Adjuvant Chemoradiotherapy Failed to Improve Survival in Intermediate-Risk Cervical Cancer
According to results from a cohort study, adjuvant chemoradiotherapy failed to improve overall survival (OS) compared to radiotherapy alone among patients with intermediate-risk cervical cancer.
“Optimal adjuvant treatment for patients with intermediate-risk cervical cancer remains controversial, and the benefit of adding chemotherapy to radiotherapy in this population is uncertain,” stated Núria Agustí, MD, MD Anderson Cancer Center, Houston, Texas, and coauthors. Here, researchers “evaluate whether adjuvant chemoradiotherapy is associated with improved [OS] compared with radiotherapy alone in patients with intermediate-risk cervical cancer.”
In this study, data from 1116 patients with stage IB cervical squamous cell carcinoma, cervical adenosquamous carcinoma, or cervical adenocarcinoma of intermediate risk who underwent radical hysterectomy and were undergoing radiotherapy from January 2010 through December 2020 were included. Of those patients, 486 received concurrent chemoradiotherapy, and propensity score matching produced a cohort of 868 patients.
At analysis, the 5-year OS rate was 87% in both treatment arms (hazard ratio [HR] 0.85; 95% confidence interval [CI], 0.59 to 1.23; P = .38). No significant difference in survival was associated with tumor size, histology, presence of lymphovascular space invasion, surgical approach, or receipt of adjuvant brachytherapy.
“The results of this cohort study suggest that adding chemotherapy to radiotherapy was not associated with improved overall survival for patients with intermediate-risk cervical cancer,” concluded Dr Agustí et al. They went on, “Widespread use of chemoradiotherapy without a demonstrated survival benefit underscores the potential to de-escalate treatment and reduce morbidity, and a better understanding of factors associated with treatment decisions is crucial for more consistent and evidence-based clinical practices.”
Source:
Agustí N, Viveros-Carreño D, Wu CF, et al. Adjuvant chemoradiotherapy vs radiotherapy alone for patients with intermediate-risk cervical cancer. JAMA Oncol. Published online: March 13, 2025. doi: 10.1001/jamaoncol.2025.0146
