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1. Inciūra A, Juozaityte E: [The guidelines for diagnostics and treatment of cervical cancer]. Medicina (Kaunas); 2004;40(4):394-403
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  • [Title] [The guidelines for diagnostics and treatment of cervical cancer].
  • Cervical cancer is one of the most common cancers in women.
  • The purpose of this article is to analyze the main diagnostic and treatment strategies for all stages and recurrences of cervical cancer.
  • The article reviews the epidemiological situation, clinical features, diagnostic procedures for detection of this tumor and for evaluation of the dissemination of the disease, staging criteria, TNM (Tumor, Nodes, Metastases) and FIGO (Federation Internationale de Gynecologie et d'Obstetrique) classification, as well as treatment and prognosis.
  • Surgical treatment (radical type II or III hysterectomy and lymphonodectomy) for early stage I and IIA cervical cancer is the main treatment method.
  • Delivery of adjuvant postoperative radiation therapy or concomitant chemoradiation depends on the prognostic factors (tumor penetration to cervical tissues, lymphovascular invasion, tumor invasion to paracervical tissues, and surgical margins).
  • For treatment of more advanced stages of cervical cancer (IIB, IIIA, IIIB, IVA) concomitant chemoradiation: external beam radiotherapy with chemotherapy and brachytherapy is used.
  • Description of the treatment guidelines for each stage of cervical cancer is given in this article.
  • These guidelines are useful for good treatment practice.
  • [MeSH-major] Camptothecin / analogs & derivatives. Uterine Cervical Neoplasms / diagnosis. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / therapeutic use. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy. Carboplatin / administration & dosage. Carboplatin / therapeutic use. Cisplatin / administration & dosage. Cisplatin / therapeutic use. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Hysterectomy. Ifosfamide / administration & dosage. Ifosfamide / therapeutic use. Lymph Node Excision. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Paclitaxel / administration & dosage. Paclitaxel / therapeutic use. Palliative Care. Practice Guidelines as Topic. Prognosis. Radiotherapy Dosage. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic. Time Factors


2. Grunenwald DH, Mazel C, Girard P, Veronesi G, Spaggiari L, Gossot D, Debrosse D, Caliandro R, Le Guillou JL, Le Chevalier T: Radical en bloc resection for lung cancer invading the spine. J Thorac Cardiovasc Surg; 2002 Feb;123(2):271-9
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  • [Title] Radical en bloc resection for lung cancer invading the spine.
  • OBJECTIVE: We reviewed our 8-year experience with en bloc partial and total vertebrectomy for lung cancer invading the spine and report outcome and survival.
  • Eleven received induction treatment (chemotherapy, n = 5; chemoradiotherapy, n = 4; and radiation, n = 2).
  • Tumor stage was IIIB in 14 patients, IIIA in 1 patient, and IIB in 4 patients (hemivertebrectomy is performed in the case of T3 disease to obtain free margins).
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / pathology. Carcinoma, Non-Small-Cell Lung / surgery. Cervical Vertebrae / surgery. Lung Neoplasms / pathology. Lung Neoplasms / surgery. Pneumonectomy. Spinal Neoplasms / pathology. Thoracic Vertebrae / surgery
  • [MeSH-minor] Follow-Up Studies. Humans. Length of Stay / statistics & numerical data. Middle Aged. Neoplasm Invasiveness. Postoperative Complications / epidemiology. Survival Rate. Time Factors

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  • (PMID = 11828286.001).
  • [ISSN] 0022-5223
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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3. Rajkumar T, Vijayalakshmi N, Sabitha K, Shirley S, Selvaluxmy G, Bose MV, Nambaru L: A 7 gene expression score predicts for radiation response in cancer cervix. BMC Cancer; 2009;9:365
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  • [Title] A 7 gene expression score predicts for radiation response in cancer cervix.
  • BACKGROUND: Cervical cancer is the most common cancer among Indian women.
  • The current recommendations are to treat the stage IIB, IIIA, IIIB and IVA with radical radiotherapy and weekly cisplatin based chemotherapy.
  • However, Radiotherapy alone can help cure more than 60% of stage IIB and up to 40% of stage IIIB patients.
  • A scoring system was developed based on the RQ value for the genes.
  • The mean score +/- 2 SE (standard error of mean) was used and at a cut-off score of greater than 5.60, the sensitivity, specificity, Positive predictive value (PPV) and Negative predictive value (NPV) were 0.64, 1.0, 1.0, 0.67, respectively, for the low risk group.
  • CONCLUSION: We have identified a 7 gene signature which could help identify patients with cervical cancer who can be treated with radiotherapy alone.
  • [MeSH-major] Gene Expression Regulation, Neoplastic. Uterine Cervical Neoplasms / genetics. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Female. Humans. Neoplasm Staging. Predictive Value of Tests. Treatment Outcome

