Chemoradiation and adjuvant chemotherapy in cervical cancer.
OBJECTIVE
Radiotherapy is the standard treatment for locally advanced cervical cancer, but treatment results remain disappointing, particularly for women with bulky central disease. We investigated the role of concurrent chemoradiation and adjuvant chemotherapy in a randomized trial.


METHODS
Two hundred twenty patients with bulky stage I, II, and III cervical cancer were randomized to receive either standard pelvic radiotherapy or chemoradiation (epirubicin 60 mg/m(2)) followed by adjuvant chemotherapy with epirubicin 90 mg/m(2) administered at 4-week intervals for five additional cycles.


RESULTS
Fifty-nine patients have relapsed, with a median follow-up duration of 77 months. Patients who received epirubicin radiation therapy showed a significantly longer disease-free (P =.03) and cumulative survival (P =.04). Patients who received radiation alone had significantly more distant metastasis than those who received chemoradiation (P =.012). There was no difference in long-term local tumor control (P =.99).


CONCLUSIONS
Survival benefit has been demonstrated in patients treated with chemoradiation followed by adjuvant chemotherapy with epirubicin as compared with patients treated with standard pelvic radiotherapy alone.
Wong
L C
LC
Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong, China.
Ngan
H Y
HY
Cheung
A N
AN
Cheng
D K
DK
Ng
T Y
TY
Choy
D T
DT
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D015251:Epirubicin / Q000627:therapeutic use*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011878:Radiotherapy / Q000379:methods; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin