This page discusses the use of chemotherapy for the treatment of cervical cancer. For a thorough review of chemotherapy for cancer treatment, please see the chemotherapy treatment monograph .

Cancer chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment, meaning the drugs travel throughout the whole body. This means chemotherapy can reach cancer cells that may have spread, or metastasized, to other areas.

For years, chemotherapy was considered an ineffective treatment modality for women with invasive cervical cancer. Its use was limited to treating women with advanced metastatic disease. In 1999, five landmark papers reported significant improvements in the survival rates of women with locally advanced cervical cancer with the concurrent administration of cisplatin-based chemotherapy and radiation therapy. Because of these findings, the National Cancer Institute issued a recommendation that cisplatin-based chemotherapy be added to the treatment of women receiving radiation therapy for cervical cancer .

The Use of Chemotherapy by Stage of Cancer

Currently, chemotherapy is used in a number of different stages of cervical cancer. It is usually used in combination with radiation therapy. Chemotherapy alone is not a curative treatment option, and should only be added to radiation therapy if cure is in mind.

Chemotherapy is used in the following cervical cancer stages:

Stage IB:

  • Radiation therapy plus chemotherapy
  • Radical hysterectomy followed by radiation therapy plus chemotherapy

Stage IIA:

  • Radiation therapy plus chemotherapy

Stage IIB:

  • Internal and external radiation therapy combined with chemotherapy

Stage III:

  • Internal and external radiation therapy combined with chemotherapy

Stage IVA:

  • Internal and external radiation therapy combined with chemotherapy

Stage IVB:

  • Chemotherapy or radiation therapy as palliative therapy to relieve symptoms

Chemotherapy Drugs Used for Cervical Cancer:

Chemotherapy is usually given intravenously and within a hospital setting. Any of the following drugs may be used:

  • Cisplatin (Platinol)
  • Paclitaxel (Taxol)
  • Gemcitabine (Gemzar)
  • Carboplatin (Paraplatin)
  • Ifosfamide (IFEX)
  • 5-fluorouracil (Adrucil)
  • Doxorubicin (Adriamycin)
  • Methotrexate (MTX, Amethopterin)
  • Vinblastine (Velban)
  • Vinorelbine (Navelbine)
  • Bleomycin (Blenoxane)

Effectiveness of Chemotherapy for Cervical Cancer

The effectiveness of chemotherapy in the treatment of cervical cancer is dependent on many factors, including the stage of the cancer and your general health.

As mentioned above, when chemotherapy—specifically cisplatin or cisplatin plus 5-fluorouracil—was used in women with locally advanced disease in combination with radiation therapy in five separate randomized trials, an overall survival advantage was seen. These trials included women with stage IB2 to IVA. Cisplatin and 5-FU are the only chemotherapeutics used in conjunction with radiotherapy in the management of cervical cancer, and shown to be better than radiation alone (with excellent tolerance in terms of toxicity).

Management and treatment of persistent or recurrent cervical cancer has not improved significantly with the advances in chemotherapy. Cisplatin has a response rate of about 20%. Other agents, like paclitaxel and ifosfamide, added to cisplatin have increased response rates. Cisplatin with paclitaxel is considered to be the standard regimen in the palliative management of cervical cancer. Survival rates have not changed.