Cervical Cancer Treatment Has Higher Survival Rates

Brigham and Women’s Hospital (BWH) researchers found in a new study that brachytherapy treatment (a type of radiation therapy for cancer treatment in which radioactive implants are inserted directly into the tissue near the tumor site) was associated with better survival in women with cervical cancer. But the study also revealed that brachytherapy treatment in the United States has declined. The decline is troubling, researchers say, because brachytherapy has been shown to increase survival rates. The study is published in the September 2013 issue of The International Journal of Radiation Oncology.

BWH describes “brachytherapy” more in depth as:

Brachytherapy is an important component of treatment that escalates the dose of radiation to the primary tumor while minimizing the dose to critical organs at risk. The standard treatment of locally advanced cervical cancer is EBRT with concurrent chemotherapy, followed by brachytherapy.

For the study, researchers looked at 7,359 patients and found that:

63 percent of these women received brachytherapy in combination with EBRT, and 37 percent received EBRT alone. Factors associated with higher odds of brachytherapy use included younger age, being married, earlier years of diagnosis, earlier stage and certain SEER regions.

Moreover, brachytherapy usage rate decreased from 83 percent in 1988 to 58 percent in 2009. There was a sharp decline from 43 percent to 23 percent in 2003. The researchers noted that the decline may be related to the decreasing incidence of cervical cancer and increased adoption of alternative treatment techniques, such as intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT).

Brachytherapy was associated with a higher four-year cause-specific patient survival rates (64.3 percent vs. 51.5 percent) and overall survival (58.2 percent vs. 46.2 percent) compared to EBRT alone. BWH says that brachytherapy treatment was also independently associated with better cause-specific survival and overall survival.

“The shift away from brachytherapy is concerning, and has directly lowered the survival rates of cervical cancer patients,” said Dr. Akila Viswanathan, the study’s senior author and the director of BWH Gynecologic Radiation Oncology, in a press release. “High-quality brachytherapy must continue to be used, ideally with image-guidance, to maximize survival and minimize toxicity.”