Chemotherapy alone versus chemotherapy plus 125I brachytherapy for the second-line treatment of locally recurrent cervical cancer after/with radical treatment: a propensity score analysis

Objectives: To retrospectively compare the survival between chemotherapy alone and the combination of chemotherapy and 125 I brachytherapy for recurrent cervical cancer (CC) after radical treatment with failure from first-line chemotherapy. Methods: Patients with recurrent CC after radical treatment with failure from first-line chemotherapy were collected between January 2007 and December 2016 from the two medical centers, and allocated into 2 groups. Group A underwent second-line chemotherapy alone and Group B received the combination of second-line chemotherapy and 125 I brachytherapy. The overall survival (OS) as well as progression free survival (PFS) were evaluated. Propensity score matching (1:1), Kaplan-Meier curves, log-rank test, along with cox proportional hazards regression were performed for survival analysis. Results: A matched cohort with Group A (n = 88) and Group B (n = 88) were included. The 1-, 2-, and 3-year cumulative PFS rates were 40.9%, 15.9%, 5.7% in Group A and 79.5%, 48.9%, 25.0% in Group B, respectively; and the difference was significant between groups (P = 0.003). Besides, the 1-, 2-, and 3-year cumulative OS rates were 67.0%, 27.3%, 5.7% in Group A and 89.8%, 63.6%, 30.7% in Group B, respectively, with significant difference between groups (P < 0.001). Additionally, the incidence of complications was similar between groups (P = 0.698). Conclusions: The combination of chemotherapy and 125 I brachytherapy has better therapeutic effect but similar rates of complications compared to chemotherapy alone in patients with locally recurrent CC after radical treatment with failure from first-line chemotherapy.