Retrospective cohort study of adjuvant chemoradiotherapy versus radiotherapy alone for intermediate-risk cervical cancer

Optimal adjuvant treatment for patients with intermediate-risk cervical cancer remains controversial, and the benefit of adding chemotherapy to adjuvant radiotherapy in this population is uncertain. A retrospective cohort study using the National Cancer Database included 1116 patients after radical hysterectomy for stage IB cervical cancer. Among these patients 43.5% received CRT, while 56.5 received RT alone. Propensity score matching yielded a cohort of 868 patients with balanced covariates. Patients who received CRT had similar overall survival as those who received RT alone (5-year survival 87% versus 87%). There also were no differences in survival associated with chemotherapy receipt among subgroups defined by tumor size, histology, presence of lymphovascular space invasion, surgical approach, or receipt of adjuvant brachytherapy. The authors conclude that these results suggest that adding chemotherapy to adjuvant radiotherapy is not associated with improved overall survival among patients with intermediate-risk cervical cancer.