title: Chemotherapy in the primary treatment of cervical carcinoma.
abstract: Two major treatment modalities in cervical cancer include radiotherapy and surgery. In an attempt to improve the outcome, these modalities have been increasingly supplemented by chemotherapy. Chemotherapy can be combined with local therapies in various sequences. Of the two possible strategies using chemotherapy and radiotherapy (sequential or concomitant), the latter seems to be more effective. Platinum-based regimens applied concurrently with both definitive and post-operative radiation therapy were demonstrated to provide survival benefit in five of the six recently published randomised trials. The positive impact of chemotherapy added to radiotherapy has also been shown in a meta-analysis including 1894 patients in 19 randomised studies. This strategy, however, is accompanied by increased early toxicity. The benefit of chemotherapy applied prior to surgery remains debatable. The role of new cytotoxic and biological substances, as well as agents combating tumour hypoxia, warrants further clinical investigation.
authors.affiliation: Department of Oncology and Radiotherapy, Medical University of Gdańsk, ul. Debinki 7, 80-211 Gdańsk, Poland. onkol@amg.gda.pl
authors.forename: Krystyna
authors.initials: K
authors.lastname: Serkies
authors.forename: Jacek
authors.initials: J
authors.lastname: Jassem
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use / Q000633:toxicity; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents