Gynecological Cancer

PV QA 4 - Poster Viewing Q&A 4

TU_14_3460 - Treatment Outcomes and Prognostic Factors of Elderly Women With Cervical Cancer : Does Conservative Treatment Strategy Be Appropriate?

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

Treatment Outcomes and Prognostic Factors of Elderly Women With Cervical Cancer : Does Conservative Treatment Strategy Be Appropriate?
P. Hou; Far Eastern Memorial Hospital, New Taipei City, Taiwan

Purpose/Objective(s): To evaluate the differences of clinical prognosis for elderly cervical cancer patients treated with radiotherapy (RT).

Materials/Methods: We retrospectively analyzed 154 patients receiving definitive or adjuvant RT with or without chemotherapy (CT) between 2007 and 2016. Patients were divided into two groups, age < 70 years old and age ≥ 70, and were analyzed by treatment efficacy and clinical outcomes.

Results: The median follow-up was 36.2 months. Median age of patients was 59 years (range with 25-92). 112 patients (73%) were group 1 (age < 70), and 42 patients (27%) were group 2 (age ≥ 70). Histopathology, FIGO stage, external beam RT (EBRT) dose, and overall treatment time (OTT) of RT were similar between two groups. Elderly patients significantly received less concurrent CT or following boost with intracavitary brachytherapy (ICRT), fewer total RT dose (EBRT and ICRT), and more limited RT volume confined to gross tumor only (Table 1). The treatment outcomes between group 1 and 2 revealed median overall survival (OS) time was not reached vs. 37 months, 3-yr/5-yr OS rate were 70% vs. 52.5%/63.5% vs. 41.5% (p = 0.001), 3-yr/5-yr cancer-specific survival (CSS) were 74.3% vs. 72.2%/68.7% vs. 66.2% (p = 0.62), 3-yr/5-yr loco-regional recurrence-free survival (LRRFS) were 86.5% vs. 83.2%/81.5% vs. 83.2% (p = 0.67), 3-yr/5-yr local recurrence-free survival (LRFS) were 89.3% vs. 83.2%/85.8% vs. 83.2% (p = 0.33). No differences were found in CSS, LRRFS and LRFS rates between two age groups, although reduced OS was noted in elderly patients. Better CSS was found in all patients receiving concurrent chemoradiotherapy (CCRT) compared with RT alone (p= 0.003). However, for elderly women, adding CT didn¡¦t improve survival. On multivariate analysis of CSS for age ≥ 70 y/o patients, the FIGO stage I-II and squamous cell carcinoma(SCC) were significantly favorable prognostic factors, neither the concurrent CT, ICRT, extended RT volume, nor the higher total RT dose(≥ 80 Gy).

Conclusion: Elderly cervical cancer patients had comparable CSS and loco-regional control rate in spite of receiving less comprehensive treatment including CT, ICRT or limited RT volume. Conservative treatment strategy with RT alone could be appropriate for age ≥ 70 y/o patients, especially favorable stage and histopathology. Table 1   Patient characteristics
age < 70 (N=112) age ≥ 70 (N=42) P value
Pathology (%)     SCC     Adenosquamous carcinoma     Adenocarcinoma     Small cell carcinoma 93 (83) 3 (3) 15 (13) 1 (1) 38 (91) 0 (0) 3 (7) 1 (2) .42
FIGO stage (%)     I     II     III     IV 23 (20) 56 (50) 20 (18) 13 (12) 2 (5) 22 (52) 10 (24) 8 (19) .13
Total RT dose, median (Gy) (range) 75 (24-106.4) 70.2 (23.4-96) .04
RT volume     Tumor only     Tumor and involved regions 3 (3) 109 (97) 6 (14) 36 (86) .01
Concurrent CT     Present     Absent 100 (89) 12 (11) 21 (50) 21 (50) .00
ICRT     Present     Absent 73 (65) 39 (35) 13 (31) 29 (69) .00
OTT of RT, median (day) 63 61 .85
OS (%)     3yr     5yr 70 63.5 52.5 41.5 .001
CSS (%)     3yr 5yr 74.3 68.7 72.2 66.2 .62

Author Disclosure: P. Hou: None.

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