Concurrent chemotherapy for cervical cancer patients primarily treated with radiotherapy: is it necessary for all?
Concurrent cisplatin-based chemotherapy has been strongly recommended in women with cervical cancer requiring radiotherapy (RT). However, our studies have shown a subset of patients can achieve good treatment outcome by RT alone and the benefit of treating them with concurrent chemoradiation (CCRT) is questionable. On the other hand, patients with positive lymph node, squamous cell carcinoma antigen (SCC-ag) level > 10 or stage III/IVA disease have a higher risk of distant metastasis and weekly single-agent cis-platinum might be ineffective in reducing systemic relapse. This review will present our rationales and suggestions for the selection of cervical cancer patients who should receive different forms of CCRT or RT alone. We believe the intensity of CCRT for cervical cancer should vary between patients based on their individual risk for local and distant relapse.
Hong
Ji-Hong
JH
Department of Radiation Oncology, Chang Gung Memorial Hospital, Taipei. jihong@adm.cgmh.org.tw
D000970:Antineoplastic Agents / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000517:prevention & control / Q000556:secondary; D011878:Radiotherapy / Q000009:adverse effects; D002583:Uterine Cervical Neoplasms / Q000628:therapy*
D000970:Antineoplastic Agents