Adding chemotherapy to radiation therapy does not improve outcomes in patients with cervical cancer

Adding chemotherapy to radiation therapy does not improve outcomes in patients with cervical cancer

Results of the Phase III NRG Oncology GOG-0263 clinical trial trial testing the addition of cisplatin-based chemotherapy to adjuvant radiotherapy after radical hysterectomy and lymphadenectomy in patients with early-stage patients with an enlarged patient versus patients with patients with patients with an enlarged licinoma. The results of this study support the use of the current standard of care using adjuvant radiation therapy alone after surgery. These results were presented during the plenary session of the Society of Gynecologic Oncology (SGO) Women's Cancer Annual Meeting in Seattle, Washington.

Despite the negative result of this study to improve recurrence-free survival in this population, there are still important findings that we can learn from that can guide future research. “

Sang Young Ryu, MD of the Department of Gynecologic Oncology, Korea Cancer Center Hospital, the Korea Institute of Radiological and Medical Sciences and the lead author of the NRG-GOG 0263 abstract

The NRG-GOG-0263 study achieved its primary goal of improving relapse-free survival with the addition of cisplatin chemotherapy. The study recognized 316 eligible patients with early-stage disease and intermediate-risk factors, including a combination of histopathological factors such as capillary lymph space involvement, stromal invasion, and tumor size. Biased patients had a radical hysterectomy before enrollment in the study. Trial participants were randomly assigned to receive either adjuvant chemoradiotherapy (CRT) or radiation therapy (RT).

Ninety-two percent of patients had 28 radiation fractions with a median dose of 50.4 Gy and a duration of 39 days, and 91% of patients in the CRT arm received at least 4 cycles of weekly cisplatin. The 3-year recurrence-free survival estimates for the CRT and RT arms were 88.5% (95% CI: 82%-93%) and 85.4% (95% CI: 79%-90%). The recurrence-free survival hazard ratio estimate for CRT versus RT was 0.6976 (95% CI: 0.408-1.192,P= 0.0927). The estimated overall survival risk for the CRT versus RT arm was 0.586 (95% CI: 0.286 – 1.199,,P= 0.0695). Overall grade 3 or 4 events occurred in 15% and 43% of the RT and CRT arms, respectively (and 43% of the RT and CRT arms, respectively (P<0.0001).

"At this time, women with early-stage disease and intermediate-risk factors are treated with radiation therapy alone. Chemotherapy was considered an adjunct to this treatment based on previous clinical data indicating that it could potentially improve outcomes for these women. The results of this study confirm that chemotherapy with chemotherapy can overcome upper chemotherapy by chemotherapy. Another alternative may be considered to improve the results of this study while limiting toxicity," Dr. Ryu added.

This study was supported by the National Cancer Institute (NCI), part of the National Institutes of Health, and supported by grants U10CA180822 (NRG Oncology SDMC) and U10CA18086 (NRG Oncology Operations) from the NCI.

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