Treatment of cervical cancer

In part of the Netherlands, patients with advanced cervical cancer are treated with combined radiotherapy and hyperthermia, after a randomised study showed substantial benefit from additional hyperthermia to patients, of whom 80% had a stage IIIb or IVa tumour.3 Although the study populations in the various trials are not comparable, the effects of adding either hyperthermia or cisplatin can be compared for odds ratios for pelvic-tumour control and hazard ratios for death, and seem similar (table). In view of the reasons listed above, we find that, to date, no definite conclusions can be drawn about adding cisplatin to standard, state of the art, radiation treatment for all patients with advanced stage cervical carcinoma, and have decided to continue with combined radiotherapy and hyperthermia in this group of patients. In radiotherapy plus chemotherapy review1 In hyperthermia trial2 Outcome Odds ratio for pelvic tumour control 0·61 0·48 Hazard ratio for death 0·71 0·53 Table Effect of adding chemotherapy or hyperthermia to radiotherapy in patients with uterine cervical cancer