Tumor Boost Using External Beam Radiation in Cervical Cancer Patients Unable to Receive Intracavitary Brachytherapy: Outcome From a Multicenter Retrospective Study (Korean Radiation Oncology Group 1419)

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PurposeWe conducted this study to evaluate the outcomes of external-beam radiotherapy tumor boost (EBRT-B) in cervical cancer patients who could not receive intracavitary brachytherapy.MethodsA total of 11 hospitals provided the data of patients who received EBRT-B during the period from January 2005 through October 2012.ResultsA total of 75 patients were included. The median radiotherapy dose was 46 Gy (range, 40–54 Gy) for whole pelvis and 24 Gy (range, 9–35 Gy) for EBRT-B. Initial tumor responses assessed at 2 to 6 months after radiotherapy were as follows: 46 with complete response, 22 with partial response, 2 with stable disease, and 3 with progressive disease. After a median follow-up time of 33 months, 30 patients (40.0%) showed disease progression including 21 (28.0%) with local progression. The 5-year local failure-free survival rate was 70.0%. Achieving complete response at the first follow-up visit and an overall treatment time of 53 days or less were significantly related to favorable local failure-free survival. The rate of grade 3 or higher toxicity was 2.6%.ConclusionsApproximately 70% of patients had local tumor control after curative radiotherapy using EBRT-B. Early tumor response and overall treatment time of 53 days or less were closely associated with favorable local control.

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