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  • (PMID = 19832977.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Databank-accession-numbers] GEO/ GSE14404
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2768747
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4. Wethington SL, Barrena Medel NI, Wright JD, Herzog TJ: Prognostic significance and treatment implications of positive peritoneal cytology in endometrial adenocarcinoma: Unraveling a mystery. Gynecol Oncol; 2009 Oct;115(1):18-25
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  • [Title] Prognostic significance and treatment implications of positive peritoneal cytology in endometrial adenocarcinoma: Unraveling a mystery.
  • OBJECTIVE: Review the literature on positive peritoneal cytology in endometrioid endometrial adenocarcinoma, its prognostic value, proposed treatment strategies, and future avenues of investigation.
  • METHODS: PubMed search of articles pertaining to stage IIIA endometrioid endometrial adenocarcinoma identified over 50 articles that were reviewed.
  • Low-risk stage IIIA1 was defined as those with grade 1 or 2 disease, no evidence of cervical involvement, myometrial invasion less than 50% and no lymph vascular space invasion (LVSI).
  • In low-risk stage IIIA1 endometrial carcinoma patients, the rate of recurrence is 4.1%.
  • In contrast, in high-risk stage IIIA1 endometrial carcinoma patients the rate of recurrence is 32%, a statistically significant difference (p<0.001).
  • CONCLUSIONS: To date there is no definitive consensus on the prognostic significance of positive peritoneal cytology alone.
  • However, even in the low-risk cohort with stage IIIA1 some patients will recur.
  • Adjuvant therapy for low-risk stage IIIA diseased may or may not be of benefit.
  • High-risk disease should be treated with chemotherapy, radiation or a combination thereof.
  • A prospective, multicenter trial of comprehensively surgically staged patients with stage IIIA endometrial cancer is indicated in order to clearly define prognosis and treatment for these patients.
  • [MeSH-major] Carcinoma, Endometrioid / pathology. Carcinoma, Endometrioid / therapy. Endometrial Neoplasms / pathology. Endometrial Neoplasms / therapy. Peritoneal Cavity / pathology

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  • (PMID = 19632708.001).
  • [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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5. Roberts KB, Urdaneta N, Vera R, Vera A, Gutierrez E, Aguilar Y, Ott S, Medina I, Sempere P, Rockwell S, Sartorelli AC, Fischer DB, Fischer JJ: Interim results of a randomized trial of mitomycin C as an adjunct to radical radiotherapy in the treatment of locally advanced squamous-cell carcinoma of the cervix. Int J Cancer; 2000 Aug 20;90(4):206-23
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  • [Title] Interim results of a randomized trial of mitomycin C as an adjunct to radical radiotherapy in the treatment of locally advanced squamous-cell carcinoma of the cervix.
  • The purpose of this study was to determine the efficacy of mitomycin C as an adjunct to radiotherapy for the treatment of locally advanced cervix cancer.
  • Patients with squamous-cell carcinoma of the cervix, stages IB2-IVA, were randomized to receive radiotherapy alone or radiotherapy with concomitant mitomycin C.
  • The 78 patients in the radiotherapy with mitomycin C group and 82 patients in the radiotherapy alone group have a comparable distribution by age and stage (mean age 47 years; stage IB 3%, IIA 11%, IIB 48%, IIIA 1%, IIIB 36%, IVA 3%).
  • On subgroup analysis, stage III-IVA patients had a four-year actuarial disease-free survival of 75% for radiotherapy plus mitomycin C compared with 35% for radiotherapy alone (P = 0.03).
  • There were no treatment- related deaths.
  • In this open phase III trial of mitomycin C as an adjunct to radical radiotherapy for squamous-cell carcinoma of the cervix, there were minimal hematologic effects and no increase in acute radiation reactions.
  • Patients with more advanced stage disease, predominantly stage IIIB, appear to have the most benefit.
  • These preliminary results support the hypothesis that targeting hypoxic cells may lead to a therapeutic enhancement in the radiotherapy of cervix cancer.
  • Cancer (Radiat. Oncol. Invest.
  • [MeSH-major] Antibiotics, Antineoplastic / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Mitomycin / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Actuarial Analysis. Adult. Chemotherapy, Adjuvant / adverse effects. Disease-Free Survival. Female. Humans. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant / adverse effects. Survival Analysis. Treatment Outcome


