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- Title
Impact of treatment time-related factors on prognoses and radiation proctitis after definitive chemoradiotherapy for cervical cancer.
- Authors
Huang, Eng‐Yen; Lin, Hao; Wang, Chong‐Jong; Chanchien, Chan‐Chao; Ou, Yu‐Che
- Abstract
This study aimed to investigate the impact of treatment time-related factors on outcomes and radiation proctitis in patients undergoing concurrent chemoradiotherapy ( CCRT) for cervical cancer. From September 2001 to December 2012, 146 patients with stage IIB cervical squamous cell carcinoma treated with CCRT were reviewed from a prospective cohort. Patients who received the same dose (45 Gy) of external beam radiation therapy ( EBRT) were included in the analysis ( n = 125). The same equivalent dose of 2 Gy ( EQD2) of high-dose-rate intracavitary brachytherapy ( HDR- ICBT) was delivered at either 4 fractions of 6 Gy or 6 fractions of 4.5 Gy. The effects of the overall treatment time ( OTT) and interval between EBRT and HDR- ICBT on the cancer-specific survival ( CSS), local recurrence ( LR), and incidence of proctitis were compared. The treatment time-related factors did not adversely affect the CSS and LR rates. The multivariate analyses did not identify the OTT as an independent factor of CSS ( P = 0.839) and LR ( P = 0.856). However, OTT ≤56 days ( P = 0.026) was identified as the only independent factor of overall proctitis. The 5-year Grade 2 or greater proctitis rates were 14.9% and 0% ( P = 0.001) in patients with the EBRT to ICBT interval ≤5 days and >5 days, respectively. To reduce rectal damage without compromising prognosis, the gap between EBRT and HDR- ICBT should exceed 5 days in cervical cancer patients undergoing CCRT. Strictly limiting the OTT to 56 days may result in radiation proctitis without improvements in prognosis.
- Subjects
PROCTITIS; CERVICAL cancer treatment; CHEMORADIOTHERAPY; RADIATION doses; CANCER prognosis; MULTIVARIATE analysis
- Publication
Cancer Medicine, 2016, Vol 5, Issue 9, p2205
- ISSN
2045-7634
- Publication type
Article
- DOI
10.1002/cam4.794