Patients with metastatic, persistent, or recurrent cervical carcinoma were eligible for the study. Patients
with recurrent disease were excluded if they were candidates for curative therapy by means of pelvic exenteration. All cancers were confirmed by a central pathology laboratory. A GOG performance status score of 0 or 1 (on a scale of 0 to 4,with 0 indicating that the person is fully active and 1 indicating that the person is restricted in physically strenuous activities but ambulatory) was required, and patients had to have adequate renal, hepatic, and bone marrow function. All patients were required to have measurable disease. Patients treated with chemotherapy for recurrence and those with nonhealing wounds, active bleeding conditions, or inadequately anticoagulated thromboembolism were ineligible. All patients provided written informed consent before enrollment.