Cervical CancerPhase 3NCT00980954
Chemotherapy and Pelvic Radiation Therapy With or Without Additional Chemotherapy in Treating Patients With High-Risk Early-Stage Cervical Cancer After Radical Hysterectomy
A Phase 3 study testing carboplatin, cisplatin and paclitaxel in people with Cervical Cancer, run by Radiation Therapy Oncology Group at 125 sites in 4 countries.
Trial summary
RATIONALE: Drugs used in chemotherapy, such as cisplatin, paclitaxel, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Cervical Cancer
- What is being tested?
- carboplatin, cisplatin and paclitaxel
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 236 participants
- Where
- 125 sitesin 4 countries
- Study dates
- Sep 2009to 4 Sep 2025
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
- Histologically confirmed squamous, adenosquamous, or adenocarcinoma of the cervix with any/all of the following high-risk features after surgery:
- Positive pelvic nodes
- Positive parametrium
- Positive para-aortic nodes that have been completely resected and are positron emission tomography (PET)/computed tomography (CT) scan-negative
- PET only required if positive para-aortic nodes during surgery
- Clinical stage IA2, IB, or IIA disease (this corresponds to surgical tumor node metastasis (TNM) staging of T1-T2, N1, M0)
- Must have undergone radical hysterectomy (open, laparoscopically, or robotic) and staging within the past 70 days
- Para-aortic and pelvic node sampling required
- If the patient did not have a para-aortic lymph node sampling/dissection, but had common iliac node dissection that was negative, a PET-CT is recommended, but not required
- A negative pre- or post-operative PET scan or PET-CT scan of the para-aortic nodes is required if the patient did not undergo para-aortic or common iliac nodal sampling/dissection
- No gross residual disease
- No neuroendocrine histology
- No distant metastases
PATIENT CHARACTERISTICS:
- Zubrod performance status 0-1
- Absolute neutrophil count (ANC) ≥ 1,800/mm³
- Platelets ≥ 100,000/mm³
- White blood cell count (WBC) ≥ 4,000/mm³
- Hemoglobin ≥ 10.0 g/dL (transfusion or other intervention allowed)
- Serum creatinine ≤ 1.5 mg/dL
- Bilirubin ≤ 1.5 times upper limit of normal
- Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) normal
- Alkaline phosphatase normal
- Known HIV positivity allowed provided cluster of differentiation 4 (CD4) count is ≥ 350/mm³ within the past 14 days
- No other invasive malignancy within the past 3 years, except nonmelanomatous skin cancer or carcinoma in situ of the breast, oral cavity, or cervix
- No severe, active co-morbidity, including any of the following:
- Unstable angina and/or congestive heart failure requiring hospitalization within the past 6 months
- Transmural myocardial infarction within the past 6 months
- Acute bacterial or fungal infection requiring IV antibiotics at the time of study entry
- Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of study entry
- Coagulation defects
- No prior allergic reaction to carboplatin, paclitaxel, and/or cisplatin
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior systemic chemotherapy for the current cervical cancer
- Prior chemotherapy for a different cancer is allowed
- No prior radiotherapy to the pelvis that would result in overlap of radiotherapy fields
Trial locations and contacts
125 sites in 4 countries.
