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The Treatment of Advanced Recurrent Carcinoma of the Uterine Cervix with Platinum Based Cytotoxic Chemotherapy
Author(s) -
Hardy J. R.,
Maclean G. D.,
Foote G. A.,
Harvey V. J.
Publication year - 1987
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1987.tb00967.x
Subject(s) - medicine , chemotherapy , nausea , radiation therapy , surgery , regimen , carboplatin , cervical cancer , vomiting , vinblastine , oncology , cancer , cisplatin
EDITORIAL COMMENT: The pessimism expressed in this paper with regard to chemotherapy of recurrent or advanced cervical cancer is shared by all who treat this disease. However, the demonstration of response rates of 30% or greater offers some encouragement and supports a reevaluation of the role of chemotherapy in this disease. Chemotherapy is usually reserved for recurrences after treatment by radiotherapy and surgery with the consequent problems of reduced tumour vascularity and renal impairment. These problems may be overcome by the early institution of cytotoxic therapy in high risk patients; studies are underway in patients with positive pelvic lymph nodes and locally advanced disease using chemotherapy in an adjunctive or primary role. Summary: Nineteen patients with advanced recurrent carcinoma of the uterine cervix received platinum based chemotherapy between February 1982 and April 1984. All patients had received prior pelvic irradiation. Eleven patients received combination chemotherapy with platinum, vinblastine and bleomycin (PVB), and 8 patients received a regimen of platinum and 5‐fluorouracil (PF). Two patients achieved a complete response and 4 patients achieved a partial response, a total response rate of 33%. Five out of 6 responders received PVB. The median survival (MS) was 8 months (1–38) months from the first treatment with cytotoxic chemotherapy. In those patients achieving a response, MS was 13.5 months (6–38 + months) with 1 patient alive at 38 months, compared to an MS of 5 months (1–15 months) in those patients without response. Toxicity was significant with nausea and vomiting in the majority of patients. Two patients refused treatment after the first course because of toxicity. The morbidity of treatment was such that despite an encouraging response rate, particularly to PVB (45%), the routine use of such treatment must be questioned.