AccScience Publishing / ARNM / Online First / DOI: 10.36922/arnm.4032
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REVIEW ARTICLE

Treatment consensus for locally advanced cervical cancer

Ping Jiang1† ,  Zhuhui Yuan1† ,  Lichun Wei2 ,  Fengju Zhao3 ,  Xiangkun Yuan4 ,  Yipeng Song5 ,  Jing Bai6 ,  Xiaofan Li7 ,  Baosheng Sun8 ,  Lijuan Zou9 ,  Sha Li10 ,  Yuhua Gao11 ,  Yanhong Zhuo12 ,  Song Gao13 ,  Qin Xu14 ,  Xiaohong Zhou15 ,  Hong Zhu16 ,  Yunyan Zhang17* ,  Zi Liu18* ,  Junjie Wang1*
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1 Department of Radiation Oncology, Cancer Center of Peking University Third Hospital, Peking University Third Hospital, Haidian District, Beijing, China
2 Department of Radiotherapy, Xijing Hospital, The Fourth Military Medical University of People’s Liberation Army, Xi’an, Shaanxi, China
3 Radiotherapy Center, Gansu Province Maternal and Child Health Hospital/Gansu Province Central Hospital, Lanzhou, Gansu, China
4 Department of Radiation Oncology, Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, China
5 Department of Oncology, Yantai Yuhuangding Hospital, Yantai, China
6 Department of Radiation Oncology, Baotou Tumor Hospital, Baotou, China
7 Department of Radiation Oncology, Peking University Cancer Hospital, Beijing, China
8 Department of Radiotherapy, Jilin Province Cancer Hospital, Changchun, China
9 The Second Hospital Affiliated to Dalian Medical University, Dalian, China
10 Department of Radiation Oncology, 940 Hospital of the Joint Logistics Support Force of The Chinese People’s Liberation Army, Lanzhou, Gansu, China
11 Obstetrics and Gynecology Radiation Ward, Liaoning Province Cancer Hospital and Institute (Cancer Hospital of China Medical University), Dadong District, Shenyang, Liaoning, China
12 Department of Radiation Oncology, Zhangzhou Hospital, Teaching Hospital of Fujian Medical University, Zhangzhou, Fujian, China
13 Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
14 Department of Gynecology, Fujian Provincial Cancer Hospital, Fuzhou, China
15 Department of Radiation Oncology, Jiamusi Cancer Hospital, Jiamusi, China
16 Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
17 Department of Gynecology, The Affiliated Tumor Hospital of Harbin Medical University, Baojian Road 6, Nangang District, Harbin, China
18 Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
ARNM, 4032 https://doi.org/10.36922/arnm.4032
Submitted: 24 June 2024 | Revised: 23 November 2024 | Accepted: 17 December 2024 | Published: 13 January 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Concurrent chemoradiotherapy (CCRT) involves the simultaneous administration of chemotherapy and radiotherapy, in which low-dose chemotherapy enhances the effectiveness of radiotherapy. This combined approach mitigates tumor recurrence and metastasis, ultimately improving patient prognosis. The primary mechanism behind the increased radiosensitivity induced by concurrent chemotherapy involves inhibiting tumor cell repair and the complementary effects of chemotherapy and radiotherapy on different phases of the cell cycle. Despite CCRT application in patients with locally advanced cervical cancer (LACC), the 5-year survival rate remains at 60%. To improve treatment efficacy, a series of exploratory investigations have been conducted, encompassing the integration of targeted therapy, immunotherapy, and utilization of immunomodulatory agents in neoadjuvant protocols preceding CCRT. Although targeted therapies and immunomodulators represent efficacious interventions for LACC management, the scarcity of robust, large-scale evidence-based data necessitates the undertaking of multicenter prospective randomized Phase III clinical trials and dissemination of high-quality publications to elevate the standard of evidence-based medicine. This consensus acts as a valuable resource for clinicians and researchers, highlighting recent seminal evidence-based studies and the evolving landscape of clinical research on targeted and immunomodulatory agents.

Keywords
Immunotherapy
Targeted therapy
Concurrent chemoradiotherapy
Locally advanced cervical cancer
Funding
This consensus was supported by the Key Specialization Project of Beijing Natural Science Foundation (Grant No. Z2008), the Clinical Scientist Training Program at Peking University (Grant No. BMU2023PYJH009), Clinical Key Project Innovation Project Class A at the Third Hospital of Peking University (Grant No. BYSYZD2021011), and the National Clinical Key Specialization Construction Project Special Fund (2021).
Conflict of interest
Junjie Wang is the Editor-in-Chief and Ping Jiang is the Editorial Board Member of this journal, but was not in any way nvolved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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