Meltem KIRLI BÖLÜKBAŞ, Betül HILLESIZ, Esengül KOÇAK UZEL
Comprehensive Medicine - 2026;18(2):137-146
Objective: This study aimed to evaluate survival outcomes and prognostic factors in cervical cancer patients treated with radical chemoradiotherapy (CRT). Materials and Methods: Between 2020 and 2024, 73 patients with cervical cancer underwent definitive EBRT (External Beam Radiotherapy) plus IGABT (Image-Guided Adaptive Brachytherapy); 67 received concurrent chemotherapy (CT), and 6 received RT alone. Statistical analyses were conducted using Jamovi and JASP software. Kaplan-Meier and log-rank tests were used for survival analysis, while Cox regression was employed to identify prognostic factors. A p-value <=0.05 was considered significant. Results: The median age was 55 years. Based on FIGO 2018 staging, 31.5% (n=23) were stage I-II and 68.5% (n=50) were stage III-IV. The median RT dose was 45 Gy. The mean HRCTV D90 was 88+/-9.4 Gy. The median overall treatment time (OTT) was 62 days. One- and three-year overall survival (OS) and disease-free survival (DFS) rates were 85% and 70%, and 80% and 65%, respectively. In univariate analysis, tumor size >4 cm prior to brachytherapy and OTT >50 days were significantly associated with poorer DFS and LRDFS. Additionally, non-cisplatin chemotherapy regimens were significantly associated with worse LRDFS (p<0.05). In multivariate analysis, both pre-brachytherapy tumor size >4 cm and non-cisplatin regimens remained independent negative prognostic factors for LRDFS (p<0.05). Conclusion: Radical CRT combined with brachytherapy remains an effective treatment modality for cervical cancer. However, prolonged OTT and persistent large tumor size before brachytherapy are associated with worse survival outcomes. Furthermore, survival rates may vary based on disease stage distribution, with lower survival expected in cohorts dominated by advanced-stage cases.
