Objective: To describe our experience with concurrent chemoradiotherapy using three-dimensional conformal radiotherapy (3D-CRT) and high-dose-rate intracavitary brachytherapy with weekly cisplatin in the treatment of patients with locally advanced cervical cancer.
Methods: Forty-three patients were identified between January 2009 and December 2015. Their medical records were retrospectively reviewed, and data on patient characteristics, tumour, treatment and toxicities were collected and analysed.
Results: The median age was 45 years (interquartile range (IQR): 26) The median tumour size was 45 mm (IQR: 20). Thirty-eight patients (88%) had a cervical tumour with a size of ≥ 40 mm. The median cervical tumour size evaluated by magnetic resonance imaging (MRI) was 52 mm (IQR: 17). Twenty-two patients (51%) had enlarged lymph nodes on MRI (≥ 10 mm). MRI demonstrated the involvement of the parametrium in 29 patients (67%). Fifteen patients had positive para-aortic nodes (36%). The median total treatment time was 58 days (IQR: 20). Sixteen patients (39%) received extended-field radiotherapy. Cisplatin was administered simultaneously for a median of five courses. The median follow-up period was 32 months (IQR: 28 months). Grade 3 acute toxicity was observed at the gastrointestinal level in seven patients (16%). Late grade 3/4 toxicity was observed in 14 patients (33%). Seven patients (16%) persisted with the disease and five died. The local relapse rate was 9%. Eleven patients underwent a hysterectomy after treatment. The disease-free interval was 24.2 months. The 2-year global survival rate was 82.9%.
Conclusion: Concurrent chemo-radiotherapy appears to be an effective regimen, with acceptable toxicity, for patients with locally advanced cervical cancer.
Keywords: brachytherapy; carcinoma of the cervix; concurrent chemotherapy; radiotherapy.