Hemostatic radiotherapy in cervical cancer: experience at the Dalal Jamm hospital radiotherapy department

Introduction: Radiotherapy is crucial in controlling life-threatening bleeding associated with advanced cervical cancer. The objective was to describe our experience in managing severe bleeding with hemostatic radiotherapy in cervical cancer and to evaluate its effectiveness. Methodology: A retrospective, descriptive study was conducted of patients with cervical cancer treated with hemostatic radiotherapy between March 2021 and January 2023 at Dalal Jamm hospital radiotherapy center. Treatment efficacy was assessed using the WHO bleeding score both before and after radiotherapy. A statistical analysis was performed by calculating the absolute frequencies for qualitative variables and comparing the frequencies using a Chi-square test. For quantitative variables, means and standard deviations were calculated and a Student's t-test was used to compare the means. The significance threshold was set at a p-value of less than 0.05. Results: The mean age was 51.3 ± 10.6 years. Squamous cell carcinoma accounted for 87% of cases. Tumor stage III-IV accounted for 60.9% of patients. Before radiotherapy, 82.6% of patients had grade 3 vaginal bleeding. Radiotherapy was administered as a single dose in all patients, with a dose of 8 Gy in 82.6% and 6 Gy in 17.4% of cases. Radiotherapy controlled bleeding in 95.7% (95% CI: [78.1-99.9], p<0.001) of patients, with a complete response in 73.9% (95% CI: [51.6 - 89.8], p=0.035) of them. The mean duration of control of metrorrhagia was 2 ± 0.69 days. The mean hemoglobin level was 8.2 ± 1.8 g/dL before radiotherapy and 8.7 ± 1.5 g/dL after radiotherapy. Conclusion: Single-dose hemostatic radiotherapy (6 or 8 Gy) is an effective short-term method for controlling life-threatening metrorrhagia associated with cervical cancer in Senegal. Keywords: hemostatic radiotherapy; cervical cancer; palliative care; metrorrhagia; Senegal.