Short course versus conventional interventional radiotherapy (brachytherapy) regimen in locally advanced cervical cancer: A randomized clinical trial.
Abstract
Purpose
To evaluate whether reducing overall treatment time (OTT) by shortening interventional radiotherapy (IRT; brachytherapy) duration affects outcomes in patients with locally advanced cervical cancer undergoing definitive chemoradiation.
Methods
AND MATERIAL In this randomized clinical trial, conducted in 2016-2017, 75 patients with stage IB2-IVA cervical cancer were enrolled. The intervention group (n = 41) completed high-dose-rate IRT within 1 week, whereas the control group (n = 34) received the conventional 3-week schedule. The primary endpoint was treatment-related complications. RESULT At 5-year follow-up, 7 patients were lost to follow-up, leaving 68 patients for analysis. Median OTT was significantly shorter in the intervention group (59 vs. 64.5 days; p = 0.01), and the complete response rate was higher (53.1% vs. 31.3%; p = 0.041). No significant differences were observed in overall survival (p = 0.962) or disease-free survival (p = 0.128). Multivariate analysis identified treatment response as a significant predictor of survival, with complete response associated with improved outcomes (p < 0.001). Acute and late adverse events, including proctitis, cystitis, and vaginal hemorrhage, were comparable between groups (all p > 0.05).
Conclusion
Shortening IRT duration reduced OTT and improved complete response without increasing treatment-related toxicity, although no significant survival benefit was observed.