Women with cervical cancer who are treated with chemoradiotherapy, as opposed to radiotherapy alone, presented higher survival rates and have a greater likelihood their cancer will not spread to other parts of the body or return at all, according to a study published Jan. 19 in the Cochrane Database of Systematic Reviews and conducted by the Chemoradiotherapy for Cervical Cancer Meta-analysis Collaboration.
Claire Vale of the Medical Research Council Clinical Trials Unit in London, and colleagues evaluated the results of 18 randomized controlled trials (RCTs) for their systematic review. The trial sought to collect and re-analyze patient data (about 3,452 cases of cervical cancer) over a long-term follow-up period in order to investigate the possible differences in the effect of chemoradiotherapy by trial or patient characteristics.
The RCTs were carried out in several countries following a National Cancer Institute (NCI) clinical alert that was issued in 1999 regarding the proposed changes in treatment guidelines for cervical cancer, including the suggestion that chemoradiotherapy should be considered as an alternative to radiotherapy.
Of the 18 trails identified, 15 were selected for inclusion in the study. Of the 15 studies, Vale and colleagues compared the administration of chemoradiotherapy to radiotherapy and the researchers found that after five years of receiving chemoradiotherapy treatment, 66 out of 100 women survived compared to the 60 out of 100 who had undergone radiotherapy alone, noting a 6 percent improvement.
"We saw clear evidence that adding chemotherapy to radiotherapy improves survival, as well as disease free survival," said Vale. “These are effective, affordable treatments that provide a benchmark for other potential treatment approaches."
The study found that chemoradiotherapy was beneficial to all women, despite tumor size and spread of the cancer. However, the authors noted that some short-term side effects of chemoradiotherapy treatment can be worse for women compared to those who undergo radiotherapy alone.
Moreover, the authors said that their research suggested that continuing chemotherapy after chemoradiotherapy could potentially improve survival rates further, as noted by two previous studies. The researchers also wrote that chemoradiotherapy was found to not be restricted to only platinum-based drugs, as recommended by the NCI.
The researchers noted that while the results of the review do endorse the recommendations of the NCI alert, further RCTs are necessary for particular findings of the study, including whether or not giving extra chemotherapy is more beneficial for a woman’s survival rate with cervical cancer.