125 sites in 4 countries
United States119 sites
Hickman Cancer Center
Adrian, Michigan, 49221
Summa Akron City Hospital/Cooper Cancer Center
Akron, Ohio, 44304
Akron General Medical Center
Akron, Ohio, 44307
Providence Alaska Medical Center
Anchorage, Alaska, 99508
Saint Vincent Anderson Regional Hospital/Cancer Center
Anderson, Indiana, 46016
Grady Health System
Atlanta, Georgia, 30303
Northside Hospital
Atlanta, Georgia, 30342
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
Greater Baltimore Medical Center
Baltimore, Maryland, 21204
Sinai Hospital of Baltimore
Baltimore, Maryland, 21215
Summa Barberton Hospital
Barberton, Ohio, 44203
Saint Francis Hospital and Health Centers
Beech Grove, Indiana, 46107
University of Alabama at Birmingham
Birmingham, Alabama, 35294
Saint Alphonsus Regional Medical Center
Boise, Idaho, 83706
State University of New York Downstate Medical Center
Brooklyn, New York, 11203
Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank, California, 91505
Cooper Hospital University Medical Center
Camden, New Jersey, 08103
Mercy San Juan Medical Center
Carmichael, California, 95608
Carolinas Medical Center
Charlotte, North Carolina, 28203
Northwestern University
Chicago, Illinois, 60611
Rush University Medical Center
Chicago, Illinois, 60612
University of Cincinnati
Cincinnati, Ohio, 45267
Case Western Reserve University
Cleveland, Ohio, 44106
Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
Central Maryland Radiation Oncology in Howard County
Columbia, Maryland, 21044
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center
Columbus, Ohio, 43210
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
University of Miami Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach, Florida, 33442
Saint John Hospital and Medical Center
Detroit, Michigan, 48236
Delaware County Memorial Hospital
Drexel Hill, Pennsylvania, 19026
City of Hope Medical Center
Duarte, California, 91010
Northeast Georgia Medical Center
Gainesville, Georgia, 30501
Saint Vincent Hospital
Green Bay, Wisconsin, 54301
Franciscan Saint Margaret Health-Hammond Campus
Hammond, Indiana, 46320
Hartford Hospital
Hartford, Connecticut, 06102
Memorial Healthcare System - Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
Queen's Medical Center
Honolulu, Hawaii, 96813
University of Hawaii
Honolulu, Hawaii, 96813
M D Anderson Cancer Center
Houston, Texas, 77030
Methodist Hospital
Houston, Texas, 77030
Franciscan Saint Francis Health-Indianapolis
Indianapolis, Indiana, 46237
University of Iowa Hospitals and Clinics
Iowa City, Iowa, 52242
University of Mississippi Medical Center
Jackson, Mississippi, 39216
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
University of Kansas Medical Center
Kansas City, Kansas, 66160
Kansas City Cancer Center - South
Kansas City, Missouri, 64131
Kansas City Cancer Centers - North
Kansas City, Missouri, 64154
University of Tennessee - Knoxville
Knoxville, Tennessee, 37920
Kansas City Cancer Center-Lee's Summit
Lee's Summit, Missouri, 64064
Elliot Hospital
Manchester, New Hampshire, 03103
Mercy Medical Center - North Iowa
Mason City, Iowa, 50401
Summa Health Center at Lake Medina
Medina, Ohio, 44256
Jackson Memorial Hospital-Holtz Children's Hospital
Miami, Florida, 33136
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
Baptist Hospital of Miami
Miami, Florida, 33176
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin, 53215
Froedtert and the Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
Michiana Hematology Oncology PC-Mishawaka
Mishawaka, Indiana, 46545-1470
Providence Hospital
Mobile, Alabama, 36608
Morristown Memorial Hospital
Morristown, New Jersey, 07962
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County
Mount Holly, New Jersey, 08060
Intermountain Medical Center
Murray, Utah, 84157
The Hospital of Central Connecticut
New Britain, Connecticut, 06050
Memorial Sloan-Kettering Cancer Center
New York, New York, 10065
UMDNJ - New Jersey Medical School
Newark, New Jersey, 07103
McKay-Dee Hospital Center
Ogden, Utah, 84403
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
The Nebraska Medical Center
Omaha, Nebraska, 68198
Saint Joseph Hospital - Orange
Orange, California, 92868
UHHS-Chagrin Highlands Medical Center
Orange, Ohio, 44122
Florida Hospital
Orlando, Florida, 32803
Kansas City Cancer Centers-Southwest
Overland Park, Kansas, 66210
Arizona Center for Cancer Care-Peoria
Peoria, Arizona, 85381
OSF Saint Francis Medical Center
Peoria, Illinois, 61637
