Chemoradiotherapy: the new standard care for invasive cervical cancer

Drugs. 2000 Dec;60(6):1239-44. doi: 10.2165/00003495-200060060-00001.

Abstract

Cervical cancer remains a major health problem worldwide, despite advances in screening. For patients with locally advanced stage disease, failure to obtain local-regional control usually results in death. In an effort to improve local-regional tumour control, neoadjuvant and concurrent chemoradiation have been tested. Recently, 5 randomised trials performed by the Gynecologic Oncology Group, Radiation Therapy Oncology Group and the Southwest Oncology Group studying cisplatin-based chemoradiation have demonstrated a significant survival advantage. Three of the trials compared cisplatin-based concurrent chemotherapy and radiation to radiation alone and 2 trials compared cisplatin-based concurrent chemotherapy and radiation to radiation with hydroxyurea. In all trials, cisplatin-based chemotherapy administered concurrently with radiation therapy was the more effective therapy, reducing the risk of death by 30 to 50%. Acute toxicities, principally neutropenia and gastrointestinal, were more common with chemoradiation but were transient and rates of late complications were similar between treatment groups. Based on the results of these 5 randomised trials, the National Cancer Institute released a Clinical Announcement stating that cisplatin-based chemotherapy as used in these trials concurrently with radiation therapy should be the new standard of therapy for high risk early stage and locally advanced stage cervical cancer.

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Cisplatin / therapeutic use
  • Combined Modality Therapy
  • Female
  • Fluorouracil / therapeutic use
  • Humans
  • Hydroxyurea / therapeutic use
  • Neoadjuvant Therapy
  • Randomized Controlled Trials as Topic
  • Survival Analysis
  • Uterine Cervical Neoplasms / drug therapy*
  • Uterine Cervical Neoplasms / radiotherapy*

Substances

  • Antineoplastic Agents
  • Cisplatin
  • Fluorouracil
  • Hydroxyurea