A SHORT AND INTENSIVE SINGLE-AGENT CISPLATIN REGIMEN FOR RECURRENT CARCINOMA OF THE UTERINE CERVIX

Between May 1991 and September 1993, 36 patients with recurrent carcin oma of the uterine cervix were treated with single-agent cisplatin usi ng an intensive regimen of four weekly cycles of 50 mg m(-2) followed in responders by a further four cycles given every fortnight. The resp onse rate was 47% (95%CI: 27-66%), 56% in those with pelvic recurrence , and 38% in those with metastatic disease. All responses but one were seen within 4 weeks of commencing treatment. Three patients (9%) had a complete response, although in two cases this was of short duration. The treatment was moderately well tolerated and the principle toxicit ies were myelotoxicity and emesis. The median survival was 32 weeks, a nd the 18-month survival was 13%. This regimen gives a response rate s imilar to that seen with more toxic combination chemotherapy regimens such as BIP (bleomycin, ifosfamide and cisplatin). It has the particul ar advantages of a short duration of treatment and early response, all owing treatment to be stopped after 4 weeks in non-responders. The res ponse rate in pelvic recurrence was better than that seen in most prev ious chemotherapy trials, particularly as 78% of the evaluable patient s with pelvic recurrence had previously received radical radiotherapy to the pelvis. Weekly, followed by fortnightly cisplatin, is an approp riate palliative treatment for patients with recurrent carcinoma of th e uterine cervix for whom chemotherapy is indicated.