6. Adewuyi SA, Shittu OS, Rafindadi AH, Zayyan MS, Samaila MO, Oguntayo AO: Cisplatin chemotherapy for haemostasis in bleeding cervical cancer: experience from a resource-poor setting. Niger Postgrad Med J; 2010 Jun;17(2):122-7
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  • [Title] Cisplatin chemotherapy for haemostasis in bleeding cervical cancer: experience from a resource-poor setting.
  • BACKGROUND: Cervical cancer is the commonest cancer in northern Nigeria.
  • The number of patients requiring radiotherapy for various malignancies is beyond the available facilities and expertise leading to long waiting time and disease progression with its attendant sequelae.
  • This is the basis of using other orthodox treatment modalities as first line.
  • PATIENTS AND METHODS: Between January 2006 and December 2007, 116 patients with histologically confirmed cervical cancer with vaginal bleeding as the predominant symptom were treated.
  • Patients were interviewed with a structured pro forma on a 3-weekly basis during chemotherapy schedules to assess and evaluate per vaginal bleeding and discharge.
  • Dose of chemotherapy was 70 mg/m² every 3 weeks.
  • 62 patients were having per vagina bleeding for more than 6 months before commencement of chemotherapy (range 1-60 months).
  • 49 patients had blood transfusion before chemotherapy, average of 2.7 pints of blood transfused per patient.
  • 84 had at least FIGO stage IIIA disease.
  • Squamous cell carcinoma is the commonest histology type followed by adenocarcinoma with 95 and 16 patients respectively.
  • 81 patients had complete cessation of per vagina bleeding with 69 having complete cessation on or before 4th course of chemotherapy (9th week) and complete cessation of per vagina discharges was seen in 52 patients.
  • 115 patients had a performance status KPS of below 80 prior to chemotherapy, and after completing 6 cycles, 100 patients had KPS of 80 and above.
  • CONCLUSION: In resource-poor setting, Cisplatin based chemotherapy can be used by medical, gynaecological oncologists and general practitioners to control vaginal bleeding and improve the quality of life of patients pending radiotherapy.
  • For optimal treatment with chemoradiotherapy, government and non-governmental agencies must do all it takes to remedy the problems of shortage of resources.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Cisplatin / therapeutic use. Hemostasis / drug effects. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Drug Administration Schedule. Female. Hemorrhage / drug therapy. Hemorrhage / etiology. Humans. Karnofsky Performance Status. Middle Aged. Neoplasm Staging. Nigeria


7. Stanojevic Z, Djordjevic B, Todorovska I, Lilic V, Zivadinovic R, Dunjic O: Risk factors and adjuvant chemotherapy in the treatment of endometrial cancer. J BUON; 2008 Jan-Mar;13(1):23-30
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  • [Title] Risk factors and adjuvant chemotherapy in the treatment of endometrial cancer.
  • Endometrial carcinoma is the most common and potentially curable gynecologic malignant neoplasm.
  • The staging of endometrial cancer, according to the International Federation of Gynecology and Obstetrics (FIGO), is surgical.
  • Recent studies suggest a therapeutic benefit associated with extensive retroperitoneal lymph node evaluation to determine the disease extent and thereby more effectively direct potentially life-saving adjuvant therapy.
  • Due to the increasing number of endometrial cancer patients who undergo surgical staging, some independent prognostic factors have been identified in early stages (stage I-II), including lymph-vascular space involvement, histologic grade 3, aggressive histologic subtypes (uterine papillary serous carcinoma, clear cell carcinoma), depth of myometrial invasion, cervical invasion and the age of patients.
  • Adjuvant radiation therapy, known to offer survival benefit in advanced-stage disease, may also offer survival benefit in intermediate-risk surgical stage I, but this is followed by a significant risk of serious complications.
  • Based on randomized clinical trials, this review identified that only a limited body of evidence is available which can help clinicians make decisions about adjuvant chemotherapy of patients with high-risk stage I and II, as well as stage IIIA endometrial cancer.
  • Further investigations are required to define the subgroup of patients who benefit from postoperative adjuvant chemotherapy.
  • Thereby, combination of carboplatin plus paclitaxel represents an efficacious, low-toxicity regimen for managing intermediate-risk surgical stage I, as well as advanced or recurrent endometrial cancer.
  • [MeSH-major] Endometrial Neoplasms / drug therapy. Endometrial Neoplasms / etiology
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Humans. Neoplasm Staging. Risk Factors

