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1. Fabrini MG, Gadducci A, Perrone F, Cosio S, Laliscia C, Pasqualetti F, Grespi S, Cionini L: Clinical outcome of tailored adjuvant postoperative chemoradiotherapy in IB FIGO stage cervical cancer. Anticancer Res; 2009 Oct;29(10):4205-10
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical outcome of tailored adjuvant postoperative chemoradiotherapy in IB FIGO stage cervical cancer.
  • AIM: The aim of the present report is to review a mono-institutional experience of postoperative radiotherapy in selected patients with cervical cancer.
  • PATIENTS AND METHODS: Between 1999 and 2008, fifty-one patients with high-risk stage IB cervical cancer underwent tailored adjuvant postoperative radiotherapy; concurrent chemoradiotherapy was administered to patients presenting a high risk of recurrence.
  • Ten patients were subject to recurrences between 7 and 54 months after treatment.
  • CONCLUSION: Tailored adjuvant postoperative chemoradiotherapy is able to obtain a satisfactory clinical outcome in patients with high-risk early-stage IB cervical cancer.
  • [MeSH-major] Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brachytherapy. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Middle Aged. Neoplasm Staging. Postoperative Care. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • (PMID = 19846974.001).
  • [ISSN] 1791-7530
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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2. Cai HB, Chen HZ, Yin HH: Randomized study of preoperative chemotherapy versus primary surgery for stage IB cervical cancer. J Obstet Gynaecol Res; 2006 Jun;32(3):315-23
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  • [Title] Randomized study of preoperative chemotherapy versus primary surgery for stage IB cervical cancer.
  • AIM: To determine the most effective treatment and long-term outcome of patients with stage IB carcinoma of the cervix.
  • METHODS: From January 1999 to December 2001, 106 women with cervical cancer stage IB received neoadjuvant chemotherapy (n = 52) or primary surgery (n = 54).
  • Surgery revealed positive nodes in 9.6% neoadjuvant chemotherapy group patients and in 29.6% primary surgery group patients (P = 0.014).
  • Similar results occurred with vascular space involvement: 27.8% in the primary surgery group compared to 9.6% in the neoadjuvant chemotherapy group (P = 0.024).
  • However, parametrial infiltration was found in 7.4% of the patients in the primary surgery group, while only 3.8% showed it in the neoadjuvant chemotherapy group (P = 0.679).
  • The overall 5-year survival rate was significantly higher for all patients who received neoadjuvant chemotherapy (84.6%) than for the control group (75.9%) (P = 0.0112).
  • The median survival time in patients with complete response and partial response to chemotherapy (83.3 months) was significantly higher than that of patients with stable disease to chemotherapy (55.2 months) (P = 0.0049).
  • 27.3% of patients developed recurrent disease within 5 years of the primary treatment.
  • CONCLUSION: Neoadjuvant chemotherapy can effectively eliminate the pathological risk factors and improve long-term survival in patients with locally advanced cervical cancer.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Middle Aged. Neoadjuvant Therapy. Prospective Studies. Survival Analysis

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  • (PMID = 16764623.001).
  • [ISSN] 1341-8076
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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3. Hänsgen G, Dunst J: [Adjuvant radio- and chemotherapy in cervix carcinoma]. Zentralbl Gynakol; 2001 May;123(5):280-5
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Adjuvant radio- and chemotherapy in cervix carcinoma].
  • [Transliterated title] Adjuvante Radio- und Chemotherapie beim Zervixkarzinom.
  • The screening for cervical cancer has been reduced both the incidence of and mortality from invasive cervical cancer in the western world.
  • Radical pelvic surgery is an effective treatment for early invasive cervical cancer (FIGO-stage IB and IIA), but for woman with more advanced disease radiotherapy is the standard treatment.
  • However, the survival of the cervical cancer patients has not been improved over the last decade.
  • Previous studies have suggested that chemotherapy and radiotherapy are synergistic.
  • The results of five large studies have shown that cisplatin-based chemotherapy when given at the same time a radiation therapy, prolongs survival in woman with cervical cancer.
  • This was also observed in primary treatment schedule as in adjuvant situation.
  • The results suggest that chemoradiation is the favorable therapy for cervical cancer in advanced stage and in high-risk-situation.
  • [MeSH-major] Adenocarcinoma / drug therapy. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Survival Rate

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  • (PMID = 11449621.001).
  • [ISSN] 0044-4197
  • [Journal-full-title] Zentralblatt für Gynäkologie
  • [ISO-abbreviation] Zentralbl Gynakol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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4. Kim JS, Kim JS, Kim SY, Kim Ki, Cho MJ: Hyperfractionated radiotherapy with concurrent chemotherapy for para-aortic lymph node recurrence in carcinoma of the cervix. Int J Radiat Oncol Biol Phys; 2003 Apr 1;55(5):1247-53
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  • [Title] Hyperfractionated radiotherapy with concurrent chemotherapy for para-aortic lymph node recurrence in carcinoma of the cervix.
  • PURPOSE: To evaluate efficacy, toxicity, and patterns of relapse in patients treated with hyperfractionated radiotherapy (HFRT) with concurrent chemotherapy for para-aortic lymph node (PALN) recurrence of cervical carcinoma.
  • METHODS AND MATERIALS: Between September 1997 and October 2000, 12 cervical carcinoma patients with isolated PALN recurrence who had previously received radical or postoperative radiotherapy were treated with HFRT and concurrent chemotherapy.
  • The initial FIGO stage was Stage IB in 4 (33%) patients, Stage IIA in 2 (17%), and Stage IIB in 6 (50%).
  • The fractionated dose was 1.2 Gy in 2 daily fractions, and the median total dose was 60 Gy.
  • The weekly concurrent chemotherapy consisted of paclitaxel in 11 patients and cisplatin in 1.
  • The median number of cycles of chemotherapy was 5.
  • RESULTS: The latent period to PALN recurrence from the time of initial treatment for all patients ranged from 2 to 92 months (median: 12 months).
  • One month after treatment, the clinical tumor response evaluated was complete in 33% (4/12) and partial in 67% (8/12).
  • The latent period to PALN recurrence was the only significant prognostic factor; the median survival of patients who relapsed in < or =24 months from the initial treatment of cervical carcinoma was 13 months vs. 45 months for those relapsed at >24 months (p = 0.026).
  • Grade 3-4 hematologic toxicity developed in 2 patients.
  • Subsequent distant metastases after PALN treatment developed in 58% (7/12).
  • CONCLUSION: HFRT of 60 Gy to PALN with concurrent chemotherapy could be regarded as an effective treatment modality without significant acute or late toxicity.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brachytherapy. Carcinoma, Squamous Cell / secondary. Cisplatin / therapeutic use. Lymphatic Irradiation. Lymphatic Metastasis / radiotherapy. Paclitaxel / therapeutic use. Radiotherapy, High-Energy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents, Phytogenic / adverse effects. Antineoplastic Agents, Phytogenic / therapeutic use. Carcinoma, Adenosquamous / drug therapy. Carcinoma, Adenosquamous / mortality. Carcinoma, Adenosquamous / radiotherapy. Carcinoma, Adenosquamous / secondary. Combined Modality Therapy. Dose Fractionation. Female. Follow-Up Studies. Hematologic Diseases / etiology. Humans. Hysterectomy. Life Tables. Middle Aged. Nausea / etiology. Neoplasm Metastasis. Radiation Injuries / etiology. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 12654434.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 29
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5. Kim YB, Cho JH, Keum KC, Lee CG, Seong J, Suh CO, Kim GE: Concurrent chemoradiotherapy followed by adjuvant chemotherapy in uterine cervical cancer patients with high-risk factors. Gynecol Oncol; 2007 Jan;104(1):58-63
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  • [Title] Concurrent chemoradiotherapy followed by adjuvant chemotherapy in uterine cervical cancer patients with high-risk factors.
  • OBJECTIVES: To determine whether concurrent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy is better than CCRT alone in the management of FIGO stage bulky IB and IIB uterine cervical cancer.
  • METHODS: Two hundred and five FIGO stage bulky IB and IIB patients with squamous cell carcinoma of the uterine cervix treated with CCRT were divided into 2 groups:.
  • (1) CCRT alone (n=103, Group A) and (2) CCRT plus adjuvant chemotherapy (n=102, Group B), and treatment outcomes were retrospectively compared between the two patient groups.
  • RESULTS: Only 63% of patients received all three planned cycles of adjuvant chemotherapy, while 16% received only one cycle because of increased treatment-related morbidity or other causes.
  • There were no treatment-related deaths.
  • Although 37 patients experienced failures after completion of treatment, no significant differences were found in patterns of local and regional failures between the two groups.
  • CONCLUSIONS: Our data failed to show discernable therapeutic advantage of adjuvant chemotherapy with given after CCRT for the management of FIGO stage bulky IB and IIB uterine cervical cancer patients.
  • A future clinical trial will be necessary to test the clinical efficacy of the adjuvant treatment using newly developed agents in uterine cervical cancer patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Brachytherapy. Carboplatin / administration & dosage. Carboplatin / adverse effects. Chemotherapy, Adjuvant / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Dose Fractionation. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy / adverse effects. Retrospective Studies. Risk Factors


