Background: To evaluate the outcome and discover predictive factors for patients with stage IVA cervical cancer treated with definitive radiation therapy.
Patients and methods: We retrospectively reviewed 34 patients with stage IVA cervical cancer who received definitive radiation therapy between 1992 and 2009.
Results: On univariate analysis, statistically significant prognostic factors for improved local control rate (LCR) were absence of pyometra (p=0.037) and equivalent dose in 2 Gy fractions (EQD2) at point A greater than 60 Gy (p=0.023). Prognostic factors for improved progression-free survival (PFS) were absence of pelvic lymph node metastasis at initial presentation (p=0.014), and EQD2 at point A greater than 60 Gy (p=0.023).
Conclusion: Patients with stage IVA disease had poor median survival. However adequate radiation dose to point A produced favorable LCR and PFS, therefore efforts should be made to increase the point A dose.
Keywords: EQD2; FIGO IVA; Radiation therapy; bladder invasion; cervical cancer; rectum invasion.