The association between additional radiotherapy after systemic chemotherapy and the prognosis of stage FIGO 2018 IVB cervical cancer.

Abstract

Objective: Systemic platinum-based chemotherapy is the first-line treatment of choice for metastatic cervical cancer. While subsequent radiotherapy after primary chemotherapy is a potential option, its benefit remains unclear. This multicenter retrospective study aimed to evaluate whether post-chemotherapy radiotherapy improves the prognosis of metastatic cervical cancer.

Methods: We retrospectively analyzed 46 eligible patients, including 22 patients receiving chemotherapy-alone and 24 patients receiving chemotherapy followed by subsequent radiotherapy. Medical records were retrospectively reviewed for patient characteristics, subsequent treatment modality, adverse events during the treatment course, metastasis site, recurrence or progression, and recurrence sites. Fisher exact test or chi-squared test, the Mann-Whitney U test, log-rank test, and Cox proportional hazards model were used.

Results: The 2-year overall survival (OS) rate for all patients was 47%, with the median OS of 24.8 months. Patients receiving chemotherapy alone (chemotherapy-alone group) had a 2-year OS rate of 23%, while those receiving subsequent radiotherapy (chemotherapy-radiotherapy group) had a significantly higher OS rate of 67% (HR = 2.83, P = 0.006). The 2-year progression-free survival (PFS) rates were 9% and 33%, respectively (HR = 3.25, P = 0.010). Serious adverse events occurred in 46.2% of the chemotherapy-alone group and 29.2% of the chemotherapy-radiotherapy group during subsequent treatment (P = 0.249).

Conclusion: Post-chemotherapy radiotherapy may improve the prognosis of metastatic cervical cancer without increasing serious adverse events. Further prospective studies are warranted to validate these findings.