Maintenance chemotherapy for high-risk patients. A preliminary report

A prospectively designed program employing surgery, radiotherapy, and maintenance chemotherapy was initiated for patients with histologic evidence of extracapsular spread of tumor in cervical metastases. Postoperative radiotherapy consisted of 6,000 rad of cobalt 60 administered in 180- to 200-rad fractions. Chemotherapy was initiated two to four weeks following radiotherapy. Methotrexate sodium (250 mg/sq m), fluorouracil (600 mg/sq m), and leucovorin calcium were administered one day per week, two weeks of three, for a total of 18 treatments in six months. Thirty-two patients have been in the therapeutic program. Toxic reaction has been minimal and self-limiting. One patient stopped chemotherapy because of toxic reaction. One patient (3%) was noncompliant. All patients have been followed up for 18 to 33 months. Twenty-one patients remain alive and free of disease (81% determinate survival). This compares with a 36% (9/25) disease-free survival for concurrent controls and 39% survival for historic controls.