• Hirte H, Strychowsky J, Oliver T, Fung-Kee-Fung M, Elit L, Oza A, Gynecology Cancer Disease Site Group. Chemotherapy for recurrent, metastatic, or persistent cervical cancer: a clinical practice guideline. Toronto (ON): Cancer Care Ontario (CCO); 2006 Jul 5. 21 p. (Evidence-based series; no. 4-20). [27 references]

• It is recommended that all patients, particularly those who have been previously treated with cisplatin as a radiosensitizer, be offered the opportunity to participate in randomized trials, if available, that evaluate the efficacy and toxicity of other single-agent or combination chemotherapy regimens.
• Until further evidence becomes available, it is recommended that cisplatin in combination with topotecan should be offered to patients on the basis of improvements in response and survival outcomes when compared with single-agent cisplatin alone.
  • The improvement in outcomes must be weighed against significant increases in adverse events, especially hematological toxicities, and the degree of the clinical benefit. Despite the increase in toxicity, no significant differences in quality of life were detected. Severe hematological toxicities were managed by dose modification and the use of granulocyte-colony–stimulating factors (G-CSFs) in subsequent cycles.

None provided

The recommendations are supported by randomized controlled trials.

• Hirte H, Strychowsky J, Oliver T, Fung-Kee-Fung M, Elit L, Oza A, Gynecology Cancer Disease Site Group. Chemotherapy for recurrent, metastatic, or persistent cervical cancer: a clinical practice guideline. Toronto (ON): Cancer Care Ontario (CCO); 2006 Jul 5. 21 p. (Evidence-based series; no. 4-20). [27 references]

Not applicable: The guideline was not adapted from another source.

2006 Jul 5

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

The Program in Evidence-based Care (PEBC) is a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

Cancer Care Ontario
Ontario Ministry of Health and Long-Term Care

Provincial Gynecology Cancer Disease Site Group

Members of the Gynecology Disease Site Group (DSG) were asked to disclose potential conflict of interest information. No conflicts were reported.

None available

This NGC summary was completed by ECRI on October 25, 2006. The information was verified by the guideline developer on November 24, 2006.