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- W2034457964 abstract "To evaluate the long term outcome and quantify the incidence of late toxicity, in patients with Carcinoma of the Cervix treated with a radical intent using Brachytherapy. Two hundred and six consecutive patients with carcinoma of the cervix treated with a radical intent using Brachytherapy at the two cancer centres serving our entire Health Authority region, from Jan 1998 to Jan 2013, we included in this study. Median age at diagnosis was 54 years, 29% of patients were single or separated, 82% had squamous cell ca, 13% adenocarcinoma and 1.5% had small cell ca. 38% had FIGO Stage I, 38% had Stage II, 19% had Stage II, and 5% had Stage IV cancers. All patients underwent a combination of external beam RT and Brachytherapy, and 77% of patients also had concurrent chemotherapy. The patients underwent a total of 602 Brachytherapy procedures, while 75 (36.5%) patients had HDR brachytherapy, 131(63.5%) were treated with LDR. After a median follow-up of 59.6 months, the 5 year local control rate, progression free survival, and overall survival were 75.7%, 68.3%, and 66.9%, respectively. Age, histology, and stage were found to be significant prognostic factors. Marital status was found to strongly predict for improved outcomes: 5yr OS for married vs. separated patients was 73.7% vs. 45.3%, p=0.013. There was no statistically significant difference in outcomes for patients who received HDR vs. LDR brachytherapy (5yr OS: 77.8% vs. 65.2%, p=0.436), or for patients who did or did not receive concurrent chemotherapy (5yr OS: 77.9% vs. 64.7%, p=0.908). The 3yr cumulative incidence of late Grade 3-4 radiation proctitis and radiation cystitis for patients treated with HDR versus LDR brachytherapy were: 10.5% vs. 9.3%, p=0.737, and 9.9% vs. 5.7%, p=0.297, respectively. Six patients developed RT related bowel obstruction or strictures for which surgery was required, 3 patients developed treatment related fistulas, 4 had pelvic insufficiency fractures, 2 developed lumbo-sacral plexopathy, and 2 had second cancers. There appears to be no significant difference in long term outcomes or late toxicities with the use of HDR versus LDR brachytherapy techniques. Apart from known prognostic factors such as age, histology and grade, we report a significant impact of the patients’ marital status on the results of treatment." @default.
- W2034457964 created "2016-06-24" @default.
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- W2034457964 date "2015-05-01" @default.
- W2034457964 modified "2023-09-26" @default.
- W2034457964 title "Long Term Outcomes and Late Effects in Survivors of Carcinoma of the Cervix Treated With Brachytherapy" @default.
- W2034457964 doi "https://doi.org/10.1016/j.brachy.2015.02.303" @default.
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