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08:34
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
Novel chemotherapy approaches in chemoradiation protocols.
Lucía González-Cortijo1, N Carballo, A González-Martín
1Department of Gynecologic Oncology, M. D. Anderson International España, Madrid, Spain. lgonzalez@mdanderson.es
Gynecologic Oncology
|August 6, 2008
Summary
Chemoradiation is the standard treatment for locally advanced cervical cancer. Weekly cisplatin with radiation therapy offers survival benefits and remains the most effective chemotherapy regimen to date.
Area of Science:
- Gynecologic Oncology
- Radiation Oncology
- Medical Oncology
Background:
- Radiation therapy was the standard treatment for locally advanced cervical carcinoma before 1999.
- Five clinical trials demonstrated improved survival with concomitant chemotherapy and radiotherapy.
Purpose of the Study:
- To review the evolution of treatment for locally advanced cervical carcinoma.
- To highlight the efficacy of chemoradiation and ongoing research into novel agents.
Main Methods:
- Review of clinical trials and NCI recommendations.
- Evaluation of various chemotherapy agents (cisplatin, fluorouracil, hydroxyurea, carboplatin, paclitaxel, gemcitabine, topotecan).
- Assessment of biologic agents and COX-2 inhibitors in clinical trials.
Main Results:
- Weekly cisplatin (40 mg/m(2)) demonstrated superior responses compared to other agents or combinations.
- Platinum-based chemotherapy is recommended by the NCI for locally advanced cervical carcinoma.
- Gemcitabine and the paclitaxel/carboplatin combination showed promise, but no agent surpassed weekly cisplatin.
- Celecoxib showed no benefit in DFS or locoregional control.
Conclusions:
- Chemoradiation is the current standard of care for locally advanced cervical carcinoma.
- Weekly cisplatin remains the benchmark chemotherapy agent in combination with radiotherapy.
- Ongoing clinical trials are investigating the integration of novel biologic agents into chemoradiation protocols.
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