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Introduction To investigate the association between chemotherapy (CMT) cycles and oncological outcomes in elders with locally advanced cervical cancer (LACC) who treated with concurrent chemoradiotherapy (CCRT). Methods We retrospective studied 498 elders with LACC who treated with radiotherapy (RT) or CCRT between 2002 and 2018. Patients were divided into three groups: RT, CCRT with 1–4 and CCRT with 5–6 cycles of CMT. We compared progression‐free survival (PFS) and overall survival (OS) among the three groups and explored survival prognostic factors via multivariate analysis and time‐varying analysis effect. Results There were 453 eligible patients; 222, 119 and 112 patients who received RT, CCRT with 1–4 and CCRT with 5–6 cycles of CMT, respectively. Patients in the RT group had older age, poorer performance status, more treatment with conventional RT technique and earlier treatment year comparing with both CCRT groups. Patients who received 5–6 cycles of CMT were less to have underweight, comorbidities and anaemia compared with the RT group. There were patients with lower FIGO stage in 5–6 cycles than in 1–4 cycles of CMT and RT groups. The 5‐year PFS and OS between RT, CCRT with 1–4 and CCRT with 5–6 cycles of the CMT group were significantly different. Performance status, comorbidity, histology, FIGO stage and total received 5–6 CMT cycles were significant prognostic factors of PFS and OS. However, the benefits of receiving 5–6 CMT cycles were evidenced only within the first 2.5 years. Conclusion Elders with LACC who received 5–6 cycles of CMT concurrently with RT can improve PFS and OS, but the benefit persisted only within the first 2.5 years.

Introduction. This study aimed to compare clinicopathological factors between late-recurrence and early-recurrence patients (using late recurrence at ≥ 3 years and 5 years as cut-off points) in locally advanced cervical cancer (LACC) treated with concurrent chemoradiotherapy (CCRT). This study also identified independent risk factors for late recurrence.Material and methods. We analyzed data from LACC patients treated at Songklanagarind Hospital between 2002 and 2016, who had received definitive CCRT. A total of 1231 patients were retrospectively reviewed.Results. The median follow-up was 4.6 years, and the total recurrence rate was 28.7% (353 of 1231 patients). The late recurrence rates were 7.4% and 2.2% for ≥ 3 and 5 years after CCRT, respectively. When comparing the risk factors of late recurrence at ≥ 3 years with early recurrence, we found that anemia and thrombocytosis were found less frequently in late recurrence (26.2% vs. 46.9% and 9.8% vs. 23.6%, respectively). At ≥ 5 years, no differences in risk factors between the recurrent groups were found. When including only patients that remained tumor-free after 3 years, stage III-IVA was the only independent risk factor associated with late recurrence at ≥ 3 years (p = 0.042).Univariate analysis showed no significant associated factor for late recurrence after 5 years.Conclusions. Late recurrence at ≥ 3 years was not rare. Even though we could not find any significant association between clinicopathologic factors and late recurrence after 5 years, 2.2% of patients still had late recurrence.Long-term follow-up should be considered, especially for more advanced stages (stage III-IVA).