What is the basis for selection of treatment in cervical cancer?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

Intravaginal application of 5% 5-fluorouracil (5-FU) was found to be an effective treatment for cervical intraepithelial neoplasia (CIN) 2 in a prospective, nonblinded, randomized controlled study of 60 women. [65, 66] At 6-month follow-up, disease regression was observed in 26 of 28 women (93%) who were treated with 5-FU and in 15 of 27 women (56%) in an observation-only group. Normal cervical biopsy, a normal Pap smear, and a negative human papillomavirus (HPV) test were seen in 14 of the 28 patients in the treatment group at 6-month follow-up, compared with 6 of the 17 patients in the observation group. [65, 66] Topical 5-FU was well tolerated.

The treatment of cervical cancer varies with the stage of the disease (see Cervical Cancer Staging). For early invasive cancer, surgery is the treatment of choice. In more advanced cases, radiation combined with chemotherapy is the current standard of care. In patients with disseminated disease, chemotherapy or radiation provides symptom palliation. (See also Cervical Cancer Treatment Protocols.)

The treatment of cervical cancer frequently requires a multidisciplinary approach. Involvement of a gynecologic oncologist, radiation oncologist, and medical oncologist may be necessary.


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