15.9 months (95% CI: 11.5-20.3). Conclusion: This real-world study provides descriptive information confirming that radiotherapy with curative intent should be offered to patients with locally advanced cervical cancer even when chemotherapy is not an option due to clinical or laboratory contraindications.

RESUMO

Objetivo: Investigar o benefício da radioterapia isolada em pacientes com diagnóstico de câncer cervical localmente avançado quando a adição de quimioterapia foi contraindicada. Métodos: Um estudo de coorte unicêntrico de pacientes com diagnóstico de câncer cervical localmente avançado, conforme definido pela FIGO 2009 (estágio IB2 a IVA) e contraindicação para quimioterapia concomitante foi retrospectivamente avaliada. Os pacientes incluídos foram tratados com radioterapia com intenção curativa e os pacientes que completaram a radioterapia com feixe externo foram considerados para braquiterapia. Dados demográficos do paciente, razões para não receber quimioterapia concomitante e respostas ao tratamento foram analisados. Sobrevida livre de doença (SLD) e sobrevida global (SG) foram calculadas. Resultados: Com um acompanhamento médio de 13,9 meses (intervalo de 0,10-81,8), a SLD mediana foi de 11,6 meses (IC 95%: 10,2-13,1) e a SG mediana foi de 15,9 meses (IC 95%: 11,5-20,3). Conclusão: Este estudo do mundo real fornece informações descritivas que confirmam que a radioterapia com intenção curativa deve ser oferecida a pacientes com câncer cervical localmente avançado, mesmo quando a quimioterapia não é uma opção devido a contraindicações clínicas ou laboratoriais.

Keywords:

Uterine cervical neoplasms - Radiotherapy - Brachytherapy - Antineoplastic agents.

Descritores:

Neoplasias do colo uterino - Radioterapia - Braquiterapia - Agentes antineoplásicos.

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