A critical overview of concurrent chemoradiotherapy in cervical cancer.

In February 1999, the National Cancer Institute of the US National Institutes of Health issued a communication stating that concurrent chemoradiotherapy should be considered as standard treatment for cervical cancer. This statement was based on the publication of five randomized prospective trials. On the basis of a critical review of these papers and others that identified different results, questions, doubts, and concerns have arisen about this therapeutic method. We analyzed the quality of the control groups managed with the standard treatment, noting data that may have altered these results, as well as analyzing the quality of chemotherapy, radiotherapy, and treatment compliance. In light of this analysis, we believe that further trials should be carried out with fairly balanced prognostic factors to demonstrate beyond a doubt that concurrent chemoradiotherapy is superior to radiotherapy alone. In developing countries where resources are scarce, this type of tumor is found frequently. Concurrent chemoradiotherapy would involve increased costs and supportive care, taking away resources from other vital areas.