Treatment of advanced or recurrent squamous cell carcinoma of the uterine cervix with mitomycin-C, bleomycin, and cisplatin chemotherapy

Fifty-nine patients with recurrent/persistent, or advanced local/metastatic squamous cell cancer of the cervix were treated with combination chemotherapy consisting of mitomycin-C, bleomycin, and cisplatin. Response to therapy and survival analysis was determined for 44 of 49 patients who had previously been treated with radiation therapy and/or surgery and for 10 patients with advanced, previously untreated disease. Seven (16%) of the 44 previously treated patients experienced either complete response (CR) or partial response (PR). The median progression-free interval for responders (CR + PR) was 14.5 months, compared with 2.6 months for the nonresponders (significant, P < 0.001). The median survival time for responders (CR + PR) was 15.9 months, compared with 5.9 months for nonresponders (significant, P < 0.01). The 10 previously untreated patients were separately evaluated for response to chemotherapy. Of these, there was 1 CR, 2 PR, 1 <PR, and 6 SD. The 3 responders (CR + PR), who subsequently underwent radiation therapy, were alive and without evidence of disease 7.9, 13.7, and 27.6 months after treatment. Toxicities were mild to moderate, with no treatment-related deaths. In this study, this combination of mitomycin-C, bleomycin, and cisplatin chemotherapy was found to have activity in local, previously untreated disease and in patients with disease recurrence outside pelvic radiation fields.