Chemotherapy and radiotherapy for locally advanced cervical cancer

Pelvic radiotherapy has been the standard treatment for locally advanced cervical cancer for many years. Survival at five years, however, is only about 65% (30-80%, depending on stage). There have been no improvements in these results since the introduction of megavoltage irradiation 40 years ago—until this year. The 15 April edition of the New England Journal of Medicine carried reports of three trials which suggest that the concurrent use of cisplatin based chemotherapy and radiotherapy results in longer progression free and overall survival than the use of radiotherapy alone. These are very optimistic conclusions: how secure are they, and what do they tell us about future research questions and ways of answering these?1^–3

These results were identified by the National Cancer Institute in the United States as being especially important, and because of this it revealed the conclusions of the studies in a “Clinical announcement” on 22 February. This suggested that “strong consideration should be given to the incorporation of concurrent cisplatin based chemotherapy with radiation therapy in women who require radiation therapy for treatment of cervical cancer.” The clinical announcement also included summary data on two similar trials that are shortly to be reported (one from the South West Oncology Group (SWOG 8797; abstract on http://www.sgo.org/meetings/30annual/abstracts/abstract1.html) and one …