ABSTRACT
PURPOSE: We aimed to evaluate the efficacy and safety of helical tomotherapy (HT) combined with computed tomography (CT)-guided three-dimensional intracavitary brachytherapy (CT-ICBT) in the treatment of locally advanced cervical cancer. METHODS: A total of 96 patients with locally advanced cervical cancer (IIB-IIIB) treated were retrospectively analyzed. They underwent concurrent radiochemotherapy, and the chemotherapy regimen paclitaxel + cisplatin was given for 3 weeks. The patients were divided into HT+CT-ICBT group (n=48) and intensity-modulated radiotherapy (IMRT) + two-dimensional ICBT (IMRT+ICBT group, n=48) according to the different extracorporeal and intracavitary radiotherapies. The short-term clinical efficacy, and short- and long-term adverse reactions were compared between the two groups, the tumor recurrence and survival status were recorded through follow-up, and the overall survival (OS) and progression-free survival (PFS) rates were compared between the two groups. RESULTS: The patient general clinical characteristics were comparable in both groups. The short-term clinical effective rate was 91.7% (44/48) and 87.5% (42/48), respectively, in HT+CT-ICBT group and IMRT+ICBT group. In the two groups, the incidence rate of grade 3-4 chronic radiation proctitis was 4.2% (2/48) and 22.9% (11/48), while that of grade 3-4 chronic radiation cystitis was 2.1% (1/48) and 18.7% (9/48), respectively. According to the follow-up results, the 3-year OS was 85.4% (41/48) and 77.1% (37/48), and the 3-year PFS was 81.3% (39/48) and 70.8% (34/48), respectively, in the two groups. Log-rank test showed that the 3-year OS and PFS had no statistically significant differences (p=0.395, p=0.401). CONCLUSION: HT+CT-ICBT is safe and effective in the treatment of locally advanced cervical cancer, and it has similar short-term clinical efficacy and long-term survival rate compared with IMRT+ICBT, which also significantly reduces the long-term incidence of radiation proctitis and cystitis, so it is worthy of popularization and application.