Saint Joseph's Hospital and Medical Center
Phoenix, Arizona, 85013
Pomona Valley Hospital Medical Center
Pomona, California, 91767
Saint Joseph Mercy Port Huron
Port Huron, Michigan, 48060
Providence Portland Medical Center
Portland, Oregon, 97213
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
Southern Ohio Medical Center
Portsmouth, Ohio, 45662
Women and Infants Hospital
Providence, Rhode Island, 02905
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
Robinson Radiation Oncology
Ravenna, Ohio, 44266
Mayo Clinic
Rochester, Minnesota, 55905
Highland Hospital
Rochester, New York, 14620
University of Rochester
Rochester, New York, 14642
Phelps County Regional Medical Center
Rolla, Missouri, 65401
Mercy Cancer Center
Sacramento, California, 95816
Mercy General Hospital Radiation Oncology Center
Sacramento, California, 95819
Cancer Care Center, Incorporated
Salem, Ohio, 44460
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
University of California At San Diego
San Diego, California, 92103
Ireland Cancer Center at Firelands Regional Medical Center
Sandusky, Ohio, 44870
Memorial Health University Medical Center
Savannah, Georgia, 31403
Saint Joseph's-Candler Health System
Savannah, Georgia, 31405
Seattle Cancer Care Alliance
Seattle, Washington, 98109
Holy Cross Hospital
Silver Spring, Maryland, 20910
Sanford Cancer Center-Oncology Clinic
Sioux Falls, South Dakota, 57104
Mercy Hospital Springfield
Springfield, Missouri, 65804
CoxHealth South Hospital
Springfield, Missouri, 65807
Saint John's Mercy Medical Center
St Louis, Missouri, 63141
Dixie Medical Center Regional Cancer Center
St. George, Utah, 84770
Saint Helena Hospital
St. Helena, California, 94574
Flower Hospital
Sylvania, Ohio, 43560
Montefiore Medical Center-Weiler Division
The Bronx, New York, 10461
Montefiore Medical Center
The Bronx, New York, 10467-2490
University of Toledo
Toledo, Ohio, 43614
MD Anderson Cancer Center at Cooper-Voorhees
Voorhees Township, New Jersey, 08043
Saint John Macomb-Oakland Hospital
Warren, Michigan, 48093
Aurora West Allis Medical Center
West Allis, Wisconsin, 53227
Reading Hospital
West Reading, Pennsylvania, 19611
UHHS-Westlake Medical Center
Westlake, Ohio, 44145
Wheeling Hospital
Wheeling, West Virginia, 26003
Via Christi Regional Medical Center
Wichita, Kansas, 67214
Cancer Treatment Center
Wooster, Ohio, 44691
Lankenau Hospital
Wynnewood, Pennsylvania, 19096
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima, Washington, 98902
South Korea4 sites
Seoul National University Bundang Hospital
Seongnam, Kyeonggi-do, 463-707
Seoul National University Hospital
Seoul, 110-744
Gangnam Severance Hospital
Seoul, 135-720
Korea Cancer Center Hospital
Seoul, 139-706
Canada1 site
McGill University Department of Oncology
Montreal, Quebec, H2W 1S6
About this study
Official title: Phase III Randomized Study of Concurrent Chemotherapy and Pelvic Radiation Therapy With or Without Adjuvant Chemotherapy in High-Risk Patients With Early-Stage Cervical Carcinoma Following Radical Hysterectomy
RATIONALE: Drugs used in chemotherapy, such as cisplatin, paclitaxel, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. It is not yet known whether chemotherapy and radiation therapy are more effective when given with or without additional chemotherapy in treating cervical cancer.
PURPOSE: This randomized phase III trial is studying chemotherapy and pelvic radiation therapy to see how well they work when given with or without additional chemotherapy in treating patients with high-risk early-stage cervical cancer after radical hysterectomy.
Read the detailed description
OBJECTIVES:
Primary
- To determine if administering adjuvant systemic chemotherapy after chemoradiotherapy will improve disease-free survival compared to chemoradiotherapy alone in patients with high-risk early-stage cervical carcinoma found to have positive nodes and/or positive parametria after radical hysterectomy.
Secondary
- To evaluate adverse events.
- To evaluate overall survival.
- To evaluate quality of life.
- To evaluate chemotherapy-induced neuropathy.
- To perform a post-hoc dose-volume evaluation between patients treated with standard radiotherapy and patients treated with intensity-modulated radiotherapy (IMRT) with respect to toxicity and local control.
- To collect fixed tissue samples to identify tumor molecular signatures that may be associated with patient outcomes, such as adverse events, disease-free survival, and overall survival.
