Eter Natelauri, Krystyna Kiel, Tea Natelauri
Objective: This study aimed to compare the available treatment options for advanced cervical cancer that is reported for the first time in Georgia.
Methods: This study identified and analyzed 43 patients who received definitive treatment. Data were collected, medians and life tables were computed using the product-limit estimate by the Kaplan-Meier method, and the logrank test was used to assess statistical significance.
Results: The median follow-up period was 33 months. The overall reported loco-regional recurrence was 23.26% (7.14%, 29.41%, 33.33%, and 33.33% in hysterectomy, brachytherapy, Intensity-Modulated Radiation Therapy [IMRT] and Stereotactic Body Radiation Therapy [SBRT]), with the distant failure rates of 14.29%, 35.29%, 44%, and 66%, respectively. The 3-year disease-free survival was the highest in the post-radiation hysterectomy group (86%) compared to brachytherapy, IMRT, or SBRT groups (70%, 55%, and 33%, respectively). The 3-year overall survival was the highest in the SBRT boost group (100%) compared to the hysterectomy, brachytherapy, and IMRT groups (78%, 76%, and 55%, respectively).
Conclusion: Brachytherapy is preferred for treating advanced cervical cancers after external beam radiation and chemotherapy. However, if unavailable, alternatives can give a chance for local control and disease-free survival. Keywords: Cervical cancer; Uterus cervix; Alternatives of brachytherapy; Neoadjuvant chemoradiation