Women with cervical cancer that is too big to be removed by surgery, or has spread to the tissues around the cervix (often called locally advanced cervical cancer) may be treated with radiotherapy (treatment with x-rays). They might also get chemotherapy (drug treatment) alongside radiotherapy. This is called chemoradiotherapy (or chemoradiation). This review brought together 18 randomised controlled trials (RCTs) that were carried out in many countries. The results of the review showed that women who had chemoradiotherapy for cervical cancer were likely to live for longer than women who had just radiotherapy. Five years after being treated, 66 out of every 100 women who received chemoradiotherapy were still alive compared with 60 out of every 100 who just had radiotherapy. Women who received chemoradiotherapy were also less likely to have the cancer come back or spread to other parts of the body. Chemoradiotherapy helped all women, even those with bigger tumours, or tumours that had spread more. Also, the different drugs that had been used in the trials (cisplatin, 5-fluourouracil or mitomycin-C) all helped women to live longer or stop the cancer from coming back or spreading. Some of the short term side effects were worse for women who received chemoradiotherapy. Doctors can usually help women to cope with the short term side effects of their treatment. Unfortunately, there was not enough information to be certain whether the long-term side effects are worse with chemoradiotherapy or not.
The review also seemed to show that women who have extra chemotherapy (after they have had chemoradiotherapy) live longer than those who just have chemoradiotherapy. However, the researchers are less certain about these results and suggest that new RCTs are needed to find out whether giving extra chemotherapy is better for women with cervical cancer, or not.