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1. Gadducci A, Cavazzana A, Cosio S, DI Cristofano C, Tana R, Fanucchi A, Teti G, Cristofani R, Genazzani AR: Lymph-vascular space involvement and outer one-third myometrial invasion are strong predictors of distant haematogeneous failures in patients with stage I-II endometrioid-type endometrial cancer. Anticancer Res; 2009 May;29(5):1715-20
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  • [Title] Lymph-vascular space involvement and outer one-third myometrial invasion are strong predictors of distant haematogeneous failures in patients with stage I-II endometrioid-type endometrial cancer.
  • The aim of this retrospective study was to assess the predictive value of different clinicopathological variables (patient age, tumour size, FIGO grade, myometrial invasion, lymph-vascular space involvement [LVSI], invasion margins, peri-tumour phlogistic infiltrate and mitotic activity) for the risk of distant haematogenous recurrences in patients with endometrioid-type stage Ib-II endometrial cancer.
  • Between August 1990 and April 2005, 259 patients had undergone laparotomy, peritoneal washing, total abdominal hysterectomy and bilateral salpingo-oophorectomy, with or without pelvic +/- para-aortic lymphadenectomy for endometrioid-type endometrial cancer.
  • Thirty-six (13.9%) patients had developed recurrent disease after a median time of 17 months (range, 2-128 months).
  • This study assessed 12 patients with FIGO stage Ib-II disease who had developed distant haematogenous recurrences and 20 randomly chosen control patients with FIGO stage Ib-II disease who had remained recurrence-free after a median follow-up of 52 months (range, 37-66 months).
  • Adjuvant therapy had been: no further treatment in 15 patients, external pelvic irradiation in 14 patients, adjuvant external pelvic irradiation plus brachytherapy in 2 patients and platinum-based chemotherapy followed by external pelvic irradiation in 1 patient.
  • A concomitant locoregional relapse (vagina or lymph nodes) had occurred in 3 patients.
  • % versus 20.0%, p=0.0022) was found in the patients who had developed distant haematogeneous metastases compared to the recurrence-free women.
  • Patients with these pathological findings should be enrolled in randomised trials designed to assess the role of adjuvant chemotherapy alone or combined with sequential and/or concomitant external pelvic irradiation.

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  • (PMID = 19443392.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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2. Ferenschild FT, Vermaas M, Verhoef C, Ansink AC, Kirkels WJ, Eggermont AM, de Wilt JH: Total pelvic exenteration for primary and recurrent malignancies. World J Surg; 2009 Jul;33(7):1502-8
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  • [Title] Total pelvic exenteration for primary and recurrent malignancies.
  • In locally advanced and recurrent pelvic malignancies, radical margins are sometimes difficult to obtain because of close relation to or growth in adjacent organs/structures.
  • Total pelvic exenteration (TPE) is an exenterative operation for these advanced tumors and involves en bloc resection of the rectum, bladder, and internal genital organs (prostate/seminal vesicles or uterus, ovaries and/or vagina).
  • METHODS: Between 1994 and 2008, a TPE was performed in 69 patients with pelvic cancer; 48 with rectal cancer (32 primary and 16 recurrent), 14 with cervical cancer (1 primary and 13 recurrent), 5 with sarcoma (3 primary and 2 recurrent), 1 with primary vaginal, and 1 with recurrent endometrial carcinoma.
  • Ten patients were treated with neoadjuvant chemotherapy and 66 patients with preoperative radiotherapy to induce down-staging.
  • Five-year local control for primary locally advanced rectal cancer, recurrent rectal cancer, and cervical cancer was 89%, 38%, and 64%, respectively.
  • Overall survival after 5 years for primary locally advanced rectal cancer, recurrent rectal cancer, and cervical cancer was 66%, 8%, and 45%.
  • CONCLUSIONS: Total pelvic exenteration is accompanied with considerable morbidity, but good local control and acceptable overall survival justifies the use of this extensive surgical technique in most patients, especially patients with primary locally advanced rectal cancer and recurrent cervical cancer.

