Table 1 Clinical Trials Assessing Efficacy and Safety of Chemotherapy and Radiotherapy in Locally advanced disease IB2 to IVA
Trials | Patient population | Treatment Arms | Results | Conclusions/Discussions |
|---|---|---|---|---|
Morris et al. 1999 [31] | Cervical cancer confined to the pelvis (stages IIB through IVA or stage IB or IIA with a tumor diameter of at least 5 cm or involvement of pelvic lymph nodes) | Radiotherapy + chemotherapy (fluorouracil + cisplatin) vs. radiotherapy alone in high risk cervical cancer | 5-year survival rate: 73% vs. 58%; p = 0.004 | Addition of chemotherapy with fluorouracil and cisplatin to radiotherapy significantly improves survival rate |
Kang et al. 2015 [32] | Patients will all tumor stages | Temporal treatment patterns for cervical cancer per guideline recommendations | Factors affecting likelihood of treatment per guidelines: age (p < 0.0001); tumor stage at diagnosis (p = 0.002) Reduction in all‑cause mortality: 56%; cancer related mortality: 49% | Treatment per guideline recommendations reduced mortality rates and OS |
Au-Yeung et al. 2013 [33] | Patients with Locally advanced cervix cancer patients | Carboplatin + radiation for locally advanced cervical cancer | No significant benefit in OS or DFS | Concurrent use of carboplatin along with radiation therapy does not impact survival rate |
Sebastiao et al. 2016 [34] | Patients with cervical cancer stage IIB-IVA | Cisplatin + radiotherapy vs. carboplatin + radiotherapy in advanced cervical cancer | 3-year PFS: 59% vs. 40% 3-year OS: 70% vs. 68% | Overall, both cisplatin and carboplatin were similar with respect to 3-years OS, PFS, ORR, and toxic effects |
Hashemi et al. 2013 [35] | Patients with cervical cancer stage IIB to stage IVA | Gemcitabine + cisplatin + radiotherapy | ORR: 97.3% 3-year DFS: 67% OS: 72% | Inconclusive regarding the benefit with gemcitabine. Further phase III studies required to validate the results |
Narayan et al. 2016 [36] | Patients with stage I(IB2) and locally advanced (stages II-IVA) cervical cancer | NACT followed by CCRT vs. CCRT | DFS: 58.3% vs. 41.8%; p=0.001 | Combination NACT with paclitaxel and cisplatin may improve long-term survival of patients with cervical cancer |
Gill et al. 2015 [37] | Patients with stage IB1 to IVA cervical cancer | MRI-guided high-dose-rate intracavitary brachytherapy for cervical cancer | 2-year local control: 91.6%; DFS: 81.8%; cancer-specific survival rate: 87.6% | Excellent local control and considerable morbidity was observed |
Li et al. 2014 [38] | Patients with stage IIb-IVa cervical squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma; seven patients had lymph node metastasis | Raltitrexed/cisplatin with concurrent radiotherapy; additional radiation was administrated to the lymph node metastases | OS: 90.7% | Favorable efficacy and acceptable adverse events |