Concurrent Cisplatin-based Chemotherapy Research Articles

Concurrent Cisplatin-Based Radiotherapy and Chemotherapy for Locally Advanced Cervical Cancer

Concurrent Cisplatin-Based Radiotherapy and Chemotherapy for Locally Advanced Cervical Cancer

Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer

Cervical carcinoma remains a common gynecologic malignancy. Physical examination has historically served as the predominant tool for staging and assessment, in part due to lack of availability of additional diagnostic resources in many parts of the world. Cross-sectional imaging in the evaluation of cervical cancer has become standard of care in developed countries, and has recently been incorporated into the official staging classification of the International Federation of Gynecology and Obstetrics. This article will describe the use of computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging in cervical cancer patients, review optimal techniques for MR evaluation of the cervix, and describe key aspects of staging and management of cervical carcinoma.

Time to add chemotherapy to radiotherapy for cervical cancer

Although screening for cervical cancer has greatly reduced both the incidence of and death rates from invasive cervical cancer in the western world, the disease remains the commonest cancer among women in Africa, Asia, and South America. A high proportion of these cancers present at an advanced stage, for which the main treatment option has been radiotherapy. However, the US National Cancer Institute has sent out a clinical alert stating that strong consideration should be given to adding chemotherapy to radiotherapy for the treatment of invasive cervical cancer. It draws attention to five phase III studies that have each shown statistically significant improvements in survival rates when chemotherapy was added to standard radiotherapy regimens. Three of the studies are reported this week in the New England Journal of Medicine, 1 Rose PG Bundy BN Watkins EB et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999; 340: 1144-1153 Crossref PubMed Scopus (2168) Google Scholar , 2 Morris M Eifel PJ Lu J et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervjcal cancer. N Engl J Med. 1999; 340: 1137-1143 Crossref PubMed Scopus (1914) Google Scholar , 3 Keys HM Bundy BN Stehman FB et al. Cisplatin, radiation, and adjuvant hsyterectomy compared with radiation and adjuvant hysterectomy for bulky stage 1b cervical carcinoma. N Engl J Med. 1999; 340: 1154-1161 Crossref PubMed Scopus (1669) Google Scholar and the other two were presented at the meeting of the Society of Gynecologic Oncologists last month in San Francisco. As the clinical alert puts it, “Overall, across the five studies, concurrent cisplatinbased chemoradiation reduced the risk of death by 30 percent to 50 percent”.