Efficacy and Safety of Concurrent Chemoradiotherapy as First-Line Treatment for Stage IVB Cervical Cancer: A Single-Center Retrospective Observational Study.

aimTo evaluate the efficacy and safety of concurrent chemoradiotherapy prior to systemic chemotherapy in patients with stage IVB cervical cancer.

methodsThis retrospective observational study included 40 patients diagnosed with stage IVB cervical cancer who received concurrent chemoradiotherapy as first-line therapy at the Yokohama City University Hospital between 2007 and 2021. The evaluated outcomes included concurrent chemoradiotherapy response rate, chemotherapy initiation rate, adverse events, and overall survival.

resultsThe disease control rate of concurrent chemoradiotherapy was 72.5%, with no significant differences across the subgroups defined by the number of metastatic sites, presence of out-of-field lesions, parenchymal involvement, or histological subtype. Systemic chemotherapy was initiated in 89% of the patients, with a median interval of 39 days after concurrent chemoradiotherapy completion, except in one patient (3.6%) due to disease progression. Including recurrent cases, 91% of patients ultimately received systemic chemotherapy. Grade 3 or higher toxicity that significantly delayed chemotherapy initiation occurred in only one patient (3.6%). The median overall survival was 23 months, with no significant differences based on lesion distribution, parenchymal involvement, histological subtype, or metastatic burden.

conclusionsConcurrent chemoradiotherapy may be a feasible first-line treatment option for stage IVB cervical cancer with manageable toxicity, acceptable disease control, and the potential to allow a timely transition to systemic chemotherapy.