[Systemic therapy in recurrent and primary advanced cervix cancer]

Area of Science:

• Gynecologic Oncology
• Medical Oncology
• Clinical Cancer Research

Context:

• Advanced cervical cancer treatment has seen minimal progress over three decades.
• Systemic therapy offers potential for improved outcomes, mirroring head and neck squamous cell carcinoma.
• Limited therapeutic options exist for primary advanced, inoperable, or recurrent cervical cancers.

Purpose:

• To evaluate an aggressive 5-day polychemotherapy regimen (cisplatin and 5-fluorouracil) with supportive care in advanced cervical cancer patients.
• To assess the efficacy and tolerability of this regimen in both primary advanced and recurrent disease.
• To compare outcomes with existing treatment modalities and inform future research directions.

Summary:

• A 5-day polychemotherapy regimen of cisplatin and 5-fluorouracil was administered to 47 patients with advanced or recurrent cervical cancer.
• This regimen achieved a 77% overall response rate (12 complete, 24 partial remissions).
• Despite high response rates, median survival was 9.5 months for recurrent disease and 13+ months for primary advanced disease, with dose reduction due to haematoxicity.

Impact:

• The study highlights the need for novel therapeutic strategies in advanced cervical cancer.
• While effective and practicable with supportive care, the regimen's survival benefit requires further investigation through prospective randomized studies.
• Chemoradiotherapy, whether sequential or simultaneous, warrants further evaluation for its role in operable and advanced cervical cancer.