125 - Hypofractionated Radiotherapy as a Potential Alternative to Conventional Treatment for Cervical Cancer in Resource-Limited Setting: A Prospective Comparative Analysis
Presenter(s)
A. Mallum1,2, H. Li3, W. Ngwa4, R. Saidu5, T. A. Ngoma6, M. Tendwa7, S. M. Avery8, M. S. S. Huq9, J. Akudugu10, L. Incrocci11, S. Seppo12, P. Phan13, E. C. Oboh14, D. Myagmarsuren15, M. Voster16, S. Bhadree16, W. Swanson17, and E. O. Olatunji18; 1University of Kwazulu Natal, Durban, South Africa, 2Walter Susilu University, Mthatha, South Africa, 3Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 4John Hopkins University, Baltimore, MD, 5University of Cape Town, Cape Town, South Africa, 6Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of, 7Global Health Catalyst, Boston, MA, 8University of Pennsylvania, Philadelphia, PA, 9Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA, 10University of Stellenbosch, Cape Town, South Africa, 11Department of Radiotherapy, Erasmus Medical Center, Rotterdam, Netherlands, 12Henry Ford Cancer Institute,, Detroit, MI, 13Johns Hopkins University, Medical School, Baltimore, MD, 14George Washington University School of Medicine, Washington, DC, United States, 15Virginia Tech Carilion School of Medicine, Roanoke, VA, 16University of Kwazulu Natal, KwaZulu Natal, South Africa, 17Weill Cornell Medicine, New York City, NY, 18Johns Hopkins Medicine, Baltimore, MD
Purpose/Objective(s): The study aimed to evaluate and compare the toxicity profiles of Hypofractionated Radiotherapy (HFRT) and Conventional Radiotherapy (CFRT) as primary endpoint while secondary endpoint the survival outcomes
Materials/Methods: The prospective cohort study was conducted at Inkosi Albert Luthuli central Hospital (IALCH), South Africa from March 2022 to March 2023. A total of 107 patient diagnosed with FIGO staged IB3-IVA cervical cancer were enrolled. Patients were randomly assigned to receive CFRT (n=54) or HFRT (n=53). Clinical data and adverse events were recorded. Statistical analysis was performed using R statistical Computing Software (version 3.6.3), with a significance level set as p=0.005
Results: The median age at diagnosis was 36.4 years (range: 28.2-62.9), with 85.0% of the patients under 40years old and 86.0% being HIV position. Most patients in both groups presented with stage IIB and moderately differentiate squamous cells carcinoma. HFRT significantly reduced treatment duration, with patients completing therapy in a median of 35 days compared to 62 days for CFRT (p=0.001). Both groups experienced similar rates of gastrointestinal (GI), genitourinary (GU), and skin toxicity, though GI (p=0.005) and GU (p=0.01) adverse effects were significantly different between groups. Vaginal stenosis was more common in the CFRT group (51.9%) than in the HFRT (43.4%). Despite these differences, both groups exhibited comparable clinical response, recurrence free survival rates, and an absence of residual disease within 12 months of treatment.
Conclusion: HFRT (42.72Gy in 16 fractions) demonstrated clinical outcomes comparable to CFRT (50.50Gy in 25 fractions) while significantly reducing treatment duration. These findings suggest that HFRT is a viable alternative in resource-limited settings, potentially improving treatment accessibility and efficiency for cervical cancer patients.