- To collect blood samples to identify secreted factors from serum and plasma that may be associated with adverse events or outcome and to identify single nucleotide polymorphisms (SNPs) in genes from buffy coat that may be associated with a genetic predisposition to tumor formation itself or a response to cytotoxic therapy.
OUTLINE: This is a multicenter study. Patients are stratified according to planned use of brachytherapy (no vs. yes), radiotherapy modality - [standard external beam radiotherapy (EBRT) vs. intensity-modulated radiotherapy (IMRT)], and radiotherapy dose (45 Gy vs. 50.4 Gy). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo standard EBRT or IMRT to the pelvis once daily 5 days a week for 5-6 weeks. Patients also receive concurrent cisplatin IV over 1 hour once weekly for 6 weeks.
NOTE: Some patients may also undergo brachytherapy beginning within 7 days after completion of radiotherapy.
- Arm II: Patients receive chemoradiotherapy as in arm I. Beginning 4-6 weeks after completion of chemoradiotherapy, patients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed by the Functional Assessment of Cancer Therapy - Gynecologic Oncology Group (FACT-GOG/NTX4), FACT-Cx, and FACIT-D questionnaires at baseline; at the completion of chemoradiotherapy; and then at 6, 12, and 24 months after completion of chemoradiotherapy.
Blood and tissue samples may be collected for gene expression analysis by immuno-histochemistry (IHC) and for biomarker and polymorphism studies.
After completion of study treatment, patients are followed up very 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
- Conditions
- Cervical Cancer
- Being tested
- carboplatin, cisplatin, paclitaxel, intensity-modulated radiation therapy, standard external beam radiation therapy
- Keywords
- cervical adenocarcinoma, cervical adenosquamous cell carcinoma, cervical squamous cell carcinoma, stage IA cervical cancer, stage IB cervical cancer, stage IIA cervical cancer
- Medical subject headings
- Uterine Cervical Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
carboplatinDrug
Intravenously
cisplatinDrug
Intravenously
paclitaxelDrug
Intravenously
intensity-modulated radiation therapyRadiation
Also called IMRT
Daily fractions
standard external beam radiation therapyRadiation
Also called EBRT
Daily fractions
Optional brachytherapy boostRadiation
Low-dose rate (20-25 Gy single application) or high-dose rate (12-18 Gy 2-3 applications), dependent on external beam dose.
| Study group | Role | What they receive |
|---|---|---|
| Arm I: Cisplatin/Radiation Therapy | Active comparator | Standard external beam radiation therapy (EBRT) or intensity-modulated radiation therapy (IMRT) to the pelvis once daily 5 days a week for 5-6 weeks as 45 Gy in 25 fractions or 50.4 Gy in 28 fractions (1.8 Gy/fraction). Concurrent cisplatin IV over one hour once weekly for 6 weeks as 40 mg/m^2, maximum dose 70 mg. A brachytherapy boost following radiation therapy is optional. Receives: Drug: cisplatin; Radiation: intensity-modulated radiation therapy; Radiation: standard external beam radiation therapy; Radiation: Optional brachytherapy boost |
| Arm II: Cisplatin/Radiation Therapy + Carboplatin/Paclitaxel | Experimental | Chemoradiotherapy as in arm I, followed 4-6 weeks later by paclitaxel IV [135 mg/m2, with maximum body surface area (BSA) of 2.0 m^2 over 3 hours] and carboplatin IV [area under the curve (AUC) 5 over 30 minutes] on day 1 of 21-day cycle for 4 cycles in the absence of disease progression or unacceptable toxicity. Receives: Drug: carboplatin; Drug: cisplatin; Drug: paclitaxel; Radiation: intensity-modulated radiation therapy; Radiation: standard external beam radiation therapy; Radiation: Optional brachytherapy boost |
What is being measured
The primary outcome is the main question the study is designed to answer.
Disease-free Survival (Percentage of Participants Alive Without Disease)
Disease-free survival (DFS) is estimated by the Kaplan-Meier method. The distribution of DFS estimates between the two arms is compared using the log rank test. DFS time is measured from the date of randomization to the date of first DFS failure (local, regional or distant metastases failure or death due to any cause) or last follow-up (censored). Analysis was to occur after disease or death was reported for 50 participants.
