Preliminary results of concomitant radiotherapy and chemotherapy in advanced cervical carcinoma

Citationsfrom the Literature The median number of chemotherapy cycles was six (range four to 14). Three patients (38%) had a complete response to therapy (two confiied by second-look laparotomy), and two patients (25%) achieved a partial response (one verified by secand-look laparotomy). The overall response rate was 63%. Toxicity was minimal. Four patients are disease-free at 13 + to 48 + months, one patient is alive with disease at six + months, and three patients are dead of tumor at four, 17, and 36 months from the start of chemotherapy. These results indicate that the combination of cisplatin, doxorubicin, and cyclophosphamide has modest activity in the treatment of metastatic ovarian stromal tumor. Randomized Phase II studies of cisplntin and a combination of cydopho@mmide-doxorbidn-dsplatin (CAP) in patients wtth progentin-refractory advanced eadometrial carcinoma Edmonson JH; Krook JE; Hilton JF; et al North Central Cancer Treatment Group, Rochester, MN 55905, USA GYNECOL. ONCOL.; 28/l (20-24)/1987/ Between May 1980 and September 1983, 30 progestinrefractory patients with metastatic endometrial carcinoma were assigned at random to treatment groups receiving either cisplatin (CDDP) 60 mg/m’ every 3 weeks or a combination of cyclophosphamide, doxorubicin, and cisplatin every 4 weeks in doses of 400,40, and 40 mg/mz, respectively. Those who failed cisplatin were then offered cyclophosphamide 500 mg/m* plus doxorubicin 40 mg/mz every 3 weeks. Reduced doses were utilized in both of the combination regimens for patients who had received extensive pelvic radiation. Of the 14 patients initially receiving cisplatin alone, 3 experienced objective tumor regression. One of these three and one other who failed primary cisplatin therapy later responded favorably to cyclophosphamide plus doxorubicin as secondary treatment. Among the 16 patients who took all three drugs simultaneously (CAP) 5 experienced objective partial tumor regression. Survival experience for these relatively late-stage patients had been uniformly poor, with only 7 and 12% surviving at 2 years after beginning CDDP and CAP, respectively. Thus, while cisplatin is clearly an active agent against endometrial carcinoma, its therapeutic index as a single drug or in combination (CAP) is not adequate to preclude new-agent Phase II studies early in patients with advanced disease. Long-term sorvival after vinblastine, bleomydn, and cisplatin treatment In patients with germ cell tumors of the ovary: An @ate Willemse PHB; Aalders JG; Bouma J; et al Division of Medical Oncology, Department of Internal Medicine, University Hospital Groningen, Groningen, NetherIan& GYNECOL. ONCOL.; 28/3 (268-277)/1987/ Thirteen patients with a malignant germ cell tumor of the ovary have been treated with a combination of vinblastine, bleomycin, and cisplatin (VBP). In 12 patients a complete remission was reached. which was maintained in 10 of these patients. One patient with large tumor residues and a partial remission became CR after surgery. The tumor recurred in 2 patients after 6 and 27 months. Overall, 11 of these patients are in long-

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term remission. from 14 to 84 months after the start of treatment. VBP is an effective treatment for malignant germ cell tumors of the ovary, even in patients with large tumor residuals. Kxperienee with pelvk washings in Stage I and II endometrial carcinoma Kennedy AW; peterson GL; Becker SN; et al Department of Gynecology, The Cleveland Clinic Foundation, Cleveland, OH, USA GVNECOL. ONCOL.; 28/l (50-60)/1987/ Pelvic washings for cytologic analysis have become an accepted diagnostic procedure in the management of endometrial carcinoma. A retrospective study was performed in 163 consecutive patients with FIG0 Stage I and II endometrial carcinoma to assess the significance and value of the washings. Abnormal results were obtained in 5.5% of patients. Patients with FIG0 grade 3 lesions were significantly most likely to have abnormal washings (P < 0.05). Significant association was not observed with stage, depth of myometrial invasion, extrauterine spread, histologic subtype, prior hormone usage, or hormone receptor status. Multivariant analysis indicated that, for Stages I and II combined and for Stage I alone, FIG0 grade 3 was most predictive of poor survival (P < 0.01). The postoperative therapy of only 2 patients (1.2%) was altered by the results of the pelvic washings and only one of these patients has survived. No patients have had recurrent disease (median follow-up 31 months) in the peritoneal cavity with negative washings unless two or more other adverse prognostic factors were present. It is concluded that pelvic washings have a limited role in the clinical management of Stage I and II endometrial carcinoma. PmBmimuy reaults of concomitant radiotherapy and ehemotberapy in advanced cervical carcinoma John M; Cooke JK; Flam M; et al Department of Radiation Oncology, Fresno Community Hospital. PO Box 1232, Fremo. CA 93715. USA GYNECOL. ONCOL.; 28/l (lOl-110)/1987/ Ten patients with advanced and previously untreated squamous cell carcinoma of the cervix were treated with a synchronous course of radiotherapy (RT) and chemotherapy (CT). RT consisted of 3600 to 4500 cGy external pelvic treatments on a 6MeV linear accelerator followed by two intracavitary applications administering a total of 4000 mg hr of radium equivalent cesium. CT consisted of a course of mitomycin C (10 mg/m2 iv bolus) and 5-fluorouracil (5FU; 1000 mg/m2/24 hr for % hr) during the second week of external RT and another course of cis-platinum (CDDP; 75 mg/m2 l-6 hr infusion) and 5FU (1000 mg/mz/24 hr for % hr) during the first intracavitary cesium application. Toxicity was acceptable and complete clinical response was obtained in all patients at the end of the regimen. Nine patients are alive (eight without disease) 6 to 37 months following initiation of treatment (median 20 months). One patient has developed lumbar spine bone me&stases and another died of local and pulmonary disease at 28 months. This combination of 5FU/mitomycin C/CDDP and RT appears to be a practical, well-tolerated, and highly effective regimen for advanced cervical carcinoma. Int J Gynecoi Obstet 27