Neoadjuvant and salvage chemotherapy with cisplatin (CDDP) and 5-fluorouracil (5-FU) in cervical carcinoma

A regime of cis-platin (CDDP) (80 mg/m2) and 5-fluorouracil (5-FU) (1000 mg/m2/day, day 1 to 5) repeated after 21 days, was prospectively analyzed in 12 advanced epidermoid cervical cancers as first treatment, prior to radiotherapy (neoadjuvant chemotherapy), and in 30 cases of progressive, recurrent or metastatic disease after radiotherapy (salvage chemotherapy), in order to evaluate efficacy and toxicity. Among the 10 evaluable neoadjuvant cases we observed 2 complete, 7 partial responders and 1 stabilized. They all achieved a complete response after radiotherapy and 6 remain alive after 18 to 72 months. None of the salvaged patients achieved a complete response and only 26.9% responded partially. Only one case, though fatal, of myelodepression was found in the neoadjuvant group. Conversely, 70% of salvages showed some grade of myelodepression, being severe or extremely severe in 23.3%, with another case of death. Neoadjuvant chemotherapy with CDDP and 5-FU seems promising in advanced cervical carcinoma and is acceptably well tolerated. In contrast, salvage therapy with the same regime yields worse results and is much more toxic.