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  • (PMID = 19421811.001).
  • [ISSN] 1432-2323
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2691931
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3. Campagnutta E, Giorda G, De Piero G, Sopracordevole F, Visentin MC, Martella L, Scarabelli C: Surgical treatment of recurrent endometrial carcinoma. Cancer; 2004 Jan 1;100(1):89-96
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  • [Title] Surgical treatment of recurrent endometrial carcinoma.
  • BACKGROUND: Surgery does not have a definite role in the treatment of patients with recurrent endometrial carcinoma, except for those with central pelvic recurrences.
  • Therapy after rescue surgery was undertaken at the discretion of the medical oncologist.
  • The progression-free interval and overall survival were defined as the time from secondary rescue surgery to the specific event and were evaluated by the Kaplan-Meier method and the log-rank test.
  • Residual disease, chemotherapy after rescue surgery, and central pelvis-vagina as the only site of recurrence were associated significantly with survival.
  • [MeSH-major] Carcinoma / surgery. Endometrial Neoplasms / surgery. Neoplasm Recurrence, Local / surgery. Postoperative Complications
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Middle Aged. Neoplasm, Residual. Patient Selection. Retrospective Studies. Salvage Therapy. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2003 American Cancer Society.
  • (PMID = 14692028.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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4. Emerich J, Milczek T, Debniak J, Majdak E: [Evaluation of surgical complications connected with intraperitoneal chemotherapy in ovarian cancer]. Ginekol Pol; 2002 Nov;73(11):1103-8
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  • [Title] [Evaluation of surgical complications connected with intraperitoneal chemotherapy in ovarian cancer].
  • OBJECTIVES: From a theoretical viewpoint, the use of intraperitoneal therapy (i.p.) in patients with ovarian cancer (a malignancy, which remains mainly confined to the peritoneal cavity) is logical.
  • Intraperitoneal catheters have moved to the forefront as a delivery system in cancer treatment.
  • MATERIAL AND METHODS: From January 1996 to January 2002, 92 patients with recurrent or persistent ovarian cancer, after surgery and first line chemotherapy, have had catheter insertion performed, but only 79 have had performed catheter evacuation: because of: not complete therapy (7 patients), three patients died during i.p. therapy, in three cases intraperitoneal catheter has spontaneously fold out.
  • Complications connected with catheter function: only 8 of 92 (8.70%) required cessation of chemotherapy prior to its expected completion, 2 fistula of the catheter to vagina, 2 fistulas to bowel, in two cases intraperitoneal catheter has spontaneously fold out due to abscess, one after citostatics flow under the skin, one because of abscess in peritoneal cavity, and problems with citostatics inflow one because of subileus.
  • IPC is valid and safe way of treatment patients with ovarian cancer.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Infusions, Parenteral / adverse effects. Ovarian Neoplasms / drug therapy. Tenascin / administration & dosage
  • [MeSH-minor] Adult. Aged. Catheterization / adverse effects. Catheterization / methods. Catheters, Indwelling / adverse effects. Female. Humans. Middle Aged. Retrospective Studies. Time Factors. Treatment Outcome

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  • (PMID = 12722406.001).
  • [ISSN] 0017-0011
  • [Journal-full-title] Ginekologia polska
  • [ISO-abbreviation] Ginekol. Pol.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Tenascin
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5. Salom EM, Penalver M: Recurrent vulvar cancer. Curr Treat Options Oncol; 2002 Apr;3(2):143-53
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  • [Title] Recurrent vulvar cancer.
  • Recurrent vulvar cancer occurs in an average of 24% of cases after primary treatment after surgery with or without radiation.
  • The relatively few primary vulvar cancers, combined with the low proportion of recurrences, has made it difficult to perform randomized studies to document the most appropriate therapeutic modalities.
  • Traditionally, the most accepted treatment of vulvar cancer has been and continues to be surgery.
  • Recently, radiation and chemotherapy have been combined with very encouraging results.
  • The therapeutic modality used depends on the location and extent of the recurrence.
  • With a central pelvic recurrence with antecedent radiotherapy involving the urethra, upper vagina, and rectum, total pelvic exenteration is indicated in a select group of patients with curative intent.
  • We recommend that inguinal recurrences without prior radiation therapy undergo excision followed by radiotherapy with chemosensitization.
  • With pelvic recurrences, we recommended chemoradiation as the treatment modality.
  • In the subset of patients with distant metastasis, chemotherapy may be offered; however, few studies have been performed to advocate any single combination.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Neoplasm Recurrence, Local / therapy. Vulvar Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Practice Guidelines as Topic

