Chemoradiotherapy (CCRT) is the primary treatment strategy for locally advanced cervical cancer (LACC) patients. Since June 2016, Brunei patients with LACC have been treated locally. However, no treatment response has been evaluated. As the first attempt in Brunei, this study aims to assess the treatment response of patients with LACC to the completing CCRT performed locally.
A retrospective cohort study on LACC patients referred to The Brunei Cancer Centre (TBCC) who met the inclusion criteria and had CCRT within the period between June 2016 and December 2019. Data was collected from TBCC patient database. All statistical analyses were carried out using R Studio Version 1.1.463 on Windows 10 where Shapiro-Wilk, Fisher’s exact and Mann-Whitney test was used. Inclusion criteria was confirmed histological diagnosis of squamous or adenocarcinoma or mixed LACC from stages IB to IIIB whom had started or completed CCRT within the period between June 2016 and December 2019. DFS is calculated in months starting from the completion of brachytherapy until the end of the study. OS is calculated in months starting from the time of diagnosis until the end of the study. Research proposal was granted ethics approval by the joint PAPRSB IHS Research and Ethics Committee and Medical and Health Research and Ethics Committee, Ministry of Health of Brunei Darussalam.
40 patients were evaluated for analysis with mean age of 46.80 ± 12.23 years. Majority of the patients had a tumor diameter of ≥5cm (52.5%) and initial stage of 2B (55%). 90% of patients were compliant to chemotherapy. After completion of CCRT, 85% of patients had tumor regression. Upon follow-up, 10 patients had relapse with majority having initial stage of 2B (60%), tumor diameter of ≥5cm (90%) and tumor grade of G3 (70%). A significant difference was observed between the living status of patients, tumor response and tumor diameter in relapse and non-relapse patients with P values of <0.001, 0.002 and 0.009, respectively. 6 patients passed away due to cancer mortality.
There was an overall satisfactory outcome, tolerance and compliance to CCRT. Patients in high-risk group had higher incidence of relapse and had poor prognosis.