DOI: https://doi.org/10.22263/2312-4156.2023.3.71
E.A. Suslova, N.A. Artemova, L.V. Mirilenko
The efficacy dependence of combined radiotherapy for cervical cancer on tumor size
N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Republic of Belarus
Vestnik VGMU. 2023;22(3):71-78.
Abstract.
Objectives. To determine the dependence of the results of combined radiation therapy for cervical cancer on the size of the tumor focus.
Material and methods. The study included patients with cervical cancer stages IIA - IIIC1, who underwent standard combined radiotherapy (control group) and radiation therapy using the developed method of adaptive combined radiation therapy (main group). Each group consisted of 112 female patients who were comparable in terms of the main clinical and biological parameters. The immediate and long-term results were evaluated.
Results. The obtained results showed the dependence of the total direct objective effect of radiation therapy in patients with stages IIA-IIIC1 cervical cancer on tumor size. Thus, for tumors ≤4 cm it was 92.0% (95% CI 83.4–97.0%), for tumors >4 cm it was 60.4% (95% CI 52.1–68.3%) (p<0.001). When comparing two methods of radiation therapy, the advantages of the developed method have been shown, especially for large tumors. So, with tumors of 4.1-6.0 cm, complete regression in the primary focus was achieved 1.9 times (p<0.001), and with >6 cm - 4.1 times more often (p<0.001) than with standard treatment method. The index of the 4-year overall survival has increased by 18.1% (p=0.018), adjusted – by 19.8% (p=0.011), event-free – by 32.5% (p<0.001) for tumors >4 cm; for female patients with tumor size >6 cm the overall survival index has increased by 22.8% (p=0.034), adjusted survival – by 27.3% (p=0.021), event-free survival – by 34.5% (p<0.001), respectively.
Conclusions. It has been established that there is a statistically significant dependence of the immediate results of treatment in patients with stage IIA–IIIC1 cervical cancer on tumor size during standard combined radiotherapy, while the developed method of adaptive combined radiotherapy is highly effective for any tumor size.
Keywords: cervical cancer, adaptive combined radiation therapy, immediate objective effect, survival.
Acknowledgements. The authors express their deep gratitude to anonymous reviewers of their article.
The research was carried out within the frames of the State Research Program (GPNI) “Scientific and technical support for the quality and accessibility of medical services”, subprogram “Malignant tumors”.
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Information about authors:
E.A. Suslova – correspondence postgraduate, radiation oncologist of the radiology department No.3, N.N. Alexandrov National Cancer Centre of Belarus
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Elena A. Suslova;
N.A. Artemova – Doctor of Medical Sciences, professor, principal research officer of the radiation therapy laboratory, scientific secretary, N.N. Alexandrov National Cancer Centre of Belarus;
L.V. Mirilenko – statistics and analysis group specialist of the department of anti-cancer fight organization, N.N. Alexandrov National Cancer Centre of Belarus.
