Primary Concurrent Chemo-Radiation
Recent results from each of five randomized phase III trials show an average overall survival advantage for cisplatin-based therapy given concurrently with radiation therapy. Although the trials vary somewhat in terms of stage of disease, dose of radiation, and schedule of cisplatin and radiation, they all demonstrate significant survival benefit for this combined approach. The risk of death from cervical cancer would decrease by 30-50% by addition of concurrent chemotherapy treatment. Based on these results, we advise concurrent cisplatin-based chemotherapy with radiation therapy in women who require radiation therapy for the treatment of stage IB2 or larger cervical cancer or for those patients with involved pelvic or para-aortic lymph nodes. The protocol designation for this therapy is GOCXCRT. It consists of weekly cisplatin at 40 mg/m2 weekly for five weeks during external beam radiation therapy.
Advanced or Recurrent Disease
Chemotherapy may be offered in the palliative setting of cancer of the cervix or as part of investigatory protocols. Our current standard is based upon cisplatin and etoposide (GOCXADV).