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Concurrent Cisplatin and Radiation Extend Survival in Cervical CarcinomaThe results of five large, randomized phase III trials in women with invasive cervical cancer show that concurrent radiation and cisplatin-based chemotherapy reduces the mortality rate by as much as 50% compared with radiation alone or radiation combined with nonplatinum chemotherapeutic agents. The National Cancer Institute (NCI) announced the findings in a clinical announcement which urges physicians to give "strong consideration to the incorporation of concurrent cisplatin-based chemotherapy with radiation therapy." Click on the link in the sidebar for the NCI report. Full text of the papers reporting on three of the studies is available at The New England Journal of Medicine (NEJM) Web site (see sidebar links). NEJM editors released the reports 2 months before their scheduled April publication date to expedite changes in clinical management based on the new findings. Up until now, women with cervical cancer were generally treated with surgery or radiation alone, depending upon stage. In 1996, the NIH Consensus Statement on Cervical Cancer concluded there was no evidence that any concomitant chemotherapy agent should be incorporated into standard practice. Evidence from the recent studies is expected to change the standard of care. NCI's Clinical Trials Cooperative Groups carried out the studies in centers throughout the country. Each of the trials enrolled several hundred women at various stages of the disease, including bulky stage IB and stages IIB through IVA. Study population, radiation dose, and schedule of cisplatin and radiation varied, but each trial found a significant benefit in survival and relapse-free survival with concurrent radiotherapy and cisplatin. |
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