Impact of CT-based brachytherapy in elderly patients with cervical cancer

PURPOSE: Three-dimensional image-guided brachytherapy (3D-IGBT) has become the standard therapy for patients with cervical cancer. However, in this population, the impact of 3D-IGBT in elderly individuals remains unknown. This study assessed the efficacy of 3D-IGBT for elderly patients with cervical cancer. METHODS AND MATERIALS: We performed a retrospective chart review of 105 consecutive patients with cervical squamous cell carcinoma aged >= 70 years who received radiotherapy alone between January 2001 and September 2014. All patients were treated with external beam radiotherapy and high-dose-rate intracavitary brachytherapy. We assessed the treatment outcomes in all patients. We then compared outcomes between two groups: patients treated by changing the Point A dose at brachytherapy (Group A, n = 71) and those treated with 3D-IGBT at least twice (Group B, n = 34). RESULTS: The median followup period was 59 (range, 6-203) months; the median age was 77 years. The 5-year local control and cause-specific survival rates were 89% and 78%, respectively. The 5-year cumulative rates of late toxicities of the rectum and bladder of Grade >= 3 were 2.0% and 4.2%, respectively. No statistically significant differences were observed in the local control and cause-specific survival rates, or in the incidence of rectal toxicities between groups. The 3-year cumulative rates of urinary toxicity of Grade >= 1 were 20.4% and 6.9% in Group A and Group B, respectively (p = 0.035). CONCLUSION: In elderly patients with cervical cancer, 3D-IGBT could be performed safely and effectively and contributed to decreasing urinary toxicity incidence rates. (C) 2019 The Authors. Published by Elsevier Inc. on behalf of American Brachytherapy Society.