Measured: From randomization to first failure (local, regional, or distant metastases failure or death due to any cause) or last follow-up. Maximum follow-up at the time of analysis was 12.8 years. The 2- and 4-year DFS estimates are reported.
Secondary outcomes (8)
Overall Survival (Percentage of Participants Alive)
Overall survival is estimated by the Kaplan-Meier method. The distribution of survival estimates between the two arms is compared using the log rank test. Survival time is measured from the date of randomization to the date of death from any cause or last known follow-up (censored). Analysis was to occur after disease or death was reported for 50 participants.
Measured: From randomization to death or last follow-up. Maximum follow-up time at time of analysis was 12.8 years. The 2- and 4-year survival estimates are reported.
Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT/GOG-NTX) at 12 Months
The FACT-GOG/NTX4 measures patient-reported symptoms of chemotherapy-induced peripheral neuropathy in cancer patients. Possible scores range from 0 to 16 with higher scores indicating a better condition. Analysis of covariance, using the baseline score as a covariate, will be used to determine if there is a difference between the treatment arms.
Measured: Baseline and 12 months after the completion of concurrent chemoradiation (6 weeks)
Functional Assessment of Chronic Illness Therapy - Diarrhea (FACIT-D) Diarrhea Subscore at 12 Months
The diarrhea-specific subscore of the FACIT-D measures patient-reported diarrhea symptoms. Possible scores range from 0 to 44 with higher scores indicating a better quality of life. Analysis of covariance, using the baseline score as a covariate, will be used to determine if there is a difference between the treatment arms.
Measured: Baseline and 12 months after the completion of concurrent chemoradiation (6 weeks)
Functional Assessment of Cancer Therapy - Cervix (FACT-Cx) Cervical Cancer Subscore at 12 Months
The cervical cancer subscore of the FACT-Cx measures patient-reported symptoms and problems related to cervical cancer. Possible scores range from 0 to 60 with higher scores indicating a better quality of life. Analysis of covariance, using the baseline score as a covariate, will be used to determine if there is a difference between the treatment arms.
Measured: Baseline and 12 months after the completion of concurrent chemoradiation (6 weeks)
Number of Participants by Highest Grade Adverse Event Reported
Common Terminology Criteria for Adverse Events (version 4.0) grades adverse event severity as follows: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, 5 = death related to adverse event. Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data.
Measured: From randomization to the date of last known follow-up. Maximum follow-up time was 12.8 years.
Associations Between Tumor Molecular Signatures, From Fixed Tissue, and Outcomes Such as Adverse Events, Disease Free Survival and Overall Survival
Measured: From randomization to last follow-up
Associations Between Secreted Factors From Serum and Plasma With Adverse Events or Outcome
Measured: From randomization to last follow-up.
Associations Between Single Nucleotide Polymorphisms (SNPs) in Genes From Buffy Coat and a Genetic Predisposition to Tumor Formation Itself or a Response to Cytotoxic Therapy
Measured: From randomization to last follow-up.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Sep 2009 (estimated)
- Study startSep 2009
- Primary completion14 Dec 2023
- Study completion4 Sep 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Cervical CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 236 participants (actual)
Sponsor and investigators
- Lead sponsor
- Radiation Therapy Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI), NRG Oncology
- Responsible party
- Sponsor
- Investigators
- Anuja Jhingran, MD, Principal investigator, M.D. Anderson Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00980954
- Sponsor's protocol ID
- RTOG-0724
- Other IDs
- CDR0000654709, NCI-2011-01973, RTOG 0724/GOG-0724
- Status last verified
- Sep 2025
- First submitted
- 18 Sep 2009
- Last updated
- 31 Dec 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 31 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase III Randomized Study of Concurrent Chemotherapy and Pelvic Radiation Therapy With or Without Adjuvant Chemotherapy in High-Risk Patients With Early-Stage Cervical Carcinoma Following Radical Hysterectomy
- ClinicalTrials.gov ID
- NCT00980954
- Acronym / sponsor ID
- RTOG-0724
- Conditions
- Cervical Cancer
- Keywords
- cervical adenocarcinoma, cervical adenosquamous cell carcinoma, cervical squamous cell carcinoma, stage IA cervical cancer, stage IB cervical cancer, stage IIA cervical cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 236 participants (actual)
- Lead sponsor
- Radiation Therapy Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI), NRG Oncology
- Study start
- Sep 2009
- Primary completion
- 14 Dec 2023 (actual)
- Study completion
- 4 Sep 2025 (actual)
- First posted
- 21 Sep 2009 (estimated)
- Results
- Posted 6 Nov 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy, such as cisplatin, paclitaxel, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. It is not yet known whether chemotherapy and radiation therapy are more effective when given with or without additional chemotherapy in treating cervical cancer.
