Treatment outcomes and patterns of failure in elderly patients with cervical cancer treated with definitive radiotherapy

Abstract

OBJECTIVE The incidence of cervical cancer among older women is increasing. The treatment outcome in these patients is affected byvarious patient and tumor-related factors. In this study, we retrospectively investi-gated the survival outcomes, treatment-related toxicity, and patterns of failures for elderly patients (≥75 years old) with cervical cancer treated with definitive radiotherapy. METHODS Twenty-three patient’s fulfilling inclusion and exclusion criteria were analyzed. The survival was studied using the Kaplan-Meir method, and its relation with different clinicopathologic parameters was com-pared. RESULTS After a median follow-up time of 46 months (range 3-93), the overall survival for the entire cohort of patients at 5 years and 7 years were 54.9% and 43.9%, respectively, and the disease-free survival at 3 years and 5 years were 66.3% and 45.9% respectively. Patients receiving total radiation dose (EqD2) more than 80 Gy achieved statistically significant improved survival than those receiving lower doses (p=0.04). Grade III acute toxicity was experienced by 2 patients (8.7%) with diarrhea and one patient (4.3%) with dermatitis, but no grade IV acute toxicity was recorded. Two patients (8.7%) developed rectal bleeding as late toxicity. At the end of follow-up, 11 patients (47.8%) experienced a relapse. Distant metastasis to the lung was the most common type of failure. CONCLUSION Definitive radiotherapy is safe and well-tolerated by elderly patients with cervix cancer with an accept-able degree of toxicities.