{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:50:15Z","timestamp":1791831015585,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Cervical cancer is the leading cause of cancer\u2010related deaths for women in South Africa. The standard of care treatment for locally advanced cervical cancer (LACC) is external beam radiation followed by brachytherapy with concurrent platinum\u2010based chemotherapy. There exists a paucity of data regarding the treatment regimens received by women with LACC in South Africa. The aim of this study is to assess the patterns of care and survival for patients with LACC treated with curative intent at a tertiary care center in South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This is a retrospective review of cervical cancer patients with histologically confirmed LACC (stage IB2\u2014IVA) who underwent radiation with curative intent at Groote Schuur Hospital in Cape Town, South Africa between July 2013 and July 2018. Overall survival (OS) and disease\u2010free survival (DFS) were evaluated using the Kaplan\u2013Meier method. Cox proportional hazards modeling analyzed patient and treatment factor associations with survival. Logistic regression modeling was performed to assess factors associated with the receipt of chemotherapy and baseline hemoglobin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 278 patients, 28.4% (<jats:italic>n<\/jats:italic>\u2009=\u200979) of women had co\u2010infection with HIV, and 64.8% (<jats:italic>n<\/jats:italic>\u2009=\u2009180) received chemoradiation. Regardless of HIV status, patients who received chemoradiation had improved 2\u2010year OS (87.4% vs. 52.8%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and DFS (80.2% vs. 58.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared to those receiving radiation alone. Factors associated with improved OS were receipt of chemotherapy (HR 0.32, <jats:italic>p<\/jats:italic>\u2009=\u20090.005) and higher baseline hemoglobin (HR 0.86, <jats:italic>p<\/jats:italic>\u2009=\u20090.018). Upon multivariate logistic regression, adjusting for age, stage, and HIV status, patients with stage III\/IV disease were less likely to receive chemotherapy (HR 48.17, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and were less likely to have hemoglobin \u2265\u200910\u2009g\/dL (HR 0.20, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Addition of chemotherapy to standard radiation improved OS in women with LACC, regardless of HIV status. Our findings add to a body of literature highlighting the importance of providing concurrent chemoradiotherapy to all patients with LACC, including persons living with HIV and those with stage III\/IV disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70712","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T05:33:56Z","timestamp":1741930436000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patterns of Care and Outcomes Among Women With Locally Advanced Cervical Cancer Treated With Curative Intent at a Tertiary Center in South Africa"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3446-7560","authenticated-orcid":false,"given":"Juliet","family":"Maina","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Cape Town, Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie E.","family":"Lichter","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elana T.","family":"Benishay","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"George","sequence":"additional","affiliation":[{"name":"Donald Bren School of Information and Computer Sciences University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Henry","sequence":"additional","affiliation":[{"name":"Centre for Higher Education University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazia","family":"Fakie","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Grover","sequence":"additional","affiliation":[{"name":"Botswana\u2010UPenn Partnership University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"issue":"2021","key":"e_1_2_10_2_1","first-page":"209","article-title":"GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"4","author":"Sung H.","year":"2020","journal-title":"CA: A Cancer Journal for Clinicians"},{"key":"e_1_2_10_3_1","volume-title":"Global Cancer Observatory: Cancer Today","author":"Ferlay 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