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  • (PMID = 12057077.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Number-of-references] 27
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6. Mundt AJ, McBride R, Rotmensch J, Waggoner SE, Yamada SD, Connell PP: Significant pelvic recurrence in high-risk pathologic stage I--IV endometrial carcinoma patients after adjuvant chemotherapy alone: implications for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys; 2001 Aug 1;50(5):1145-53
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  • [Title] Significant pelvic recurrence in high-risk pathologic stage I--IV endometrial carcinoma patients after adjuvant chemotherapy alone: implications for adjuvant radiation therapy.
  • OBJECTIVE: To evaluate the risk of pelvic recurrence (PVR) in high-risk pathologic Stage I--IV endometrial carcinoma patients after adjuvant chemotherapy alone.
  • METHODS: Between 1992 and 1998, 43 high-risk endometrial cancer patients received adjuvant chemotherapy.
  • No patients received preoperative radiation therapy (RT).
  • All patients received 4-6 cycles of chemotherapy as the sole adjuvant therapy, consisting primarily of cisplatin and doxorubicin.
  • Recurrent disease sites were divided into pelvic (vaginal, nonvaginal) and extrapelvic (para-aortic, upper abdomen, liver, and extra-abdominal).
  • RESULTS: Twenty-nine women (67.4%) relapsed.
  • Of the 17 women who developed a PVR, 8 relapsed in the vagina, 3 in the nonvaginal pelvis, and 6 in both.
  • The 3-year vaginal and nonvaginal PVR rates were 37.8% and 26%, respectively.
  • The most significant factor correlated with vaginal PVR was CI (p = 0.0007).
  • Nine of the 29 relapsed patients (31%) developed PVR as their only (6) or first site (3) of recurrence.
  • CONCLUSIONS: PVR is common in high-risk pathologic Stage I-IV endometrial cancer patients after adjuvant chemotherapy alone.
  • These results support the continued use of locoregional RT in patients undergoing adjuvant chemotherapy.
  • Further studies are needed to test the addition of chemotherapy to locoregional RT.
  • [MeSH-major] Adenocarcinoma / secondary. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Endometrial Neoplasms / drug therapy. Pelvic Neoplasms / secondary
  • [MeSH-minor] Adenocarcinoma, Clear Cell / epidemiology. Adenocarcinoma, Clear Cell / prevention & control. Adenocarcinoma, Clear Cell / secondary. Adenocarcinoma, Clear Cell / therapy. Adult. Aged. Carcinoma, Adenosquamous / epidemiology. Carcinoma, Adenosquamous / prevention & control. Carcinoma, Adenosquamous / secondary. Carcinoma, Adenosquamous / therapy. Chicago / epidemiology. Cisplatin / administration & dosage. Combined Modality Therapy. Cystadenocarcinoma, Papillary / epidemiology. Cystadenocarcinoma, Papillary / prevention & control. Cystadenocarcinoma, Papillary / secondary. Cystadenocarcinoma, Papillary / therapy. Doxorubicin / administration & dosage. Female. Follow-Up Studies. Humans. Hysterectomy. Life Tables. Lymphatic Metastasis. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Ovariectomy. Radiotherapy, Adjuvant. Retrospective Studies. Risk. Treatment Outcome. Vaginal Neoplasms / epidemiology. Vaginal Neoplasms / prevention & control. Vaginal Neoplasms / secondary

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  • (PMID = 11483323.001).
  • [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
  • [Publication-country] United States
  • [Chemical-registry-number] 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin
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7. Silver SA, Tavassoli FA: Glomus tumor arising in a mature teratoma of the ovary: report of a case simulating a metastasis from cervical squamous carcinoma. Arch Pathol Lab Med; 2000 Sep;124(9):1373-5
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  • [Title] Glomus tumor arising in a mature teratoma of the ovary: report of a case simulating a metastasis from cervical squamous carcinoma.
  • This lesion represented an incidental finding in a 43-year-old woman who underwent bilateral salpingo-oophorectomy at the time of detection of locally recurrent squamous carcinoma of the cervix.
  • The glomus tumor was initially interpreted as a metastasis due to its superficial morphologic resemblance to the recurrent carcinoma in the vagina.
  • [MeSH-major] Carcinoma, Squamous Cell / pathology. Glomus Tumor / pathology. Neoplasms, Multiple Primary. Ovarian Neoplasms / pathology. Teratoma / pathology. Uterine Cervical Neoplasms / pathology
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Humans. Hysterectomy. Immunohistochemistry. Lymph Node Excision. Microscopy, Electron. Neoplasm Invasiveness. Neoplasm Recurrence, Local. Ovariectomy. Vaginal Neoplasms / pathology. Vaginal Neoplasms / surgery

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  • (PMID = 10975942.001).
  • [ISSN] 0003-9985
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
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8. Milczek T, Emerich J, Klasa-Mazurkiewicz D: [Surgical complications connected with intraperitoneal chemotherapy in ovarian cancer]. Ginekol Pol; 2003 Sep;74(9):817-23
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  • [Title] [Surgical complications connected with intraperitoneal chemotherapy in ovarian cancer].
  • OBJECTIVES: From a theoretical viewpoint, intraperitoneal therapy (i.p.) in-patients with ovarian cancer, a malignancy, which remains mainly, confined to the peritoneal cavity is logical.
  • Intraperitoneal catheters have moved to the forefront as a delivery system in cancer treatment.
  • MATERIAL AND METHODS: From January 1996 to January 2003, 118 patients with recurrent or persistent ovarian cancer, after surgery and first line chemotherapy, have had catheter insertion, but only 91 have had catheter evacuation: because of: not complete therapy (21 patients).
  • Three patients died during i.p. therapy, Four times intraperitoneal catheter has spontaneously fold out.
  • Complications connected with catheter function: only 10 patients required cessation of chemotherapy prior to its expected completion because of following reasons: 2 fistula of the catheter to vagina, 2 fistulas to bowel, in four cases intraperitoneal catheter has spontaneously fold out due to abscess (two after citostatics flow under the skin, and two without clear reason probably because of not proper fixation) one because of abscess in peritoneal cavity, and problems with citostatics inflow, one because of subileus.
  • 2 IPC is valid and safety way of treatment ovarian cancer patients.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Infusions, Parenteral / adverse effects. Infusions, Parenteral / methods. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / surgery
  • [MeSH-minor] Aged. Catheterization / adverse effects. Catheters, Indwelling / adverse effects. Disease-Free Survival. Female. Humans. Middle Aged. Retrospective Studies. Risk Factors. Time Factors. Treatment Outcome

