Radiotherapy of stage IVA cervical cancer in the Radiotherapy Department of the Aristide le Dantec Hospital in Dakar

Abstract

INTRODUCTION: The management of stage IVA cervical cancer is based on radio-chemotherapy followed by utero-vaginal brachytherapy. In this study, we evaluate the results of external radiotherapy on stage IVA cervical cancer. MATERIALS AND METHODS: This was a retrospective, descriptive study. It covered all patients with stage IVA carcinoma of the cervix who received external radiotherapy at the Joliot Curie Institute of the Aristide Le Dantec Hospital from January 2018 to December 2019. RESULTS: We found 164 clinical records of patients, of which 24 patients had stage IVA, (14.3% of all cases). The average age of our patients was 51 years ± 12.13. Seventeen patients (70.9%) had an altered general condition on admission. The predominant histological type was squamous cell carcinoma found in 22 cases (91.6%). Anemia was found in 14 patients, (58.4%). Neo-adjuvant chemotherapy was performed in 21 of our patients (87.5%). Radiotherapy was exclusive in 20 patients (83.3%) and concomitant radio-chemotherapy was performed in 4 patients (16.7%). Normo-fractionated radiotherapy with curative intent was performed in 13 patients (54.2%), and hypo-fractionated radiotherapy with palliative intent was performed in the other 11 patients (45.8%). An objective response was found in 17 cases (70.8%) including 8 in patients who received hypo-fractionated radiotherapy and 9 in patients treated with normo-fractionated radiotherapy at a curative dose. Five patients (20.8%) had acute toxicity and 7 (29.2%) late toxicity. After 3 years of follow-up, 5 patients (29.2%) had loco-regional progression, 9 patients (37.5%) presented loco-regional recurrence and 4 patients (16.7%) presented distant metastases. Overall survival was 26.8% at 3 years. CONCLUSION: Normo-fractionated radiotherapy does not seem superior to palliative hypo-fractionated radiotherapy in terms of clinical response in stage IVA cervical cancer. KEYWORDS: Carcinoma; Uterine cervix; External radiotherapy.