(Tuesday, 7/31/2018) 1:15 PM - 1:45 PM
Room: Exhibit Hall | Forum 7
Purpose: To evaluate the clinical outcome benefit while treating cervical cancer patients with intensity modulated radiation therapy (IMRT) and 3D-conformal radiation therapy (3D-CRT).
Methods: We have analyzed National Cancer Database for locally advanced cervical cancer patients with FIGO stage IB-IIIB, treated from 2004 to 2014. Considered non-surgical patients who received both chemotherapy and external beam radiation therapy (EBRT). Included patients received primary/initial treatment with either IMRT (n=286) or 3D-CRT (n=120) of 40-60Gy dose. Patients were stratified based on treatment modality; one group received IMRT for both initial and boost while the other group received 3D-CRT for initial as well as boost treatment. IBM-SPSS (ver-24.0) was used for statistical analysis; p-value < 0.05 (two-tail, t-test) was considered statistically significant.
Results: The median age of the patients was 53 years. The median follow-up was 24.4 months. Median overall survival was 36.1 months for the patients treated with IMRT while those for 3D-CRT was 51.2 months, which was statistically significant (p < 0.05). 2-year, 5-year and 10-year overall survival were about 9%, 7% and 4% higher for the patients treated with 3D-CRT (p < 0.007).
Conclusion: From the long-term data analysis it appears that 3D-CRT modality is superior to IMRT, so far the overall survival of cervical cancer patients is concerned. It may be due the finer modulation of the radiation beam in IMRT technique, while the daily variation of patient’s anatomy as well as the tumor/target motion and set up interplay might not be negligible. If the daily position of the tumor is uncertain, the beam modulation in IMRT may result in inadequate coverage of the target. Whereas, the 3D-CRT is less susceptible to inter-fractional or inter-fractional uncertainties of tumor/target position as well as the interplay of small IMRT segments and the target location.
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