CISPLATIN, METHOTREXATE AND BLEOMYCIN (PMB) FOR CARCINOMA OF THE CERVIX - THE INFLUENCE OF PRESENTATION AND PREVIOUS TREATMENT UPON RESPONSE

Combination chemotherapy using cis-platinum, methotrexate and bleomycin (PMB) has been evaluated in 60 patients with carcinoma of the cervix; 24 were treated neo-adjuvantly prior to definitive local treatment with radical radiotherapy and 36 were treated for recurrent or metastatic disease. The overall response rate was 40% with two complete responses. The response rate was 67% when the combination was used as a neoadjuvant treatment compared to only 27% with recurrent and metastatic disease. When relapse occurred in a previously irradiated site only 2/22 (9%) responded. This chemotherapy schedule was well-tolerated with no treatment-related deaths. It is concluded that PMB has a potential role as a neo-adjuvant treatment prior to radical radiotherapy in high risk patients with cervical cancer but alternative regimes are required for recurrent disease, particularly where there has been previous irradiation.