e17501 Background: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced cervical cancer (LACC). However, the adoption of CCRT is often hindered by financial barriers, limited healthcare capacity, and heightened concerns about adverse events, leading to the reluctance in administering CCRT. This study aimed to decipher factors associated with the clinical outcomes of stage III cervical cancer patients treated with (chemo)radiotherapy in Indonesia. Methods: This retrospective cohort study included patients with stage III cervical cancer receiving definitive external beam radiotherapy (EBRT) and brachytherapy at Dr. Cipto Mangunkusumo Hospital, Indonesia, between 2019 and 2022. Demographic, clinical, tumor, and treatment-related characteristics were extracted from medical records. Bivariate and multivariate analyses were performed to identify factors associated with 2-year overall survival (OS) and progression-free survival (PFS) estimated using the Kaplan-Meier method. Results: A total of 218 patients were eligible for this study. Most patients were diagnosed with stage IIIC1r (70.2%) cervical squamous cell carcinoma (82.6%). Most of them received CCRT (65.6%) with a median total EQD2 dose of 80 Gy and overall treatment time (OTT) of 97 days. With a median follow-up was 21 months, the 2-year OS and PFS were 70.6% and 71.6%, respectively. On multivariate analysis, tumor size (hazard ratio HR: 2.47; p = 0.013), hemoglobin level (HR: 0.50; p = 0.010), and CCRT (HR: 2.38, p = 0.001) were significant predictors for OS. Furthermore, tumor size (HR: 2.14, p = 0.032), nodal involvement (HR: 0.44, p = 0.015), and CCRT (HR: 1.75, p = 0.037) were significant predictors for PFS. Conclusions: Smaller tumor size and administering CCRT were independent prognostic factors for improved OS and PFS. In addition, anemia was significantly associated with poorer OS, whereas nodal involvement was significantly associated with poorer PFS. Expanding access for CCRT must be prioritized to improve clinical outcomes for patients with LACC. Multivariate analysis of prognostic factors for 2-year OS and PFS. Variables Reference/Median HR (95% CI) for OS P value HR (95% CI) for PFS P value Age (years) 50 0.92 (0.56 – 1.51) 0.731 1.10 (0.66 – 1.82) 0.716 Histology SCC vs other 1.15 (0.59 – 2.25) 0.685 1.19 (0.61 – 2.35) 0.609 Tumor size (cm) 4 2.47 (1.21 – 5.01) 0.013* 2.14 (1.07 – 4.26) 0.032* Nodal involvement – vs + 1.24 (0.52 – 2.93) 0.632 0.44 (0.23 – 0.85) 0.015* Hemoglobin (g/dL) 10 0.50 (0.29 – 0.85) 0.010* 0.58 (0.33 – 1.00) 0.051 Treatment CCRT vs RT 2.38 (1.42 – 3.98) 0.001* 1.75 (1.04 – 2.97) 0.037* Total EQD2 (Gy) 80 0.58 (0.30 – 1.12) 0.105 0.89 (0.39 – 2.02) 0.771 OTT (days) 97 1.22 (0.73 – 2.05) 0.455 1.01 (0.60 – 1.67) 0.967 <jats:table-wr
Oktavianda et al. (Thu,) studied this question.