Treatment Compliance and Clinical Outcomes in Older Patients with Cervical Cancer Treated with Radio(chemo)therapy—A Retrospective Analysis

To evaluate the treatment patterns, compliance and survival outcomes in older patients with cervical cancer. Data on demographic, tumour and treatment characteristics, toxicities and outcomes were analysed in women with cervical cancer of age ≥ 65 years treated between March 2010 and November 2015 with radical radio(chemo)therapy (RT ± CT) and high-dose-rate (HDR) intracavitary brachytherapy (ICBT). A total of 111 patients with median age 66 years (interquartile range [IQR], 65–70) were included. Majority (82%) had locally advanced cervical cancer, and 45% (50 patients) had comorbidities. Cisplatin-based concurrent chemotherapy was received by 54 (48.6%) patients with a median of 4 (IQR, 3–5) cycles. Radical RT ± CT was received by 105 (94.6%) patients of whom 98% (103 patients) received HDR ICBT with a median of 4 applications (IQR, 3–4). The median overall treatment time (OTT) was 60 days (IQR, 49–69). The median follow-up duration was 45 months (IQR, 22–71). The 3-year overall survival (OS), disease-free survival (DFS), local control (LC) and distant metastasis control rates (DMCR) were 71.7% [95% CI, 71.6–71.8], 65.6% [95% CI, 65.5–65.7], 93% [95% CI, 92.9–93.1] and 86.5% [95% CI, 86.4–86.6], respectively. The OS and DFS were significantly better with the addition of concurrent chemotherapy compared to RT alone (3-year OS 85.5% [95% CI, 85.4–85.6] vs 58.1% [95% CI, 57.9–58.2], p = 0.01; 3-year DFS 79.3% [95% CI, 79.2–79.3] vs 53.8% [95% CI, 53.7–53.9], p = 0.002). Older patients with cervical cancer tolerate radical radio(chemo)therapy and better outcomes were observed in patients who received concurrent chemoradiation.