Common Chemotherapy Regimens for Gynecologic cancers

ˇ@

ˇ@

Cervical carcinoma

BIC

Bleomycin: 30 units IV on day 1
Ifosfamide: 2,000 mg/m² IV on days 1-3
Mesna: 400 mg/m² IV 15 minutes prior to ifosfamide, then 400 mg/m² IV 4 and 8 hours following ifosfamide (800 mg/m² of mesna may be given PO according to the same schedule)
Carboplatin: 200 mg/m² IV on day 1

Repeat cycle every 21 days.

Murad AM, Santiago FF, Triginelli SA: Proc Am Soc Clin Oncol 11:229, 1992.

Fluorouracil + cisplatin concurrently with pelvic radiationˇXfor high-risk patients

Radiation therapy: 1.8 Gy per fraction (total dose, 45 Gy) to the pelvic and para-aortic lymph nodes
Cisplatin: 75 mg/m² IV infused over 4 hours

Followed by

Fluorouracil: 4 g/m² infused continuously over 96 hours

Give chemotherapy 16 hours after the administration of the first radiation fraction (day 1-5 of radiation therapy). Repeat chemotherapy every 21 days for additional 2 cycles.

Morris M, Eifel PJ, Lu J, et al: N Engl J Med 340:1137-1143, 1999.

ˇ@

ˇ@

ˇ@

Cisplatin-based chemotherapy + radiation therapyˇXfor locally advanced cervical cancer

Radiation therapy: 24 fractions totaling 40.8 Gy or 30 fractions totaling 51.0 Gy to the whole pelvis, followed, 1 to 3 weeks later, by intracavitary brachytherapy
Cisplatin: 40 mg/m² IV infused over 4 hours per week for 6 weeks before radiation (ie, at weeks 1 to 6 of radiation)

or

Cisplatin: 50 mg/m² IV on days 1 and 29 of radiation
Fluorouracil: 4 g/m² given as an IV infusion continuously over a 96 hours on days 1 and 29 of radiation
Hydroxyurea: 2 g/m² PO twice weekly 2 hours before radiation at weeks 1-6

Give chemotherapy concurrently with radiation therapy.

Rose PG, Bundy BN, Watkins EB, et al: N Engl J Med 340:1144-1153, 1999.

ˇ@

ˇ@

Ovarian carcinoma

Cisplatin + cyclophosphamide

Cisplatin: 100 mg/m² IV on day 1
Cyclophosphamide: 600 mg/m² IV on day 1

Repeat cycle every 28 days for 6 courses.

Albert D, Green S, Hannigan E, et al: J Clin Oncol 10:706ˇV717, 1992.

Paclitaxel + cisplatin

Paclitaxel: 135 mg/m² IV infused continuously over 24 hours
Cisplatin: 75 mg/m² IV on day 1

Repeat cycle every 21 days.

PREMEDICATIONS: Dexamethasone, 20 mg PO 12 and 6 hours before paclitaxel; as well as diphenhydramine, 50 mg IV, and ranitidine 50 mg IV, both 30-60 minutes before paclitaxel

McGuire WP, Hoskins WJ, Brady MF, et al: N Engl J Med 334:1ˇV6, 1996.

ˇ@

ˇ@

ˇ@

Paclitaxel + carboplatin

Paclitaxel: 175 mg/m² IV infused over 3 hours on day 1
Carboplatin: Dose calculated by the Calvert formula to an AUC between 7.0 and 7.5 mg/mL/min IV infused over 30 minutes. Carboplatin is given after paclitaxel.

Repeat cycle every 21 days for 6 courses.

PREMEDICATIONS: Dexamethasone, 20 mg PO 12 and 6 hours prior to paclitaxel; as well as diphenhydramine, 50 mg IV, and ranitidine, 50 mg IV, both 30-60 minutes prior to paclitaxel.

Coleman RL, Bagnell KG, Townley PM: Cancer J Sci Am 3:246ˇV253, 1997.

Single-agent regimens

Topotecan

Topotecan: 1.5 mg/m² IV over 30 minutes daily for 5 days

Repeat cycle every 21 days.

Iva B, Ondrej B, Milan B, et al: Proc Am Soc Clin Oncol 19:1570A, 2000.

Liposomal Doxorubicin

Liposomal doxorubicin: 40-50 mg/m² IV on day 1

Repeat cycle every 3 weeks.

Muggia FM, Hainsworth JD, Jeffers S, et al: J Clin Oncol 15:987-993, 1997.

ˇ@

Melanoma

DTIC + BCNU + cisplatin
DTIC (dacarbazine): 220 mg/m² IV on days 1-3
BCNU (carmustine): 150 mg/m² IV on day 1 of every odd 3-week cycle
Cisplatin: 25 mg/m² IV on days 1-3

Repeat DTIC and cisplatin every 3 weeks and BCNU every odd 3-week cycle (ie, every 6 weeks)

Creagan ET, Suman VJ, Dalton RJ, et al: J Clin Oncol 17:1884-1890, 1999.

ˇ@


ˇ@