Lack of proven efficacy of chemotherapy for patients with carcinoma of the uterine cervix

This article reviews prospective randomized phase III studies that use chemotherapy and irradiation for the treatment of patients with carcinoma of the uterine cervix. Neoadjuvant chemotherapy has been administered in four separate trials. None of these has shown a benefit to neoadjuvant therapy compared with irradiation alone. One study has been performed in which postoperative pelvic irradiation was administered to all patients with positive pelvic nodes following radical hysterectomy. Those randomized to also receive chemotherapy failed to show an improvement in survival. Radiosensitization with hydroxyurea or misonidazole has shown little, if any, benefit. Only one concurrent chemotherapy and irradiation trial has been published and showed no benefit in the chemotherapy arm. Data are maturing or accruing in the Gynecological Oncology Group and the Radiation Therapy Oncology Group for concurrent chemotherapy studies. In conclusion, no prospective phase III studies have shown a survival advantage for the use of chemotherapy for patients with carcinoma of the uterine cervix.