Retrospective Study of Pelvic Irradiation in Patients With Advanced Uterine Cervical Cancer

Background/Aim: The clinical role of local therapy for advanced uterine cervical cancer remains unclear. While systemic chemotherapy is the standard treatment, pelvic radiotherapy may contribute to local control and potentially improve outcomes in selected patients. This study aimed to evaluate the clinical significance of pelvic irradiation in patients with advanced cervical cancer with para-aortic lymph node (PAN) and/or distant metastases. Patients and Methods: We retrospectively reviewed 35 patients with cervical cancer with PAN and/or distant metastases who underwent radiotherapy including whole-pelvic irradiation between 2009 and 2019. Patients were classified into a distant metastasis (DM) group and a PAN group. The DM group was further subdivided into patients with lymph node-only metastases (LY group) and those with organ metastases (OR group). Overall survival (OS) was estimated using the Kaplan–Meier method and compared using the log-rank test and Cox proportional hazards model. Results: The median OS for all patients was 2.22 years. The median OS was 1.76 years in the DM group and 3.02 years in the PAN group, with no statistically significant difference between the groups (p=0.838). Within the DM group, the median OS was 1.18 years in the OR group and 2.01 years in the LY group, with no significant difference (p=0.590). Treatment was generally well tolerated, with limited severe adverse events. In Cox proportional hazards analysis using the PAN group as the reference, neither the OR nor the LY group showed a statistically significant difference in OS. Conclusion: Although limited by its retrospective design and small sample size, this study suggests that semi-definitive pelvic radiotherapy may be a reasonable treatment option for selected patients with cervical cancer with distant metastases.