Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T00:46:46.099Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of postoperative intravaginal brachytherapy on survival for patients with intermediate-risk cervical cancer at National Cancer Institute (NCI), Egypt

Published online by Cambridge University Press:  23 March 2018

Mohamed Mahmoud ,
Shaimaa Abdelgeleel  and
Ahmed M. Mahmoud
Mohamed Mahmoud*
Affiliation:
Radiation Oncology Department, National Cancer Institute (NCI), Cairo University, Giza, Egypt
Shaimaa Abdelgeleel
Affiliation:
Epidemiology and Cancer biostatistics Department, National Cancer Institute (NCI), Cairo University, Giza, Egypt
Ahmed M. Mahmoud
Affiliation:
Surgical Oncology Department, National Cancer Institute (NCI), Cairo University, Giza, Egypt
*
Author for correspondence: Mohamed Mahmoud, Radiation Oncology Department, National Cancer Institute (NCI), Cairo University, Giza, Egypt. Tel: +2010 0153 6681. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cervical cancer is considered to be the fourth most frequent cancer among women. Postoperative treatment is indicated depending up on surgical findings and disease stage.

Objective

The objective of this study was to assess the long-term postoperative outcomes of cervical cancer patients with intermediate risk factors who have received pelvic external beam radiotherapy with or without vaginal brachytherapy, and treatment-related toxicities.

Patients and methods

In this retrospective study, the records were collected for all patients with cervical cancer who received postoperative radiotherapy at the National Cancer Institute between the years 2008 and 2013. The end points of the study were local control, progression-free survival, overall survival (OS) and delayed complications.

Results

Out of 248 patients, the median age of patients who did not receive brachytherapy was 53 years and the median age of patients who received brachytherapy was 52 years. A statistically significant difference was found in OS, progression-free survival and recurrence-free survival for those who received brachytherapy, with a p value<0·001, 0·01 and 0·004, respectively.

Conclusion

The addition of brachytherapy to postoperative external beam radiotherapy improves OS, progression-free survival and local control for patients with intermediate-risk cervical cancer.

Keywords

brachytherapycervical cancersurvival
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 17 , Issue 3 , September 2018 , pp. 332 - 336
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Parkin, D M, Bray, F, Fertay, J, Pisani, P. Global statistics 2002. CA Cancer J Clin 2005; 55: 74–7108.Google Scholar
2. Kamangar, F, Dores, G M, Anderson, W F. Patterns of cancer incidence, mortality and prevelance across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006; 24: 2137–2150.Google Scholar
3. International Agency for Research in Cancer, World Health Organization. Cervical cancer: estimated incidence, mortality and prevalence, worldwide in 2012. Lyon, France: International Agency for Research in Cancer and World Health Organization, 2012.Google Scholar
4. Jemal, A, Bray, F, Center, M M, Ferlay, J, Ward, E, Forman, D. Global cancer statistics. CA Cancer J Clin 2011; 61: 69–90.Google Scholar
5. Rodríguez, AC, Schiffman, M, Herrero, R, Hildesheim, A, Bratti, C, Sherman, M E. Longitudinal study of human papillomavirus persistence and cervical intraepithelial neoplasia grade 2/3: critical role of duration of infection. J Natl Cancer Inst 2010; 102: 315–324.Google Scholar
6. Gray, H J. Primary management of early stage cervical cancer (IA1-IB) and appropriate selection of adjuvant therapy. J Natl Compr Canc Netw 2008; 6: 47–52.Google Scholar
7. American College of Obstetricians and Gynecologists. ACOG practice bulletin. Diagnosis and treatment of cervical carcinomas. Number 35 May 2002. American college of Obstetricians and Gynecologists. Int J Gynaecol Obstet 2002; 78: 79–91.Google Scholar
8. Landoni, F, Maneo, A, Colombo, A et al. Randomised study of radical surgery versus radiotherapy for stage Ib–IIa cervical cancer. Lancet 1997; 350: 535–540.Google Scholar
9. Sedlis, A, Bundy, B N, Rotman, M Z, Lentz, S S, Muderspach, L I, Zaino, R J. A randomized trial of pelvic radiation therapy versus no therapy in selected patients with stage IB carcionoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a gynecologic Oncology Group Study. Gynecol Oncol 1999; 73: 177–183.Google Scholar
10. Rotman, M, Sedlis, A, Piedmonte, M R et al. A phase III randomized trial of postoperative pelvic irradiation in stage IB cervical carcinoma with poor prognostic features: follow up of a gynecologic oncology group study. Int J Radiat Oncol Biol Phys 2006: l65–l169.Google Scholar
11. Monk, B J, Wang, J, Im, S et al. Rethinking the use of radiation and chemotherapy after radical hysterectomy: a clinical-pathological analysis of a Gynecologic Onclogy Group/Southwest oncology Group/Radiation Therapy Group trial. Gynecol Oncol 2005; 96: 721–728.Google Scholar
12. Chernofsky, M R, Felix, J C, Muderspach, L I, Morrow, C P, Ye, W, Groshen, S G. Influence of quantity of lymph vascular space invasion on time to recurrence in women with early-stage cancer of the cervix. Gyencol Oncol 2006; 100: 288–293.Google Scholar
13. Marchiole, P, Buenerd, A, Benchaib, M et al. Clinical significance of lympho vascular space involvement and lymph node micrometastasis in early-stage cervical cancer: a retrospective case-control surgico-pathological study. Gynecol Oncol 2005; 97: 727–732.Google Scholar
14. Kundargi, R S, Guruprasad, B, Rathod, P S et al. Risk strata-based therapy and outcome in stage Ib-IIa carcinoma cervix: single-centre ten-year experience. Cancer Medical Science 2013; 7: 341.Google Scholar
15. Peters, WA 3rd, Liu, PY, Barrett, RJ 2nd et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol 2000; 18 (8): 1606–1613.Google Scholar
16. Li, L, Kou, X X, Feng, X J, Zhang, M C, Chao, H T, Wang, L Y. Postoperative external beam irradiation with and without brachytherapy in pelvic node-positive IB1-IIA2 cervical cancer patients: a retrospective clinical study. Radiat Oncol 2015; 10: 189.Google Scholar
17. Sharma, D N, Gandhi, A K, Rath, G K, Julka, P K, Haresh, K P, Gupta, S. Postoperative intravaginal brachytherapy with pelvic radiotherapy for patients with cervical carcinoma. Brachytherapy 2015; 14 (1): S61.Google Scholar