Topotecan, Cisplatin, and Radiation Therapy in Treating Patients With Advanced Cervical Cancer

OBJECTIVES: * Determine the maximum tolerated dose of topotecan when administered with cisplatin in patients with advanced cervical cancer. * Identify any unique toxicities associated with administering radiotherapy along with adjuvant cisplatin and topotecan in patients with cervical cancer. * Determine the feasibility of administering continuous infusion topotecan chemotherapy together with radiation therapy. * Assess the quality of life of patients treated with this regimen. OUTLINE: This is a dose-escalation study of topotecan. Patients undergo radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, and 36. Some patients may also undergo brachytherapy. Patients also receive cisplatin intravenously (IV) over 1 hour on days 1, 8, 15, 22, 29, and 36 and topotecan IV continuously on days 1-5, 8-12, 15-19, 22-26, 29-33, and 36. Treatment continues in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of topotecan until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Quality of life is assessed at baseline and at 4 and 14 weeks after completion of study treatment. After completion of study treatment, patients are followed periodically.