AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO026080090
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ORIGINAL RESEARCH ARTICLE

Risk factors and treatment outcomes of 3D brachytherapy in premenopausal cervical cancer patients: A retrospective cohort study

Haonan Han1† ,  Dongmin Liu2,3,4,5† ,  Yuan Dong1 ,  Pan Qi1 ,  Siyang Zhang1 ,  Xiaofeng Yao1* ,  Liming Xu2,3,4,5,6*
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1 Department of Plastic Surgery, Xiangyang Hospital of Traditional Chinese Medicine, Xiangyang, Hubei, China
2 Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
3 National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
4 Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
5 Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
6 Department of Radiation Oncology, Tianjin Cancer Hospital Airport Hospital, Tianjin, China
†These authors contributed equally to this work.
EJMO, 026080090 https://doi.org/10.36922/EJMO026080090
Received: 20 February 2026 | Revised: 15 March 2026 | Accepted: 1 April 2026 | Published online: 7 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Cervical cancer is one of the most common gynecological malignancies in women. 3D brachytherapy, as a local radiotherapy technique, has made significant progress in cervical cancer treatment in recent years.

Objective: By analyzing and identifying risk factors that affect treatment outcomes, this study aims to optimize survival benefits for high-risk young cervical cancer patients, thereby improving treatment efficacy and prognosis.

Methods: A retrospective observational study design was adopted, using clinical data from cervical cancer patients aged ≤50 years who received 3D brachytherapy. Clinical and treatment-related information was collected from the hospital information system of the Tianjin Cancer Hospital and Xiangyang Hospital of Traditional Chinese Medicine. Kaplan–Meier survival analysis was applied to estimate survival probabilities, while Cox proportional hazards regression models were used to identify independent prognostic factors.

Results: A total of 102 eligible patients were included in the analysis. Treatment interruption was significantly associated with an increased risk of disease progression (hazard ratio [HR] = 3.09, 95% CI: 1.35–7.09). Patients receiving a total brachytherapy dose greater than 2,800 cGy showed improved progression-free survival (PFS). Multidisciplinary treatment approaches, including concurrent chemoradiotherapy (CRT), thermotherapy, and targeted therapy, were associated with better PFS outcomes. In multivariate analysis, thermotherapy combined with CRT was identified as an independent prognostic factor associated with improved PFS (HR = 0.019, 95% CI: 0.01–0.53). A nomogram model demonstrated excellent predictive performance for 2-, 3-, and 5-year PFSs.

Conclusion: Radiotherapy dose parameters, treatment interruption, and multidisciplinary treatment strategies significantly influence the prognosis of premenopausal cervical cancer patients receiving 3D brachytherapy. The combination of thermotherapy and CRT may provide additional survival benefits. These findings may help optimize individualized treatment strategies for younger cervical cancer patients.

Graphical abstract
Keywords
Cervical cancer
Three-dimensional brachytherapy
Age
High-risk factors
Prognostic impact
Radiotherapy
Funding
None.
Conflict of interest
The authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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