Concurrent Cisplatin-based Chemotherapy plus Radiotherapy for Cervical Cancer–a Meta-analysis

Lukka, Himu; Hirte, H.; Fyles, Anthony; Thomas, Gillian; Elit, Laurie; Johnston, Mary; Fung, Michael Fung Kee; Browman, George P.

doi:10.1053/clon.2002.0076

Cited by 216 publications

(106 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cisplatin is the most commonly used drug [46]; [48], usually administered weekly [48], as a single agent [48] [49], and this is supported by the evidence to date [16]; [17]; [21]. In addition, the use of chemoradiotherapy based on cisplatin combinations [49]; [49]; [46], non-platinum drugs, such as 5-FU, or non-platinum combinations [49] also seems reasonably evidencebased [21].…”

Section: Discussionmentioning

confidence: 99%

“…A subsequent systematic review and meta-analysis investigating the effects of cisplatin-based chemoradiotherapy used a slightly different set of trials and was based on death rates [17] (rather than the duration of survival as described above While both systematic reviews further confirmed the benefits of adding to chemotherapy to radiotherapy on outcome, issues were raised and questions remained. The first systematic review [16] incorporated more trials than any previous or summary of chemoradiotherapy, but even then not all trials were included, follow-up was variable and the differences between results could not be explained.…”

Section: Other Cytotoxic Chemotherapymentioning

confidence: 99%

“…Also, any potential adverse effects of chemoradiotherapy in the long term could not be assessed. The second review [17] highlighted the difficulties of interpreting the effects of cisplatin-based chemoradiotherapy when the included trials used different chemotherapy agents and regimens, as well as different control treatments.…”

Section: Other Cytotoxic Chemotherapymentioning

confidence: 99%

“…By analysing the results of trials that were not confounded by the use of additional treatments on the control or treatment arms, this IPD meta-analysis has given a more reliable and readily interpretable estimate of the effect of concomitant chemotherapy and radiotherapy [21]. While this is smaller than previously suggested [16]; [17], a benefit persists, even with the inclusion of more trials and patients than any previous review, and a full publication is awaited. Other ongoing randomised trials are investigating ways of enhancing the benefits of standard weekly cisplatin-based chemoradiotherapy.…”

Section: Other Cytotoxic Chemotherapymentioning

confidence: 99%

See 3 more Smart Citations

Concomitant and Neoadjuvant Chemotherapy for Cervical Cancer

Tierney¹,

Vale²,

Symonds³

2008

Clinical Oncology

View full text Add to dashboard Cite

In the past, women with early stage cervical cancer have been treated with radical radiotherapy or radical surgery, and women with locally advanced disease with radical radiotherapy, each offering a good chance of cure. Numerous trials have investigated whether giving cytotoxic chemotherapy alongside radiotherapy or prior to local treatment could augment the established benefits of these therapies, and are reviewed here. There is a strong basis for the use of platinum-based chemoradiotherapy, the current standard of care, but little convincing evidence as to the therapeutic benefits of using concomitant hydroxyurea. Chemoradiotherapy based on other non-platinum agents may offer alternatives. The effect of chemoradiotherapy appears to vary according to the stage of disease, but all types of women benefit. Neoadjuvant chemotherapy prior to radiotherapy could jeopardise survival and should be avoided unless perhaps a 'quick', dose intense regimen is used. Neoadjuvant chemotherapy before surgery may be beneficial, but the approach will remain controversial until it is tested against platinum-based chemoradiotherapy. Future studies many include combinations of other cytotoxics such as topotecan with cisplatin-based concomitant chemoradiotherapy or the addition of agents targeted against specific receptors such as EGFR.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Other Cytotoxic Chemotherapymentioning

confidence: 99%

Section: Other Cytotoxic Chemotherapymentioning

confidence: 99%

Section: Other Cytotoxic Chemotherapymentioning

confidence: 99%

See 2 more Smart Citations

Concomitant and Neoadjuvant Chemotherapy for Cervical Cancer

Tierney¹,

Vale²,

Symonds³

2008

Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…In recent years, combined treatments of chemotherapy and radiotherapy have been investigated extensively in clinical studies, revealing promising applications for a variety of malignancies such as NSCLC, head and neck, oesophageal and cervical cancer (Pignon et al, 2000;Geh, 2002;Kim et al, 2002;Lukka et al, 2002;Rose, 2002). This may result from an improvement in systemic and local tumour control, and from direct interactions between cytotoxic agents and radiation, leading to increased antitumour activity.…”

mentioning

confidence: 99%

In vitro interaction between Ecteinascidin 743 (ET-743) and radiation, in relation to its cell cycle effects

et al. 2003

View full text Add to dashboard Cite

Ecteinascidin 743 (ET-743) is a new marine-derived agent with promising activity against a number of solid tumours. In four human tumour cell lines, the interaction between ET-743 and radiation was investigated in relation to the effects of ET-743 on the cell cycle, in vitro. Cell survival was measured based on quantitative staining of cellular protein by sulforhodamine B. A 24 h treatment with ET-743 before radiation resulted in a moderate increase in radiosensitivity in three out of four cell lines. Dose enhancement factors X1.8 were observed for concentrations resulting in 52, 46 and 30% cell kill in ECV304, H292 and CAL-27, respectively, whereas in A549 no radiosensitisation was observed (no significant increase in radiosensitivity). According to the combination index analysis, synergism was observed only in ECV304 and CAL-27 cells. A 24 h incubation with ET-743 resulted in a concentration-dependent G2/M block, which might explain the moderate radiosensitising effects in ECV304 and H292. The lack of radiosensitisation in A549 might be due to the S phase delay preceding the G2/M block at the moment of radiation, which only occurred in this cell line. In conclusion, ET-743 has moderate cell line-dependent radiosensitising properties; however, only when cytotoxic concentrations of ET-743 are used. In one of the four cell lines tested, no radiosensitisation was observed.

show abstract

Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: individual patient data meta-analysis

2010

Cochrane Database of Systematic Reviews

135

View full text Add to dashboard Cite

Concurrent Cisplatin-based Chemotherapy plus Radiotherapy for Cervical Cancer–a Meta-analysis

Cited by 216 publications

References 17 publications

Concomitant and Neoadjuvant Chemotherapy for Cervical Cancer

Concomitant and Neoadjuvant Chemotherapy for Cervical Cancer

In vitro interaction between Ecteinascidin 743 (ET-743) and radiation, in relation to its cell cycle effects

Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: individual patient data meta-analysis

Contact Info

Product

Resources

About