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  • (PMID = 14674130.001).
  • [ISSN] 0017-0011
  • [Journal-full-title] Ginekologia polska
  • [ISO-abbreviation] Ginekol. Pol.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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9. Raspagliesi F, Ditto A, Martinelli F, Hanozet F, Solima E, Grijuela B, Haeusler E, Fontanelli R: Nerve-sparing radical vaginectomy: two case reports and description of the surgical technique. Int J Gynecol Cancer; 2009 May;19(4):794-7
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  • CASE REPORTS: A 58-year-old woman with a diagnosis of locally advanced cervical cancer underwent neoadjuvant chemotherapy with local and nodal progression of disease.
  • A 14-year-old adolescent girl with a diagnosis of recurrent embryonal-botryoidal rhabdomyosarcoma was referred to us.
  • She underwent 6 courses of chemotherapy with persistent disease.
  • Two months after the surgical procedure, she was able to void the bladder.
  • [MeSH-major] Pelvis / innervation. Rhabdomyosarcoma, Embryonal / surgery. Uterine Cervical Neoplasms / surgery. Vagina / surgery. Vaginal Neoplasms / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Gynecologic Surgical Procedures / methods. Humans. Middle Aged. Neoadjuvant Therapy. Urinary Bladder / innervation

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  • (PMID = 19509590.001).
  • [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] Case Reports; Journal Article
  • [Publication-country] United States
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10. Temkin SM, Hellman M, Lee YC, Abulafia O: Surgical resection of vulvar metastases of endometrial cancer: a presentation of two cases. J Low Genit Tract Dis; 2007 Apr;11(2):118-21
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  • [Title] Surgical resection of vulvar metastases of endometrial cancer: a presentation of two cases.
  • OBJECTIVE: Endometrial cancer generally carries a good prognosis.
  • However, 10% to 15% of patients will manifest recurrent disease.
  • One half of these recurrences are confined to the vagina.
  • Whereas pelvic recurrence is most common in patients who do not receive postoperative adjuvant radiation therapy, distant metastases predominate among patients who received postoperative radiation therapy.
  • Surgical resection of disease may be possible, therapeutic and even curative, in select patients with isolated cancer recurrence.
  • CASE 1: A 63-year-old patient presented 7 years after treatment of endometrial cancer with a vulvar lesion and groin mass.
  • The lesions were successfully resected and confirmed to be recurrent endometrial cancer.
  • Adjuvant radiation and chemotherapy were prescribed leading to a complete clinical response.
  • CASE 2: An 83-year-old patient with a history of a hysterectomy for endometrial cancer and radiation therapy for a vaginal vault recurrence presented with an exophytic labial mass.
  • After radical wide excision of her vulvar mass and bilateral groin dissection, final pathology revealed that the mass was consistent with recurrent endometrial cancer.
  • This patient remains without evidence of disease 18 months after treatment of disease recurrence.
  • CONCLUSIONS: Uncommon sites of recurrence of endometrial cancer may include the vulva.
  • These rare metastases may be amenable to surgical resection with adjuvant therapy as indicated.
  • [MeSH-minor] Aged, 80 and over. Chemotherapy, Adjuvant. Female. Humans. Middle Aged. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 17415118.001).
  • [ISSN] 1089-2591
  • [Journal-full-title] Journal of lower genital tract disease
  • [ISO-abbreviation] J Low Genit Tract Dis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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11. Li SM, Zhang WH, Wu LY, Zhang R, Chen L: [Primary adenocarcinoma of vagina--attaching 24 cases clinical analysis]. Ai Zheng; 2002 Jan;21(1):83-6
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  • [Title] [Primary adenocarcinoma of vagina--attaching 24 cases clinical analysis].
  • BACKGROUND & OBJECTIVES: The incidence of primary vaginal adenocarcinoma was lower and its treatment was difficult and its prognosis was worse.
  • This study was designed to explore the clinical characters, treatment, prognosis of primary vaginal adenocarcinoma in this paper as the incidence of primary vaginal adenocarcinoma was lower, its treatment was difficult and its prognosis was worse.
  • RESULTS: The main clinical symptoms were vaginal bleeding and discharge.
  • Two patients were concurrently received chemotherapy and irradiation, Eight patients were received chemotherapy as the tumor was not control and recurrent or metastatic.
  • The survival mean time of patients with stage I and stage II was 60.3 months obviously much longer than 14.8 months of patients with stage III and stage IV, and they were significantly statistical difference (P < 0.01).
  • But the survival mean time of patients more than 40 years and less than or equal to 40 years was not significantly statistical difference.
  • Eight patients had local recurrence, which is the main reason of failure treatment.
  • CONCLUSIONS: Primary vaginal adenocarcinomas should mainly be adopted combined treatment depending on radiotherapy, but the prognosis was worse, the stage was the important factors affecting on the prognosis.
  • [MeSH-major] Adenocarcinoma / therapy. Vaginal Neoplasms / therapy

