Cisplatin has proven to be the most active single agent in the treatment of metastatic and recurrent squamous cell cancer of the cervix. In a previous southwest Oncology Group (SWOG) pilot study, the addition of cisplatin to a mitomycin-C, vincristine, and bleomycin (MVB) regimen resulted in a relatively high percentage of durable complete responses. To gain more experience with cisplatin-based chemotherapy regimens, the SWOG initiated a phase II randomized trial of cisplatin, mitomycin-C plus cisplatin (MC), and MVB plus cisplatin (MVBC) in 119 patients with advanced squamous cell cancer of the cervix and no prior chemotherapy exposure. Because of slow patient accrual early in the trial, the cisplatin arm was discontinued. Five patients were declared ineligible according to protocol criteria. The three treatment groups were relatively well matched for age, prior radiation exposure, and sites of measurable disease. The overall objective response rates for cisplatin, MC, and MVBC treated patients were 33%, 25%, and 22%, respectively. Median response durations were greater than 6 months. Median survival durations associated with cisplatin, MC, and MVBC treatment were 17.0, 7.0, and 6.9 months, respectively. There were no drug-related deaths. Severe or life-threatening leukopenia and thrombocytopenia were observed in 18% to 24% of patients treated with MVBC and MC, but in none of those receiving cisplatin alone. We conclude that the low response rates and short durations of both response and survival observed in patients randomized to the two chemotherapy combinations suggest that only enhanced toxicity was gained through the addition of mitomycin-C or MVB to cisplatin in patients with advanced cervix cancer.

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The Ohio State University Registry recorded 1208 uterine corpus malignancies between 1940 and 1983. Thirty cases occurred in women with a history of pelvic irradiation. Eight patients had previously been irradiated for pelvic malignancy, four of whom presented with advanced stage sarcomas and died of their disease within 14 months. This represents an increase over the expected sarcoma prevalence which is less than 5%. In contrast, the majority of women (20 of 22) previously irradiated for benign conditions were diagnosed with endometrial adenocarcinoma. In 18, the adenocarcinoma was diagnosed as Stage I, and the prognosis was only slightly less favorable than for nonirradiated women. No significant effect of age at the time of irradiation was apparent. This study of women with a history of pelvic irradiation who later developed uterine cancer demonstrates a tendency for patients previously irradiated for pelvic ma-lignancy to present with advanced stage, extremely aggressive uterine tumors compared to those previously irradiated for benign conditions.