title: Outcome of cervix uteri cancer patients: Clinical treatment results and toxicity profile in a retrospective study from Saudi Arabia.
abstract: OBJECTIVE
  This study evaluated the survival outcome, pattern of failure and prognostic factors in cervix uteri cancer patients.
  
  
  METHODS
  We reviewed the data of 60 patients with stages IB-IVA cancer who were treated between January 2004 and December 2010.
  
  
  RESULTS
  Most patients (n = 50; 83%) had squamous cell carcinoma. Stage IIB was the most common presentation (n = 41; 68%). Forty-seven patients (78%) received Cisplatin concurrent with radiotherapy (CRT). The 2- and 4-year overall survival (OS) was 82% and 79%, respectively. Prolongation of the overall treatment time (OAT) for greater than 56 days, advanced stage and pretreatment hemoglobin (Hb) levels (<10 g/dL) negatively predicted OS (P = 0.039, P = 0.044 and P = 0.008, respectively). The 2- and 4-year disease-free survival (DFS) rates were 80% and 69%, respectively. Vaginal infiltration and brachytherapy (orthogonal versus CT-based planning) were significant factors for the prediction of relapse (P = 0.048 and P = 0.049, respectively). The 2- and 4-year loco-regional control (LRC) rates were 78% and 70%, respectively, and the distant metastasis-free survival (DMFS) rates were 82% and 79%, respectively. Vaginal infiltration was the only negative predictive factor for LRC (P = 0.045), and pathological tumor grade was the only factor indicative of distant metastases (P = 0.037). Grade 3 or 4 late rectal reactions were reported in two patients (3%), and no patients developed grade 3 or 4 urinary reactions.
  
  
  CONCLUSIONS
  The treatment results in our cervix uteri cancer patients and the prognostic factors are comparable to those of previous reports. Orthogonal brachytherapy planning and vaginal infiltration negatively predicted relapse.
authors.affiliation: Department of Oncology, Radiation Oncology Section, King Abdulaziz University, Jeddah, Saudi Arabia.|Radiation Oncology and Nuclear Medicine Department, National Cancer Institute (NCI), Cairo University, Egypt.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: El Sayed
authors.affiliation: Department of Oncology, Radiation Oncology Section, King Abdulaziz University, Jeddah, Saudi Arabia.|Radiology Department, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Yasir A
authors.initials: YA
authors.lastname: Bahadur
authors.affiliation: Department of Oncology, Radiation Oncology Section, King Abdulaziz University, Jeddah, Saudi Arabia.|Radiation Oncology and Nuclear Medicine Department, National Cancer Institute (NCI), Cairo University, Egypt.
authors.forename: Ashraf H
authors.initials: AH
authors.lastname: Hassouna
authors.affiliation: Department of Oncology, Radiation Oncology Section, King Abdulaziz University, Jeddah, Saudi Arabia.|Faculty of Medicine, Radiation Oncology and Nuclear Medicine Department (NEMROK), Cairo University, Egypt.
authors.forename: Ehab E
authors.initials: EE
authors.lastname: Fawzy
authors.affiliation: Radiation Oncology Department, King Abdulaziz Oncology Center, King Abdulaziz University, Jeddah, Saudi Arabia.|Radiation Oncology and Nuclear Medicine Department, National Cancer Institute (NCI), Cairo University, Egypt.
authors.forename: Azza M
authors.initials: AM
authors.lastname: Nasr
authors.affiliation: Research Center Department, King Faisal Specialist Hospital and Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Bakr B
authors.initials: BB
authors.lastname: Sadiq
authors.affiliation: Medical Oncology Section, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Reyad
authors.initials: R
authors.lastname: Dada
authors.affiliation: Gynecology Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Khalid H
authors.initials: KH
authors.lastname: Sait
authors.affiliation: Gynecology Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Nisrin M
authors.initials: NM
authors.lastname: Anfinan
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*
keywords: cancer in Saudi Arabia; cervix uteri cancer; concurrent chemo-radiotherapy; high-dose rate brachytherapy