Cervical chemotherapy

Rose PG, Bundy BN, Watkins EB, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med 1999 340(15) 1144—1153. 

Vanderbilt University Medical Center has recently completed accruing patients to a Phase II study of neoadjuvant chemoradiation, which consists of preoperative paclitaxel (175 mg/m2,3-h infusion) followed by cisplatin 75 mg/m2 d 1 and 21. Concurrent radiation was given to a total dose of 3000 cGy, in 200 cGy/fraction. Patients who are resectable go on to surgery 4 wk after completion of chemoradiation, whereas those who are unresectable (i.e., cervical esophageal cancer) continue to a total dose of 60 Gy without treatment interruptions. One month following surgery, patients receive two cycles (q 21-28 d) of postoperative chemotherapy, which consists of paclitaxel 175 mg/m2 over 3 h d 1,5-FU 350 mg/m2, d 1-3, and leucovorin 300 mg d 1-3. Preliminary analysis of this... 

Results of Prospective Randomized Trials that Compared Neoadjuvant Cisplatin-Containing Chemotherapy Followed by Radiation Therapy with Radiation Therapy Alone in Patients with Locally Advanced Cervical Cancer (52)... 

Prospective Randomized Trials that Investigated the Role of Concurrent Radiotherapy and Chemotherapy for Patients with Loco regionally Advanced Cervical Cancer... 

Citing the success of mitomycin-C in the treatment of anal cancer, a number of investigators have explored the use of this drug, usually in combination with fluorouracil, in patients treated with radiation for cervical and vulvar carcinomas (23-27). Roberts et al. (27) recently reported results of an interim analysis of a randomized trial, conducted in Venezuela, in which women with locally advanced cervical cancer were treated with radiation therapy with or without mitomycin. At the time of this interim analysis (published while the authors were continuing to accrue patients to the study), the authors noted a significant improvement in disease-free survival (p - 0.01) with chemotherapy but no significant difference in overall survival (p = 0.1). 

Tattersall MHN, Ramirez C, Coppleson M. A randomized trial comparing platinum-based chemotherapy followed by radiotherapy vs. radiotherapy alone in patients with locally advanced cervical cancer. Int J Gynecol Cancer 1992 2 244-251. 

Wong LC, Ngan HY, Cheung AN, et al. Chemoradiation and adjuvant chemotherapy in cervical cancer. J Clin Oncol 1999 17 2055-2060. 

Kumar L, Kaushal R, Nandy M, et al. Chemotherapy followed by radiotherapy versus radiotherapy alone in locally advanced cervical cancer A randomized study. Gynecol Oncol 1994 54 307-315. 

Tattersall MHN, Larvidhaya V, Vootiprux V, et al. Randomized trial of epirubicin and cisplatin chemotherapy followed by pelvic radiation in locally advanced cervical cancer. Am J Clin Oncol 1995 13 444-451. 

Sundfpr K, Trope CG, Hogberg T, et al. Radiotherapy and neoadjuvant chemotherapy for cervical carcinoma. A randomized multicenter study of sequential cisplatin and 5-fluorouracil and radiotherapy in advanced cervical carcinoma stage 3B and 4A. Cancer 1996 77 2371-2378. 

Methotrexate is part of curative combination chemotherapy for acute lymphoblastic leukemias, Burkitt s lymphoma, and trophoblastic choriocarcinoma. It is also useful in adjuvant therapy of breast carcinoma in the palliation of metastatic breast, head, neck, cervical, and lung carcinomas and in mycosis fungoides. 

First- and second-trimester abortion Cervical reopening Induction of labor Augmentation of labor Postpartum hemorrhage Ectopic pregnancy Lactation suppression In gastrointestinal disease Peptic ulceration Liver transplantation Chemotherapy-induced mucosal lesions In cardiovascular disease Congenital cardiac malformations Raynaud s syndrome Chronic obstructive pulmonary disease Adult respiratory distress syndrome Pulmonary hypertension Arterial occlusive disease Extracorporeal circulation In urology Erectile dysfunction... 

Wun T, Law L, Harvey D, Sieracki B, Scudder SA, Ryu JK. Increased incidence of symptomatic venous thrombosis in patients with cervical carcinoma treated with concurrent chemotherapy, radiation and erythropoietin. Cancer 2003 98(7) I 514-1 520. 

A 54-year-old man with stage I folUcnlar Ijmphocytic lymphoma with cervical lymph nodes nnderwent splenectomy followed by chemotherapy with chlorambncil and had a partial response. Five months later, when he developed generalized lymphadenopathy and bone marrow involvement, he received fludarabine, cyclophosphamide, and ritnximab, with complete remission. Ten months later he developed a Merkel cell carcinoma involving the liver and lymph nodes. The disseminated tumor was chemoresistant and he died. His lymphoma remained in complete clinical remission throughout this time. 

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