Combining drugs and radiotherapy improves the survival chances of women receiving treatment for cervical cancer. These are the conclusions of Cochrane Researchers who carried out the most comprehensive study of the effects of combined drug and radiotherapy in cervical cancer treatment to date.

Cervical cancer is the second most common cancer in women worldwide. Treatments for the disease have changed markedly over the last decade as a result of guidelines issued by the National Cancer Institute (NCI) in 1999, which stated that chemoradiotherapy should be considered as an alternative to radiotherapy. Chemoradiotherapy combines chemotherapy (drug treatment) and x-ray treatment, whereas radiotherapy is just x-ray treatment.

"We saw clear evidence that adding chemotherapy to radiotherapy improves survival, as well as disease free survival," said Claire Vale, of the Medical Research Council Clinical Trials Unit in London in the UK. "These are effective, affordable treatments that provide a benchmark for other potential treatment approaches."

The researchers analysed data from 15 trials involving a total of 3,452 women. They found that compared to women who had radiotherapy alone, women receiving chemoradiotherapy were more likely to live for longer after treatment. Five years after receiving treatment, 66 out of every 100 women survived with chemoradiotherapy compared to 60 out of 100 with radiotherapy. In addition, treatment with chemoradiotherapy reduced the chance of the cancer coming back or spreading to other areas. Crucially, their analysis showed that the benefits of chemoradiotherapy were not just restricted to the platinum-based drugs recommended by the NCI.

Based on a small subset of the data, there was also an indication that continuing drug therapy after chemoradiotherapy could improve survival rates even further, although the researchers say more studies are required to confirm this. "We suggest that new trials are needed to find out whether giving extra chemotherapy is better for women with cervical cancer or not," said Vale.

Source: Jennifer Beal
Wiley-Blackwell