Current state-of-the-art of concomitant chemoradiation in cervical carcinomas.
Despite screening programs, cervical carcinoma remains a major health problem throughout the world. Until recently pelvic radiation has been the standard therapy for advanced disease with overall five-year survival rates of 50%. Recently, five randomized trials demonstrated a significant survival advantage for the concomitant administration of radiotherapy and cisplatin-based chemotherapy. Although the trials vary somewhat in terms of stage of disease, dose of radiation, and schedule of radiation and cisplatin, they all demonstrated a significant survival benefit for the combined approach. Congruent to these findings are results from a meta-analysis based on the data from 19 trials with 4,580 randomized patients. The absolute increase in progression-free and overall survival was 16% and 12%, respectively. Contrary to these findings is the result of the National Cancer Institute of Canada (NCCI) trial. Despite that result cisplatin-based concomitant chemoradiotherapy has become the standard treatment of locally advanced cervical cancer.
Vrdoljak
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Center of Oncology, University of Split School of Medicine, Clinical Hospital of Split, Croatia.
Hamm
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D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage*; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*
D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D002945:Cisplatin