Patterns of Care and Outcome in Elderly Patients With Cervical Cancer: A Retrospective Analysis

Abstract

Background: The goal of this report was to evaluate the efficacy and tolerance of chemoradiotherapy in elderly cervical cancer patients. Methods: One hundred thirteen patients aged older than 75 years had been treated in Mackay Memorial Hospital with Zubrod performance status 0–1. Patients were classified into three groups: Group 1 with radiation less then 45 Gy for palliation or no radiotherapy, Group 2 with at least 45 Gy to whole pelvis with or without brachytherapy, and Group 3 with completed radiotherapy with brachytherapy of 30 Gy and concurrent chemotherapy. Toxicities were graded weekly according to National Cancer Institute Common Toxicity Criteria version 3.0. Overall survival and progression-free survival were analyzed with Kaplan-Meier method and compared by the log-rank test. Result: About 30% of the patients had diabetes or hypertension or both. Only one case with adenocarcinoma was noted in Group 2. Higher ratio of Stage IV disease was noted in Group 1, but clinical stage is not significantly different in the three groups (p=0.55). In Group 3, 52% patients completed six cycles of cisplatin-based chemotherapy, but higher noncancer-related death ratio was noted. The 5-year actuarial overall survival of Group 1, Group 2, and Group 3 is 11%, 27%, and 74%, respectively (p<0.001). The 5-year progression-free survival of Group 1, Group 2, and Group 3 is 11%, 24%, 64%, respectively (p=0.003). Conclusion: Chemoradiotherapy is effective and tolerable in elders with cervical cancers. Chemoradiotherapy should be considered in elderly patients with invasive cervical cancer.

Keywords

• cervical cancer
• chemoradiotherapy
• elderly