Radical Hysterectomy in Patients with Locally Advanced Cervical Cancer: Would it be an Option in Centers Lacking Brachytherapy Technique? | ||||
SECI Oncology Journal | ||||
Volume 12, Issue 1, January 2024, Page 14-22 | ||||
View on SCiNiTO | ||||
Abstract | ||||
Background: Locally advanced cervical cancer patients’ treatment depends optimally on multimodality options, which could be very challenging, due to the lack of intracavitary brachytherapy in many centers. Although non-surgical option is very appealing, yet it is not always available. An alternative non- standard approach is neo-adjuvant concurrent chemo-radiotherapy (CCRT) followed by radical hysterectomy. Patients and methods: A retrospective study involving patients with pathologically proven cervical cancer, FIGO stages IB2 till IVA who presented to Clinical Oncology Department, Cairo University, during the period from January 2015 till December 2020. Data was retrieved from our medical records. Patients were divided into 2 arms; (Arm A: 40 patients) included patients treated with neoadjuvant CCRT, followed by radical hysterectomy and (Arm B: 41 patients) included those who received the standard of care; CCRT followed by intracavitary brachytherapy. Results: The loco-regional control rate was 75% in arm A, compared to 85.3%in arm B, with non-significant P-value (p=0.24). However, relapse rates were significantly higher in arm A (47.5%) than in arm B (14.5%) (p= 0.007). Moreover, distant metastases were higher in arm A (22.5%) than in arm B (4.9%) with a statistically significant P-value = 0.025. There was no significant difference between the two groups as regards survival data (PFS and OS). However, concerning the toxicity profile, both arms experienced comparable toxicity profile pattern after CCRT; Yet dysuria was the most common early and late toxicity after intracavitary brachytherapy (arm B) presenting 39% and 29.7% respectively. Conclusion: Offering surgery as an alternative approach to intracavitary brachytherapy is an acceptable option, in centers lacking brachytherapy technique, without compromising survival outcome. | ||||
Keywords | ||||
Radical Hysterectomy; Brachytherapy Technique? | ||||
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