Postoperative therapy modalities for cervical carcinoma.

Currently, the standard therapy for cervical carcinoma of FIGO stage IIB following adequate radical surgery is simultaneous radiochemotherapy with a platinous chemotherapeutic agent. According to the current state of scientific knowledge, all patients of FIGO stages IIA-IB with at least one additional risk factor (adenocarcinoma, pN1, L1, V1, pT1b2) also benefit from adjuvant radiochemotherapy. Various studies have shown that it is possible to successfully carry out a platinous radiochemotherapy. However, one disadvantage is that a number of patients have to break off therapy because of treatment-related toxicities. It has also been proven that a low hemoglobin level during radiochemotherapy is a negative prognostic factor for overall survival. The data regarding a possible survival advantage following an increase in the hemoglobin content in the blood of cancer patients by erythropoietin administration is still contradictory. As a result, the administration of new cytostatics, platinous combination chemotherapies, sequential instead of simultaneous regimens and appropriate supportive therapies have to be taken into account. Several studies are currently being conducted into the effectiveness of such new therapies on both life expectancy and quality of life (e.g., Cervix-NOGGO-AGO-Uterus 7-study).