6. Manchana T, Triratanachat S, Sirisabya N, Vasuratna A, Termrungruanglert W, Tresukosol D: Prevalence and prognostic significance of COX-2 expression in stage IB cervical cancer. Gynecol Oncol; 2006 Mar;100(3):556-60
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prevalence and prognostic significance of COX-2 expression in stage IB cervical cancer.
  • OBJECTIVES: To evaluate the prevalence of cyclooxygenase-2 (COX-2), correlation with various clinicopathologic factors and prognostic significance of COX-2 in stage IB cervical cancer patients.
  • METHODS: 89 paraffin-embedded specimens of patients with stage IB cervical cancer underwent radical hysterectomy and pelvic lymphadenectomy at King Chulalongkorn Memorial Hospital during 1 January 1997-31 December 2002 and were stained with polyclonal goat antiserum against COX-2 using immunohistochemical method.
  • RESULTS: The prevalence of positive COX-2 expression in stage IB cervical cancer in this study was 49.4%.
  • Positive COX-2 expression in cervical adenocarcinoma was higher than squamous cell carcinoma (86.7% versus 40.6%, P < 0.05) and significantly expressed when lymph node metastasis was presented (100% versus 46.4%, P < 0.05).
  • CONCLUSIONS: Strong correlation was found in cervical adenocarcinoma and lymph node metastasis.
  • However, COX-2 expression failed to demonstrate as a significant prognostic factor in stage IB cervical cancer.
  • [MeSH-major] Cyclooxygenase 2 / biosynthesis. Uterine Cervical Neoplasms / enzymology
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / enzymology. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / enzymology. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Disease-Free Survival. Female. Humans. Immunohistochemistry. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging

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  • (PMID = 16246405.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] EC 1.14.99.1 / Cyclooxygenase 2
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7. Martín-Martínez A, Molano F, Lloret M, Falcón-Vizcaino O, García-Hernández JA: Concurrent chemotherapy and radiotherapy for cervical cancer. Eur J Gynaecol Oncol; 2003;24(2):160-2
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  • [Title] Concurrent chemotherapy and radiotherapy for cervical cancer.
  • OBJECTIVE: To compare the results obtained following treatment, from a group of patients with locally advanced cervical cancer (Stage IB or higher) treated with concurrent chemotherapy and radiotherapy in relation to a group of patients treated exclusively with radiotherapy.
  • MATERIAL AND METHOD: All patients treated with concurrent chemotherapy and radiotherapy at the Gynaecologic Oncology Unit of the University Hospital Materno Infantil of the Canaries between 1999 and 2000, both inclusive, were included.
  • The first group to be considered was formed by patients who received combined treatment.
  • The results were compared in relation to survival in the two following years from treatment (2000-2001) in the group of combined treatment and years 1999-2000 in the group that received only radiotherapy.
  • RESULTS: The groups compared are homogeneous when looking at the stage of the disease when diagnosed, the histological type of tumour and its degree of cellular differentiation, the CAT results and tumoral markers.
  • Survival of more than two years was observed in the group treated with concurrent chemotherapy and radiotherapy in relation to the group treated exclusively with radiotherapy; chi-square 9.92, p < 0.01, OR: 0.1 (0.01-0.6).
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Middle Aged. Radiation Dosage. Treatment Outcome


8. Petsuksiri J, Chansilpa Y, Therasakvichya S, Suntornpong N, Thephamongkhol K, Dankulchai P, Mahasitthiwat P, Ieumwananonthachai N, Veerasarn V, Sangruchi S, Pattaranutaporn P: Treatment options in bulky stage IB cervical carcinoma. Int J Gynecol Cancer; 2008 Nov-Dec;18(6):1153-62
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

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  • [Title] Treatment options in bulky stage IB cervical carcinoma.
  • Cervical cancer is the most common female cancer in the developing countries.
  • Treatments of bulky stage IB cervical cancer have been challenged as the local control is relatively poor compared to smaller stage I disease, whether treated by radical surgery or irradiation.
  • The treatment options are definitive concurrent chemoradiation therapy or radical surgery with or without neoadjuvant or adjuvant therapy.
  • The treatment decision is based on the patients' status and preferences, tumor characteristics, and experiences of clinician.
  • This study will review and compare the treatment modalities and rationales of a combination of treatment including surgery, radiation therapy, and chemotherapy for bulky stage IB cervical carcinoma.
  • [MeSH-major] Uterine Cervical Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma / classification. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Adenocarcinoma / therapy. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Humans. Hysterectomy. Neoplasm Staging

