AccScience Publishing / ARNM / Online First / DOI: 10.36922/arnm.4310
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ORIGINAL RESEARCH ARTICLE

Evaluating the impact of brachytherapy duration on therapeutic outcomes in patients with cervical cancer

Haonan Han1† ,  Hailing Hou2† ,  Lin Qiu3 ,  Chingyun Cheng4 ,  Keying Xu4 ,  Minglei Kang5 ,  Tingting Chen2 ,  Yanling Yang2 ,  Xiangpan Li6* ,  Liming Xu2*
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1 Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences Three Gorges University, Yichang, Hubei, China
2 Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
3 Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China
4 Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States of America
5 New York Proton Center, New York, United States of America
6 Department of Radiation Oncology, Renmin Hospital of Wuhan University/Hubei General Hospital, Wuhan, China
ARNM 2024, 2(4), 4310 https://doi.org/10.36922/arnm.4310
Submitted: 23 July 2024 | Accepted: 3 September 2024 | Published: 21 October 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The total duration of radiotherapy for patients with cervical cancer should be limited to 56 days to optimize treatment outcomes. This study aimed to statistically evaluate the effects of extended radiotherapy duration on survival and complications in 649 patients with cervical cancer treated with brachytherapy at our institution from 2014 to 2019. All patients had undergone intensity-modulated external beam radiation therapy, with 525 receiving two-dimensional (2D) brachytherapy and 124 receiving three-dimensional (3D) brachytherapy. Using the inverse probability of treatment weighting (IPTW) and propensity score matching (PSM), clinical data regarding treatment duration, survival outcomes, and complications were analyzed. PSM revealed that overall survival (OS) did not significantly differ between patients receiving prolonged treatment (>56 days) and those receiving treatment for a standard duration (<56 days) (P > 0.05). However, among patients who had received 2D brachytherapy, prolonged treatment correlated with increased recurrence and metastasis risks (P < 0.001); this trend was not evident in patients receiving 3D brachytherapy (P = 0.287). Higher FIGO stages were associated with worse OS and higher progression risks, which persisted post-IPTW adjustment. Extended radiotherapy duration was linked to a higher incidence of rectal and bladder reactions, particularly in the 2D group. Consequently, strictly controlling radiotherapy duration for patients receiving 2D brachytherapy is essential to reduce recurrence and metastasis risks. Close monitoring of rectal and bladder reactions is also recommended.

Keywords
Cervical cancer
Radiotherapy
Brachytherapy
Treatment duration
Funding
This study was supported by the National Natural Science Foundation of China (Grant no.: 82373194).
Conflict of interest
Minglei Kang and Liming Xu are the Editorial Board Members of this journal but were not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Published by AccScience Publishing
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