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Cervical Cancer Treatment (PDQ®)

  • Last Modified: 03/14/2014

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Changes to This Summary (03/14/2014)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Cervical Cancer

Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 1).

Stage 0 Cervical Cancer

Added text to state that the World Health Organization has made recommendations about the use of cryotherapy for providers in low-resource settings and has recognized the need to consider the availability of cryotherapy in relation to the availability of other treatment options (cited Santesso et al. as reference 3).

Added text to state that in a randomized, double-blind, placebo-controlled, phase II trial of 59 patients, a vaginal preparation of imiquimod, an immune-modulating agent, showed improved clearance rates for cervical intraepithelial neoplasia (CIN), or CIN 2/3, and high-risk human papillomavirus (cited Grimm et al. as reference 9).

Revised text to add only if excisional biopsy is not feasible to the total abdominal or vaginal hysterectomy for postreproductive patients treatment option.

Added text to state that after treatment for CIN, women remain at a higher risk of developing cervical cancer, even if they follow accepted posttreatment screening guidelines (cited Rebolj et al. as reference 15).

Stage IB Cervical Cancer

Added text to state that a meta-analysis, which is evaluating the role of radiosensitizing chemotherapy in IA2 and IB1 lesions, suggests a likely benefit from the addition of platinum-based radiosensitizing chemotherapy, although numbers are small in this patient population (cited Rosa et al. as reference 26).

Stage IIB Cervical Cancer

Added text about a phase III randomized trial that compared concurrent gemcitabine plus cisplatin and radiation therapy followed by adjuvant gemcitabine and cisplatin with concurrent cisplatin plus radiation in patients with stage IIB to IVA cervical cancer (cited 2011 Dueñas-González et al. as reference 18).

Added text to state that the primary endpoint was progression-free survival (PFS) at 3 years; however, the study found improvement in the experimental arm for PFS at 3 years. Added that patients in the experimental arm had increased hematologic and nonhematologic grade 3 and 4 toxic effects, and two deaths in the experimental arm were possibly related to treatment. Also added that a subgroup analysis showed an increased benefit in patients with a higher stage of disease and suggests that the increased toxic effects of the experimental protocol may be justified for these patients (cited 2012 Dueňas-González et al. as reference 19).

Stage III Cervical Cancer

Added text about a phase III randomized trial that compared concurrent gemcitabine plus cisplatin and radiation therapy followed by adjuvant gemcitabine and cisplatin with concurrent cisplatin plus radiation in patients with stage IIB to IVA cervical cancer (cited 2011 Dueñas-González et al. as reference 16).

Added text to state that the primary endpoint was PFS at 3 years; however, the study found improvement in the experimental arm for PFS at 3 years. Added that patients in the experimental arm had increased hematologic and nonhematologic grade 3 and 4 toxic effects, and two deaths in the experimental arm were possibly related to treatment. Also added that a subgroup analysis showed an increased benefit in patients with a higher stage of disease and suggests that the increased toxic effects of the experimental protocol may be justified for these patients (cited 2012 Dueňas-González et al. as reference 17).

Stage IVA Cervical Cancer

Added text about a phase III randomized trial that compared concurrent gemcitabine plus cisplatin and radiation therapy followed by adjuvant gemcitabine and cisplatin with concurrent cisplatin plus radiation in patients with stage IIB to IVA cervical cancer (cited 2011 Dueñas-González et al. as reference 11).

Added text to state that the primary endpoint was PFS at 3 years; however, the study found improvement in the experimental arm for PFS at 3 years. Added that patients in the experimental arm had increased hematologic and nonhematologic grade 3 and 4 toxic effects, and two deaths in the experimental arm were possibly related to treatment. Also added that a subgroup analysis showed an increased benefit in patients with a higher stage of disease, and suggests that the increased toxic effects of the experimental protocol may be justified for these patients (cited 2012 Dueňas-González et al. as reference 12).

Recurrent Cervical Cancer

Added Schmidt et al. as reference 3.

Added text about interim results for GOG-0240 presented in abstract form that showed 452 patients with stage IVB, recurrent, or persistent cervical cancer were randomly assigned to chemotherapy versus chemotherapy plus bevacizumab-containing regimens (cited Tewari et al. as reference 12).

Added text to state that preliminary results for GOG-0240 showed the topotecan-paclitaxel combination was not superior to the cisplatin-paclitaxel combination. The addition of bevacizumab led to improved median overall survival when compared with chemotherapy alone. The hazard ratio for death was 0.71 when regimens were compared with and without bevacizumab. The bevacizumab-containing regimens were associated with more grade 3 or 4 bleeding, thrombosis and embolism, and gastrointestinal fistula (level of evidence 1iiA).

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.