Abstract 298P
Background
Cervical Cancer is one of the leading causes of cancer mortality in Indian women.Most of the women present in advanced stages of cervical cancer. Although CTRT remains the standard of care there were several challenges in implementation. In this study we assesed 3-year outcomes of LACC patients and the factors impacted the outcome.
Methods
We retrospectively analysed the records and follow up data of 131 patients of locally advanced cervical cancer registered in 2019. We noted the baseline characteristics include demographic data, comorbidities, histology and stage, treatment details, follow up data which include their disease status, death. Table: 298P
Baseline characterstics
| Variables | N=131 | (%) | |
| Comorbidities | |||
| Diabetes Mellitus | 19 | 14.5 | |
| Hypertension | 18 | 13.7 | |
| Others | 16 | 12.2 | |
| None | 78 | 59.5 | |
| ECOG | |||
| 1 | 98 | 74.8 | |
| 2 | 29 | 22.1 | |
| 3 | 4 | 3.1 | |
| Histology | |||
| Squamous Cell Carcinoma | 121 | 92.4 | |
| Adenocarcinoma | 6 | 4.6 | |
| Others | 4 | 3.1 | |
| Stage (FIGO 2018) | |||
| IB | 8 | 6.1 | |
| IIA | 5 | 3.8 | |
| IIB | 47 | 35.9 | |
| IIIA | 6 | 4.6 | |
| IIIB | 47 | 35.9 | |
| IIIC1 | 9 | 6.9 | |
| IIIC2 | 3 | 2.3 | |
| IVA | 6 | 4.6 |
Results
The median follow-up time was 45.5 months (IQR - 39.7-47.4). 5 patients had defaulted radiotherapy, 5 defaulted brachytherapy and 9 deferred brachytherapy. The average time from diagnosis to start of treatment is 109 days. 3-year OS was 78.6%. Stage-wise survival was IB (100%), IIA (100%), IIB (78.7%), IIIA (83.3%), IIIB (78.7%), IIIC (66.6%) & IVA (50%). 82.4% in CTRT patients and 72.4% in RT alone were alive. Dose >85Gy resulted in better local control and survival. The 3-year OS of patients with Overall Treatment Time <56 days is 89.1% while OTT >56 days is 80.7% (p=0.215).
Conclusions
The findings of this study highlighted the importance of concurrent chemoradiation in locally advanced cervical cancer. Doses >85 Gy to the disease and OTT <56 days showed better outcomes. Strategies to improve compliance to CTRT and image-guided adaptive brachytherapy will help in improved local control and survival. In low-middle income countries, these outcomes are also impacted by non-compliance and long wait-list to treatment, which is often due to logistical and socio-cultural barriers.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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