Factors affecting survival of cervical cancer patients treated at the radiation unit of Srinagarind Hospital, Khon Kaen University, Thailand.

ABSTRACT

This retrospective longitudinal study aimed to evaluate factors for survival of cervical cancer patients treated with radiation therapy. Information was retrieved from the medical records of 1,180 cervical cancer patients and pathologic material was reviewed to confirm the diagnosis who treated with radiation therapy at Srinagarind Hospital, Khon Kaen University between 1 January 1994 to 31 December 1999. And they were followed up until December 31, 2004. The patients current vital status was searched through hospital-based registry, the population-based cancer registry of Khon Kaen Province, the civil registration database, the Ministry of Interior and mails were sent to them. Data were analysed with the Kaplan-Meier, Log-rank test and Cox proportion hazard model. Results were found that mortality rate of 70 per 1,000 person-year. The overall 5-years survival rate was 62.5%. Median time survival was <10 years. From multivariate analyses, the factors that were statistically affected survival of cervical cancer patients included staging (p-value<0.001), hemoglobin level (p-value<0.001), interval between external and intracavitary radiation (p-value<0.001) and fractionation (p-value=0.024). Stage III was the most important risk factors of mortality risk with 1.65-fold mortality risk compared with stage I (95% CI=1.05-2.59). Patients with low hemoglobin level (< or = 10 g./dl.) was associated with 1.85-fold mortality risk compared with patients who had level >12 g./dl. (95% CI=1.40-2.44). The interval between external and intracavitary radiation >28 days was associated with 2.28-fold mortality risk compared with patients who had duration <1 day (95% CI= 1.40-2.44). The fractionation 2 faction was associated with 0.25-fold mortality risk compared with 1 fraction (95% CI=0.07-0.96).The results of study show that stage of disease, hemoglobin level, interval between external- intracavitary radiation and fractionations were factors affected survival cervical patients treated with radiation. Future prospective trials should be undertaken to confirm the validity of these factors and to elucidate their therapeutic implications.