SMALL-CELL CARCINOMA OF THE CERVIX TREATED WITH CONCURRENT RADIOTHERAPY, CISPLATIN, AND ETOPOSIDE

A multimodality regimen of four cycles of cisplatin and etoposide with concurrent locoregional radiotherapy (XRT) has been, since May 1988, the standard therapy for women with small cell carcinoma of the cervix (SCCC). Prophylactic cranial irradiation was to be used in all but pr imary progressors. All 11 patients (median age 47; 4 with pure SCCC an d 7 with mixed histology) seen by us were treated with this regimen. O nly 1 patient progressed while on treatment. The 3-year overall and fa ilure-free survivals were 28%. Four patients remain alive in first rem ission; the remaining 7 died (2 from toxicity, 5 from cancer). Althoug h not statistically significant due to the small numbers, it appeared that the chance of long-term survival depended both on the amount of t he cancer as indicated by the FIGO stage and size of the primary and a lso the performance status. The toxicity was significant with 70% expe riencing severe neutropenia and 40% being admitted for control of emes is. This regimen is only appropriate for those women in whom all of th e apparent tumor can be encompassed within a radiation field and who, in addition, have a performance status of 0 or 1. For the remainder it does not offer any chance of long-term survival and its toxicity rend ers it antipalliative. (C) 1995 Academic Press, Inc.