Neoadjuvant chemotherapy to radiation and concurrent chemoradiation for locally advanced squamous cell carcinoma of the cervix: A review of the recent literature

Alessandro Colombo, Fabio Landoni, Andrea Maneo, Gerardo Zanetta, Simonetta Nava, Gabriele Tancini

Research output: Contribution to journalArticlepeer-review

Abstract

Radiotherapy is the standard treatment for locally advanced cervical cancer; nevertheless it fails to control disease progression within the irradiation fields in more than 40% of cases, particularly in patients with bulky tumor. Distant metastases are not infrequent in more advanced cases. Chemotherapy has been integrated with radiotherapy to improve local control and treat distant subclinical metastases. Schedules of combined treatment more frequently represented by neadjuvant chemotherapy followed by radiation (NACT) and by concomitant chemotherapy and radiation (CT-RT). A review of the recent literature is presented. The role of NACT is controversial: high response rates are reported but doubtful advantages in terms of survival or local control have been shown. In randomized trials, hydroxyurea concomitant to radiation improves local control and survival, particularly in stage IIIB and IVA. Several randomized trials of concurrent chemoradiation with 5FU, cisplatin and mitomycin C are underway, but few have been published: no significative differences are reported in term of local control or survival. Acute toxicity is higher than in radiation alone, but usually manageable. For the analysis of late morbidity a longer follow-up is required. Large randomized trials of adequate radiotherapy versus concomitant chemoradiation are necessary to refine our understanding of the benefits of this integrated treatment.

Original languageEnglish
Pages (from-to)229-237
Number of pages9
JournalTumori
Volume84
Issue number2
Publication statusPublished - Mar 1998

Keywords

  • Cervical cancer
  • Concurrent chemoradiation
  • Neoadjuvant chemotherapy
  • Radiotherapy

ASJC Scopus subject areas

  • Cancer Research

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