Cisplatin, 5-fluorouracil, and ifosfamide in the treatment of recurrent or advanced cervical cancer.
We performed a prospective, phase II trial of cisplatin, 5-fluorouracil, and ifosfamide in the treatment of 30 women with recurrent or advanced cervical cancer. Median age was 47 years old. Twenty-one tumors were squamous and 83% of tumors were grade 2 or 3. Twenty-six patients (87%) received prior pelvic radiotherapy, and six patients (20%) received prior radiation sensitizing chemotherapy. Median time to recurrence was 6 months. In 11 patients (37%) tumor recurred in the pelvis. A combination of cisplatin 90 mg/m2, 5-fluorouracil 1500 mg/m2, and ifosfamide 3 g/m2 was administered intravenously in divided doses over 3 consecutive days every 28 days. Sixteen patients (53%) responded to chemotherapy with a complete response occurring in 5 patients (17%) and a partial response in 11 patients (36%). One of 11 patients (7%) with a pelvic recurrence responded compared to 15 of 19 (79%) with extrapelvic recurrence (P = 0.001). Tumors recurring after 6 months had a higher response rate (73%) compared to those recurring before 6 months (33%) (P = 0.05). Three of the six patients (50%) treated with prior radiation sensitizing chemotherapy responded. Seven of nine patients (78%) with adenocarcinoma responded. Median survival is 12 months (3-36 months). In conclusion, cisplatin, 5-fluorouracil, and ifosfamide resulted in a favorable response rate (53%) and a median survival of 12 months. As expected, patients with extrapelvic recurrence and recurrence after 6 months had an improved response rate while, surprisingly, those receiving prior radiation sensitizing chemotherapy and those with adenocarcinoma did not exhibit a less favorable response rate.
Fanning
J
J
Division of Gynecologic Oncology, Southern Illinois University School of Medicine, Springfield 62794-9230, USA.
Ladd
C
C
Hilgers
R D
RD
D000230:Adenocarcinoma / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy*
D002945:Cisplatin; D005472:Fluorouracil; D007069:Ifosfamide