The paper reports the results of a prospective controlled study with two drug combinations (adriamycin plus bleomycin versus cyclophosphamide plus vincristine) in 34 consecutive patients with advanced or recurrent carcinoma of uterine cervix. Despite adequate dosage, the incidence of complete and partial remission was low (10% vs 20%) and not superior to that usually obtained with single agent chemotherapy. By adding objective improvement, the over all response rate was 47% and 26%, respectively. The duration of complete plus partial remission was 7.5 and 7.2 months, the median survival for responders 19 and 8.3 months, respectively. After cross over, adriamycin plus bleomycin yielded response in 4/10 patients, cyclophosphamide plus vincristine objective improvement in 1/3 patients. Since the control of advanced cervical carcinoma remains difficult, a combined modality approach with radiotherapy plus adjuvant chemotherapy for stages IIB and III appears worth of trial.
Get full access to this article
View all access options for this article.
References
1.
AnsfieldF. J., CurreriA. R.: Further clinical studies with 5-fluorouracil.J. Nat. Cancer Inst., 22: 497–507, 1959.
2.
BajettaE., De PaloG. M., LucianiL., BonadonnaG.: Controlled study with Adriamycin (ADM) plus Bleomycin (BLM) versus Cyclophosphamide (CTX) plus Vincristine (VCR) in advanced carcinoma of the cervix. Abstr., Workshop 3, pp. 255, Vol. 1. Proc. XI International Cancer Congress, Florence, 1974.
3.
BarlowJ. J., PiverM. S., ChuangT., CortesE. P., OhnumaT., HollandJ. F.: Adriamycin and Bleomycin, alone and in combination, in gynecological cancers.Cancer, 32: 735–743, 1973.
4.
BlumR. H., CarterS. K., AgreK.: A clinical review of Bleomycin, a new antineoplastic agent.Cancer, 31: 903–914, 1973.
5.
BlumR. H., CarterS. K.: Adriamycin. A new anticancer drug with significant clinical activity.Ann. Intern. Med., 80: 249–259, 1974.
6.
BonadonnaG., BerettaG., TanciniG., BrambillaC., BajettaE., de PaloG. M., De LenaM., Fossati BellaniF., GaspariniM., ValagussaP., VeronesiU.: Adriamycin (NSC 123127). Studies at the Istituto Nazionale Tumori, Milan.Cancer Chemother. Rep., 6: 231–245, 1975.
7.
Clinical Screening Co-operative Group of the EORTC:Study of the clinical efficiency of bleomycin in human cancer.Br. Med. J.,2: 643–645, 1970.
8.
de PaloG. M., BajettaE., LucianiL., MusumeciR., Di ReF., BonadonnaG.: Methotrexate (NSC 740) and Bleomycin (NSC 125066) in the treatment of advanced epidermoid carcinoma of the uterine cervix.Cancer Chemother. Rep., 57: 429–435, 1973.
9.
De VitaV. T., YoungR. C., CanellosG. P.: Combination versus single agent chemotherapy; a review of the basis for selection of drug treatment of cancer.Cancer, 35: 98–110, 1975.
10.
EaganR. T., MaurerL. H., ForcierR. J.: Chemotherapy of recurrent carcinoma of the cervix; a preliminary report.Cancer Chemother. Rep.,57: 90 (Abstr. 6), 1973.
11.
FisherB., CarboneP., EconomouS. G.: L.-phenylalanine mustard (L-PAM) in the management of primary breast cancer. A report of early findings.New Engl. J. Med., 292: 117–122, 1975.
12.
HreshchyshynM. M.: Vincristine treatment of patients with carcinoma of the uterine cervix.Proc. Am. Ass. Cancer Res.,4: 29 (Abstr. 114), 1963.
13.
HreshchyshynM. M., HollandJ. F.: Chemotherapy in patients with gynecological cancer.Am. J. Obstet. Gynec., 83: 468–489, 1962.
14.
KatoT., AbeH., YamagamiT., UchinoM.: Therapeutic effects of Bleomycin, an anticarcinogenetic agent on cancers occured in the female genital organs.Kurume Med. J., 17: 75–95, 1970.
15.
JaffeN.: The potential of combined modality approaches for the treatment of malignant bone tumors in children.Cancer Treat. Rev., 2: 33–53, 1975.
16.
MalkasianG. D., DeckerD. G., MusseyE., JohnsonC. E.: Preliminary observations on carcinoma of the cervix treated with 5-fluorouracil.Am. J. Obstet. Gynec., 88: 82–85, 1964.
17.
MastersonJ. C., NelsonJ. H.Jr.: The role of chemotherapy in the treatment of gynecologic malignancy.Am. J. Obstet. Gynec., 93: 1102–1111, 1965.
18.
MonfardiniS., de PaloG. M., BajettaE., VeronesiU.: Adriamycin (ADM) plus Bleomycin (BLM) versus Cyclophosphamide (CTX) plus Vincristine (VCR) in advanced carcinoma of the uterine cervix.Proc. Am. Ass. Cancer Res. and Am. Soc. Clin. Oncol.,15: 91 (Abstr. 361), 1974.
19.
O'BryanR. M., LuceJ. K., TalleyR. W., GottliebJ. A., BakerL. H., Bona-donnaG.: Phase II evaluation of adriamycin in human neoplasia.Cancer, 32: 1–8, 1973.
20.
PiverS. M., BarlowJ. J., VongtamaV., WebsterJ.: Hydroxyurea and radiation therapy in advanced cervical cancer.Am. J. Obstet. Gynec., 120: 969–972, 1974.
21.
SmithJ. P., RutledgeF., BurnsB. C., SoffarS.: Systemic chemotherapy for carcinoma of the cervix.Am. J. Obstet. Gynec., 97: 800–807, 1967.
22.
SolidoroA. S., EstevesL., CastellanoC., ValdiviaE., BarrigaO.: Chemotherapy of advanced cancer of the cervix.Experience in 55 cases treated with cyclophosphamide. Am. J. Obstet. Gynec., 94: 208–213, 1966.
23.
TanL., EtcubanasE., WollnerN., RosenG., GilladogaA., ShowelJ., MurphyL. M., KrakoffI. H.: Adriamycin - an antitumor antibiotic in the treatment of neoplastic diseases.Cancer, 32: 9–17, 1973.
24.
YagodaA., LippmanA. J., WinnR. J., SchulmanP., CohenF. B.: Combination chemotherapy with Bleomycin (BLM) and Methotrexate (MTX) in patients with advanced epidermoid carcinomas.Proc. Am. Ass. Cancer Res. and Am. Soc. Clin. Oncol.,16: 247 (Abstr. 1105), 1975.
