Concurrent chemoradiation in carcinoma of the uterine cervix

Carcinoma of the cervix is most commonly treated with radiotherapy when the disease is locally advanced. Tumor bulk often limits the efficacy of this therapy, as does the tolerance of adjacent healthy tissue. Cytotoxic chemotherapeutic agents have been used with concomitant radiotherapy. Extensive data are available on dose and schedule tolerance for cisplatin, 5-fluorouracil, and a number of combination regimens. Phase III data that confirm any advantage in terms of local control, disease-free survival, or overall survival have been published only for hydroxyurea. Hydroxyurea, an S-phase-specific inhibitor of ribonucleotide reductase, lacks single-agent activity against metastatic, squamous cell cervical cancer. Further studies are required before agents other than hydroxyurea can be considered standard therapy with concomitant radiotherapy for locally advanced carcinoma of the cervix.