Radiation therapy cervical cancer

Although flaws in these studies of hydroxyurea left their results open to question, the GOG was convinced that the weight of the evidence supported inclusion of hydroxyurea in the control arms of future trials. In the early 1980s, 308 patients with stages IIB-IVA cervical cancer were randomly assigned to receive radiation therapy with concurrent hydroxyurea or radiation therapy with concurrent misonidazole. A preliminary review... 

Results of Prospective Randomized Trials that Compared Neoadjuvant Cisplatin-Containing Chemotherapy Followed by Radiation Therapy with Radiation Therapy Alone in Patients with Locally Advanced Cervical Cancer (52)... 

Citing the success of mitomycin-C in the treatment of anal cancer, a number of investigators have explored the use of this drug, usually in combination with fluorouracil, in patients treated with radiation for cervical and vulvar carcinomas (23-27). Roberts et al. (27) recently reported results of an interim analysis of a randomized trial, conducted in Venezuela, in which women with locally advanced cervical cancer were treated with radiation therapy with or without mitomycin. At the time of this interim analysis (published while the authors were continuing to accrue patients to the study), the authors noted a significant improvement in disease-free survival (p - 0.01) with chemotherapy but no significant difference in overall survival (p = 0.1). 

Other potential radiation sensitizers for cervical cancer are being explored in phase I and II trials. Paclitaxel has been combined with cisplatin in several small phase I studies. Pignata et al. (29) found that 50 mg/m2 per week of paclitaxel could be combined with weekly cisplatin (30 mg/m2) and radiation therapy with acceptable toxicity, although 10 of 18 patients in their study had grade 3-4 hematologic toxicity. Chen etal. (30) also were able to give weekly paclitaxel at a dose of 50 mg/m2 (in this case combined with 50 mg/m2 of cisplatin every three weeks) with tolerable toxicity and minimal delay in planned radiation therapy. In both studies, the dose-limiting side effect appeared to be diarrhea. It should be noted that the total dose of cisplatin delivered in these trials was lower than that used in the most successful prospective trials of cisplatin or cisplatin and fluorouracil (Table 3). 

Piver M, Barlow J, Vongtama V, et al. Hydroxyurea and radiation therapy in advanced cervical cancer. Am J Obstet Gynecol 1974 120 969-972. 

Kunos CA, Winter K, Dicker AP, Small W Jr, Abdul-Karim FW, Dawson D, Jhingran A. Valicenti, Widha JB, Gaffney DK. Ribonucleotide reductase expression in cervical cancer a radiation therapy oncology group translational science analysis. Int J Gynecol Cancer. 2013 23 615-21. 

Eifel PJ, Winter K, Morris M et al (2004) Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aortic irradiation for high-risk cervical cancer an update of Radiation Therapy Oncology Group Trial (RTOG) 90-01. J Clin Oncol 22 872-880... 

I.V. Chemotherapy Plus Radiation (Chemoradiation) In a multi-institutional study reported in 1999 by Morris et al. of MDACC, the effects of radiation therapy to the pelvic and paraaortic field were compared to that of pelvic irradiation and concurrent chemotherapy with 5FU and cisplatin in women with advanced cervical cancer. The estimated cumulative rates of survival at 5 years were 73% among patients treated with radiotherapy and chemotherapy and 58% among patients treated with radiotherapy alone. Because of the success of chemoradiation in the management... 

Sommers GM, Alfieri AA (1998) Multimodality therapy radiation and continuous concomitant ds-platinum and PKC inhibition in a cervical cardnoma model. Cancer Invest 16 462-470... 

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