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  • [CommentIn] Int J Gynecol Cancer. 2009 Apr;19(3):480 [19407578.001]
  • (PMID = 18298563.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 61
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9. Mossa B, Mossa S, Corosu L, Marziani R: Follow-up in a long-term randomized trial with neoadjuvant chemotherapy for squamous cell cervical carcinoma. Eur J Gynaecol Oncol; 2010;31(5):497-503
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  • [Title] Follow-up in a long-term randomized trial with neoadjuvant chemotherapy for squamous cell cervical carcinoma.
  • OBJECTIVE: To assess the role of neoadjuvant chemotherapy to achieve radical surgery in a larger number of patients with locally advanced/or bulky Stage IB cervical carcinoma.
  • We conducted a trial to determine whether neoadjuvant chemotherapy would improve disease-free survival and overall survival in Stage IB-III cervical cancer.
  • METHODS: 288 patients with squamous cell carcinoma of the uterine cervix, FIGO Stage IB-IIIB were randomized to one of the following treatments: three courses of neoadjuvant chemotherapy with cisplatin, vincristine, bleomycin (NACT arm; n = 159); conventional surgery or exclusive radiotherapy (CONV arm; n = 129).
  • There was no difference in age, FIGO stage, tumor size and lymph node involvement between the two groups (p = ns).
  • Two hundred and thirty-four patients in Stage IB-IIb (n = 129 NACT arm and n = 105 CONV arm) and 24 patients in Stage III (NACT arm) who proved to be chemosensitive underwent radical hysterectomy.
  • Six Stage III patients, non responders to chemotherapy, and 24 patients, Stage III of the CONV arm, underwent radiotherapy.
  • RESULTS: The study was performed on disease-free survival related to several prognostic factors: age, FIGO stage, tumor size, grading, parametrial involvement, lymph node status and surgical margins.
  • Statistically significant differences in the recurrence of the disease were related to FIGO stage (p < 003), grading (p < .05), parametrial involvement (p < .002) lymph node status (p < .0001) and tumor size (p <.002).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / surgery. Hysterectomy. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Middle Aged. Neoadjuvant Therapy. Radiotherapy. Vincristine / administration & dosage


10. Aubard Y, Genet D, Philippe HJ: [Caring for stage IB cancer of the cervix. Proposal for a protocol based on a review of the literature]. Gynecol Obstet Fertil; 2003 Jan;31(1):2-13
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  • [Title] [Caring for stage IB cancer of the cervix. Proposal for a protocol based on a review of the literature].
  • [Transliterated title] Prise en charge du cancer du col utérin au stade IB. Proposition d'un protocole fondé sur une revue de la littérature.
  • A review of the literarure indicates that there are two essential prognostic factors in stage Ib cancer of the cervix: the size of the tumour (determined by a physical examination and MRI) and invasion of the lymph nodes (determined by lymphadenectomy).
  • Of the available means of treatment, many workers use surgery at stage Ib1 and a combination of chemotherapy and radiotherapy at stage Ib2.
  • Hence, our pre-therapeutic assessment usually includes a physical examination under general anaesthesia, MRI of the abdomen and pelvis, and laparoscopic pelvic lymphadenectomy for stage Ib1 and laparoscopic lumbo-aortic lymphadenectomy for stage Ib2.
  • For stage Ib1 < 2 cm, if extemporaneous examination of the pelvic lymph nodes is positive, we perform lymphadenectomy of the lumbo-aortic lymph nodes and initiate treatment with chemotherapy and radiotherapy.
  • If the margins are healthy and devoid of vascular or lymphatic involvement, no further treatment is given.
  • If this is not the case, we suggest a postoperative radio-chemotherapy.
  • For tumours measuring between 2 and 4 cm, and if pelvic lymphadenectomy is positive, we propose radio-chemotherapy, or radical hysterectomy as for small tumours.
  • For Ib2 tumours, and if no lumbar adenopathy is seen at MRI, we perform a lumbo-aortic lymphadenectomy, followed by a radio-chemotherapy.
  • If invasion of lumbar lymph nodes is suspected at MRI, we perform a biopsy on the left scalenic lymph nodes; if invasion is present at this level, we give palliative treatment with simple pelvic radiotherapy.
  • If, at the end of combined chemotherapy and radiotherapy, some remaining tumour is discovered at the MRI assessment, we carry out extrafacial hysterectomy.
  • [MeSH-major] Antineoplastic Protocols. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Aging. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Fertility. Humans. Hysterectomy / methods. Lymph Node Excision. Lymphatic Metastasis. Magnetic Resonance Imaging. Neoplasm Staging. Prognosis. Radiotherapy

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  • [CommentIn] Gynecol Obstet Fertil. 2003 Jul-Aug;31(7-8):689 [14563617.001]
  • (PMID = 12659779.001).
  • [ISSN] 1297-9589
  • [Journal-full-title] Gynécologie, obstétrique & fertilité
  • [ISO-abbreviation] Gynecol Obstet Fertil
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 87
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11. Kim HS, Kim JY, Park NH, Kim K, Chung HH, Kim YB, Kim JW, Kim HJ, Song YS, Kang SB: Matched-case comparison for the efficacy of neoadjuvant chemotherapy before surgery in FIGO stage IB1-IIA cervical cancer. Gynecol Oncol; 2010 Nov;119(2):217-24
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  • [Title] Matched-case comparison for the efficacy of neoadjuvant chemotherapy before surgery in FIGO stage IB1-IIA cervical cancer.
  • OBJECTIVE: To evaluate whether neoadjuvant chemotherapy before surgery (NCS) is more efficient than primary surgical treatment (PST) for improving clinical outcomes in FIGO stage IB1-IIA cervical cancer.
  • Patients with ≥2 intermediate- or ≥1 high-risk factors received adjuvant concurrent chemoradiation using cisplatin-based chemotherapy.
  • RESULTS: NCS reduced more definitely intermediate- and high-risk factors than PST in stage IIA disease in spite of little difference of them in stage IB disease (large tumor size, 25% vs. 52.4%; deep stromal invasion, 57.1% vs. 82.1%; lymphovascular space invasion, 35.7% vs. 65.5%; parametrial invasion, 17.9% vs. 41.7%; p<0.05).
  • Moreover, ≥2 intermediate-risk factors were less common in NCS than PST despite no difference of the number of high-risk factors between the 2 treatments, which decreased the need of adjuvant radiotherapy in patients with stage IIA disease who received NCS (46.4% vs. 84.5%, p<0.01).
  • Although there were no differences in progression-free survival and disease recurrence between the 2 treatments, NCS led to poorer overall survival than PST in stage IIA disease with no difference of it in stage IB disease.
  • CONCLUSIONS: The efficacy between NCS and PST may be similar in FIGO stage IB cervical cancer.
  • However, NCS can lead to poor prognosis despite the reduction of intermediate-risk factors and the need of adjuvant radiotherapy in FIGO stage IIA disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Hysterectomy. Lymph Node Excision. Middle Aged. Neoadjuvant Therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Paclitaxel / administration & dosage. Risk Factors. Survival Rate


