Outcomes of patients with cervical cancer treated with low- or high-dose rate brachytherapy after concurrent chemoradiation
| Autor: | Aba Anoa Scott, Samuel Ntiamoah Boateng, Verna Vanderpuye, Tony Obeng-Mensah, Charles Aidoo, Joel Yarney, Kwabena Anarfi, Mervin Agyeman, Evans Sasu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
cervical cancer medicine.medical_treatment Brachytherapy Urology Uterine Cervical Neoplasms Kaplan-Meier Estimate Adenocarcinoma Ghana 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Humans Stage (cooking) Original Research Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Cervical cancer Proportional hazards model business.industry Obstetrics and Gynecology Dose-Response Relationship Radiation Chemoradiotherapy Concurrent chemoradiation Middle Aged medicine.disease High-Dose Rate Brachytherapy Radiation therapy Oncology 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female Stage iv business |
| Zdroj: | International Journal of Gynecological Cancer |
| ISSN: | 1525-1438 1048-891X |
| DOI: | 10.1136/ijgc-2020-002120 |
| Popis: | ObjectiveThe majority of patients with cervical cancer in Ghana present with locally advanced disease. In October 2014, high-dose rate (HDR) brachytherapy was introduced at the National Center for Radiotherapy, Accra after years of using low-dose rate (LDR) brachytherapy. The aim of this study was to compare the treatment outcomes of patients treated with LDR versus HDR brachytherapy.MethodsPatients with cervical cancer treated from January 2008 to December 2017 were reviewed. Those with stage IB–IIIB who received chemoradiation plus brachytherapy were included in the study. Post-operative patients and those with stage IV were excluded. The study end points were local control, disease-free survival, and overall survival at 2 years. Endpoints were estimated using the Kaplan–Meier method. Comparisons between treatment groups were performed using the log-rank test and Cox proportional hazards model.ResultsWe included 284 LDR and 136 HDR brachytherapy patients. For stages IB, IIA, IIB, IIIA and IIIB disease, the 2-year local control for LDR versus HDR brachytherapy was 63% and 61% (p=0.35), 86% and 90% (p=0.68), 86% and 88% (p=0.83), 66% and 60% (p=0.56), and 77% and 40% (p=0.005), respectively. The 2-year disease-free survival for LDR versus HDR brachytherapy was 64% and 61% (p=0.50), 81% and 69% (p=0.18), 81% and 80% (p=0.54), 62% and 33% (p=0.82), and 71% and 30% (p=0.001) for stages IB, IIA, IIB, IIIA, and IIIB, respectively. The 2-year overall survival for LDR versus HDR brachytherapy was 94% and 93% (p=0.92), 98% and 68% (p=0.21), 89% and 88% (p=0.60), and 88% and 82% (p=0.34) for stages IB, IIA, IIB, and IIIB disease, respectively.ConclusionThere was no difference between LDR and HDR brachytherapy in local control and disease-free survival for all stages of disease, except in stage IIIB. These findings highlight the need to refine this brachytherapy technique for this group of patients. |
| Databáze: | OpenAIRE |
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