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Short course versus conventional interventional radiotherapy (brachytherapy) regimen in locally advanced cervical cancer: A randomized clinical trial

In brief

One-week brachytherapy boosts complete response to 53% vs 31% without extra toxicity

In a randomized trial of 75 women with stage IB2-IVA cervical cancer, a one-week high-dose-rate brachytherapy schedule shortened overall treatment time by about five days and increased complete response from 31% to 53% compared with the conventional three-week regimen, while acute and late toxicities were similar. Survival rates at five years did not differ.

Journal
Brachytherapy (Q2)
Published
10 September 2026
Study design
Randomized controlled trial
Evidence level
Level 1, High (CEBM 1b)
Authors
Mohammad Babaie, Mahdi Aghili, Mohadeseh Poudineh, Reyhane Bayani, Luca Tagliaferri, Ava Yousefi, et al.
PMID
42722513
DOI
10.1016/j.brachy.2026.07.163

Why clinicians should know about it

Abstract

PURPOSE: To evaluate whether reducing overall treatment time (OTT) by shortening interventional radiotherapy (IRT; brachytherapy) duration affects outcomes in patients with locally advanced cervical cancer undergoing definitive chemoradiation. METHODS AND MATERIAL: In this randomized clinical trial, conducted in 2016-2017, 75 patients with stage IB2-IVA cervical cancer were enrolled. The intervention group (n = 41) completed high-dose-rate IRT within 1 week, whereas the control group (n = 34) received the conventional 3-week schedule. The primary endpoint was treatment-related complications. RESULT: At 5-year follow-up, 7 patients were lost to follow-up, leaving 68 patients for analysis. Median OTT was significantly shorter in the intervention group (59 vs. 64.5 days; p = 0.01), and the complete response rate was higher (53.1% vs. 31.3%; p = 0.041). No significant differences were observed in overall survival (p = 0.962) or disease-free survival (p = 0.128). Multivariate analysis identified treatment response as a significant predictor of survival, with complete response associated with improved outcomes (p < 0.001). Acute and late adverse events, including proctitis, cystitis, and vaginal hemorrhage, were comparable between groups (all p > 0.05). CONCLUSION: Shortening IRT duration reduced OTT and improved complete response without increasing treatment-related toxicity, although no significant survival benefit was observed.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.