12. Yu L, Tan GS, Xiang XH, Guo WB, Li HP, Huang YH, Yang JY: [Comparison of uterine artery chemoembolization and internal iliac arterial infusion chemotherapy for the combining treatment for women with locally advanced cervical cancer]. Ai Zheng; 2009 Apr;28(4):402-7
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  • [Title] [Comparison of uterine artery chemoembolization and internal iliac arterial infusion chemotherapy for the combining treatment for women with locally advanced cervical cancer].
  • BACKGROUND AND OBJECTIVE: Uterine artery chemoembolization (UACE) and internal iliac arterial infusion chemotherapy (IAIC) are important methods to treat cervical cancer.
  • This study was to evaluate the curative effects of UACE and IAIC on the combining treatment for women with locally advanced cervical cancer.
  • METHODS: One hundred and seventy-five patients with locally advanced cervical cancer treated between April 1997 and November 2007 were retrospectively analyzed.
  • The UACE group was treated by bilateral uterine artery chemoembolization.
  • The IAIC group was treated by bilateral internal iliac arterial infusion chemotherapy.
  • All patients were treated by carboplatin-based combining chemotherapy.
  • The effective rate for clinical stage IB cervical cancer in the UACE group was 77.8%, which was significantly higher than 41.2% in the IAIC group (P=0.037).
  • However, for clinical stage II,III cervical cancer, the effective rates between the two groups had no significant differences (P=0.137 and P=0.524).
  • Postoperative pathologic examinations showed that the negative percentages of cancer cell residue and pelvic lymph node metastasis in the UACE group were slightly higher than those in the IAIC group (17.2% and 80.6% vs. 12.9% and 79.4%, P=0.504 and P=0.861).
  • CONCLUSIONS: UACE followed by preoperative radiotherapy can more effectively reduce the tumor volume of locally advanced cervical cancer compared with IAIC.
  • But UACE does not increase the pathological complete response rate and not decrease the pelvic lymph node metastasis rate, the postoperative recurrence rate, and tumor embolus within lymphovascular space.The effect of UACE on the long-term survival of locally advanced cervical cancer needs to be further evaluated.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Chemoembolization, Therapeutic. Infusions, Intra-Arterial. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / therapy. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy. Carboplatin / administration & dosage. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Hysterectomy / methods. Iliac Artery. Iridium Radioisotopes / therapeutic use. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Neoplasm, Residual. Remission Induction. Retrospective Studies. Tumor Burden. Uterine Artery. Young Adult


13. Jacobson GM, Kamath RS, Smith BJ, Goodheart MJ: Thromboembolic events in patients treated with definitive chemotherapy and radiation therapy for invasive cervical cancer. Gynecol Oncol; 2005 Feb;96(2):470-4
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  • [Title] Thromboembolic events in patients treated with definitive chemotherapy and radiation therapy for invasive cervical cancer.
  • OBJECTIVES: Determine the incidence of and risk factors for thromboembolic events (TE) in patients treated with definitive chemoradiation for cervical cancer at our institution.
  • METHODS: A retrospective chart review was performed of all patients with a diagnosis of invasive carcinoma of the cervix (FIGO Stage IB-IVA) treated with definitive chemoradiation at University of Iowa Hospitals and Clinics (UIHC) from July 2002 to December 2003.
  • All but one patient received 45 Gy to the pelvis followed by brachytherapy, IMRT, or conformal boost.
  • One patient received 39.6 Gy to the pelvis.
  • Cisplatin chemotherapy, 40 mg/m squared, was given weekly for 6 weeks.
  • Data were collected for FIGO stage, age, body mass index (BMI), and smoking history.
  • Log-rank tests were used to examine the association between time to TE and the variables FIGO stage and smoking status.
  • The association between time to TE and the continuous variables age and BMI was examined with Cox proportional hazards regression.
  • Eight patients (16.7%) developed a TE.
  • The associations were not statistically significant for stage (P = 0.72), smoking status (P = 0.72), age (P = 0.63) or BMI (P = 0.86).
  • CONCLUSIONS: We noted a high incidence of TE (16.7%) in patients treated at UIHC with chemoradiation for invasive cervical cancer.
  • We did not find a statistical association between age, stage, smoking history, or BMI and risk of TE in this group.
  • [MeSH-major] Radiation Injuries / etiology. Thromboembolism / etiology. Uterine Cervical Neoplasms / complications
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Middle Aged. Neoplasm Invasiveness. Radiotherapy / adverse effects. Risk Factors


14. Whitney CW, Stehman FB: The abandoned radical hysterectomy: a Gynecologic Oncology Group Study. Gynecol Oncol; 2000 Dec;79(3):350-6
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: The aim of this study was to evaluate the frequency with which intended radical hysterectomy for cervical cancer is abandoned and the outcomes for those patients.
  • There were 1127 patients with Stage IB carcinoma of the cervix entered on Gynecologic Oncology Group Protocol No. 49.
  • Sixty-three (93%) patients subsequently underwent pelvic radiation therapy and one or two intracavitary applications.
  • Five patients received radiotherapy and chemotherapy; 4 patients received chemotherapy alone.
  • One patient declined any further therapy.
  • The disease-free survival was shorter for patients whose radical procedure was abandoned than for those patients who underwent radical hysterectomy.
  • CONCLUSIONS: Retrospective comparisons of radical hysterectomy to radiation therapy are not valid unless the group of patients whose radical operation was abandoned is included.
  • The morbidity of the operation is low even when followed by radiation therapy.
  • However, no recommendations for optimal therapy can be made from this analysis.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Hysterectomy. Uterine Cervical Neoplasms / surgery

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  • [Copyright] Copyright 2000 Academic Press.
  • (PMID = 11104604.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA12484; United States / NCI NIH HHS / CA / CA12534; United States / NCI NIH HHS / CA / CA27816; etc
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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15. Eddy GL, Bundy BN, Creasman WT, Spirtos NM, Mannel RS, Hannigan E, O'Connor D: Treatment of ("bulky") stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the gynecologic oncology group. Gynecol Oncol; 2007 Aug;106(2):362-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of ("bulky") stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the gynecologic oncology group.
  • OBJECTIVE: A randomized phase III trial was conducted to determine if neoadjuvant chemotherapy (NACT) prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy (RHPPL) could improve progression-free survival (PFS) and overall survival (OS), as well as operability, with acceptable levels of toxicity.
  • Adjuvant radiation therapy was prescribed for specific surgical/pathological risk factors for both regimens.
  • METHODS: Eligible patients were required to have bulky FIGO Stage IB cervical cancer, tumor diameter > or =4 cm, adequate bone marrow, renal and hepatic function, and performance status < or =2.
  • Prospective random allocation was to either NACT (vincristine-cisplatin chemotherapy every 10 days for 3 cycles) before exploratory laparotomy and planned RHPPL (NACT+RHPPL), or RHPPL only.
  • The median follow-up time is 62 months among living patients.
  • CONCLUSION: There is no evidence from this trial that NACT offered any additional objective benefit to patients undergoing RHPPL for suboptimal Stage IB cervical cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Disease-Free Survival. Female. Humans. Hysterectomy. Lymph Node Excision. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Vincristine / administration & dosage


16. Lee JM, Lee KB, Nam JH, Ryu SY, Bae DS, Park JT, Kim SC, Cha SD, Kim KR, Song SY, Kang SB: Prognostic factors in FIGO stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study. Ann Oncol; 2008 Feb;19(2):321-6
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic factors in FIGO stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study.
  • BACKGROUND: To determine the clinical and pathologic prognostic factors in surgically treated patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix (SCNEC).
  • PATIENTS AND METHODS: We retrospectively reviewed a total of 68 patients with FIGO stage IB-IIA SCNEC surgically treated from January 1997 to December 2003 in Korea.
  • RESULTS: Of the 68 patients, 43 had FIGO stage IB1 SCNEC, 15 had stage IB2, and 10 had stage IIA.
  • Seven were treated with radical surgery alone; 11 with neoadjuvant chemotherapy (NACT) followed by radical surgery; 24 with radical surgery followed by adjuvant chemotherapy; and 26 with radical surgery followed by adjuvant radiation or chemoradiation.
  • Univariate and multivariate analysis showed that FIGO stage was predictive of poor prognosis.
  • Adjuvant chemoradiation did not improve survival compared with adjuvant chemotherapy alone.
  • CONCLUSIONS: FIGO stage may act as a surrogate for factors prognostic of survival.
  • Primary radical surgery followed by adjuvant chemotherapy is the preferred treatment modality for patients with early stage SCNEC.

