Radical external-beam radiotherapy in combination with intracavitary brachytherapy for localized carcinoma of the cervix in Sri Lanka: is treatment delayed treatment denied?
Authors
Joseph, N.Jayalath, H.
Balawardena, J.
Skandarajah, T.
Perera, K.
Gunasekera, D.
Weerasinghe, S.
Hoskin, Peter J
Choudhury, Ananya
Affiliation
General Hospital Chilaw, Ministry of Health, Chilaw, Sri Lanka.Issue Date
2020
Metadata
Show full item recordAbstract
Purpose: Radical external-beam radiotherapy (EBRT) followed by intracavitary brachytherapy is standard of care for patients with localized carcinoma of the cervix unsuitable for radical surgery. However, outcome data are scarce in resource-limited settings. We conducted a retrospective analysis of survival in a cohort of patients treated with this strategy in Sri Lanka. Patients and methods: All patients with localized cervical cancer treated with primary EBRT and intracavitary brachytherapy from 2014 to 2015 were included in the study. Primary end point was disease-free survival (DFS), defined as time to local or systemic recurrence or death. Univariable analysis was performed to determine the prognostic significance of the following variables: age, stage, use of concurrent chemotherapy, EBRT dose, brachytherapy dose, and time to completion of treatment (dichotomized at 60 days). Factors significant on univariable analysis were included in a multivariable model. Results: A total of 113 patients with available data were included in the analysis. Mean age was 58 years (range, 35-85 years), and most patients (n = 103 of 113) presented with stage ? IIB disease. Median time to delivery of brachytherapy from commencement of EBRT was 110 days (range, 34-215 days), with only 12 (11%) of 113 patients completing treatment within 60 days. Median follow-up was 28 months (range, 5-60 months), and 2-year DFS was 63.7% (95% CI, 55.4% to 73.2%). Treatment delay was the only significant factor associated with inferior DFS on univariable analysis (log-rank P = .03), and therefore, multivariable analysis was not performed. Conclusion: There are significant delays in receiving intracavitary brachytherapy after completing EBRT for cervical cancer in Sri Lanka, which is associated with inferior DFS. Increasing brachytherapy resources is an urgent priority to improve outcomes of patients with cervical cancer.Citation
Joseph N, Jayalath H, Balawardena J, Skandarajah T, Perera K, Gunasekera D, et al. Radical External-Beam Radiotherapy in Combination With Intracavitary Brachytherapy for Localized Carcinoma of the Cervix in Sri Lanka: Is Treatment Delayed Treatment Denied? JCO Glob Oncol. 2020;6:1574-81.Journal
JCO Global OncologyDOI
10.1200/go.20.00196PubMed ID
33079608Additional Links
https://dx.doi.org/10.1200/go.20.00196Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1200/go.20.00196
Scopus Count
Collections
Related articles
- Results of external-beam radiotherapy alone in invasive cancer of the uterine cervix: a retrospective analysis.
- Authors: Saibishkumar EP, Patel FD, Sharma SC, Karunanidhi G, Sankar AS, Mallick I
- Issue date: 2006 Feb
- Clinical outcomes following conventional external beam radiotherapy boost in Japanese patients with cervical cancer who are ineligible for intracavitary brachytherapy.
- Authors: Ito K, Shimizuguchi T, Karasawa K
- Issue date: 2019 Mar 1
- Transperineal low-dose rate iridium-192 interstitial brachytherapy in cervical carcinoma stage IIB.
- Authors: Budrukkar AN, Shrivastava SK, Jalali R, Agarwal JP, Deshpande DD, Nehru RM, Dinshaw KA
- Issue date: 2001 Oct
- Pulsed low dose rate brachytherapy for uterine cervix carcinoma.
- Authors: Rogers CL, Freel JH, Speiser BL
- Issue date: 1999 Jan 1
- An audit of the treatment of carcinoma of the uterine cervix using external beam radiotherapy and a single line source brachytherapy technique.
- Authors: Tan LT, Jones B, Gee A, Kingston RE
- Issue date: 1997 Dec