Evaluating the use of external beam radiation alone in the management of cervix cancer

Abstract

AimTo determine the outcome of patients with locally advanced cervix cancer treated with curative intent using external beam radiotherapy (EBRT), without brachytherapy.Materials and methodsA chart review was performed of all patients with cervix cancer who received EBRT alone at our centre from 2000 to 2010. Overall survival and local control were evaluated using Kaplan–Meier survival curves.ResultsIn total, 22 patients were identified. The median age and follow-up were 56 years and 65 months, respectively. The stage included IB to IVB. Main histology was squamous cell carcinoma (82%). Median tumour size was 5·5 cm. Majority treated with 3D conformal techniques and nine patients (41%) were treated with intensity-modulated radiation therapy (IMRT); 14 patients received doses of ≥65 Gy. Most patients (73%) received weekly concurrent cis-platinum. The major reason for not receiving brachytherapy was locally extensive tumour (59%). The 5-year relapse-free survival and overall survival rates were 57 and 50%, respectively. Seven patients (32%) had a component of loco-regional failure, mainly within the cervix. There was a better outcome among the nine patients treated with IMRT to a median dose of 66 Gy with a loco-regional control of 78%.ConclusionsPatients who cannot have brachytherapy may still achieve acceptable rates of loco-regional disease control if high radiation doses (>65 Gy) was delivered.

Response of External Radiotherapy Alone in Stage IIB – IIIC Cervical Cancer Patients

“…7 It was stated that the primary management of cervical cancer is surgery or radiation therapy with chemotherapy as a valuable adjunct. [8][9][10][11] In the fi eld of gynecological cancer, radiation therapy is widely used as a therapeutic modality for cervical cancer, vulvar/vaginal cancer, and endometrial cancer. 3 Radiotherapy is one of the main treatment options in cancer management where about 50% to 60% of patients require radiation therapy at some stage of the disease.…”

“…10 Patients who do not receive brachytherapy therapy can still reach the loco-regional level if given at high radiation doses (> 65 Gy). 9 The prognosis of patients who get only external radiation therapy will get much worse results than patients who get a combination of external radiation and brachytherapy. Brachytherapy should be used whenever technically possible and its coadministration with chemotherapy should be considered.…”