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  • (PMID = 12500405.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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12. Coulter J, Gleeson N: Local and regional recurrence of vulval cancer: management dilemmas. Best Pract Res Clin Obstet Gynaecol; 2003 Aug;17(4):663-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Local and regional recurrence of vulval cancer: management dilemmas.
  • Vulval cancer has an incidence of 1-2/100000.
  • Approximately one-third of patients develop recurrent disease usually within the first 2 years following primary treatment.
  • Radical exenterative procedures are considered when the recurrence involves the urethra, bladder, vagina and/or the anorectal canal.
  • Chemoradiation therapy may be used pre-operatively or to palliate the disease.
  • Surgical effort to debulk large-volume groin disease is often unsuccessful and chemoradiation therapy is the cornerstone of treatment.
  • The management of retroperitoneal and distant disease recurrence is generally based on symptom control as radiation therapy and chemotherapy have limited success.
  • Palliative medicine should be integrated early in the management plan both in patients with incurable recurrent disease and in those undergoing potentially curative treatments.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Neoplasm Recurrence, Local / therapy. Palliative Care / methods. Vulvar Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Hemorrhage / therapy. Humans. Inguinal Canal. Neoadjuvant Therapy. Pelvis. Radiotherapy, Adjuvant. Terminal Care / methods

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  • (PMID = 12965138.001).
  • [ISSN] 1521-6934
  • [Journal-full-title] Best practice & research. Clinical obstetrics & gynaecology
  • [ISO-abbreviation] Best Pract Res Clin Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 55
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13. Haidopoulos D, Diakomanolis E, Rodolakis A, Voulgaris Z, Vlachos G, Intsaklis A: Can local application of imiquimod cream be an alternative mode of therapy for patients with high-grade intraepithelial lesions of the vagina? Int J Gynecol Cancer; 2005 Sep-Oct;15(5):898-902
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  • [Title] Can local application of imiquimod cream be an alternative mode of therapy for patients with high-grade intraepithelial lesions of the vagina?
  • The aim of the present study was to assess the local application of imiquimod cream 5% as an alternative mode of therapy for high-grade vaginal intraepithelial neoplasia (VAIN 2/3).
  • Positive human papillomavirus (HPV) patients with multifocal high-grade VAIN (2/3) not involving the vaginal vault in hysterectomized patients took part in this study.
  • The treatment consisted of vaginal application of the cream under colposcopic guidance.
  • Following management, biopsies were obtained from the previously recorded lesions. p53 expression was recorded prior and after therapy.
  • Six patients (86%) were positive for high-risk HPV type while three (43%) women who were positive for p53 nuclei prior to therapy were found to be negative following treatment.
  • After treatment, 86% of the patients were found to have either HPV infection or low-grade VAIN.
  • During follow-up, two patients (28.5%) were managed by vaginectomy, one for persistent and one for recurrent high-grade VAIN.
  • Imiquimod cream 5% might represent an alternative although not permanent method of management in young, HPV-positive women with multifocal high-grade lesions of the vagina (VAIN 2/3).
  • [MeSH-major] Aminoquinolines / administration & dosage. Aminoquinolines / therapeutic use. Epithelial Cells / pathology. Vaginal Neoplasms / drug therapy. Vaginal Neoplasms / pathology
  • [MeSH-minor] Adult. Female. Follow-Up Studies. Humans. Middle Aged. Vaginal Creams, Foams, and Jellies / administration & dosage. Vaginal Creams, Foams, and Jellies / therapeutic use

