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The Role of Radiotherapy for Metastatic Cervical Cancer: A Real-World Study
1Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China; Department of Oncology, Liuzhou People's Hospital, Liuzhou, Guangxi, China.
Aims:
Data on the efficacy of radiotherapy (RT) in metastatic cervical cancer (mCC) are limited. Herein, we evaluated the efficiency of RT for mCC.
Materials And Methods:
This is a retrospective cohort study. A total of 99 patients with mCC from April 2018 to April 2022 were treated with either radiotherapy group (RT group) or non-radiotherapy group (NRT group). All patients received systemic treatments.
Results:
The complete response rates (CRRs) were 15.8% and 4.8% (P = 0.322) and the objective response rates (ORRs) were 68.4% and 42.8% (P = 0.011) in the RT group and NRT group, respectively. The median follow-up was 16 months (5-53 months). The RT group showed higher overall survival (OS) (1-year 82.5% vs 57.1%, 2-years 60.7% vs 31.1%, P = 0.035) and progression-free survival (PFS) (1-year 64.7% vs 35.7%, 2-years 41.3% vs 24.4%, P = 0.022). RT extended median OS (mOS) from 16 to 27 months and median PFS (mPFS) from 9 to 18 months. Multivariate analyses revealed radiotherapy, 5-8 chemotherapy cycles, and nonhepatic metastasis as independent prognostic factors for OS and PFS. Subgroup analysis showed improved OS and PFS with RT in patients aged over 60, with squamous cell carcinoma, single organ metastasis, and those receiving 2-4 chemotherapy cycles. Besides, notably, enhanced OS was observed in patients with lymph node-only metastasis who received RT (78.9% vs. 50.0%, P = 0.029). The primary acute adverse event was haematology toxicity. There was no increased toxicity with the addition of RT.
Conclusion:
Radiotherapy combined with systemic therapy demonstrates an increased objective response rate for mCC. It can also improve OS and PFS and extend mOS and mPFS for mCC without escalating treatment-related toxicity. For patients aged over 60, with squamous cell carcinoma, single organ metastasis, lymph node-only metastasis, and those receiving 2-4 chemotherapy cycles, proactive RT intervention is recommended. Careful patient selection is advised for RT in mCC.
