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Obstetrics and Gynecology International
Volume 2013, Article ID 536765, 8 pages
Review Article

Novel Approaches for Concurrent Irradiation in Locally Advanced Cervical Cancer: Platinum Combinations, Non-Platinum-Containing Regimens, and Molecular Targeted Agents

1Department of Medical Oncology and Translational Research, 251 Air Force General Hospital, Neo Psychiko, 154 51 Athens, Greece
2Department of Clinical Therapeutics, University of Athens School of Medicine, “Alexandra” University Hospital, 115 25 Athens, Greece
3Second Department of Internal Medicine, University of Athens School of Medicine, “Hippocrateion” Hospital, 115 25 Athens, Greece

Received 24 February 2013; Revised 31 March 2013; Accepted 12 April 2013

Academic Editor: Robert Coleman

Copyright © 2013 Giannis Mountzios et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Despite the available prevention and early detection strategies, squamous-cell carcinoma of the uterine cervix is still diagnosed as locally advanced disease in a considerable proportion of patients. As a potent sensitizer of cancer cells, cisplatin has been the “traditional partner” of external beam irradiation in this setting for more than two decades. Induction chemotherapy strategies followed by concurrent chemoradiation or surgery and preoperative concurrent chemoradiation have been recently implemented in clinical trials in an effort to optimize local control and to minimize the risk of distant metastases. In this context, cisplatin has been combined with a number of other potential radiosensitizers, including 5-fluorouracil, capecitabine, and gemcitabine. In patients resistant or intolerant to platinum compounds, numerous non-platinum-containing regimens have been developed, implementing various antimetabolites, taxanes, antineoplastic antibiotics, and topoisomerase II inhibitors. More recently, molecular agents targeting critical pathways in cervical malignant transformation are being assessed in early clinical trials in combination with external-beam irradiation. In the current work, we review the evolving role of cisplatin and other platinum compounds, either alone or in combination regimens, in the context of other potent radiosensitizers. The emerging role of molecular targeted agents, as candidate partners of external beam irradiation, is also discussed.