Four-drug combination chemotherapy for advanced cervical carcinoma

Thirty-one patients with advanced stage squamous cell carcinoma of the cervix were treated with the four-drug combination fluorouracil, doxorubicin, cyclophosphamide, and vincristine. Four patients achieved complete remission (13%) and 15 partial remission (45%). The only factor of adverse prognostic significance was poor initial patient performance. Median survival for the patients entering complete remission exceeded 54 weeks and was 43 weeks for patients achieving partial remission. Seven patients are still alive at 50 weeks. This represents a notable prolongation of survival compared with those patients who did not achieve remission. Toxicity for the combination was not excessive; myelosuppression and vincristine-induced neuropathy were the most prominent. These results are moderately encouraging and confirm the sensitivity of cervical carcinoma to systemic chemotherapy. Further studies to define the optimal use of chemotherapy in both advanced and earlier stages of disease are warranted.