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  • (PMID = 17962205.001).
  • [ISSN] 1569-8041
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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17. Lee IJ, Park KR, Lee KK, Song JS, Lee KG, Lee JY, Cha DS, Choi HI, Kim DH, Deung YK: Prognostic value of vascular endothelial growth factor in Stage IB carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys; 2002 Nov 1;54(3):768-79
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic value of vascular endothelial growth factor in Stage IB carcinoma of the uterine cervix.
  • PURPOSE: To clarify the role of vascular endothelial growth factor (VEGF) expression as an independent prognostic factor in Stage IB cervical cancer.
  • METHODS AND MATERIALS: A total of 117 patients with Stage IB cervical cancer who had undergone radical hysterectomy and pelvic lymph node dissection with complete histopathologic examination were included.
  • Eighty-eight (75.2%) patients received postoperative radiotherapy and/or chemotherapy.
  • Functional and quantitative tools to assess tumor angiogenesis in addition to the expression of VEGF need to be developed and would be helpful to support the finding that tumor angiogenesis correlates significantly with prognosis in early-stage cervical cancer.
  • [MeSH-major] Adenocarcinoma / chemistry. Carcinoma, Adenosquamous / chemistry. Carcinoma, Squamous Cell / chemistry. Endothelial Growth Factors / analysis. Intercellular Signaling Peptides and Proteins / analysis. Lymphokines / analysis. Neoplasm Proteins / analysis. Uterine Cervical Neoplasms / chemistry
  • [MeSH-minor] Adult. Aged. Analysis of Variance. Female. Humans. Middle Aged. Prognosis. Treatment Failure. Vascular Endothelial Growth Factor A. Vascular Endothelial Growth Factors

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  • (PMID = 12377329.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Endothelial Growth Factors; 0 / Intercellular Signaling Peptides and Proteins; 0 / Lymphokines; 0 / Neoplasm Proteins; 0 / Vascular Endothelial Growth Factor A; 0 / Vascular Endothelial Growth Factors
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18. Moore DH: Treatment of stage IB2 (bulky) cervical carcinoma. Cancer Treat Rev; 2003 Oct;29(5):401-6
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of stage IB2 (bulky) cervical carcinoma.
  • Tumour size is an important prognostic factor in patients with stage IB cervical cancer.
  • The patient with stage IB2 (bulky) cervical cancer represents a therapeutic challenge.
  • Neither radical hysterectomy nor primary radiation therapy are sufficiently effective and are associated with significant treatment-related complications including ovarian failure and psychosexual deficits.
  • It appears that extrafascial hysterectomy following radiation therapy does not improve overall survival relative to radiation therapy alone.
  • Consistent with results seen in locally advanced cervical carcinoma, chemoradiation therapy is superior to radiation therapy alone as primary treatment for stage IB2 cervical cancer and as adjuvant therapy for surgically treated patients with high-risk factors for recurrence.
  • Neoadjuvant chemotherapy has resulted in high clinical response rates and operability rates.
  • There are two phase III trials suggesting an improvement in survival with neoadjuvant chemotherapy followed by radical hysterectomy versus either surgery (and selected postoperative radiation) or radiation therapy alone.
  • These emerging treatments should be scrutinized in prospective controlled trials.
  • [MeSH-major] Hysterectomy / methods. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Biopsy, Needle. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Middle Aged. Neoadjuvant Therapy / methods. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 12972358.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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19. D'Agostino G, Distefano M, Greggi S, Salerno M, Ferrandina G, Poerio A, Mancuso S, Scambia G: Neoadjuvant treatment of locally advanced carcinoma of the uterine cervix with epirubicin, paclitaxel and cisplatin. Cancer Chemother Pharmacol; 2002 Mar;49(3):256-60
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  • [Title] Neoadjuvant treatment of locally advanced carcinoma of the uterine cervix with epirubicin, paclitaxel and cisplatin.
  • PURPOSE: The present study was conducted to explore whether neoadjuvant chemotherapy with a combination of epirubicin, paclitaxel and cisplatin could improve the operability and pathological response rate in locally advanced cervical cancer patients.
  • METHODS: Between April 1996 and July 2000, 42 patients with carcinoma of the uterine cervix, FIGO stage Ib(2)-IVa, were treated with two or three 21-day cycles of an epirubicin 100 mg/m(2), paclitaxel 175 mg/m(2), cisplatin 100 mg/m(2) regimen.
  • A total of 92 courses of therapy were administered.
  • The median follow-up time was 17 months for the 42 patients enrolled (range 3-62 months).
  • Median overall survival had not been reached at the time of this report.
  • CONCLUSIONS: Neoadjuvant chemotherapy with the epirubicin, paclitaxel and cisplatin combination followed by radical surgery proved to be a safe and effective approach to advanced cervical cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Disease Progression. Disease-Free Survival. Epirubicin / administration & dosage. Female. Humans. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Treatment Outcome

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  • (PMID = 11935219.001).
  • [ISSN] 0344-5704
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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20. Boruta DM 2nd, Schorge JO, Duska LA, Crum CP, Castrillon DH, Sheets EE: Multimodality therapy in early-stage neuroendocrine carcinoma of the uterine cervix. Gynecol Oncol; 2001 Apr;81(1):82-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multimodality therapy in early-stage neuroendocrine carcinoma of the uterine cervix.
  • OBJECTIVE: Patients with early-stage neuroendocrine cervical carcinoma (NECC) have a high mortality rate despite aggressive therapy.
  • We reviewed our experience in early stage disease and performed a meta-analysis of the literature to identify prognostic factors and determine optimal multimodality therapy.
  • METHODS: Eleven women with International Federation of Gynecology and Obstetrics (FIGO) early stage (IB--IIA) NECC were treated with surgery and chemotherapy at our institutions between 1978 and 1998.
  • Administration of radiation therapy was recorded, but not required for inclusion in this study.
  • Twenty-three early-stage NECC patients who were similarly treated during the study interval were identified by a Medline search of the English literature and included in the analysis.
  • Median cervical tumor diameter was 3.2 cm (range 0.5--11.0 cm).
  • Fifteen patients received postoperative platinum/etoposide (PE), seven received vincristine/adriamycin/cyclophosphamide (VAC), two received alternating cycles of VAC and PE, and ten received other chemotherapy regimens.
  • Twenty women were treated with radiation therapy.
  • PE and VAC chemotherapy was associated with increased survival (P < 0.01).
  • CONCLUSION: NECC is a highly lethal variant of cervical cancer.
  • [MeSH-major] Carcinoma, Neuroendocrine / therapy. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Hysterectomy. Middle Aged. Neoplasm Staging. Prognosis. Survival Rate. Vincristine / administration & dosage