PURPOSE: This randomized phase III trial is studying chemotherapy and pelvic radiation therapy to see how well they work when given with or without additional chemotherapy in treating patients with high-risk early-stage cervical cancer after radical hysterectomy.
Detailed description
OBJECTIVES:
Primary
- To determine if administering adjuvant systemic chemotherapy after chemoradiotherapy will improve disease-free survival compared to chemoradiotherapy alone in patients with high-risk early-stage cervical carcinoma found to have positive nodes and/or positive parametria after radical hysterectomy.
Secondary
- To evaluate adverse events.
- To evaluate overall survival.
- To evaluate quality of life.
- To evaluate chemotherapy-induced neuropathy.
- To perform a post-hoc dose-volume evaluation between patients treated with standard radiotherapy and patients treated with intensity-modulated radiotherapy (IMRT) with respect to toxicity and local control.
- To collect fixed tissue samples to identify tumor molecular signatures that may be associated with patient outcomes, such as adverse events, disease-free survival, and overall survival.
- To collect blood samples to identify secreted factors from serum and plasma that may be associated with adverse events or outcome and to identify single nucleotide polymorphisms (SNPs) in genes from buffy coat that may be associated with a genetic predisposition to tumor formation itself or a response to cytotoxic therapy.
OUTLINE: This is a multicenter study. Patients are stratified according to planned use of brachytherapy (no vs. yes), radiotherapy modality - [standard external beam radiotherapy (EBRT) vs. intensity-modulated radiotherapy (IMRT)], and radiotherapy dose (45 Gy vs. 50.4 Gy). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo standard EBRT or IMRT to the pelvis once daily 5 days a week for 5-6 weeks. Patients also receive concurrent cisplatin IV over 1 hour once weekly for 6 weeks.
NOTE: Some patients may also undergo brachytherapy beginning within 7 days after completion of radiotherapy.
- Arm II: Patients receive chemoradiotherapy as in arm I. Beginning 4-6 weeks after completion of chemoradiotherapy, patients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed by the Functional Assessment of Cancer Therapy - Gynecologic Oncology Group (FACT-GOG/NTX4), FACT-Cx, and FACIT-D questionnaires at baseline; at the completion of chemoradiotherapy; and then at 6, 12, and 24 months after completion of chemoradiotherapy.
Blood and tissue samples may be collected for gene expression analysis by immuno-histochemistry (IHC) and for biomarker and polymorphism studies.
