Mittal P, et al. - Researchers investigated the outcomes of patients with locally advanced cervical cancer treated with chemoradiation and point A–based brachytherapy (BT) using x-ray– or computed tomography–based planning. Comparable to a published magnetic resonance imaging–based brachytherapy (MRBT) series, good 3-year outcomes were observed in this current investigation. A recommendation was made for continuing conventional BT with selective use of interstitial needles and MRBT as standard procedures until level-I evidence for MRBT becomes available.

Methods

• Researchers included patients treated between January 2014 and December 2015.
• Patients were asked to undergo x-ray– or computed tomography–based BT planning with a goal to deliver equivalent doses in 2 Gy (EQD2) > 84 Gy₁₀ to point A while minimizing maximum dose received by rectum or bladder to a point or 2 cc volume to < 75 Gy EQD2 and < 90 Gy EQD2, respectively.

Results

• Analysis included 339 patients with a median age of 52 (32 to 81) years; 52% of these patients had stage IB2 to IIB disease and 48% had stage III to IVA disease.
• Data showed 85% compliance with chemoradiation, and four or more cycles were received by 87% of patients.
• The median point A dose of 84 (64.8 to 89.7) Gy was administered and the median rectal and bladder doses used in this population were 73.5 (69.6 to 78.4) Gy₃ and 83 (73.2 to 90.0) Gy₃, respectively.
• A median follow-up of 28 (4 to 45) months revealed 94.1%, 83.3%, and 82.7% to be the estimated 3-year local, disease-free, and overall survival for stage IB to IIB disease, respectively, while corresponding rates for stage III to IVA were 85.1%, 60.7%, and 69.6%.
• In 4.7% and 0% of patients, researchers observed grade III to IV proctitis and cystitis, respectively.