Factors Affecting Survival of Cervical Cancer Patients Treated at the Radiation Unit of Srinagarind Hospital, Khon Kaen University, Thailand

This retrospective longitudinal study aimed to evaluate factors for survival of cervical cancer patients treatedwith radiation therapy. Information was retrieved from the medical records of 1,180 cervical cancer patientsand pathologic material was reviewed to confirm the diagnosis of those treated with radiation therapy atSrinagarind Hospital, Khon Kaen University between 1 January 1994 and 31 December 1999. The patientswere followed up until December 31, 2004, with current vital status determined through the hospital-basedregistry, the population-based cancer registry of Khon Kaen Province, the civil registration database, the Ministryof Interior and by mail. Data were analysed with the Kaplan-Meier, Log-rank test and Cox proportion hazardmodels. The mortality rate was 70 per 1,000 person-years with an overall 5-year survival of 62.5%. Mediansurvival was >10 years. From multivariate analyses, the factors that statistically affected survival of cervicalcancer patients included stage (p-value<0.001), hemoglobin level (p-value<0.001), interval between externaland intracavitary radiation (p-value<0.001) and fractionation (p-value=0.024). Stage III was associated with a1.65-fold mortality risk compared with stage I (95% CI=1.05-2.59). Patients with a low hemoglobin level (≤ 10g./dl.) demonstrated a 1.85-fold mortality risk compared with patients a value >12 g./dl. (95% CI=1.40-2.44). Aninterval between external and intracavitary radiation >28 days was associated with 2.28-fold mortality riskcompared with a duration of <1 day (95% CI= 1.40-2.44). The fractionation 2 faction was associated with 0.25-fold mortality risk compared with 1 fraction (95% CI=0.07-0.96). Future prospective trials should be undertakento confirm the validity of these factors and to elucidate their therapeutic implications.