| Summary: | Jiabin Ma, Weiping Wang, Jing Shen, Xiaorong Hou, Xin Lian, Junfang Yan, Shuai Sun, Zheng Miao, Qingyu Meng, Ke Hu,* Fuquan Zhang* Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ke Hu; Fuquan Zhang Tel/Fax +86-10-69155482; +86-10-69155485Email huk@pumch.cn; zhangfuquan3@126.comObjective: To determine the toxicity and efficacy of radiotherapy for cervical cancer in patients with systemic lupus erythematosus (SLE).Methods: Medical records of patients with SLE who received radiation for cervical cancer from January 2011 to January 2019 were reviewed. For definitive radiotherapy, a dose of 50.4 Gy in 28 fractions was delivered by intensity-modulated radiation therapy (IMRT) combined with high-dose-rate brachytherapy of 28 to 30 Gy in 5 fractions. A dose of 45 to 50.4 Gy in 25– 28 fractions was delivered for postoperative radiation. All patients were in remission with or without a low dosage of prednisone or immunosuppressive medication. Survival data were analyzed with the Kaplan–Meier method. The incidence of severe toxicities among patients was compared with the chi-square test or Fisher’s exact test.Results: Twelve patients with SLE were included in this study. Definitive radiotherapy was delivered in 7 patients with FIGO (2009) stage II–III disease. Five patients with FIGO I disease received postoperative radiation. The median follow-up time was 22.1 months. The 3-year overall survival (OS) and 3-year progression-free survival (PFS) were 77.8% and 83.3%, respectively. One patient of definitive radiotherapy and one patient of postoperative radiation died due to distant metastasis of cervical cancer. Grade 3 or higher acute and chronic reactions occurred in 58.3% and 8.3% patients, respectively. Acute grade 3 or higher toxicity correlated with the presence of chemotherapy (p = 0.045).Conclusion: Modern radiotherapy for cervical cancer was well tolerated in SLE patients with remission and provided a favorable outcome.Keywords: systemic lupus erythematosus, SLE, cervical cancer, intensity-modulated radiation therapy, IMRT, radiotherapy, toxicity
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