Comparative Analysis of Radiation-Induced Proctitis in Hypofractionated vs. Conventional Pelvic Radiotherapy for Cervical Cancer: Evaluating Incidence, Risk and Mitigation Strategies

Document Type

Conference Proceeding

Publication Date

9-1-2025

Publication Title

Int J Radiat Oncol Biol Phys

Abstract

Purpose/Objective(s): Radiation-induced proctitis (RIP), a complication of pelvic radiotherapy, poses significant challenges in cervical cancer treat ment. Radiation-induced proctitis (RIP) is a significant complication aris ing from cervical cancer treatment. Hypofractionated radiation (HFRT), delivering larger doses in fewer sessions offers advantages such as reduced treatment duration and improved patient convenience compared to con ventional fractionation (CFRT). However, the effect of HFRT on RIP inci dence remains unclear. This study investigates RIP occurrence in patients receiving HFRT versus CFRT to improve risk understanding and inform mitigation strategies. Materials/Methods: This prospective cohort study included 107 patients with histologically confirmed cervical carcinoma treated at Inkosi Albert Luthuli Central Hospital (IALCH) in South Africa between March 2022 and March 2023. Patients were randomly assigned to receive either external beam radiotherapy (EBRT) HFRT (n = 53; 42.72 Gy in 16 fractions) or CFRT (n = 54; 50.50 Gy in 25 fractions) with weekly chemotherapy, followed by booster-dose-rate intracavitary brachytherapy (HDR). The incidences of radia tion proctitis and associated factors were recorded. Statistical analyses were conducted using R Statistical Computing Software (version 3.6.3). Descriptive statistics were employed to summarize numerical variables, while categorical variables were compared using chi-squared or Fisher’s exact tests, as appropri ate. A p-value of < 0.05 was considered statistically significant. Results: The study cohort (median age at diagnosis: 36.4 years [range: 28.2 −62.9]) comprised predominantly younger patients, with 85.0% aged < 0.001). Comorbidities were more prevalent in the HFRT group (15.7%) than in the CFRT group (3.7%) (p = 0.001). RIP occurred in 30.8% of all patients, with significantly higher incidence in the CFRT cohort (46.2%) compared to HFRT (18.9%) (p = 0.004). Notably, proctitis incidence showed no correlation with age or comorbidity status in either group (p > 0.05). Conclusion: These findings indicate that CFRT patients are at a higher risk of developing RIP compared to those receiving HFRT. However, further analysis of additional data is required to confirm these observations.

Volume

123

Issue

1S

First Page

e361

Find It @ Sladen

Share

COinS