Impact of treatment duration on cervical cancer outcomes with concomitant chemoradiation

Treatment duration has been linked to outcomes in cervical cancer. This study aimed to evaluate the impact of treatment duration on overall survival (OS) and disease-free survival (DFS) in patients undergoing concomitant chemoradiation (CCRT).

A retrospective analysis was conducted on 82 consecutive cervical cancer patients treated with curative-intent CCRT over the course of one year. All patients received external beam radiotherapy followed by high-dose-rate brachytherapy, with concomitant weekly intravenous cisplatin (40 mg/m², maximum 70 mg/week). Clinicopathologic factors, treatment-related factors, and toxicities were collected. OS and DFS were estimated using Kaplan-Meier analysis and compared via log-rank tests. Multivariate analysis was performed using the Cox proportional hazards model. Median treatment duration of 75 days was used as a cut-off.

Median patient age was 55 years, and 50% were stage IIB. Median follow-up was 36 months. The 3-year OS and DFS rates were 65.9 % and 40.2 %, respectively. Treatment duration >75 days was significantly associated with worse OS (HR 6.54, p<0.001) and DFS (HR 3.68, p<0.001). Prolonged treatment was primarily due to delays in initiating brachytherapy. Completion of CCRT within 75 days was associated with improved survival outcomes.

Treatment prolongation adversely affects OS and DFS in cervical cancer patients receiving CCRT. Timely completion of therapy is crucial for optimal outcomes.

Identifying and addressing modifiable factors that contribute to treatment delays, such as timely scheduling of brachytherapy, may improve prognosis and overall treatment efficacy in cervical cancer management.