ADAPTIVE COMBINED RADIATION THERAPY STAGE IIA—IIIC1 CERVICAL CANCER

Objective. To increase the efficiency of treatment of patients with cervical cancer stages IIA—IIIC1 by developing the method of adaptive combined radiation therapy.

Materials and methods. The study included 224 patients with IIA—IIIC1 stages of cervical cancer (112 in main and 112 in control group). The groups were comparable in terms of the main clinical and biological parameters.

Results. A new method of adaptive combined radiation therapy (СRT) has been developed in patients with stage IIA—IIIC1 of cervical cancer, what allows achieving a statistically significant improvement in the total immediate effect in the primary focus — in 88,4 % (95 % CI 81,0—93,7 %) patients, what is 1,6 times more than in case of using the standard treatment — in 53,6 % (95 % CI 43,9—63,1 %) (p<0,001). Thanks to the use of the adaptive СRT method it was possible to reduce the severity of late radiation complications: 0 (0 %, 95 % CI 0,0—11,2 %) versus 12 (27,3 %, 95 % CI 15,0—42,8 %) cases G3—G4 in the control group after completion of RT according to the standard method (p = 0,004). Clinically significant differences were obtained comparing with the standard method in the following levels: 4-year overall survival — 74,5 % (SE 4,2 %) vs. 65,2 % (SE 4,5 %) (p = 0,13), 4-year adjusted survival — 77,3 % (SE 4,0 %) vs. 66,0 % (SE 4,5 %) (p = 0,066), 4-year event-free survival — 69,0 % (SE 4,5 %) vs. 48,2 % (SE 4,7 %) (p<0,001).

Conclusion. Thus, the method of adaptive CRT was developed, what increased the effectiveness of treatment in patients suffering from cervical cancer stages IIA—IIIC1.

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Автор(ы): E. A. Suslova, N. A. Artemova, L. V. Mirilenko, D. I. Kozlovsky