Oligometastatic cervical cancer: definitive RT confers survival benefit

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Takeaway

  • Definitive radiation therapy (DRT) to limited sites in patients with oligometastatic cervical cancer (CC) yields favorable outcomes with potential long-term survival benefit.
  • At 2 y post-RT, approximately half of the patients had disease progression with minimal toxicity.

Why this matters

  • In patients with regional CC who progress to metastatic disease, systemic chemotherapy offers median survival of <1 to 2 y.
  • Although chemotherapy is the current treatment of choice, DRT may be more effective and safe in this patient population.

Study design

  • Study of 38 patients with oligometastatic CC involving ≤2 extra-pelvic/para-aortic sites, receiving external-beam DRT and brachytherapy with concurrent chemotherapy or surgical resection..
  • Oligometastasis included synchronous (n=9) or metachronous (n=15) disease to supraclavicular nodes or recurrence in mediastinum (n=10), lung (n=7), or supraclavicular+mediastinal sites (n=3).
  • Median follow-up, 35.2 mo (range 3.1-94.7).
  • Funding: National Institute of Cancer.

Key results

  • Median OS was 50.7 mo (95% CI, 36.8-64.6 mo); 2- and 3-y OS rates were 73.5% and 63.7%, respectively.
  • 18 and 6 patients had survived >3 and >5 y, respectively.
  • Median PFS was 21.7 mo (95% CI, 5.6-37.8 mo).
  • 55% patients progressed; median time to progression was 24.8 mo (95% CI, 5.0-44.6 mo).
  • Treatment-associated grade ≥3 toxicity was <3%.

Limitations

  • Highly selected and small study population.