1.
Selected phase III trials addressing the role of chemotherapy concomitant and adjunctive to RT
| Author (ref.) | No. of eligible patients | FIGO
stage |
Histology | Study arms | Chemotherapy regimen | Survival |
| FIGO, International Federation of Gynecology and Obstetrics; 1, IB2 and IIA (≥5 cm), IIB–IVA or histologically confirmed pelvic lymph node involvement; 2, I, II with histologically confirmed pelvic/paraaortic lymph node involvement; SCC, squamous cell carcinoma; ADC, adenocarcinoma; ADS, adenosquamous carcinoma; RT, radiation therapy; CCRT, concomitant chemoradiotherapy; S, surgery; ACT, adjuvant chemotherapy; CDDP, cisplatin; 5-FU, 5-fluorouracil; HU, hydroxyurea; EPI, epirubicin; *, calculated from survival curves; MMC, mitomycin C; GEM, gemcitabine; OS, overall survival; DFS, disease-free survival; PFS, progression-free survival; NS, not significant. | ||||||
| Keys et al.
(1999) (4) |
369 | IB2 | SCC,
ADC, ADS |
RT
CCRT (both arms followed by S) |
CDDP | 4-year OS 74% vs.
83% (P=0.008) |
| Morris et al.
(1999) (5,6) |
403 | IB2–IVA | SCC,
ADC, ADS |
RT
CCRT |
CDDP+5-FU | 8-year OS 41% vs.
67% (P<0.0001) |
| Rose et al.
(1999) (7,8) |
526 | IIB–IVA | SCC,
ADC, ADS |
CCRT
CCRT CCRT |
HU
CDDP CDDP+5-FU+HU |
2-year OS 50% vs.
66% vs. 67% (P=0.002) (10-year OS 34% vs. 53% vs. 53%) |
| Whitney et al.
(1999) (9) |
368 | IIB-IVA | SCC,
ADC, ADS |
CCRT
CCRT |
HU
CDDP+5-FU |
5-year OS 43% vs.
55% (P=0.018) |
| Wong et al.
(1999) (10) |
220 | I, II, III
“bulky” |
SCC | CCRT
CCRT+ACT |
EPI during RT
and as ACT |
5-year OS 68% vs. 79% (P=0.04)* |
| Pearsey et al.
(2002) (11) |
253 | IB–IVA1 | SCC | RT
CCRT |
CDDP | 5-year OS 62% vs.
58% (NS) |
| Lorvidhaya et al.
(2003) (12) |
926 | IIB–IVA | SCC,
ADC, ADS |
RT
RT+ACT CCRT CCRT+ACT |
MMC+oral 5-FU during RT
ACT: oral 5-FU |
5-year DFS 48.2% vs. 54.1% vs.
64.5% vs. 59.7% |
| Duenas-Gonzalez
et al. (2011) (13) |
515 | IIB–IVA | SCC,
ADC, ADS, poorly differentiated carcinoma |
CCRT
CCRT as above + ACT |
CDDP+GEM during RT
ACT: CDDP+GEM |
3-year PFS 65% vs.
74% (P=0.029) |
| Wang et al.
(2015) (14) |
74 | I, II2, III,
IVA |
SCC | CCRT
CCRT |
CDDP
CDDP+GEM |
3-year OS 74.1% vs.
85.9% (NS) |