Combining Chemotherapy, Radiation Therapy Improves Survival Odds for Cervical Cancer Patients

The updated results of a study confirm preliminary findings that chemotherapy can increase the chances of survival for some cervical cancer patients, according to a new study presented October 7, 2002, at the American Society for Therapeutic Radiology and Oncology's Annual Meeting in New Orleans.

The study reports the findings of a randomized trial that compared extended field radiotherapy with chemoradiation in women with locally advanced cervical carcinoma. Patients were eligible for the study if they had stages IIB-IVA, stages IB2-IIA with a tumor diameter greater than or equal to 5 centimeters or positive pelvic lymph nodes. Four hundred and three women were entered into the study between 1990 and 1997. One group was randomized to receive extended field radiation therapy, with 45 Gy to the pelvis and para-aortic nodes followed by low dose rate intracavitary radiation. The other group received chemoradiation, with 45 Gy pelvic radiation therapy, intracavitary radiation and three cycles of the chemotherapy drugs flourouracil and cisplatin.

Median follow-up of surviving patients was 5.8 years. Of the 403 patients randomized, 195 in the radiation therapy arm and 194 in the chemoradiation arm could be evaluated. The overall five-year survival rate was 52 percent for patients in the radiation therapy arm, and 72 percent in the chemoradiation arm. Disease-free survival rates for the radiation therapy and chemoradiation arms were 43 percent and 67 percent, respectively. The five-year rates of late grade 3 or higher treatment-related toxicity were comparable for patients in each arm.

"The addition of chemotherapy improves survival rates without significantly increasing late treatment-related side effects," said Patricia J. Eifel, M.D., of the Department of Radiation Oncology at the University of Texas M.D. Anderson Cancer Center and lead author of the study. "These results suggest that women with high-risk cervical cancer should receive chemotherapy in conjunction with radiation therapy."