Chemotherapy and irradiation in locally advanced squamous cell carcinoma of the uterine cervix: A review

This article describes the potential role of chemotherapy combined with irradiation in the management of patients with locally advanced carcinoma of the uterine cervix. A review of a Medline literature search and preliminary data from a nonrandomized study comparing irradiation alone with irradiation plus chemotherapy (5-fluorouracil and cisplatin) in the management of patients with locally advanced carcinoma of the uterine cervix treated at Washington University between 1984 and 1992 are presented. Except for one report, there is currently no conclusive evidence that chemotherapy plus irradiation significantly improves tumor control or survival in these patients. Nevertheless, chemotherapy may have a potential role in managing carcinoma of the uterine cervix as an adjuvant to irradiation in patients with pelvic or para-aortic lymph nodes or recurrent tumor after surgery or radiation therapy. Treatment morbidity has been acceptable. Based on available data, chemotherapy should not be advocated in the standard management of carcinoma of the uterine cervix, and patients and physicians should be strongly encouraged to participate in properly designed prospective clinical trials.