Early Radiological Response Following Concurrent Chemoradiotherapy and Brachytherapy in Cervical Carcinoma: A Single-Centre Observational Study From Pakistan.
- 1Oncology, Cancer Care Hospital & Research Centre, Lahore, PAK.
Abstract
Background
Cervical cancer remains an important cause of cancer morbidity and mortality, with a disproportionate burden in low- and middle-income countries. Definitive treatment for non-metastatic disease requiring radical therapy generally combines external-beam radiotherapy, concurrent platinum-based chemotherapy, and brachytherapy. This study primarily aimed to determine the distribution of complete response, partial response, stable disease, and progressive disease on routine pelvic magnetic resonance imaging performed approximately three months after treatment and secondarily to explore whether objective response differed by recorded FIGO (International Federation of Gynecology and Obstetrics) 2009 stage group.Methods
This retrospective single-centre observational study was conducted in the Department of Clinical Oncology, Cancer Care Hospital & Research Centre, Lahore, Pakistan, and included 113 women with histologically confirmed cervical carcinoma, recorded as FIGO 2009 stage IB1 to IVA, who completed planned external-beam radiotherapy and brachytherapy and had follow-up pelvic MRI available at approximately three months. The institutional protocol comprised external-beam radiotherapy to 45 Gy in 25 fractions using conventional two-dimensional simulation, with weekly cisplatin planned at 40 mg/m², followed by CT-planned high-dose-rate intracavitary brachytherapy at 7 Gy per fraction for three fractions. Investigators retrospectively mapped routine radiology-report descriptions to complete response, partial response, stable disease, or progressive disease using RECIST 1.1 concepts; this was not a formal prospectively measured or blinded central RECIST assessment. The primary outcome was the four-category early radiological response distribution. Objective response was defined as complete plus partial response. The stage comparison was exploratory and unadjusted.Results
The mean age was 50.8 ± 10.2 years. Squamous cell carcinoma was the predominant histology (82/113, 72.6%). Complete response occurred in 61 patients (54.0%; 95% CI 44.8-62.9%), partial response in 32 (28.3%), stable disease in 14 (12.4%), and progressive disease in six (5.3%). Objective response occurred in 93 patients (82.3%; 95% CI 74.2-88.2%). In the exploratory stage analysis, objective response occurred in 77 of 78 patients (98.7%) in the FIGO IB1-IIB group and 16 of 35 patients (45.7%) in the FIGO IIIB-IVA group (absolute difference 53.0 percentage points; 95% CI 36.0-68.3; Fisher's exact test, p < 0.001).Conclusion
This study provides real-world insight into early MRI-assessed radiological response following definitive chemoradiotherapy and brachytherapy for cervical cancer in a resource-constrained Pakistani setting. The observed difference in response between FIGO stage groups was exploratory and requires confirmation in future studies. Longer follow-up is needed to determine whether early radiological response translates into durable disease control and survival.
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BibTeX
@article{siddique2026early,
title = {{Early Radiological Response Following Concurrent Chemoradiotherapy and Brachytherapy in Cervical Carcinoma: A Single-Centre Observational Study From Pakistan.}},
author = {Anam Siddique and Nusrat Nazar and Mohammad A Sahi and Jannat Asif and Taleeha Moazam and Abdul S Waqar},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116908},
url = {https://europepmc.org/article/MED/42928859},
note = {CC BY},
}
RIS
TY - JOUR
TI - Early Radiological Response Following Concurrent Chemoradiotherapy and Brachytherapy in Cervical Carcinoma: A Single-Centre Observational Study From Pakistan.
AU - Anam Siddique
AU - Nusrat Nazar
AU - Mohammad A Sahi
AU - Jannat Asif
AU - Taleeha Moazam
AU - Abdul S Waqar
PY - 2026
DA - 2026/09/25
JO - Cureus
DO - 10.7759/cureus.116908
UR - https://europepmc.org/article/MED/42928859
AB - Background Cervical cancer remains an important cause of cancer morbidity and mortality, with a disproportionate burden in low- and middle-income countries. Definitive treatment for non-metastatic disease requiring radical therapy generally combines external-beam radiotherapy, concurrent platinum-based chemotherapy, and brachytherapy. This study primarily aimed to determine the distribution of complete response, partial response, stable disease, and progressive disease on routine pelvic magnetic resonance imaging performed approximately three months after treatment and secondarily to explore whether objective response differed by recorded FIGO (International Federation of Gynecology and Obstetrics) 2009 stage group.Methods This retrospective single-centre observational study was conducted in the Department of Clinical Oncology, Cancer Care Hospital & Research Centre, Lahore, Pakistan, and included 113 women with histologically confirmed cervical carcinoma, recorded as FIGO 2009 stage IB1 to IVA, who completed planned external-beam radiotherapy and brachytherapy and had follow-up pelvic MRI available at approximately three months. The institutional protocol comprised external-beam radiotherapy to 45 Gy in 25 fractions using conventional two-dimensional simulation, with weekly cisplatin planned at 40 mg/m², followed by CT-planned high-dose-rate intracavitary brachytherapy at 7 Gy per fraction for three fractions. Investigators retrospectively mapped routine radiology-report descriptions to complete response, partial response, stable disease, or progressive disease using RECIST 1.1 concepts; this was not a formal prospectively measured or blinded central RECIST assessment. The primary outcome was the four-category early radiological response distribution. Objective response was defined as complete plus partial response. The stage comparison was exploratory and unadjusted.Results The mean age was 50.8 ± 10.2 years. Squamous cell carcinoma was the predominant histology (82/113, 72.6%). Complete response occurred in 61 patients (54.0%; 95% CI 44.8-62.9%), partial response in 32 (28.3%), stable disease in 14 (12.4%), and progressive disease in six (5.3%). Objective response occurred in 93 patients (82.3%; 95% CI 74.2-88.2%). In the exploratory stage analysis, objective response occurred in 77 of 78 patients (98.7%) in the FIGO IB1-IIB group and 16 of 35 patients (45.7%) in the FIGO IIIB-IVA group (absolute difference 53.0 percentage points; 95% CI 36.0-68.3; Fisher's exact test, p < 0.001).Conclusion This study provides real-world insight into early MRI-assessed radiological response following definitive chemoradiotherapy and brachytherapy for cervical cancer in a resource-constrained Pakistani setting. The observed difference in response between FIGO stage groups was exploratory and requires confirmation in future studies. Longer follow-up is needed to determine whether early radiological response translates into durable disease control and survival.
SN - 2168-8184
ER -