Evaluation of Three- and Five-Year Disease-Free Survival in Patients With Cervical Cancer With Spinal Cord Metastasis Under Treatment With External Radiotherapy + Brachytherapy

Abstract

Objectives: In developing countries, treatment of cervical cancer with metastasis to the spinal cord is generally associated with failure and reduced patient survival due to the lack of appropriate facilities. Oncologists are using a variety of methods to prolong patient survival. In the present study, we aimed to estimate the three- and five-year disease-free survival of patients with cervical cancer and spinal cord metastasis, treated with external radiotherapy + brachytherapy (i.e., internal radiotherapy. Materials and Methods: This descriptive cross-sectional study was performed over a period of ten years (2010-20) in the brachytherapy ward of Shahid Madani Hospital (Tabriz, Iran). Overall, 200 patients with cervical cancer and spinal cord metastasis who were candidates for external radiotherapy + brachytherapy were recruited by the census sampling method. The variables that were likely to affect survival were recorded and analyzed using the Koch survival test and relevant descriptive and inferential statistics in SPSS version 23 software. Results: The patients’ overall survival was 43.12 ± 1.44 months; 78 patients (39%) survived until the end of the third year, and 49 (24.5%) lived till the end of the fifth year. Also, the pathological diagnosis (P=0.013- P=0.015), disease stage (P=0.014- P=0.018), the length of the treatment area (P=0.026- P=0.044), and undergoing chemotherapy (P=0.001- P=0.002) were significantly associated with the survival of the patients who completed the treatment course. Conclusions: Chemotherapy, advanced disease, and greater length of the treatment area reduced three- and five-year survival in the patients with cervical cancer and spinal cord metastasis who underwent brachytherapy.