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  • [Copyright] Copyright 2001 Academic Press.
  • (PMID = 11277655.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; CAV protocol; VP-P protocol
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21. Grigsby PW: Cervical cancer: combined modality therapy. Cancer J; 2001 Jul-Aug;7 Suppl 1:S47-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cervical cancer: combined modality therapy.
  • Prospective, randomized studies conducted over the past 10 years have changed the management of patients with advanced cervical cancer.
  • The reviewed studies evaluated the use of surgery, irradiation, and chemotherapy in patients with various stages of cervical carcinoma in the absence and presence of high-risk factors for recurrence.
  • A study by the Radiation Therapy Oncology Group (RTOG) compared pelvic with pelvic plus prophylactic para-aortic irradiation in patients with stages IB (> 4 cm), IIA, and IIB cervical cancer.
  • A follow-up study compared pelvic plus prophylactic para-aortic irradiation and brachytherapy with pelvic irradiation, brachytherapy, and chemotherapy with cisplatin and 5-FU in patients with IB-to IVA-stage cervical cancer.
  • Overall and disease-free survivals were significantly improved in patients receiving chemotherapy.
  • In patients with a prevalence of stage IIB and III, the Gynecologic Oncology Group (GOG) demonstrated that treatment with hydroxyurea alone was inferior to cisplatin or cisplatin, 5-FU, and hydroxy-urea in patients treated concurrently with pelvic irradiation and brachytherapy, and the GOG adopted irradiation and weekly cisplatin as standard therapy.
  • Further GOG studies suggest that irradiation and weekly cisplatin chemotherapy without hysterectomy is the optimal treatment for patients with stage IB cervical cancer.
  • Prospective, randomized studies conducted by the GOG evaluated the effectiveness of various treatments in patients with high-risk factors.
  • In one study that did not use chemotherapy, the recurrence-free interval was about 10% better for stage IB patients receiving postoperative irradiation after radical hysterectomy and pelvic lymphadenectomy compared with those who received no further therapy.
  • Patients with Stages IB and IIA disease who, following radical hysterectomy and lymph node dissection, are identified as having positive pelvic lymph nodes and positive parametrial involvement, are at higher risk for recurrence and death than the high-risk group described above.
  • An intergroup study conducted by the GOG, RTOG, and Southwest Oncology Group compared postoperative pelvic irradiation alone with postoperative pelvic irradiation plus concurrent chemotherapy in this group of patients.
  • Overall and progression-free survivals were superior for patients receiving chemotherapy, and their greatest survival occurred in patients who received 3 or 4 chemotherapy cycles compared with 1 or 2 cycles or no chemotherapy.
  • These findings are summarized with respect to their implications fortreatment of patients with advanced cervical cancer.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Brachytherapy. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Hysterectomy. Risk Factors

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  • (PMID = 11504285.001).
  • [ISSN] 1528-9117
  • [Journal-full-title] Cancer journal (Sudbury, Mass.)
  • [ISO-abbreviation] Cancer J
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 8
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22. Zempolich K, Fuhrman C, Milash B, Flinner R, Greven K, Ryu J, Forbes A, Kerlin K, Nichols RC, Gaffney DK: Changes in gene expression induced by chemoradiation in advanced cervical carcinoma: a microarray study of RTOG C-0128. Gynecol Oncol; 2008 May;109(2):275-9
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  • [Title] Changes in gene expression induced by chemoradiation in advanced cervical carcinoma: a microarray study of RTOG C-0128.
  • PURPOSE: To evaluate gene expression patterns in patients with advanced cervix cancer before and during chemoradiation in a multi-institutional cooperative group setting.
  • METHODS: RTOG C0128 was designed as a Phase II trial of radiation therapy with concomitant chemotherapy and Celecoxib at 400 mg twice daily for one year.
  • Tumor samples were obtained for microarray gene expression analysis before treatment and at the time of the first implant (paired sample).
  • Gene expression pre-treatment was compared with clinical characteristics.
  • Tissue was obtained prior to initiation of therapy from 34 patients (40%).
  • FIGO stages of the patients providing tissue were IB (23%), II (57%), and IIIA-IVA (20%).
  • RNA quality was sufficient in 22 pre-treatment and 14 post-treatment samples.
  • Among pre-treatment samples, no significant differences in gene expression were observed by FIGO stage, age, or race.
  • However, between comparison of histologic subtypes (adenocarcinoma, n=5; squamous cell carcinoma, n=17) demonstrated 45 genes differentially expressed with a false discovery rate of 0.018.
  • Cluster analysis segregated unpaired samples into 2 groups: 18/22 comprising pre-treatment samples and 10/14 in group 2 representing post-treatment samples.
  • Gene expression significantly correlated with histology, but not stage, age or race.
  • Cluster analysis identified two groups of gene expression profiles correlating with pre or post-treatment acquisition of tissue.
  • Hopefully, this data will lead to the development of molecularly based therapies.
  • [MeSH-major] Carcinoma / genetics. Carcinoma / radiotherapy. Gene Expression. Uterine Cervical Neoplasms / genetics. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cluster Analysis. Female. Humans. Microarray Analysis. Middle Aged. Neoplasm Staging. Treatment Outcome


23. Stryker JA, Mortel R: Survival following extended field irradiation in carcinoma of cervix metastatic to para-aortic lymph nodes. Gynecol Oncol; 2000 Dec;79(3):399-405
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Survival following extended field irradiation in carcinoma of cervix metastatic to para-aortic lymph nodes.
  • OBJECTIVE: Our goal was to determine survival after extended-field treatment of para-aortic lymph node (PALN) metastasis.
  • The FIGO stages were IB 10, 2A 3, IIB 9, IIIA 1, IIIB 10, 4A 1, and unstaged 1.
  • Four patients (3 stage IB, 1 stage IIIA) survived without recurrence.
  • CONCLUSIONS: PALN metastasis in stage IB is curable in approximately 30% of cases.
  • The management approach in this series in stage IB was as follows: If PALN metastasis was identified at exploration for radical hysterectomy, the procedure was aborted and extended-field RT administered.
  • The value of chemotherapy for PALN metastasis remains to be defined but results from clinical trials suggest that cisplatin-based chemotherapy may be beneficial.
  • [MeSH-major] Lymphatic Irradiation / methods. Uterine Cervical Neoplasms / radiotherapy

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  • [Copyright] Copyright 2000 Academic Press.
  • (PMID = 11104609.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] UNITED STATES
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24. Carballo N, González-Cortijo L, González-Martín A, Rojo A, Chiva L: Indications for adjuvant radiotherapy treatment after surgery and novel modalities for treatment. Gynecol Oncol; 2008 Sep;110(3 Suppl 2):S41-4
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Indications for adjuvant radiotherapy treatment after surgery and novel modalities for treatment.
  • Carcinoma of the uterine cervix is a frequent common cancer in women.
  • Patients diagnosed with early stage cervix cancer are managed with surgery.
  • Overall survival for stage IB (IB1-IB2) and IIA, is in the range of 80-90% at 5 years.
  • In the presence of 2 of the 3 adverse risk factors, radiotherapy reduces tumor recurrence in stage IB cervical cancer with negative lymph nodes.
  • Radiotherapy plays an important role in the management of cervical cancer.
  • Conventional radiotherapy may treat a large amount of normal tissue resulting in acute toxicity.
  • With standard doses of external beam radiotherapy 45 Gy-50 Gy (1.8 Gy-2 Gy) grade 3-4 late toxicity occurs in about 10%-12%.
  • Intensity modulated radiation therapy (IMRT) represents an advance in treatment delivery with doses that conform tightly to the target, and may reduce the acute gastrointestinal and chronic toxicity when compared with conventional 3D radiotherapy.
  • Also IMRT treats less bone marrow and may lead to a better tolerance of chemotherapy.
  • [MeSH-major] Uterine Cervical Neoplasms / radiotherapy

