Definitive chemoradiotherapy for cervical cancer: A 11-year population-based study

Eur J Cancer Care (Engl). 2020 May;29(3):e13223. doi: 10.1111/ecc.13223. Epub 2020 Jan 15.

Abstract

Purpose: To assess the recurrence pattern and survival in women treated with definitive chemoradiotherapy for cervical cancer.

Methods: A retrospective cohort study of women FIGO (2012) stage IB2 to IVA from the Grampian region of Scotland between February 2000 and March 2011. These women were followed up until April 2018.

Results: A total of 121 eligible women allocated with mean age at treatment 50.59 years (SD = 13.98, range 22-82). Tumours staged: IB2: n = 24 (19.8%), II: n = 45 (37.2%), III: n = 43 (35.5%) and IVA: n = 7 (5.8%). Two (1.7%) women had no available data. Fifty-five (45.5%) women had recurrence after treatment, and 51 (42.15%) women died from the disease. The sites of recurrence were as follows: central pelvic only (n = 4, 7.27%), pelvic and distant (n = 39, 70.91%) and distant only (n = 12, 21.82%) with median time from end of treatment to first recurrence 44 months (range 2-98), 26 months (range 1-146) and 22 months (range 3-66) respectively. 5-and 8-year overall survival was 76.0% (95% CI: 68.8%-84.0%) and 64.4% (95% CI: 56.4%-73.5%) respectively.

Conclusions: Though overall survival is better than with radiotherapy alone, recurrence occurs up to 10 years after treatment. This raises the issues of how to reduce late recurrence and the appropriateness of current follow-up protocols.

Keywords: cervical cancer; chemoradiotherapy; recurrence pattern; site of recurrence; time of recurrence.

Publication types

  • Observational Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Bone Neoplasms / secondary
  • Brachytherapy
  • Brain Neoplasms / secondary
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy*
  • Cisplatin / therapeutic use
  • Disease-Free Survival
  • Female
  • Humans
  • Liver Neoplasms / secondary
  • Logistic Models
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Staging
  • Odds Ratio
  • Pelvis
  • Radiotherapy, Conformal
  • Retrospective Studies
  • Scotland
  • Survival Rate
  • Tumor Burden
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / therapy*
  • Young Adult

Substances

  • Antineoplastic Agents
  • Cisplatin