When would you consider sequential chemotherapy and radiation rather than concurrent for early stage cervical cancer with high risk pathologic features?

The recently released STARS phase 3 RCT found improved DFS, decreased distant recurrence, with reduced toxicities for chemotherapy (cisplatin + taxol) followed by RT versus concurrent chemo-radiation.

Answer from: Radiation Oncologist at Academic Institution

How much of the results of the STARS (Huang et al., PMID 33443541) (showing improved DFS with SCRT compared to CCRT) driven by only a 62% completion rate of CCRT (compared to 73.4% in SCRT, p< 0.001) as per the specified protocol is unknown.While the authors state within their results section tha...

Comments

Radiation Oncologist at Delaware Valley Urology Cancer Treatment Center
Can you please explain your rationale for the fina...

Radiation Oncologist at Vanderbilt-Ingram Cancer Center
Because a trial evaluated sequential CRT using Car...

at West Cancer Center and Research Institute
I really appreciate the review of the STARS trial ...

Radiation Oncologist at Vanderbilt-Ingram Cancer Center
Thanks for the comments. I meant the use of Cis/Ta...

Answer from: Radiation Oncologist at Academic Institution

A critical review of this paper is not appropriate in this forum. Yes, I would consider it. No, I don't believe that this paper creates a new standard of care at this point. The differences in OS are very small, and the overall compliance with the SCRT arm is still less than 75% (drop out rate mostl...

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When would you consider sequential chemotherapy and radiation rather than concurrent for early stage cervical cancer with high risk pathologic features?

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