Prognostic Factors and Treatment Outcomes in Patients With Cervical Carcinoma Following Standard Treatment: A Retrospectivesingleinstitutional Observational Study

Background:Cervical cancer remains an important health burden, particularly in low- and middle-income countries.Treatment-related toxicity and short-term disease control are important considerations in the management and follow-up ofpatients receiving radiotherapy-based treatment. The objective is to evaluate treatment-related early and late toxicities andthe 1-year disease-free outcome in patients with cervical cancer treated with radiotherapy-based approaches. Materials andMethods:This retrospective, observational, single-institutional study was conducted in the Department of Radiotherapy atMalda Medical College and Hospital. Patients with cervical cancer who underwent radiotherapy-based treatment, includingexternal beam radiotherapy (EBRT) with brachytherapy, with or without surgery and concurrent chemotherapy, wereincluded. EBRT was administered using conventional fractionation to a total dose of 50–54 Gy, with brachytherapydelivered subsequently. Early toxicities included gastrointestinal, hematological, and skin toxicities, while late toxicitiesincluded radiation proctitis and radiation cystitis. Disease-free status was assessed at 6 and 12 months after completion oftreatment.Results: A total of 42 patients were included. Three patients (7.1%) received 54 Gy in 27 fractions, whereas 39patients (92.9%) received 50 Gy in 25 fractions. All patients received brachytherapy in three fractions of 7 Gy. EBRTinterruption was documented in 9 patients (21.4%). Gastrointestinal toxicity was the most frequently recorded early toxicity,occurring in 9 patients (21.4%), followed by hematological toxicity in 6 (14.3%) and skin toxicity in 3 (7.1%) patients.Radiation proctitis and radiation cystitis were documented in 4 (9.5%) and 2 (4.8%) patients, respectively. At 6 months aftercompletion of treatment, 40 of 42 patients (95.2%) remained disease-free, while 2 patients (4.8%) had developed diseaserecurrence. During subsequent follow-up, 3 additional patients developed disease recurrence between 6 and 12 months.Thus, at 12 months, 37 of 42 patients (88.1%) remained disease-free, while 5 patients (11.9%) had developed diseaserecurrence. An exploratory analysis demonstrated a statistically significant association between pretreatment nodal stage andthe 12-month disease-free outcome (p=0.003).Conclusion:Radiotherapy-based treatment incorporating EBRT andbrachytherapy was associated with favorable short-term observed disease-free outcomes in this single-institutionretrospective cohort. The observed disease-free proportion was 95.2% at 6 months and 88.1% at 12 months after treatment.Although nodal status showed a statistically significant exploratory association with the 12-month disease-free outcome, thesmall sample size, limited number of recurrence cases, and incomplete staging information preclude definitive conclusionsregarding independent prognostic factors. Larger prospective studies with complete follow-up and standardized assessmentare warranted.