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  • (PMID = 16174242.001).
  • [ISSN] 1048-891X
  • [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] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Vaginal Creams, Foams, and Jellies; 99011-02-6 / imiquimod
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14. Shamseddine A, Taher A, Abou-Mourad Y, Seoud M, Khalil A: Cure of metastatic uterine carcinosarcoma to lungs: a case report. Int J Gynecol Cancer; 2003 Jan-Feb;13(1):88-9
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  • Most patients with advanced or recurrent uterine sarcoma experience disease progression and ultimately die.
  • We present a case of uterine sarcoma with lung metastasis treated with systemic chemotherapy and with no evidence of disease for more than 5 years.
  • Ten months later, the tumor recurred in the apex of the vagina and was treated with brachytherapy.
  • After four cycles of systemic chemotherapy with cisplatin and ifosfamide, the pulmonary nodules completely disappeared.
  • Currently she is still in complete remission after more than 5 years, but unfortunately she has developed myelodysplastic syndrome.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinosarcoma / drug therapy. Carcinosarcoma / secondary. Lung Neoplasms / drug therapy. Lung Neoplasms / secondary. Uterine Neoplasms / pathology
  • [MeSH-minor] Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Ifosfamide / administration & dosage

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  • (PMID = 12631227.001).
  • [ISSN] 1048-891X
  • [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] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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15. Gadducci A, Cionini L, Romanini A, Fanucchi A, Genazzani AR: Old and new perspectives in the management of high-risk, locally advanced or recurrent, and metastatic vulvar cancer. Crit Rev Oncol Hematol; 2006 Dec;60(3):227-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Old and new perspectives in the management of high-risk, locally advanced or recurrent, and metastatic vulvar cancer.
  • During the last decades there has been a continuing evolution in the surgical approach of squamous cell carcinoma of the vulva that has been traditionally treated with radical vulvectomy and bilateral inguinal-femoral lymphadenectomy.
  • Modifications of the surgical technique of deep femoral lymphadenectomy and the mapping of sentinel node can offer new interesting therapeutic perspectives.
  • Locally advanced squamous cell carcinoma of the vulva has been long surgically treated with en-block radical vulvectomy and bilateral inguinal-femoral lymphadenectomy plus partial resection of urethra, vagina or anum, or by exenteration, with severe postsurgical complications, poor quality of life, and unsatisfactory survival rates.
  • 5-Fluorouracil [5-FU] or 5-FU- and cisplatin-based chemotherapy concurrent with irradiation followed by tailored surgery represents an attractive therapeutic option for advanced disease, planned to avoid such ultra-radical surgical procedures and, hopefully, to improve patient outcome.
  • Chemotherapy has also been used in neoadjuvant setting, with contrasting and generally unsatisfactory results, and in palliative treatment of patients with distant metastases.
  • Surgery is the primary treatment also for vulvar malignancies other than squamous cell carcinoma, whereas the clinical usefulness of adjuvant irradiation or chemotherapy is still to be defined.
  • Primary chemoradiation can be also used for advanced carcinoma of the Bartholin gland or for advanced adenocarcinoma associated with extramammary Paget's disease.
  • The drugs used for chemotherapy of metastatic melanomas or sarcomas of the vulva are the same employed for the melanomas or sarcomas developed in other sites.
  • [MeSH-major] Vulvar Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Neoplasm Metastasis. Recurrence

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  • (PMID = 16945551.001).
  • [ISSN] 1040-8428
  • [Journal-full-title] Critical reviews in oncology/hematology
  • [ISO-abbreviation] Crit. Rev. Oncol. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Number-of-references] 167
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16. Ruo L, Paty PB, Minsky BD, Wong WD, Cohen AM, Guillem JG: Results after rectal cancer resection with in-continuity partial vaginectomy and total mesorectal excision. Ann Surg Oncol; 2003 Jul;10(6):664-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Results after rectal cancer resection with in-continuity partial vaginectomy and total mesorectal excision.
  • BACKGROUND: Although sharp mesorectal excision reduces circumferential margin involvement and local recurrence, a concomitant partial vaginectomy may be required in women with locally advanced rectal cancer.
  • METHODS: Sixty-four patients requiring a partial vaginectomy during resection of primary rectal cancer were identified.
  • Thirty-five patients received adjuvant radiation with or without chemotherapy.
  • At a median follow-up of 22 months, 27 (42%) patients developed recurrent disease, with most of these occurring at distant sites.
  • CONCLUSIONS: Partial vaginectomy is indicated for locally advanced rectal cancers involving the vagina.
  • [MeSH-major] Neoplasm Invasiveness. Neoplasm Recurrence, Local. Rectal Neoplasms / pathology. Rectal Neoplasms / surgery. Vagina / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Lymphatic Metastasis. Middle Aged. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 12839851.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Güth U, Ella WA, Olaitan A, Hadwin RJ, Arora R, McCormack M: Total vaginal necrosis: a representative example of underreporting severe late toxic reaction after concomitant chemoradiation for cervical cancer. Int J Gynecol Cancer; 2010 Jan;20(1):54-60
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  • [Title] Total vaginal necrosis: a representative example of underreporting severe late toxic reaction after concomitant chemoradiation for cervical cancer.
  • INTRODUCTION: There is paucity of information regarding a late toxic reaction after chemoradiation for locally advanced cervical cancer.
  • We discuss this problem with special consideration to total vaginal necrosis (TVN), an underreported severe late complication of chemoradiation.
  • METHODS: The records of 98 cervical cancer patients who received chemoradiation at the Department of Oncology of the University College London Hospital between January 2004 and May 2008 were reviewed.
  • RESULTS: Eight women (8.2%) developed a severe late toxic reaction.
  • From these, 3 patients (3.1% of the entire cohort and 37.5% of the patients with a severe late toxic reaction), who were 44 to 60 years old, developed a TVN 6 to 18 months after completion of chemoradiation.
  • CONCLUSIONS: Total vaginal necrosis is an underreported but serious late complication after chemoradiation and leads to considerable chronic morbidity.
  • Radiologic examinations and biopsies are required to exclude recurrent disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma / drug therapy. Carcinoma / radiotherapy. Radiation Injuries / pathology. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy. Vagina / pathology
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant / adverse effects. Combined Modality Therapy / adverse effects. Delayed Diagnosis. Female. Humans. Middle Aged. Necrosis / diagnosis. Necrosis / epidemiology. Necrosis / etiology. Radiotherapy / adverse effects. Retrospective Studies. Severity of Illness Index. Time Factors. Vaginal Diseases / diagnosis. Vaginal Diseases / epidemiology. Vaginal Diseases / etiology. Vaginal Diseases / pathology


