Neoadjuvant chemotherapy followed by radiotherapy should not be a standard approach for locally advanced cervical cancer

Int J Radiat Oncol Biol Phys. 1998 Mar 1;40(4):889-96. doi: 10.1016/s0360-3016(97)00906-1.

Abstract

Purpose: To investigate the role of neoadjuvant chemotherapy followed by radiotherapy in locally advanced cervical cancer.

Methods and materials: This study cites all known literature on the subject in the English language. Articles were selected for analysis by MEDLINE and CANCERLINE computer searches. In Phase II trials, the response rates of some selective series were analyzed. However, This article will specially emphasize the result of all Phase III randomized trials.

Results: Several investigators did obtain promising results from Phase II trials of neoadjuvant chemotherapy, mostly cisplatin-based combinations, followed by radiotherapy. However, most Phase III trials failed to demonstrate any benefit in terms of loco-regional relapse and/or survival by up-front chemotherapy.

Conclusion: The role of neoadjuvant chemotherapy remains to be defined, and the search for more active new agents must be continued. The neoadjuvant setting is still experimental and could not be recommended as a standard treatment at the present.

Publication types

  • Meta-Analysis

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bleomycin / administration & dosage
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • Cyclophosphamide / administration & dosage
  • Female
  • Humans
  • Ifosfamide / administration & dosage
  • Mesna / administration & dosage
  • Mitomycins / administration & dosage
  • Neoplasm Staging
  • Randomized Controlled Trials as Topic
  • Uterine Cervical Neoplasms / drug therapy*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / radiotherapy*
  • Vincristine / administration & dosage

Substances

  • Mitomycins
  • Bleomycin
  • Vincristine
  • Cyclophosphamide
  • Mesna
  • Cisplatin
  • Ifosfamide