Ifosfamide, adriamycin and cisplatin (IAP) plus bleomycin (B) combination chemotherapy in patients with recurrent cancer of the uterine cervix.

A combination chemotherapy of ifosfamide, adriamycin and cisplatin (IAP) plus bleomycin (IAP plus B) was used to treat nine patients with recurrent cervical cancer of the uterus. All patients had received conventional radiation therapy with or without hydroxyurea as a potential radiation sensitizer, and seven of them had measurable disease in a previous irradiated field (4 cases) or distant area (3 cases). The tumors included 5 squamous cell carcinomas (non keratinizing: 2, keratinizing: 3), two adenosquamous (including one glassy cell carcinoma), one adenocarcinoma (endometrioid type) and one argyrophil cell carcinoma. All histologic type cancers except argyrophil cell carcinoma responded to IAP plus B treatment. In seven evaluable cases, three complete responses (CR) and 3 partial responses (PR) were recorded (response rate was 85.7%), including 3 responded tumors within previously irradiated pelvic tissue. The median duration of CR was over 7 months and that of PR was 3.5 months. Side effects of IAP plus B were severe in hematologic toxicity (100% of grade 4 leucopenia) but acceptable, permitting five courses of treatments at four week intervals. The results obtained were encouraging, although therapeutic benefits of IAP plus B were not evident in a patient with argyrophil cell carcinoma and the intractable nature of this histologic type cancer in the uterine cervix was again emphasized.