18. Di Bartolomeo N, Balestra MR, Liddo G, Innocenti P: [Pelvic recurrence of rectal cancer: our experience]. Suppl Tumori; 2005 May-Jun;4(3):S21-3
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  • [Title] [Pelvic recurrence of rectal cancer: our experience].
  • [Transliterated title] Recidiva pelvica da cancro del retto: nostra esperienza.
  • Isolated recurrence of rectal carcinoma have been reported from 7% to 33% with a median of 15.
  • The diagnosis of a locally recurrent rectal cancer was obtained with CT; imaging is the first step to estimate the extent and location of the local tumor growth and the presence or absence of distant metastases.
  • Local or locoregional recurrence implies the reappearance of carcinoma after an intended complete removal of the tumor.
  • For rectal cancer, the adjacent organs include the perineum, bladder and vagina, and LR failure includes perineal or pelvic lesions.
  • Total pelvic exenteration is performed in patients with local recurrence of rectal cancer and a 5-year suvival rate of 30-40% was achieved.
  • For patient with unresectable recurrence, chemotherapy and radiation contribute to a better quality of life and prolong survival.
  • The anastomotic recurrence that can be locally resected, the best approach for long-term survival is an extensive surgical procedure requiring en bloc removal of adjacent organs and pelvic structures so called composite resection.
  • While radioterapy remains the most common antineoplastic modality used for palliation of symptoms, surgical resection remains the mainstay of curative treatment for carcinoma of colon and rectum.

