Chemotherapy of advanced or recurrent cervical carcinoma with a consecutive low-dose cisplatin combined with bleomycin, vincristine, and mitomycin-C (consecutive low-dose BOMP).

There are many problems encountered in devising chemotherapy for patients with advanced or recurrent cervical carcinoma, in part because the vast majority of such patients have received prior radiation therapy with or without radical hysterectomy. Prior radiation therapy not only impairs bone marrow reserve but also interferes with the vascular supply to the tumor bed and delivery of the drug. In addition, many of the patients with advanced or recurrent cervical carcinoma have ureteral obstruction with impaired renal excretion of certain agents, thus limiting the tolerance to these agents. Despite these problems, there is considerable information regarding the chemosensitivity of this disease, and there is no doubt that cervical carcinoma is sensitive to platinum compounds. The authors have designed a new chemotherapy protocol utilizing a consecutive low-dose cisplatin to overcome the above difficulties. This review article includes the results of this regimen for recurrent or persistent cervical carcinoma and the preliminary data obtained from patients with advanced cervical carcinoma receiving this regimen in a neoadjuvant setting.