TREATMENT OF CERVICAL CANCER


Adding chemo to traditional XRT improves outcomes in locally advanced cervical Ca:

  1. 369 women with Ca confined to the cervix tx'd randomized to cisplatin vs. no cisplatin; all got pelvic irradiation then hysterectomy; cisplatin group had RR 0.5 for disease progression or death over avg. 3y f/u (NEJM 340:1154, 1999--JW)
  2. 526 women with locally advanced cervical Ca randomized to cisplatin vs.cisplatin + fluorouracil + hydroxyuria vs. hydroxyurea alone; all got radiotherapy; rates of overall survival and progression-free survival was sig. higher in both cisplatin groups (NEJM 340:1144, 1999--JW)
  3. 403 women with advanced cervical Ca confined to the pelvis randomized to cisplatin + fluorouracil vs. no chemo; all got pelvic irradiation; at 5y, chemo group had sig. higher overall and disease-free survival rates (73% vs. 58% and 67% vs. 40%, respectively) (NEJM 340:1137, 1999--JW)