Concurrent chemoradiation in the routine management of patients with cervical cancer: does marital status matter?

The aim of this study was to investigate the relationship between marital status and outcome in women treated with concurrent chemoradiation (CT-RT) for locally advanced cervical cancer.

We reviewed the records of all women who received CT-RT for squamous or adenocarcinomas of the cervix at the M. D. Anderson Cancer Center between 1998 and 2005. Patients with extrapelvic disease, prior hysterectomy, concurrent second malignancies, or prior pelvic radiation therapy or chemotherapy were excluded. All patients received external beam and intracavitary radiation therapy with concurrent weekly cisplatin or cisplatin and 5-fluorouracil. Of 226 women, 117 were married (MPs; median follow-up, 41 months) and 109 were single, divorced, or separated (SPs; median follow-up, 42 months).

The SPs were more likely to be African American (P < 0.001), be medically indigent (P < 0.001), and have used illicit drugs (P = 0.01). Married patients were more likely to have traveled to Houston for care; SPs were more likely to be permanent residents of Houston (61% vs 29.1%, P < 0.001). The SPs more often presented with tumors of 6.0 cm or more (P = 0.01) and stage II to IVA disease (P = 0.02). There were no other significant between-group differences in patient or tumor characteristics or CT-RT compliance. At 3 years, there were no significant between-group differences in disease-specific (80% in MPs vs 78% in SPs, P = 0.61) or pelvic relapse-free survival rates (88% in MPs vs 86% in SPs, P = 0.62).

Despite patient and tumor characteristics traditionally associated with poorer outcomes, SPs do not have significantly poorer treatment completion rates or outcomes after CT-RT. Further studies are needed to determine whether these trends hold true in other practice settings.