Cervical cancer recurrence among patients treated with external beam and intracavitary radiotherapy at Ocean Road Cancer Institute

Abstract

Cervical cancer still represents a significant public health problem with increased incidence of new cases worldwide. Cervical cancer occurs as malignant changes in the squamo-columnar junction in the uterine canal. It is the most common malignancy among Tanzanian women and leading cause of cancer related deaths. Cervical cancer is the first among the top ten cancers at Ocean Road Cancer Institute (ORCI) for the past five years and accounted for 36% of all patients seen at the hospital in 2011.Delayed hospital presentation with advanced disease has lead to poor results of treatment. Cervical cancer recurrence after radical treatment has been a major problem to our patients and medical care providers at the institute for the past several years. Percentage of recurrence is still a challenge depending on different risk factors. Unfortunately there is no exact data that show the trend of recurrence in patients. Objective; to determine cervical cancer recurrence among patients treated with external beam and intracavitary radiotherapy at ORCI. Methodology; it is a retrospective crossectional study design to determine the recurrence among cervical cancer patients after treatment and factors related to it, where retrospective secondary data was obtained from patient medical files and filled into data collection form. The data was collected from Septermber to December 2013. The study was conducted at Ocean Road Cancer Institute, Dar es Salaam the only cancer centre in the country. Results: 230 patients were studied with a median age of 52 years (range 30-92). Most of them 90(39.10%) were referred to ORCI with disease stage IIB. Disease recurrence was seen in 92 patients (41.1%), the most recurrence site was pelvic area (98.9%). The recurrence rate was significantly associated with overall treatment time. Conclusion: Most of our patients are diagnosed with locally advanced stage a finding that influences treatment results. Receiving radiotherapy in proper time together with chemotherapy and intensive screening methods may improve treatment results.