To explore possible predictors of early vaginal stenosis among patients with locally advanced cervix cancer on pelvic chemoradiation.

A total of 232 patients with locally advanced cervix cancer, who received pelvic radiotherapy at our institute from November 2011 to October 2013, were prospectively studied. Possible predictors chosen were age, tumour stage, initial vaginal involvement, concomitant chemotherapy and development of vaginitis of Radio Therapy Oncology Group grade 2 or more during radiotherapy. Multiple logistic regression was carried out to assess predictors and the relative risk of predictors was calculated.

Initial vaginal involvement and addition of concomitant chemotherapy are predictors of early vaginal stenosis in locally advanced cervix cancer patients on pelvic chemoradiation. Relative risk for early vaginal stenosis with vaginal involvement at presentation was 16·31, whereas that for concomitant chemotherapy was 9·95.

Among patients with locally advanced cervix cancer receiving pelvic chemoradiation, two factors, namely, initial vaginal involvement and concomitant chemotherapy are predictive of early vaginal stenosis. Patients with these factors should be assessed at regular intervals for early vaginal stenosis during pelvic chemoradiation to assess the optimal timing of intracavitary brachytherapy. This is particularly of importance in the absence of facilities for interstitial brachytherapy to ensure appropriate target coverage.