Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep;5(9):2205-12.
doi: 10.1002/cam4.794. Epub 2016 Jul 15.

Impact of treatment time-related factors on prognoses and radiation proctitis after definitive chemoradiotherapy for cervical cancer

Eng-Yen Huang  1   2 , Hao Lin  3 , Chong-Jong Wang  1 , Chan-Chao Chanchien  3 , Yu-Che Ou  4
Affiliations

Impact of treatment time-related factors on prognoses and radiation proctitis after definitive chemoradiotherapy for cervical cancer

Eng-Yen Huang et al. Cancer Med. 2016 Sep.

Abstract

This study aimed to investigate the impact of treatment time-related factors on outcomes and radiation proctitis in patients undergoing concurrent chemoradiotherapy (CCRT) for cervical cancer. From September 2001 to December 2012, 146 patients with stage IIB cervical squamous cell carcinoma treated with CCRT were reviewed from a prospective cohort. Patients who received the same dose (45 Gy) of external beam radiation therapy (EBRT) were included in the analysis (n = 125). The same equivalent dose of 2 Gy (EQD2) of high-dose-rate intracavitary brachytherapy (HDR-ICBT) was delivered at either 4 fractions of 6 Gy or 6 fractions of 4.5 Gy. The effects of the overall treatment time (OTT) and interval between EBRT and HDR-ICBT on the cancer-specific survival (CSS), local recurrence (LR), and incidence of proctitis were compared. The treatment time-related factors did not adversely affect the CSS and LR rates. The multivariate analyses did not identify the OTT as an independent factor of CSS (P = 0.839) and LR (P = 0.856). However, OTT ≤56 days (P = 0.026) was identified as the only independent factor of overall proctitis. The 5-year Grade 2 or greater proctitis rates were 14.9% and 0% (P = 0.001) in patients with the EBRT to ICBT interval ≤5 days and >5 days, respectively. To reduce rectal damage without compromising prognosis, the gap between EBRT and HDR-ICBT should exceed 5 days in cervical cancer patients undergoing CCRT. Strictly limiting the OTT to 56 days may result in radiation proctitis without improvements in prognosis.

Keywords: Cervical cancer; concurrent chemoradiotherapy; high-dose-rate; intracavitary brachytherapy; overall treatment time; radiation proctitis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Effect of treatment time on overall proctitis. (A) Overall treatment time (OTT) of 56 days or less increased the risk of proctitis. (B) A gap interval >5 days between EBRT to ICBT could significantly reduce proctitis in patients receiving six fractions of 4.5 Gy ICBT. EBRT, external beam radiation therapy.
Figure 2
Figure 2
Effect of treatment time on grade 2 or greater proctitis. (A) None of the patients with a gap interval >5 days developed grade 2–4 proctitis. (B) An overall treatment time (OTT) of 56 days or less did not affect Grade 2–4 proctitis.
See this image and copyright information in PMC

References

    1. Chen, S. W. , Liang J. A., Yang S. N., Ko H. L., and Lin F. J.. 2003. The adverse effect of treatment prolongation in cervical cancer by high‐dose‐rate intracavitary brachytherapy. Radiother. Oncol. 67:69–76. - PubMed
    1. Fyles, A. , Keane T. J., Barton M., and Simm J.. 1992. The effect of treatment duration in the local control of cervix cancer. Radiother. Oncol. 25:273–279. - PubMed
    1. Girinsky, T. , Rey A., Roche B., Gerbaulet A., Randrianarivello H., and Chassagne D.. 1993. Overall treatment time in advanced cervical carcinomas: a critical parameter in treatment outcome. Int. J. Radiat. Oncol. Biol. Phys. 27:1051–1056. - PubMed
    1. Lanciano, R. M. , Pajak T. F., Martz K., and Hanks G. E.. 1993. The influence of treatment time on outcome for squamous cell cancer of the uterine cervix treated with radiation: a patterns‐of‐care study. Int. J. Radiat. Oncol. Biol. Phys. 25:391–397. - PubMed
    1. Perez, C. A. , Grigsby P. W., Castro‐Vita H., and Lockett M. A.. 1995. Carcinoma of the uterine cervix. I. Impact of prolongation of overall treatment time and timing of brachytherapy on outcome of radiation therapy. Int. J. Radiat. Oncol. Biol. Phys. 32:1275–1288. - PubMed

MeSH terms