Cervical cancer best treated with chemoradiotherapy
MedWire News: Results of a Cochrane meta-analysis confirm that adding chemotherapy to radiotherapy improves overall and disease-free survival (DFS) in women with cervical cancer compared with radiotherapy alone.
Claire Vale (Medical Research Council, London, UK) and co-authors say the analysis endorses the recommendations made in the 1999 National Cancer Institute alert, and “also demonstrates their applicability to all women and a benefit of non-platinum based chemoradiotherapy.”
The researchers gathered individual patient data (n = 3,452 women) from 15 randomized controlled trials comparing radiotherapy with concomitant chemoradiotherapy.
Analysis of 13 trials showed that women who received chemoradiotherapy experienced a 6 and 8 percent improvement in 5-year overall survival and DFS, respectively, compared with those receiving radiotherapy alone.
Larger survival benefits were seen in the two trials where additional chemotherapy was administered following chemoradiotherapy, with an absolute improvement of 19 percent at 5 years.
Importantly, the researchers found no significant difference in overall survival between women using platinum and non-platinum-based chemotherapy regimens (hazard ratio [HR] = 0.84 and 0.76, respectively).
There was no evidence of a difference in the degree of survival benefit in terms of radiotherapy or chemotherapy dose, or treatment scheduling. The effect of chemoradiotherapy was consistent across patient subgroups, but there was a decreasing relative effect on survival with increasing tumor stage.
“We suggest that new trials are need to find out whether giving extra chemotherapy is better for women with cervical cancer or not,” said Vale.
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By Ingrid Grasmo