Early-stage cervical cancer is treated with radical hysterectomy. The patients undergo radiation alone (RT) as post-operative adjuvant treatment. In some cases, they also receive either sequential or concurrent chemoradiation (SCRT or CCRT). This study evaluates the benefits of SCRT and CCRT and compares them with RT.
The randomized trial had 1048 women with 353 in the SCRT group. There were 345 and 350 women in CCRT and RT groups respectively. They had IB to IIA stage of cervical cancer with serious pathological factors. The 10-year data got collected from a Chinese hospital in a post-operative setup. The patients received a total dosage adjuvant RT with 45 to 50 Gy. The weekly cisplatin CCRT was 30 to 40 mg/m square. The cisplatin and paclitaxel SCRT were 60 to 75 and 135 to 175 mg/m square. A 21-day cycle was followed with two cycles before radiotherapy and two cycles afterward.
The RT group with 18.3% had the lowest rate of lymph node involvement, and the disease characteristics and baseline demographics in treatment groups were balanced. SCRT had a higher disease-free survival rate than RT at 90% vs. 82%. The SCRT and CCRT comparison gave 90% to 85%.
SCRT decreased death risk compared to RT at 92% to 88% for a 5-year rate, with lymph node adjustment. The three year and distant DFS improved as compared to RT or CCRT. But no improvements were in CCRT vs. RT comparison.
Ref: https://jamanetwork.com/journals/jamaoncology/article-abstract/2774871
