The addition of chemotherapy (cisplatin) to radiotherapy improves survival of women with locally advanced cervical cancer compared with radiotherapy alone, without an apparent rise in late treatment complications, according to a study published in the September issue of Clinical Oncology.
Cisplatin is a platinum-based molecule which directly affects the DNA strands within cells to cause controlled cell death or 'apoptosis'. It was already known that a combination of radiotherapy and cisplatin was more effective than radiotherapy alone in curing cancer of the cervix but there was no reliable data on the long-term effects of the combined treatment, according to Paul Symonds, MD, from the department of cancer studies and molecular medicine, Leicester Royal Infirmary in Leicester, U.K.
Symonds led the Royal College of Radiologists’ retrospective audit of cervix cancer patients treated with radical radiotherapy (with or without surgery and/or chemotherapy) in U.K. cancer centers in 2001 and 2002. The study analyzed data for 1,243 patients from 42 different cancer treatment centers across the U.K.
Overall five-year survival was 56 percent (any radical treatment); 44 percent (radical radiotherapy); 55 percent (chemoradiotherapy) and 71 percent (surgery with postoperative radiotherapy), according to the researchers. Overall survival at five years was 59 percent (stage IB), 44 percent (stage IIB) and 24 percent (stage IIIB) for women treated with radiotherapy, and 65 percent (stage IB), 61 percent (stage IIB) and 44 percent (stage IIIB) for those receiving chemoradiotherapy.
The authors also noted that, in general, the results at five years were less reliable because of relatively low numbers of patients at risk.
Although complications continued to develop up to seven years after treatment for those receiving chemoradiotherapy, there was no apparent increase in overall late complications compared with radiotherapy alone when other factors were taken into account, wrote Symonds and colleagues.
According to the researchers, the addition of cisplatin to radiation has saved the lives of hundreds of women with locally advanced cancer in the east midlands. “The addition of cisplatin in routine U.K. practice reduces the odds of death by 23 percent. As this is curative treatment we can genuinely say that this is a reduction in the odds of death,” Symonds said.
"This audit showed a marked improvement in five-year survival of locally advanced cervix cancer compared to the last national audit of patients who were treated in 1993. Moreover the U.K. results, as derived from a total of 42 centers, show that the results in the U.K. are now compatible with the best international practice,” said Symonds.