Chemotherapy rapidly alternating with accelerated radiotherapy for advanced carcinoma of the uterine cervix

The objective of this study was to determine the feasibility of treating patients with advanced cervical carcinoma using a regimen combining chemotherapy with intermittent hyperfractionated teletherapy. Eight patients with advanced cervical carcinoma were treated with bleomycin, ifosfamide and cisplatin, followed by a 5-day course of hyperfractionated external radiation. Three such courses were given at 21-day intervals. Treatment was completed using standard brachytherapy. Seven of the eight patients were evaluable for response; all obtained a complete response. Two patients developed recurrence (one in the pelvis and one distant) and died of disease. One patient died of treatment complications. The remaining four remain alive and free of disease 9-42 months after treatment. The simultaneous use of chemotherapy and intermittent hyperfractionated teletherapy is a promising strategy for the treatment of cervical carcinoma, resulting in a high rate of complete response.