Chemotherapy of recurrent/ XXXX : results of the Yale University PBM-PFU protocol.

@entity1 @entity4181 @entity137 @entity5 @entity28760 @entity358 @entity1732 @entity158 @entity1499 @entity902 @entity1487
Chemotherapy for cervical @entity5 @entity1 with recurrent and/or advanced disease has been complicated by excessive @entity137 and short duration of responses, leading to little or no improvement in survival. Modification of drug scheduling and delivery of @entity902 , @entity1732 , @entity1499 , and @entity1487 has resulted in a new combination regimen with @entity137 and a survival advantage for responders. PBM ( @entity902 80 mg/m2 D1, @entity1732 10 mu/m2/day D3-6, @entity1499 150 mg/m2 D15, 22 with @entity4181 ) is alternated with @entity28760 ( @entity902 100 mg/m2 D1, @entity1487 1000 mg/m2/day D2-5) q 4 weeks for 3-6 months. The @entity902 , @entity1732 , and @entity1487 were delivered by continuous infusion. Twenty-three @entity1 with recurrent and 17 with @entity5 are evaluable; 91% of @entity1 with recurrent disease had received prior radiation therapy. The response rate was 30.4% in those with recurrent disease, and 41.2% in those with advanced disease, with 86 and 42.9% of responders respectively achieving a CR. Survival data were analyzed for each group separately, as well as for the combined recurrent/advanced disease group (N = 40). The results and significance were not changed by the groupings. In the combined recurrent/advanced group, median duration of response was 10.5 months, mean 20.1, and the median overall survival was 11 months, mean 20.5 +/- 3.5. There was a survival advantage accrued to the responders (median, 28 months) vs the nonresponders (10 months) (P = 0.0005 by log rank test). Moreover, there was a significant difference in progression-free interval between responders vs nonresponders (P = 0.0001), as well as between responders and those with stable disease (P = 0.001). This regimen was very well tolerated and there was no significant @entity358 . Furthermore, in the subset of 23 @entity1 who had recurrent disease, 67% achieved palliation of @entity158 . Experience with this protocol supports the continuing use of chemotherapy in the management of cervical @entity5 @entity1 .
