Addition of chemotherapy to radiation is associated with improved survival in older patients with cervical cancer: a Surveillance, Epidemiology, and End Results database analysis.
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引用次数: 0
Abstract
Objective: We evaluated the effectiveness of chemoradiation compared with radiotherapy alone in older patients with cervical cancer and determined the age sub-group wherein chemotherapy loses its significance using the Surveillance, Epidemiology, and End Results database.
Methods: Women aged ≥65 years with cervical cancer who received definitive radiotherapy or chemoradiation were identified on the basis of the 2000-2019 Surveillance, Epidemiology, and End Results data. Overall and cancer-specific survival were compared in treatment groups, with survival prognostic factors assessed using multivariate analysis. Exploratory sub-group analyses at 5-year age increments determined the age threshold at which chemotherapy benefits became non-significant, with a multivariate p value ≥ .05 indicating reduced impact on overall and cancer-specific survival.
Results: A total of 1832 patients were included in the study. Of these, 563 patients received radiotherapy, and 1269 patients received chemoradiation. The median age of the cohort was 74 years (Q1-Q3, 69.00-80.00). The 5-year overall and cancer-specific survival rates were 40.52% and 53.47%, respectively. In the multivariate analysis, chemotherapy significantly improved both overall (HR 0.47, p < .001) and cancer-specific (HR 0.57, p < .001) survival. For cancer-specific survival, the chemotherapy benefits progressively decreased with age, remaining significant until the age of >75 years (HR 0.63, p < .001) and decreasing after the age of 80 years (HR 0.79, p = .12). However, for overall survival, the chemotherapy benefit was observed in all age groups, except for patients aged >85 years (HR 0.72, p = 0.14).
Conclusions: Chemotherapy was beneficial for women aged ≥65 years with cervical cancer who underwent radiotherapy. However, in patients aged >80 years, chemotherapy had no significant impact on cancer-specific survival.
期刊介绍：
The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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