To investigate the treatment outcomes of patients with pelvic recurrence or uncontrolled disease after radical hysterectomy for uterine cervical cancer who received salvage radiotherapy (RT) with concurrent chemotherapy.

Thirty-two patients with pelvic recurrence or uncontrolled disease after hysterectomy for uterine cervical cancer who received salvage chemoradiotherapy at Subei People's Hospital of Jiangsu Province between January 2008 and December 2016 were enrolled retrospectively. The median interval between initial operation and recurrence was 27 months. Whole-pelvic irradiation was delivered at a median dose of 50.0-50.4 Gy, followed by a boost at a median dose of 10.0-15.0 Gy to the gross tumor volume. Cisplatin-based concurrent chemotherapy was administered to all patients, and 10 patients accepted paclitaxel-cisplatin consolidation chemotherapy after chemoradiotherapy. The Logistic regression model was used to determine the predictors of treatment response, and the timing test was used to analyze the relationship between the initial International Federation of Gynecology and Obstetrics (FIGO) stage, pelvic wall infiltration, recurrent tumor size and remission status and survival status.

All patients completed ≥50.0 Gy RT. Complete response (CR) was achieved in 26 (81.2%, 26/32) patients. Initial International Federation of Gynecology and Obstetrics stage, tumor size at recurrence, and pelvic sidewall involvement were identified to be important predictors in univariate Logistic regression analysis. The 5-year progression-free survival (PFS), local control (LC), distant metastasis-free survival (DMFS), and overall survival (OS) rates were 68.7%, 78.1%, 81.3%, and 75.0%, respectively. FIGO stage, pelvic wall involvement and CR status were significant factors affecting PFS and OS rate in univariate log-rank test. The incidence of mild to moderate acute and late toxicities was 12.5% (4/32) and 3.1% (1/32), respectively. The incidence of severe acute toxicities was 40.0% (4/10).

Aggressive salvage RT with concurrent chemotherapy for recurrent cervical cancer confined to the pelvis is feasible, with promising treatment outcomes and acceptable toxicities.