Over the past year, a number of important papers have appeared in the medical literature dealing with the chemotherapeutic management of gynecologic
cancers. Among these papers, several studies have again demonstrated the superiority of
platinum-based
chemotherapy regimens for
ovarian cancer compared with non-
platinum-containing regimens, and have confirmed the equivalence of
carboplatin to
cisplatin in advanced disease. A number of trials have reported activity for intraperitoneal
chemotherapy regimens in patients with small-volume residual disease. In
endometrial cancer, combination
cisplatin-based
chemotherapy programs have been reported to achieve an overall 40% to 50% objective response rate. Although
induction chemotherapy has been advocated in the management of advanced localized
cervical cancer, this conclusion has yet to be supported by the results of randomized trials. The
etoposide,
methotrexate,
dactinomycin,
cyclophosphamide,
vincristine regimen has been demonstrated to be highly effective in patients with high-risk gestational
trophoblastic tumors. Finally, a recent report has demonstrated that it is possible to perform conservative surgery in patients with
germ cell tumors to preserve fertility without compromising therapeutic efficacy.