Cervical Cancer - Treatment for Invasive Cervical Cancer

Investigative temporary silicone implants or a noninvasive device called the belly board may protect the small intestine during radiation therapy and help reduce complications.

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Radiation itself may increase the risk for later development of cancer in the area surrounding the treated tissue. Although newer more precise radiotherapy approaches should reduce this risk, there is some concern that IMRT may double the incidence of secondary cancers over time compared to 3-D conformal techniques. This is of particular concern in younger patients.

Radiation and Hyperthermia. Investigators are studying hyperthermia (use of high heat often provided by ultrasound) in combinations with radiation therapy. This approach has shown some promise in achieving significant response rates in small studies. Comparison studies are important to determine if this approach would be as beneficial with radiation therapy as concurrent chemotherapy.

Chemotherapy

Chemotherapyuses cell-killing drugs called cytotoxic agents to destroy widespread cancer cells that have spread from the primary tumor and can no longer be treated with surgery or radiation.

For many years, chemotherapy was only used to reduce symptoms in women with very advanced disease. Today, platinum-based chemotherapy agents (see below) are being used in many situations for cervical cancer such as:

In combination with radiation therapy to improve survival rates in certain women, including some with locally advanced cancer.
In some women with locally advanced cancer to reduce tumors to the point where the cancer may be operable.
When cancer has spread (metastasized), mostly to reduce symptoms such as pain.

Platinum-BasedAgents. One of the mosteffective types of chemotherapy drugs for cervical cancer is cisplatin. Cisplatinis aplatinum-based drug, andis one ofthe standard drugs used for cervical cancer. (Carboplatin is another.) Other platinum agents, such as nedaplatin, are under investigation.

Cisplatinenhances the effectiveness of radiation in patients with more advanced disease stages. (This is called a radiation enhancer or sensitizer.) Combining certain chemotherapy drugs with radiation therapy may destroy more cancer cells.Combination therapy is animportant treatment strategyfor many patients with late-stage cervicalcancer.There is some evidence that a combination of platinum agents plus paclitaxel and other single agents may work better than platinum agents alone in the treatment of metastatic disease.

Topotecan, a chemotherapy drug that interfereswith the growth of cancer cells,is now showing promise in early studies as an effectiveradiation enhancer.