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Combined Chemotherapy Using Cisplatin, Ifosfamide and Bleomycin (PIB) in the Treatment of Advanced and Recurrent Cervical Carcinoma
Author(s) -
Tay S. K.,
Lai F. M.,
Soh L. T.,
Ho T. H.,
Ang P. T.,
Au E.
Publication year - 1992
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.1992.tb01962.x
Subject(s) - medicine , ifosfamide , chemotherapy , cervix , oncology , bleomycin , regimen , nausea , cisplatin , surgery , cancer
EDITORIAL COMMENT: We accepted this paper to inform readers about chemotherapy combinations that may be used in treatment of women with advanced or recurrent cervical carcinoma. Only 1 of the 14 patients completed the 6 courses and she is alive, apparently with resolution of tumour in cervical lymph nodes 40 weeks later. However toxicity was severe and the overall results were difficult to assess especially as 5 women who discontinued the chemotherapy, presumably because they did not respond after 2 or 3 courses, are alive. We agree with the authors that controlled trials of chemotherapy should be undertaken in those women with advanced or recurrent disease who request further attempts at curative or palliative therapy. It is interesting that the regimen reported seemed effective against remote metastases in lung and cervical nodes but local disease did not respond, possibly because of previous pelvic therapy. Summary: Combined cisplatin, ifosfamide and bleomycin (PIB) chemotherapy was given to 14 (11 recurrent and 3 advanced and metastatic) cervical carcinoma patients. At least 2 cycles of chemotherapy were given before assessment of tumour response. The overall response rate was 28.6%; the complete response rate was 14.3%. Sites of response included cervical lymph nodes and the lung. Toxicity was common. Alopecia was universal. Other toxicity included suppression of haematopoiesis (73%), leucopenia (71%) and nausea and vomiting. Two patients died from sepsis during the myelo‐suppressive phase. The role of PIB in the management of advanced and recurrent carcinoma of the cervix should be evaluated in a randomized‐controlled trial.