Tumor Response after the First Serie of Treatment for Locally Advanced Cervical Cancer: A Retrospective Study (750 Cases)

Introduction: Tumor response after the first series of treatment is a predictive factor for outcomes in cervical cancer. There is a correlation between early tumor regression and the probability of loco-regional control. This study aims to assess the tumor response following concurrent radio-chemotherapy in the treatment of locally advanced cervical cancer.  Materials and Methods: This retrospective study includes 750 patients with locally advanced cervical cancer (started from IB) treated with concurrent radio-chemotherapy (46 Gy with weekly cisplatin) between January 1, 2018, and December 2022, at the National Oncology Institute in Rabat.  Results: The patients’ ages ranged from 22 to 85 years, with a median age of 50.67 years. The predominant histological type was squamous cell carcinoma (83%), followed by adenocarcinoma (16%). All patients received concurrent radio-chemotherapy with a dose of 46 Gy (2 Gy per fraction in 23 sessions), along with weekly cisplatin at 40 mg/m2. Tumor response after RCC was evaluated using clinical examination and\or pelvic MRI at the end of the treatment. In this study, 610 patients (81.33%) showed near-complete or complete tumor regression based and subsequently underwent intracavitary brachytherapy. Conversely, 140 patients (18.66%) presented significant residual tumors on pelvic MRI, rendering them ineligible for brachytherapy. These patients received additional irradiation using 3D conformal techniques, delivering a dose of 66–70 Gy in normo-fractionated sessions, combined with weekly cisplatin.  Conclusion: Tumor response after the initial series of concurrent radio-chemotherapy serves as a key prognostic factor for locally advanced cervical cancer. Patients with significant tumor regression demonstrate favorable outcomes with brachytherapy, while alternative radiation techniques are required for those with residual tumors.