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  • (PMID = 18760712.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Rao GG, Rogers P, Drake RD, Nguyen P, Coleman RL: Phase I clinical trial of weekly paclitaxel, weekly carboplatin, and concurrent radiotherapy for primary cervical cancer. Gynecol Oncol; 2005 Jan;96(1):168-72
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  • [Title] Phase I clinical trial of weekly paclitaxel, weekly carboplatin, and concurrent radiotherapy for primary cervical cancer.
  • OBJECTIVES: Standard primary treatment for locally advanced cervix cancer is radiation (RT) with concomitant platinum-based chemotherapy (CT).
  • Paclitaxel and carboplatin are active agents in recurrent cervical carcinoma, have potent, synergistic in vitro radiosensitization, and are cytotoxic in weekly schedules.
  • This study was done to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of weekly paclitaxel/carboplatin chemoradiotherapy in locally advanced cervix cancer.
  • METHODS: Women with primary, previously untreated, squamous cell or adenocarcinoma of the cervix, FIGO stage IB(2) to IVA, negative para-aortic lymph nodes, adequate organ function and performance status were eligible.
  • Pelvic RT (45 Gy over 5 weeks--180 cGy/day, four-field) was followed by two brachytherapy applications (Point A low dose rate (LDR): 90 Gy, high dose rate (HDR): 75 Gy).
  • Median RT treatment time was 61 days (range, 55-79).
  • Fourteen patients received brachytherapy (LDR: 8, HDR: 6), and one received external RT only due to cervical stenosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Brachytherapy / adverse effects. Brachytherapy / methods. Carboplatin / administration & dosage. Carboplatin / adverse effects. Combined Modality Therapy. Drug Administration Schedule. Female. Humans. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Radiotherapy / adverse effects. Radiotherapy / methods


26. Rouzier R, Morice P, De Crevoisier R, Pomel C, Rey A, Bonnet K, Recoules-Arche A, Duvillard P, Lhomme C, Haie-Meder C, Castaigne D: Survival in cervix cancer patients treated with radiotherapy followed by radical surgery. Eur J Surg Oncol; 2005 May;31(4):424-33
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

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  • [Title] Survival in cervix cancer patients treated with radiotherapy followed by radical surgery.
  • AIM: To determine the incidence and predictive value of residual disease in the hysterectomy specimens of cervical cancer patients treated with primary radiotherapy, with or without chemotherapy, followed by surgery and to determine whether pathologically confirmed residual disease is a surrogate marker of outcome.
  • METHODS: The medical records of patients treated for stage IB/II carcinoma of the cervix in a single institution between 1985 and 2000 were retrospectively analysed into two different groups, depending on whether they had received radiotherapy or concurrent chemo-radiotherapy.
  • In multivariate analysis, FIGO stage, residual disease, and pathologic nodal involvement were independent predictive factors of both local recurrence and overall survival.
  • [MeSH-major] Uterine Cervical Neoplasms / radiotherapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Chi-Square Distribution. Female. Humans. Hysterectomy. Middle Aged. Neoplasm Staging. Neoplasm, Residual / pathology. Radiotherapy, Adjuvant. Survival Analysis. Treatment Outcome

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  • (PMID = 15837052.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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27. Chen SW, Liang JA, Yang SN, Lin FJ: High dose-rate brachytherapy for elderly patients with uterine cervical cancer. Jpn J Clin Oncol; 2003 May;33(5):221-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] High dose-rate brachytherapy for elderly patients with uterine cervical cancer.
  • BACKGROUND: The need for radiotherapy (RT) in cancer treatment for the elderly patient is growing.
  • The purpose of this study was to analyze the efficacy and complication rate for radiotherapy, using external-beam irradiation (EBRT) and high dose-rate intracavitary brachytherapy (HDRICB), for patients aged 70 years or older with carcinoma of the uterine cervix.
  • METHODS: From September 1992 to December 1997, 295 patients diagnosed with uterine cervical cancer completed RT at the Shin Kong Memorial Hospital and China Medical College Hospital.
  • Two hundred and fifty-eight patients [International Federation of Gynecology and Obstetrics (FIGO) stage distribution: 35 Ib, 26 IIa, 122 IIb, 10 IIIa, 58 IIIb, 7 IVa] who had undergone at least two courses of HDRICB and a minimum of 3 years of follow-up, were evaluated.
  • A retrospective analysis was conducted to compare the outcome of radiation therapy for the 179 patients under 70 years of age (younger group) and the 79 patients aged 70 years or older (older group).
  • After a total EBRT dose of 40-45 Gy/20 in 25 fractions, irradiating the whole pelvis over 4-5 weeks, dosage for patients diagnosed as FIGO stage IIb-IVa bilateral parametrial disease was boosted to 54-58 Gy, with central shielding.
  • Total prescribed Point A dosages (EBRT + HDRICB) ranged from 58 to 71.6 Gy (median, 65.6 Gy) for stage IB-IIA, while for larger lesions (stage IIB-IVA) analogous dosages were 59-75.6 Gy (median, 65.6 Gy).
  • RESULTS: The respective 5-year actuarial survivals (AS) for the older and younger groups were 82/85% for stage Ib, 65/65% for IIa, 61/71% for IIb and 35/59% for IIIa-b.
  • The 5-year cause-specific survivals (CSS) for the older and younger groups were 100/95% for stage Ib, 85/75% for IIa, 78/72% for IIb and 42/61% for IIIa-b.
  • The 5-year pelvic relapse-free survivals (PRFS) for the older and younger groups were 100/100% for stage Ib, 91/93% for IIa, 91/90% for IIb and 67/80% for IIIa-b.
  • The 5-year distant metastasis-free survivals (DMFS) for older and younger groups were 100/100% for stage Ib, 92/88% for IIa, 84/73% for IIb and 55/75% for IIIa-b.
  • There was no statistically significant survival difference on comparing the two groups according to stage.
  • Twelve (15.0%) of the 79 older patients and 14 (7.8%) of the 179 younger patients developed RTOG grade 3-4 rectal complications (P = 0.12), while seven (8.9%) of the 79 older patients and 10 (5.6%) of the 179 younger patients developed RTOG grade 3-4 small bowel complications (P = 0.34).
  • CONCLUSION: Radiation therapy, consisting of a combination of EBRT and three or four fractions of HDRICB, proved to be effective for older patients.
  • Further optimization of treatment policy is essential by changing the HDRICB fractionation strategy, shortening the treatment time and designing combination drug regimens that are both effective and tolerable during radiotherapy.
  • [MeSH-major] Brachytherapy. Carcinoma, Squamous Cell / radiotherapy. Dose Fractionation. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / radiotherapy. Adult. Age Factors. Aged. Carcinoma, Adenosquamous / drug therapy. Carcinoma, Adenosquamous / mortality. Carcinoma, Adenosquamous / radiotherapy. Chemotherapy, Adjuvant. Female. Humans. Middle Aged. Radiation Injuries / epidemiology. Retrospective Studies. Survival Rate

