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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1511748

A Comparative Analysis of Survival Outcomes and Adverse Effects between Preoperative brachytherapy with Radical Surgery and Concurrent Chemoradiotherapy in Patients with Locally Advanced Cervical Cancer

Provisionally accepted
Honggui Zhou Honggui Zhou 1*Yuna Niu Yuna Niu 2Chengchao Du Chengchao Du 1Miao Zhang Miao Zhang 1Qi Guo Qi Guo 2
  • 1 Affiliated Hospital of North Sichuan Medical College, Nanchong, China
  • 2 North Sichuan Medical College, Nanchong, Sichuan Province, China

The final, formatted version of the article will be published soon.

    Background: To compare the long-term efficacy and adverse effects of preoperative brachytherapy combined with radical surgery versus concurrent chemoradiotherapy (CCRT) in patients with locally advanced cervical cancer (LACC).Methods: This retrospective study analyzed 161 patients with LACC treated at the Affiliated Hospital of North Sichuan Medical College between January 2015 and December 2020. Of these, 76 patients underwent preoperative brachytherapy combined with radical surgery (study group), while 85 received CCRT (control group).After propensity score matching (PSM) to minimize confounding, 124 patients (62 per group) were included in the analysis. Survival outcomes and prognostic factors were evaluated using Kaplan-Meier survival analysis and Cox regression models.Adverse effects of treatment were compared between the groups.Results: After PSM, the 5-year progression-free survival (PFS) rate in the study group was significantly higher than that in the control group (81.2% vs. 62.7%,There was no significant between-group difference regarding the 5-year overall survival (OS) rate (81.4% vs. 74.9%, P=0.41). Multivariate analysis identified treatment modality (preoperative brachytherapy combined with radical surgery vs. CCRT) as an independent prognostic factor for PFS (HR: 0.458, 95% CI 0.221-0.945, P=0.035). The study group had significantly lower rates of grade 2 acute radiation enteritis, grade 3-4 leukopenia, and anemia compared to the control group (P<0.05), with no significant differences observed in other adverse effects (P>0.05).Preoperative brachytherapy combined with radical surgery may help improve the PFS of patients with LACC, with fewer adverse effects, making it a potentially viable treatment option for these patients.

    Keywords: Locally advanced cervical cancer, concurrent chemoradiotherapy, Preoperative brachytherapy, Propensity score matching, Progression-free survival

    Received: 15 Oct 2024; Accepted: 10 Feb 2025.

    Copyright: © 2025 Zhou, Niu, Du, Zhang and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Honggui Zhou, Affiliated Hospital of North Sichuan Medical College, Nanchong, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.