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Chemoradiation for Cervical Cancer

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Pelvic Cancer Surgery

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Abstract

Cisplatin-based concurrent chemoradiation therapy has become the standard primary therapy in patients with locally advanced (stage IIB–IVA) or bulky early stage (IB2) cervical cancers and as an adjuvant therapy in patients with non-bulky early stage (IA2-IB1 and IIA) cervical cancer with at least one high risk factor after radical hysterectomy and pelvic lymphadenectomy. Five randomized clinical trials have shown that cisplatin-based concurrent chemoradiation is associated with 30–50 % improvement in both relative progression free survival and overall survival. This is contrast to neo-adjuvant chemotherapy administered preceding radiation therapy which in randomized trials has no survival advantage compared to radiation therapy alone in locally advanced cervical cancer. Weekly cisplatin in a dose of 40 mg/m2 for 6 weeks given during external pelvic radiation and brachytherapy represents the most widely acceptable regimen. Two current randomized clinical trials are studying the role of adjuvant chemotherapy with carboplatin and paclitaxel following standard chemoradiation in patients with locally advanced disease or early stage disease with high risk factors after radical surgery. Further, the role of biologic agents as radiation therapy sensitizers is currently being investigated either alone or in combination with cisplatin.

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Authors and Affiliations

  1. Women’s Health Institute/Gynaecologic Oncology Division, Cleveland Clinic Health System, Cleveland, OH, USA

    Haider Mahdi MD & Peter G. Rose MD

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  1. Haider Mahdi MD
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  2. Peter G. Rose MD
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Correspondence to Peter G. Rose MD .

Editor information

Editors and Affiliations

  1. Urology, University Hospital of North Norway, Tromsø, Norway

    Hitendra R.H. Patel

  2. University College London Hospital, London, United Kingdom

    Tim Mould

  3. Laparoscopic and Robotic Surgery, University of Rochester Medical Center, Rochester, New York, USA

    Jean V. Joseph

  4. Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA

    Conor P. Delaney

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Mahdi, H., Rose, P.G. (2015). Chemoradiation for Cervical Cancer. In: Patel, H., Mould, T., Joseph, J., Delaney, C. (eds) Pelvic Cancer Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4258-4_36

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  • DOI: https://doi.org/10.1007/978-1-4471-4258-4_36

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