3499 - Treatment Patterns and Outcomes in Geriatric Women with Cervical Cancer

S. Feldkamp¹, E. Herbert², J. Zhang², T. Meier¹, and S. M. C. Sittenfeld¹; ¹Department of Radiation Oncology, University of Cincinnati Cancer Center, Cincinnati, OH, ²University of Cincinnati, Cincinnati, OH

Purpose/Objective(s): Historically disparate outcomes are seen in older women with cervical cancer. We aimed to review how patterns of care and outcomes may differ in the treatment of older women with cervical cancer at an academic cancer center. We hypothesize that with the delivery of standard of care treatment, cancer specific mortality is equivalent in patients above and below the age of 65. Materials/

Methods: We performed a retrospective review of patients undergoing brachytherapy for cervical cancer at a single institution from 2015-2023. Age at diagnosis, histology, FIGO stage, external beam radiotherapy (EBRT) dose, cumulative EQD2 doses, chemotherapy cycles completed, recurrence status, vital status, and cause of death were documented for each patient. An independent sample, two-tailed t-test was used to determine statistical significance using a p value of <0.05.
Results: A total of 140 patients treated for cervical cancer with brachytherapy from 2015-2023, with a minimum of one year of follow-up, were identified for analysis. Of the 140 patients, 29 (20.7%) were 65 years or older. The percent of patients with FIGO Stage III or higher disease was 34.5% in women 65 years or older and 44.1% in women less than 65. This difference was not statistically significant. There was a statistically significant difference in the histologic representation in the two age groups, with Squamous Cell Carcinoma in 81.2% of younger patients vs 62.1% of older patients (p=0.03). There was no statistically significant difference in concurrent chemotherapy use between age groups, with 84% of patients 65 years or older and 81% younger than 65 receiving at least 4 cycles of chemotherapy. Similarly, no difference existed between cumulative D90 EQD2 doses to high risk CTVs. At a median follow-up time of 3 years, overall survival was 79.3% in women 65 or older and 84.7% in women younger than 65. Cancer specific mortality was 10.3% in the older group and 14.4% in the younger group. The overall rate of recurrence was nearly identical for the two groups at 31% in those 65 or older and 31.5% in those less than 65. No difference was found in the rate of distant recurrence,17.2% in the older group vs 21.6% in the younger group, or in the rate of locoregional recurrence, 12.6% in the older group vs 13.7% in the younger group. None of the numeric differences in outcomes were statistically significant.
Conclusion: This single institution review suggests that when older women receive standard of care treatment for cervical cancer, their outcomes are similar to those seen in younger women despite previous reports of inferior outcomes. Further larger studies may elucidate patterns of care responsible for the historically disparate outcomes seen in older women with cervical cancer on a national level.

Abstract 3499 – Table 1

	Percent receiving = 4 Cycles of Chemotherapy	Mean D90 to HR-CTV in EQD2	Overall Survival	Rate of Recurrence	Cancer specific mortality
< 65 years at diagnosis	81.0%	88.6	84.7%	31.5%	14.4%
= 65 years at diagnosis	84.0%	87.3	78.3%	31.0%	10.3%