Chemotherapy alone versus chemotherapy plus 125I brachytherapy for the second-line treatment of locally recurrent cervical cancer after/with radical treatment: a propensity score analysis

Abstract

Abstract Objectives To retrospectively compare the survival between chemotherapy alone and the combination of chemotherapy and 125I brachytherapy for recurrent cervical cancer (CC) after radical treatment with failure from first-line chemotherapy.Methods Patients with recurrent CC after radical treatment with failure from first-line chemotherapy were collected between January 2007 and December 2016 from the two medical centers, and allocated into 2 groups. Group A underwent second-line chemotherapy alone and Group B received the combination of second-line chemotherapy and 125I brachytherapy. The overall survival (OS) as well as progression free survival (PFS) were evaluated. Propensity score matching (1:1), Kaplan-Meier curves, log-rank test, along with cox proportional hazards regression were performed for survival analysis.Results A matched cohort with Group A (n = 88) and Group B (n = 88) were included. The 1-, 2-, and 3-year cumulative PFS rates were 40.9%, 15.9%, 5.7% in Group A and 79.5%, 48.9%, 25.0% in Group B, respectively; and the difference was significant between groups (P = 0.003). Besides, the 1-, 2-, and 3-year cumulative OS rates were 67.0%, 27.3%, 5.7% in Group A and 89.8%, 63.6%, 30.7% in Group B, respectively, with significant difference between groups (P < 0.001). Additionally, the incidence of complications was similar between groups (P = 0.698).Conclusions The combination of chemotherapy and 125I brachytherapy has better therapeutic effect but similar rates of complications compared to chemotherapy alone in patients with locally recurrent CC after radical treatment with failure from first-line chemotherapy.