Chemotherapy in the management of cervical carcinoma

Cervical carcinoma, although largely preventable, is one of the most prevalent cancers worldwide. Early-stage disease can be successfully treated with surgery alone, and women with locally advanced cervical carcinoma are treated with radiation and concurrent weekly cisplatin at a dose of 40 mg/m2 for six doses. For women with advanced, persistent, or recurrent disease not amenable to local resection or radiation, however, few treatment options exist. In this subset of patients, palliative cytotoxic chemotherapy is playing an ever-increasing role. Only the combination of topotecan and cisplatin has been shown to prolong survival in this setting and although the benefit of combination therapy is modest, there has been no decrease in quality of life when this doublet is compared to single-agent cisplatin. Newer innovative agents are needed to treat metastatic and recurrent cervical cancer.