Combined chemoradiotherapy and pelvic high-frequency focused hyperthermia for locally advanced cervical cancer: efficacy and incidence of acute radiation proctitis

Background: This study evaluated the efficacy of concurrent chemoradiotherapy (CCRT) combined with pelvic high-frequency focused hyperthermia (HFH) in stage IIB–IVA cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) classification) and assessed the incidence of acute radiation proctitis (ARP). Methods: Patients with locally advanced cervical cancer (LACC) were assigned to control (standard CCRT: volumetric modulated arc therapy, brachytherapy, and weekly cisplatin) or experimental groups (CCRT plus pelvic HFH). Primary endpoints included ARP incidence, clinical response, progression-free survival (PFS), and overall survival (OS). Results: Among the 70 enrolled patients (36 experimental, 34 control), the experimental group showed significantly lower symptomatic ARP incidence (19.44% vs. 44.12%; p = 0.026) and reduced severity. The objective response rate was higher (86.11% vs. 70.59%) but not statistically significant (p = 0.114). The experimental group had superior 2-year PFS (44.44% vs. 26.47%; p = 0.003) and 3-year OS (61.11% vs. 47.06%; p = 0.006), with prolonged median PFS (18 vs. 11 months) and OS (29 vs. 18 months). Cox regression indicated a significantly reduced risk of progression (Hazard Ratio (HR) = 0.3574, p = 0.002) and death (HR = 0.4627, p = 0.034) in the experimental group. Conclusions: Adding pelvic HFH to CCRT reduced ARP incidence and improved survival outcomes in LACC, suggesting its potential as a beneficial adjunct therapy.

Cervical cancer; Volumetric modulated arc therapy; High-frequency focused hyperthermia; Chemoradiotherapy; Acute radiation proctitis

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