A Phase I Evaluation of Extended Field Radiation Therapy With Concomitant Cisplatin Chemotherapy Followed by Paclitaxel and Carboplatin Chemotherapy in Women With Cervical Carcinoma Metastatic to the Para-Aortic Lymph Nodes

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Patients with histologically confirmed cervical cancer (squamous, adenocarcinoma, or
adenosquamous)

- FIGO Clinical stages IB, IIA, IIB, IIIA, IIIB, IVA, with positive para-aortic
lymph nodes confirmed by PET/CT scan, fine-needle biopsy, extraperitoneal
biopsy, laparoscopic biopsy, or lymphadenectomy

- Scalene node sampling is NOT required

PATIENT CHARACTERISTICS:

- GOG performance status 0-2

- ANC ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Creatinine normal OR creatinine clearance > 50 mL/min

- Bilirubin ≤ 1.5 times upper limit of normal (ULN)

- AST and ALT ≤ 2.5 times ULN

- Alkaline phosphatase ≤ 2.5 times ULN

- Peripheral neuropathy (sensory and motor) ≤ grade 1

- Patients of child-bearing potential must have a negative serum pregnancy test prior
to study entry (within 72 hours prior to initiation of study treatment) and be
practicing an effective form of contraception

- No active infection

- No circumstances that will not permit completion of this study or the required
follow-up

- No renal abnormalities, such as pelvic kidney, horseshoe kidney, or renal
transplantation, that would require modification of radiation fields

- Patients with ureteral obstruction must undergo stent or nephrostomy tube placement
prior to study entry

- No history of other invasive malignancies within the past 5 years except non-melanoma
skin cancer

- No significant history of cardiac disease, (i.e., uncontrolled hypertension, unstable
angina, congestive heart failure, or uncontrolled arrhythmias) within the past 6
months

- No known sensitivity reactions to products containing Cremaphor® EL

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- No prior pelvic or abdominal radiotherapy, cytotoxic chemotherapy, or therapy of any
kind for this malignancy

- No prior cancer treatment that contraindicates this protocol therapy

- No major surgery, excluding diagnostic biopsy, within the past 30 days (to allow for
full recovery)

- No other concurrent investigational agent

- No concurrent intensity-modulated radiotherapy or helical tomotherapy

- Patients may NOT receive amifostine or other protective reagents