# Impact of high-dose pelvic radiotherapy combined with chemotherapy on local control, symptom relief, and safety in patients with stage IVB cervical cancer (FIGO 2018): a two-center retrospective study

## TL;DR

This study examines the effectiveness and safety of high-dose pelvic radiotherapy combined with chemotherapy in treating advanced cervical cancer.

## Contribution

The study provides new evidence on the use of high-dose radiotherapy with chemotherapy and immune checkpoint inhibitors in stage IVB cervical cancer.

## Key findings

- 2-year local control rate was 82% in patients with stage IVB cervical cancer.
- Most patients experienced symptom relief from genital bleeding and pain.
- Late adverse events were observed but remained within acceptable limits.

## Abstract

This study evaluated the efficacy and safety of high-dose pelvic radiotherapy combined with chemotherapy, including bevacizumab and immune checkpoint inhibitors (ICI) in patients with stage IVB cervical cancer (CC) based on the 2018 International Federation of Gynecology and Obstetrics (FIGO) cervical cancer staging system.

A retrospective analysis was conducted on 38 patients with stage IVB CC, as classified by the 2018 FIGO cervical cancer staging system, who received pelvic external beam radiotherapy (≥ 40 Gy) with or without brachytherapy and chemotherapy. Data were collected from two centers. The 2-year local control (LC), progression-free survival (PFS), and overall survival (OS) rates were analyzed using the Kaplan–Meier method. Symptom relief, including reductions in genital bleeding and pain from the primary lesion, was assessed. Acute and late adverse events were also evaluated.

The median follow-up period was 17.5 months. The 2-year LC, PFS, and OS were 82%, 11%, and 47%, respectively. Although the evaluation method has limitations, most patients with genital bleeding and pain from the primary lesion showed improvement in symptoms. Late adverse events of grade ≥ 2 related to both pelvic radiotherapy and bevacizumab included one case of grade 3 gastrointestinal bleeding and two cases of grade 2 fistula.

This two-center study demonstrated that high-dose pelvic radiotherapy combined with chemotherapy, including bevacizumab and ICI, may achieve favorable local control and symptom relief in patients with stage IVB CC while maintaining an acceptable safety profile.