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Introduction/Background Cervical cancer is a global health problem with increasing incidence of diagnosing locally advanced disease in lower economic countries. Patients with locally advanced cervical cancer (LACC) treated with concomitant chemoradiation (CCRT) have different diseases free survival (DFS) and overall survival (OS). Staging of patients is not the only prognostic factor affecting the treatment outcomes and assessment of the other prognostic factors is essential to tailor the treatment . Methodology This retrospective analysis included 160 patients with LACC from January 2018 to January 2022.They were treated by definitive 3D conformal radiotherapy with concurrent chemotherapy followed by 4 fractions of 7 Gy CT guided HDR Brachytherapy . The clinicopathological factors were collected. Assessment of the relationship between these factors and survival were estimated by the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used as well. Results The mean of OS and PFS were 26.5 and 22.59 months respectively. The mean overall treatment time was long (12 weeks) . Patients with higher tumor grade and positive both pelvic & paraaortic LNs had lower survival rates. On multivariate analysis, tumor grade and positivity of pelvic and paraaortic LNs significantly adversely affected survival and considered independent prognostic parameter for survival. Only 2 patients with positive paraaortic LNs received radiotherapy boost beside the limited number of these patients might affect the validity to accurately determine their impact on the outcomes. Additionally, prolonged treatment time had a bad influence on the outcome and could be the reason for a poorer outcome, rather than the prognostic factors studied. Conclusion Tumor grade and positive pelvic & paraaortic LNs were considered independent poor prognostic factors for survival and changes in treatment strategies for these category of patients should be considered. Disclosures No.
Hegazy et al. (Fri,) studied this question.