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Korean Journal of Obstetrics & Gynecology 2004;47(11):2116-2122.
Published online November 1, 2004.
The efficacy of combination of paclitaxel, ifosfamide, and cisplatin for the treatment of recurrent carcinoma of the uterine cervix.
Chel Hun Choi, Chul Jung Kim, Sun Joo Lee, Jeong Won Lee, Chang Soo Park, Young Soo Son, Byoung Gie Kim, Je Ho Lee, Duk Soo Bae
1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Department of Obstetrics and Gynecology, Cheong-Ju St. Mary's Hospital, Cheong-Ju, Korea.
Abstract
OBJECTIVE
Paclitaxel, ifosfamide, and cisplatin have moderate single-agent activity in patients with metastatic or recurrent cancer of the uterine cervix. We administered a combination of these three agents (TIP) to patients with recurrent cervical carcinoma to evaluate its activity. METHODS: Forty-three patients were treated with ifosfamide (I) 1500 mg/m2 intravenously over 3 hours on Days 1-3, paclitaxel (T) 135 mg/m2 as a 3-hour intravenous infusion and cisplatin (P) 50 mg/m2 intravenously over 30 min on Day 1. The chemotherapy was repeated every 3 weeks. RESULTS: Thirty-five patients received at least three courses of treatment and were evaluable for response. Eighteen patients (51.4%) achieved an objective response, including 5.7% complete and 45.7% partial responses. The median time to progression and overall survival for all patients were 8.0 and 16.0 months, respectively. The site of recurrence relative to prior radiation field and histopathology (squamous vs other pathology) did not affect the response rate and survival. Patients treated with another chemotherapy regimen before the initiation of TIP regimen showed lower response rate (28.6% vs 66.6%, p=0.027) and shorter survival (14 month vs 25 month, p=0.028). Grade 3 or 4 toxicity included granulocytopenia in 13% of patients, anemia in 8%, thrombocytopenia in 5%. CONCLUSION: The TIP regimen is relatively well tolerated and moderately active in patients with recurrent carcinoma of the uterine cervix. Patients more likely to benefit are those who received TIP regimen for the first time after recurrence.
Key Words: Recurrent cervical cancer, TIP, paclitaxel, ifosfamide, cisplatin


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