Hypofractionated Radiotherapy as a Potential Alternative to Conventional Treatment for Cervical Cancer in Resource-Limited Setting: A Prospective Comparative Analysis

Document Type

Conference Proceeding

Publication Date

9-1-2025

Publication Title

Int J Radiat Oncol Biol Phys

Abstract

Purpose/Objective(s): The study aimed to evaluated and comparing 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.

Volume

123

Issue

1S

First Page

S46

Last Page

S47

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