After completion of study treatment, patients are followed up very 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm I: Cisplatin/Radiation Therapy | Active comparator | Drug: cisplatin, Radiation: intensity-modulated radiation therapy, Radiation: standard external beam radiation therapy, Radiation: Optional brachytherapy boostStandard external beam radiation therapy (EBRT) or intensity-modulated radiation therapy (IMRT) to the pelvis once daily 5 days a week for 5-6 weeks as 45 Gy in 25 fractions or 50.4 Gy in 28 fractions (1.8 Gy/fraction). Concurrent cisplatin IV over one hour once weekly for 6 weeks as 40 mg/m^2, maximum dose 70 mg. A brachytherapy boost following radiation therapy is optional. |
| Arm II: Cisplatin/Radiation Therapy + Carboplatin/Paclitaxel | Experimental | Drug: carboplatin, Drug: cisplatin, Drug: paclitaxel, Radiation: intensity-modulated radiation therapy, Radiation: standard external beam radiation therapy, Radiation: Optional brachytherapy boostChemoradiotherapy as in arm I, followed 4-6 weeks later by paclitaxel IV [135 mg/m2, with maximum body surface area (BSA) of 2.0 m^2 over 3 hours] and carboplatin IV [area under the curve (AUC) 5 over 30 minutes] on day 1 of 21-day cycle for 4 cycles in the absence of disease progression or unacceptable toxicity. |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| carboplatinIntravenously | Drug | Arm II: Cisplatin/Radiation Therapy + Carboplatin/Paclitaxel |
| cisplatinIntravenously | Drug | Arm I: Cisplatin/Radiation Therapy, Arm II: Cisplatin/Radiation Therapy + Carboplatin/Paclitaxel |
| paclitaxelIntravenously | Drug | Arm II: Cisplatin/Radiation Therapy + Carboplatin/Paclitaxel |
| intensity-modulated radiation therapyAlso: IMRTDaily fractions | Radiation | Arm I: Cisplatin/Radiation Therapy, Arm II: Cisplatin/Radiation Therapy + Carboplatin/Paclitaxel |
| standard external beam radiation therapyAlso: EBRTDaily fractions | Radiation | Arm I: Cisplatin/Radiation Therapy, Arm II: Cisplatin/Radiation Therapy + Carboplatin/Paclitaxel |
| Optional brachytherapy boostLow-dose rate (20-25 Gy single application) or high-dose rate (12-18 Gy 2-3 applications), dependent on external beam dose. | Radiation | Arm I: Cisplatin/Radiation Therapy, Arm II: Cisplatin/Radiation Therapy + Carboplatin/Paclitaxel |
Primary outcome
Disease-free Survival (Percentage of Participants Alive Without Disease)
Time frame: From randomization to first failure (local, regional, or distant metastases failure or death due to any cause) or last follow-up. Maximum follow-up at the time of analysis was 12.8 years. The 2- and 4-year DFS estimates are reported.
Disease-free survival (DFS) is estimated by the Kaplan-Meier method. The distribution of DFS estimates between the two arms is compared using the log rank test. DFS time is measured from the date of randomization to the date of first DFS failure (local, regional or distant metastases failure or death due to any cause) or last follow-up (censored). Analysis was to occur after disease or death was reported for 50 participants.
8 secondary outcomes
Overall Survival (Percentage of Participants Alive)
Time frame: From randomization to death or last follow-up. Maximum follow-up time at time of analysis was 12.8 years. The 2- and 4-year survival estimates are reported.
Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT/GOG-NTX) at 12 Months
Time frame: Baseline and 12 months after the completion of concurrent chemoradiation (6 weeks)
Functional Assessment of Chronic Illness Therapy - Diarrhea (FACIT-D) Diarrhea Subscore at 12 Months
Time frame: Baseline and 12 months after the completion of concurrent chemoradiation (6 weeks)
Functional Assessment of Cancer Therapy - Cervix (FACT-Cx) Cervical Cancer Subscore at 12 Months
Time frame: Baseline and 12 months after the completion of concurrent chemoradiation (6 weeks)
Number of Participants by Highest Grade Adverse Event Reported
Time frame: From randomization to the date of last known follow-up. Maximum follow-up time was 12.8 years.
Associations Between Tumor Molecular Signatures, From Fixed Tissue, and Outcomes Such as Adverse Events, Disease Free Survival and Overall Survival
Time frame: From randomization to last follow-up
Associations Between Secreted Factors From Serum and Plasma With Adverse Events or Outcome
Time frame: From randomization to last follow-up.
Associations Between Single Nucleotide Polymorphisms (SNPs) in Genes From Buffy Coat and a Genetic Predisposition to Tumor Formation Itself or a Response to Cytotoxic Therapy
Time frame: From randomization to last follow-up.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Dec 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Anuja Jhingran, MD principal investigator
M.D. Anderson Cancer Center
125 sites in 4 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing carboplatin, cisplatin and paclitaxel in people with Cervical Cancer, run by Radiation Therapy Oncology Group at 125 sites in 4 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 125 sites in United States, South Korea, Canada, Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 6 Nov 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Disease-free Survival (Percentage of Participants Alive Without Disease) (time frame: From randomization to first failure (local, regional, or distant metastases failure or death due to any cause) or last follow-up. Maximum follow-up at the time of analysis was 12.8 years. The 2- and 4-year DFS estimates are reported.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Dec 2025.