Gynecological Cancer

PV QA 4 - Poster Viewing Q&A 4

TU_13_3443 - Effect of Radiation Boost Modality in Overall Survival of Cervical Cancer Patients

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Effect of Radiation Boost Modality in Overall Survival of Cervical Cancer Patients
T. K. Podder1, A. Dey2, S. Datta2, and T. Biswas3; 1Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, 2University of Akron, Akron, OH, 3University Hospitals Seidman Cancer Center, Cleveland, OH

Purpose/Objective(s): To evaluate the efficacy of radiation boost modality in locally advanced cervical cancer patients treated with initial external beam radiation therapy (EBRT) and chemotherapy.

Materials/Methods: We have analyzed National Cancer Database for FIGO stage IB-IIIB cervical cancer patients treated from 2004 to 2014. Considered non-surgical patients who received both chemotherapy and EBRT. Included patients (n = 9,936) received primary/initial treatment with either intensity modulated radiation (IMRT) or 3D conformal radiotherapy (3D-CRT) of 40-60Gy dose. We have considered three options for radiation boost: no boost, EBRT boost and brachytherapy (BT) boost. Patients who had EBRT boost dose 10-40Gy were included in this study. Statistical software was used for statistical analysis; p-value < 0.05 was considered statistically significant.

Results: The median age of the patients was 51 years (range: 18-90yrs). The median follow-up was 33.8 months (range: 6.2-143.1mo). Mean/median overall survival (OS) in months were: 69.7/52.1, 63.5/38.2 and 90.8/112.9 for no boost, EBRT boost and BT boost, respectively. Observed marginal differences in OS between patients treated with no boost and EBRT boost modalities. However, the OS of the patients treated with BT boost modality was much higher as compared to that of other two groups, i.e. no boost and EBRT boost. The same trend was observed across the clinical stages IB-IIIB (Table 1). All these differences in OS were statistically significant (p<0.05).

Conclusion: This study indicates that the BT boost is superior to EBRT boost modality for overall survival in locally advanced cervical cancer patients. Therefore, every effort should be made to use BT boost in treating cervical cancer patients with curative intent. Table 1: Overall survival (OS; mean/ median in months) of stage IB-IIIB cervical cancer patients.
Initial/Primary Tx modality EBRT (40-60Gy) + Chemotherapy p-value
Boost Tx modality No boost EBRT boost BT boost
No. of patients 2,003 (20.2%) 902 (9.1%) 7,031 (70.7%)
OS for all patients 69.7/ 52.1 63.5/ 38.2 90.8/ 112.9 <0.001
OS for Stage IB pts. 91.1/ 120.3 72.2/ 71.9 102.1/ 133.6 <0.001
OS for Stage II pts. 83.5/ 105.5 73.8/ 65.6 96.3/ 127.9 <0.001
OS for Stage III pts. 52.1/ 24.6 57.8/ 29.1 79.3/ 71.6 <0.001

Author Disclosure: T.K. Podder: None. A. Dey: None. S. Datta: None. T. Biswas: None.

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