Sequential chemoradiation after radical hysterectomy in women with early-stage cervical cancer may an optimal adjuvant treatment, according to a study published in JAMA Oncology.
In this phase 3 randomized clinical trial, after radical hysterectomy, 1048 patients with stage IB to IIA cervical cancer with adverse pathological factors were randomized to receive adjuvant radiation alone (RT, n = 350), concurrent chemoradiation (CCRT, n = 345), or sequential chemoradiation (SCRT, n = 353). The rate of lymph node involvement was lowest in the RT group, but other baseline demographics and disease characteristics were similar among the groups.
At 3 years, SCRT has a disease-free survival (DFS) rate of 90%, compared to 82% and 85% in the RT and CCRT groups, respectively.
After adjusting for lymph node involvement, SCRT decreased cancer death risk compared with RT at 5-years.
There were no substantial improvements in survival seen in patients receiving CCRT compared with RT.
Huang H, Feng Y, Wan T, et al. Effectiveness of sequential chemoradiation vs concurrent chemoradiation or radiation alone in adjuvant treatment after hysterectomy for cervical cancer: The STARS Phase 3 randomized clinical trial. JAMA Oncol. 2021; doi:10.1001/jamaoncol.2020.7168