Redefining Role of 5-Fluorouracil and Exploring the Impact of Taxanes and Cisplatin in Locally Advanced and Recurrent Carcinoma Cervix in Concurrent Setting With Radiotherapy: A Literature Review.

Jasmeet Kaur,Anju Kansal,Shreya Garg,Sapna Marcus

doi:10.7759/cureus.11645

Abstract

Cervical carcinoma is the fourth most frequent cancer among women worldwide while it is common in rural India. The irony of the situation is that it continues to present in a locally advanced stage with bulky disease posing a significant challenge to the current treatment modalities despite various screening programs. Concurrent chemoradiotherapy is the mainstay of treatment for locally advanced carcinoma cervix. However, the appropriate dosing schedules, along with the salutation of the chemotherapeutic agent, remain a matter of debate to date. The use of chemotherapy in the neoadjuvant and adjuvant setting promises to improve progression-free survival and overall survival. The article aims to review various chemotherapy and their regimens in the treatment of carcinoma of the cervix.

Highlights

BackgroundCervical cancer is the fourth most common cancer and the fourth leading cause of cancer-related mortality worldwide in women [1]
One-third of total cervical cancer patients worldwide are contributed by China and India together with “106,000 cases in China and 97,000 cases in India” [2,3]
The treatment for early-stage carcinoma cervix is surgery and chemoradiotherapy, while for advanced stage, chemoradiation therapy is the mainstay of treatment

Summary

Introduction

Cervical cancer is the fourth most common cancer and the fourth leading cause of cancer-related mortality worldwide in women [1]. In a phase III study comparing “radical radiotherapy with and without chemotherapy in patients with advanced squamous cell cancer of the cervix with pelvic lymph node involvement” showed no improvement in progression-free survival and mortality benefits of weekly cisplatin with concurrent RT over RT alone [27]. In a study by Kim et al in “locally advanced cervical cancer compared monthly fluorouracil and cisplatin versus cisplatin alone concurrent with external beam radiotherapy, and high dose rate brachytherapy” showed no difference in tumor response and overall survival but there is improvement in treatment compliance seen in patients with cisplatin alone group [29].

Conclusions

Disclosures

Findings

Arneth B