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  • (PMID = 12865465.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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28. Rutledge TL, Kamelle SA, Tillmanns TD, Gould NS, Wright JD, Cohn DE, Herzog TJ, Rader JS, Gold MA, Johnson GA, Walker JL, Mannel RS, McMeekin DS: A comparison of stages IB1 and IB2 cervical cancers treated with radical hysterectomy. Is size the real difference? Gynecol Oncol; 2004 Oct;95(1):70-6
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  • [Title] A comparison of stages IB1 and IB2 cervical cancers treated with radical hysterectomy. Is size the real difference?
  • OBJECTIVE: To compare stages IB1 and IB2 cervical cancers treated with radical hysterectomy (RH) and to define predictors of nodal status and recurrence.
  • METHODS: Patients with stage IB cervical cancers undergoing RH between 1990 and 2000 were evaluated and clinicopathological variables were abstracted.
  • The perioperative complication rate, estimated blood loss (EBL), and OR time were also tabulated.
  • RESULTS: RH was performed on 109 stage IB1 and 86 stage IB2 patients.
  • Univariate predictors of nodal status included lymphovascular space involvement (LVSI) (P = 0.001), DOI (P = 0.011), PI (P = 0.001), and stage (P = 0.011).
  • Neoadjuvant chemotherapy, age, grade, histology, and adjuvant radiation were not associated with recurrence.
  • CONCLUSIONS: The prognosis in stage IB cervical cancer seems to be most influenced by presence of LVSI and DOI and not by tumor size as the staging criteria would suggest.
  • Treatment decisions based on tumor size alone should be reconsidered.
  • [MeSH-major] Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Disease-Free Survival. Female. Follow-Up Studies. Humans. Hysterectomy / adverse effects. Hysterectomy / methods. Lymph Node Excision / adverse effects. Lymph Node Excision / methods. Lymph Nodes / pathology. Lymph Nodes / surgery. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Risk Factors. Treatment Outcome


29. Wong FC, Tung SY, Leung TW, Sze WK, Wong VY, Lui CM, Yuen KK, O SK: Treatment results of high-dose-rate remote afterloading brachytherapy for cervical cancer and retrospective comparison of two regimens. Int J Radiat Oncol Biol Phys; 2003 Apr 1;55(5):1254-64
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

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  • [Title] Treatment results of high-dose-rate remote afterloading brachytherapy for cervical cancer and retrospective comparison of two regimens.
  • PURPOSE: To review the treatment results and complications of high-dose-rate (HDR) intracavitary brachytherapy for patients with carcinoma of the cervix in a single institute and to compare them with those of low-dose-rate (LDR) brachytherapy reported in the literature.
  • METHODS AND MATERIALS: Two hundred twenty patients with carcinoma of the cervix were treated by primary radiotherapy between 1991 and 1998.
  • The distribution according to Federation of Gynecology and Obstetrics (FIGO) staging system was as follows: Stage IB, 11.4%; IIA, 9.1%; IIB, 50.9%; IIIA, 3.6%; IIIB, 23.2%; and IVA, 1.8%.
  • They were treated with whole pelvic irradiation giving 40 Gy to the midplane in 20 fractions over 4 weeks.
  • This was followed by parametrial irradiation, giving 16-20 Gy in 8-10 fractions.
  • HDR intracavitary brachytherapy was given weekly, with a dose of 7 Gy to point A for three fractions and, starting from 1996, 6 Gy weekly for four fractions.
  • The median overall treatment time was 50 days (range 42-73 days).
  • The median follow-up time was 4.7 years (range 3 months to 11.1 years).
  • The 5-year actuarial failure-free survival (FFS) and cancer-specific survival (CSS) rates for stage IB, IIA, IIB, IIIA, IIIB, and IVA were 87.7% and 86.6%, 85% and 85%, 67.8% and 74%, 46.9% and 54.7%, 44.8% and 50.4%, 0% and 25%, respectively.
  • On multivariate analysis, young age (< 50) (p = 0.0054), adenocarcinoma (p = 0.0384), and stage (p = 0.0005) were found to be independent poor prognostic factors.
  • CONCLUSION: Our experience in treating cervical cancer with HDR intracavitary brachytherapy is encouraging.
  • Our treatment results and complication rates were compatible with those of the LDR series.
  • Further studies are eagerly awaited to better define the optimal fractionation schedule for HDR brachytherapy and the schedule on how chemotherapy may be combined with it.
  • [MeSH-major] Brachytherapy / methods. Carcinoma, Squamous Cell / radiotherapy. Radiotherapy, High-Energy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Carcinoma, Adenosquamous / mortality. Carcinoma, Adenosquamous / pathology. Carcinoma, Adenosquamous / radiotherapy. Carcinoma, Adenosquamous / surgery. Combined Modality Therapy. Cystitis / etiology. Disease-Free Survival. Dose Fractionation. Enteritis / etiology. Female. Follow-Up Studies. Humans. Life Tables. Lymphatic Irradiation. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Particle Accelerators. Pelvis. Proctitis / etiology. Proportional Hazards Models. Radiation Injuries / etiology. Remission Induction. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2003 Apr 1;55(5):1159-61 [12654419.001]
  • (PMID = 12654435.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 41
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30. Gaffney DK, Winter K, Dicker AP, Miller B, Eifel PJ, Ryu J, Avizonis V, Fromm M, Greven K: A Phase II study of acute toxicity for Celebrex (celecoxib) and chemoradiation in patients with locally advanced cervical cancer: primary endpoint analysis of RTOG 0128. Int J Radiat Oncol Biol Phys; 2007 Jan 1;67(1):104-9
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  • [Title] A Phase II study of acute toxicity for Celebrex (celecoxib) and chemoradiation in patients with locally advanced cervical cancer: primary endpoint analysis of RTOG 0128.
  • PURPOSE: To determine treatment-related acute toxicity rates in patients with locally advanced cervical cancer treated by oral celecoxib, i.v. cisplatin and 5-FU, and concurrent pelvic radiation therapy.
  • METHODS AND MATERIALS: Eligible patients on this RTOG Phase I-II study for advanced cervix cancer included FIGO Stage IIB-IVA or patients with FIGO Stage IB through IIA with biopsy proven pelvic node metastases or tumor size > or =5 cm.
  • Cisplatin (75 mg/m2) and 5-FU (1g/m2 for 4 days) were administered every 3 weeks times 3.
  • The primary end point of the study was treatment related toxicity.
  • Albeit, the toxicity was deemed excessive in this trial, the rate of toxicities was not too different compared to other recent experiences with concurrent chemoradiation for advanced cervix cancer.

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  • (PMID = 17084549.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA106633-03; United States / NCI NIH HHS / CA / R01 CA106633; United States / NCI NIH HHS / CA / R01 CA106633-01; United States / NCI NIH HHS / CA / CA106633-02; United States / NCI NIH HHS / CA / R01 CA106633-02; United States / NCI NIH HHS / CA / CA106633-03; United States / NCI NIH HHS / CA / R01 CA106633-04; United States / NCI NIH HHS / CA / CA106633-04; United States / NCI NIH HHS / CA / CA106633-01
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cyclooxygenase 2 Inhibitors; 0 / Pyrazoles; 0 / Sulfonamides; JCX84Q7J1L / Celecoxib; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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