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Table 1 Clinical Trials Assessing Efficacy and Safety of Chemotherapy and Radiotherapy in Locally advanced disease IB2 to IVA

From: Meeting report, “First Indian national conference on cervical cancer management - expert recommendations and identification of barriers to implementation”

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
  1. Legend: OS Overall survival, PFS Progression free survival, ORR Overall response rate, DFS Disease free survival, NACT Neoadjuvant chemotherapy, CCRT Concurrent chemoradiation therapy, MRI Magnetic resonance imaging