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Analysis of risk factors after three-dimensional brachytherapy for cervical cancer: A real-world study

Year: 2026

Type: article

Abstract: Introduction: Cervical cancer is a common malignancy of the female reproductive system. This study retrospectively analyzed cervical cancer patients treated with three-dimensional brachytherapy (3D-BT) to evaluate the effects of radiotherapy dose, treatment fractions, and combined therapeutic modalities on prognosis. Objectives: To identify prognostic factors associated with treatment efficacy and provide evidence for individualized treatment strategies. Methods: In this retrospective cohort study, data from cervical cancer patients treated with 3D-BT at Tianjin Cancer Hospital and Xiangyang Hospital of Traditional Chinese Medicine were collected. Variables included radiotherapy dose, treatment fractions, and combined treatment modalities. Kaplan–Meier and Cox regression analyses were performed using R and SPSS to identify prognostic factors associated with survival outcomes. Results: Concurrent chemoradiotherapy, targeted therapy plus chemotherapy, targeted therapy plus hyperthermia, immunotherapy plus chemotherapy, immunotherapy plus hyperthermia, and hyperthermia plus chemotherapy were associated with improved progression-free survival (PFS) (all p < 0.001). Concurrent chemoradiotherapy (hazard ratio [HR]: 0.436, 95% confidence interval [CI]: 0.227–0.839, p = 0.013) and hyperthermia plus chemotherapy (HR: 0.106, 95% CI: 0.013–0.837, p = 0.033) were associated with reduced overall survival (OS) risk. A total brachytherapy dose > 2,800 cGy (HR: 0.177, 95% CI: 0.041–0.771, p = 0.021) and hyperthermia plus chemotherapy (HR: 0.186, 95% CI: 0.055–0.630, p = 0.007) were independently associated with improved PFS. More than four brachytherapy fractions were also associated with better PFS. Conclusion: Higher brachytherapy doses (>2,800 cGy) and certain combination strategies, particularly concurrent chemoradiotherapy with hyperthermia, were associated with improved PFS and OS. However, the absence of key prognostic variables limits interpretation, and prospective studies are required to confirm these findings.

Source: Eurasian Journal of Medicine and Oncology

DOI: 10.36922/ejmo026080091