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  • (PMID = 16437880.001).
  • [ISSN] 2283-5423
  • [Journal-full-title] I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]
  • [ISO-abbreviation] Suppl Tumori
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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19. Uzan C, Vincens E, Balleyguier C, Gouy S, Pautier P, Duvillard P, Haie-Meder C, Morice P: Outcome of patients with incomplete resection after surgery for stage IB2/II cervical carcinoma with chemoradiation therapy. Int J Gynecol Cancer; 2010 Apr;20(3):379-84
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  • [Title] Outcome of patients with incomplete resection after surgery for stage IB2/II cervical carcinoma with chemoradiation therapy.
  • OBJECTIVE: Standard treatment of stage IB2/II cervical carcinoma is chemoradiation therapy.
  • The place of surgery after this treatment is debated, except when there is suspicion of residual disease.
  • (1) stage IB2/II cervical cancer, (2) external radiotherapy (45 Gy) with concomitant chemotherapy followed by uterovaginal brachytherapy (15 Gy), (3) magnetic resonance imaging performed between 3 and 8 weeks after brachytherapy, and (4) completion surgery with incomplete resection of pelvic disease.
  • The locations of the incomplete resection were (some patients had several locations) the parametrium (n = 4), lateral limit of the cervix (n = 4), anterior (n = 2), posterior (n = 3), and vagina (n = 2).
  • One patient had received chemotherapy for metastatic para-aortic nodes.
  • One patient is alive with recurrent disease, and 2 are free of disease with 23 and 33 months of follow-up.
  • CONCLUSIONS: The prognosis is poor when resection is incomplete after chemoradiation therapy in advanced-stage cervical cancer, and further surgery does not seem to improve this outcome.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy. Carcinoma, Adenosquamous / therapy. Carcinoma, Squamous Cell / therapy. Hysterectomy. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Neoplasm, Residual / pathology. Neoplasm, Residual / therapy. Para-Aortic Bodies / pathology. Pelvic Neoplasms / pathology. Pelvic Neoplasms / therapy. Radiotherapy Dosage. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 20375801.001).
  • [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
  • [Publication-country] United States
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20. Kyo S, Hashimoto M, Maida Y, Mizumoto Y, Nakamura M, Takakura M, Inoue M: Analysis of outcome of Stage I-III endometrial cancer treated with systematic operation omitting paraaortic lymphadenectomy. Eur J Gynaecol Oncol; 2007;28(3):170-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Analysis of outcome of Stage I-III endometrial cancer treated with systematic operation omitting paraaortic lymphadenectomy.
  • PURPOSE: The aim of this study was to assess the outcomes of endometrial cancer patients treated with systematic surgery omitting paraarotic lymphadenectomy.
  • PATIENTS AND METHODS: We retrospectively analyzed a consecutive series of 84 endometrioid-type endometrial cancer patients at FIGO Stage I, II or III without grossly metastatic paraaortic lymphadenodes, who underwent surgery at our institute.
  • The patients with high risk for recurrence were treated mainly by adjuvant irradiation therapy of the whole pelvis.
  • Out of the eight recurrent patients, five patients had a recurrent tumor at extra-pelvic sites (chest or abdomen), two patients had a recurrent tumor only in a paraaortic lymph node, and one patient had a recurrent tumor only in the vagina.
  • However, all the six recurrent patients who underwent adjuvant radiation therapy had distant recurrence.
  • CONCLUSIONS: These findings indicate that omission of paraarotic lymphadenectomy may be acceptable for endometrial cancer patients without gross metastasis at this site.
  • However, the high rate of distant recurrence after whole pelvic irradiation strongly indicates an urgent need to develop potent systemic adjuvant therapy, potentially by chemotherapy or chemoradiation therapy.
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • (PMID = 17624080.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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21. Ewies AA, Alfhaily F: Topical vaginal estrogen therapy in managing postmenopausal urinary symptoms: a reality or a gimmick? Climacteric; 2010 Oct;13(5):405-18
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Topical vaginal estrogen therapy in managing postmenopausal urinary symptoms: a reality or a gimmick?
  • Postmenopausal estrogen deprivation has been suggested as a risk factor for lower urinary tract dysfunction including stress incontinence, overactive bladder and recurrent urinary tract infection.
  • Recent randomized, controlled trials suggested that systemic hormone replacement therapy does have a negative effect on female lower urinary tract function, probably because of the progestogen component.
  • Further, it may be unacceptable for many women because of concerns about breast cancer or the return of withdrawal bleeding.
  • Topical vaginal estrogen preparations reverse urogenital atrophic changes and may relieve associated urinary symptoms while avoiding systemic and progestogenic effects.
  • This article provides an up-to-date overview of the role, effectiveness and safety of topical vaginal estrogen therapy for the treatment of lower urinary tract symptoms in postmenopausal women.
  • [MeSH-major] Estrogen Replacement Therapy / methods. Estrogens / administration & dosage. Postmenopause / physiology. Urinary Incontinence / drug therapy. Women's Health
  • [MeSH-minor] Administration, Intravaginal. Aged. Atrophy / prevention & control. Clinical Trials as Topic. Europe / epidemiology. Female. Great Britain / epidemiology. Humans. Middle Aged. Randomized Controlled Trials as Topic. United States / epidemiology. Urogenital System / drug effects. Vagina / drug effects. Women's Health Services / organization & administration

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  • (PMID = 20670198.001).
  • [ISSN] 1473-0804
  • [Journal-full-title] Climacteric : the journal of the International Menopause Society
  • [ISO-abbreviation] Climacteric
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Estrogens
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22. Salama JK, Mundt AJ, Roeske J, Mehta N: Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies. Int J Radiat Oncol Biol Phys; 2006 Jul 15;65(4):1170-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies.
  • METHODS AND MATERIALS: Between November 2002 and May 2005, 13 women with gynecologic malignancies were treated with extended-field radiation therapy.
  • Of the women, 7 had endometrial cancer, 4 cervical cancer, 1 recurrent endometrial cancer, and 1 suspected cervical cancer.
  • All women underwent computed tomography planning, with the upper vagina, parametria, and uterus (if present) contoured within the CTV.
  • All late toxicity was scored using the Radiation Therapy Oncology Group late toxicity score.
  • Extended-field intensity-modulated radiation therapy (IMRT) for gynecologic malignancies was well tolerated.
  • Both patients were treated with concurrent cisplatin based chemotherapy.
  • Extended-field-IMRT achieved good local control with only 1 patient, who was metastatic at presentation, and 1 patient not able to complete treatment, experiencing in-field failure.

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  • (PMID = 16730136.001).
  • [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
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