Single-agent chemotherapy for recurrent carcinoma of the cervix

A randomized study of 59 patients with recurrent squamous carcinoma of the cervix originally treated with radiotherapy is reported. Patients were randomized on recurrence to either Hexamethylmelamine, Adriamycin, or Cytoxan as first agent. When analysis was restricted to 37 patients with easily evaluable disease, Cytoxan had a significantly greater response rate (23.1%, 3/13) than Hexamethylmelamine (0%, 0/14) (p = 0.098). The response rate of Adriamycin was 20% (2/10). There was no evidence of a significant effect of first agent on survival time taken from the start of chemotherapy. The number of months from diagnosis to the start of chemotherapy (p = 0.04) and the patients' response status (p = 0.002) did however have significant effects on survival time. There was no evidence of a significant effect of first agent on survival time after treatment change but response to first agent did have a significant effect on survival (p = 0.05). Hexamethylmelamine had a greater frequency of severe toxicity (50%, 10/20) than Adriamycin (10.5%, 2/19) (p = 0.014) and Cytoxan (10%, 2/10) (p = 0.014).