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  • (PMID = 18404782.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Greece
  • [Number-of-references] 66
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8. De Leyn P, Stroobants S, De Wever W, Lerut T, Coosemans W, Decker G, Nafteux P, Van Raemdonck D, Mortelmans L, Nackaerts K, Vansteenkiste J: Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 Non-small-cell lung cancer: a Leuven Lung Cancer Group Study. J Clin Oncol; 2006 Jul 20;24(21):3333-9
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  • [Title] Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage IIIA-N2 Non-small-cell lung cancer: a Leuven Lung Cancer Group Study.
  • PURPOSE: Mediastinal restaging after induction therapy for non-small-cell lung cancer remains a difficult and controversial issue.
  • The goal of this prospective study was to compare the performance of integrated positron emission tomography (PET)--computed tomography (CT) and remediastinoscopy in the evaluation of mediastinal lymph node metastasis after induction chemotherapy.
  • PATIENTS AND METHODS: Thirty consecutive stage IIIA-N2 non-small-cell lung cancer patients surgically treated at our institution were entered onto this prospective study.
  • N2 disease was proven by cervical mediastinoscopy, at which a mean number of 3.8 lymph node levels were biopsied.
  • After completion of induction chemotherapy, the mediastinum was reassessed by integrated PET-CT and remediastinoscopy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy. Lymph Nodes / pathology. Mediastinoscopy. Positron-Emission Tomography. Tomography, X-Ray Computed

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  • [CommentIn] J Clin Oncol. 2006 Jul 20;24(21):3317-8 [16849743.001]
  • [CommentIn] J Clin Oncol. 2006 Nov 20;24(33):5338; author reply 5339-40 [17114674.001]
  • (PMID = 16849747.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] United States
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9. Ikeda O, Mizukami N, Murata Y, Arakawa A, Katabuchi H, Okamoto H, Yasunaga T, Tsunawaki A, Yamashita Y: Randomized comparison of intra-arterial chemotherapy versus intra-arterial chemotherapy and gelfoam embolization for treatment of advanced cervical carcinoma. Cardiovasc Intervent Radiol; 2005 Nov-Dec;28(6):736-43
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  • [Title] Randomized comparison of intra-arterial chemotherapy versus intra-arterial chemotherapy and gelfoam embolization for treatment of advanced cervical carcinoma.
  • PURPOSE: We evaluated the effects of intra-arterial infusion therapy by comparing the results obtained with a combination of intra-arterial anticancer drugs with and without transcatheter arterial embolization (TAE) in patients with cervical cancer.
  • METHODS: Between April 1999 and March 2003, intra-arterial therapy was administered to 45 patients (mean age 49 years) with cervical cancer.
  • Of these, 18 had stage IIb , 4 had stage IIIa, 19 had stage IIIb, and 4 had stage IVb cancer; the histopathologic types were squamous cell carcinoma (n = 35), adenocarcinoma (n = 8), and adenosquamous carcinoma (n = 2).
  • A total of 45 patients gave their informed consent and were randomized on a continuous basis into one of three groups according to the therapeutic protocols: group A consisted of 15 patients who received cisplatin, group B consisted of 17 patients who received cisplatin, mitomycin, doxorubicin hydrochloride, and 5-fluorouracil, and group C consisted of 13 patients who received cisplatin and TAE.
  • Each protocol was administered twice with a 3 week interval between treatments.
  • The efficacy of treatment was evaluated on the basis of the tumor reduction ratio (%) using MR imaging and the side effects were analyzed.
  • Although all group C patients developed severe pain after TAE, the pain was controlled with analgesics.
  • [MeSH-major] Carcinoma / therapy. Drug Therapy, Combination. Embolization, Therapeutic / methods. Gelatin Sponge, Absorbable / therapeutic use. Hemostatics / therapeutic use. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Antibiotics, Antineoplastic / adverse effects. Antibiotics, Antineoplastic / therapeutic use. Antimetabolites, Antineoplastic / adverse effects. Antimetabolites, Antineoplastic / therapeutic use. Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Cervix Uteri / pathology. Cisplatin / adverse effects. Cisplatin / therapeutic use. Combined Modality Therapy / adverse effects. Combined Modality Therapy / methods. Doxorubicin / adverse effects. Doxorubicin / therapeutic use. Female. Fluorouracil / adverse effects. Fluorouracil / therapeutic use. Humans. Infusions, Intra-Arterial / methods. Magnetic Resonance Imaging / methods. Middle Aged. Mitomycin / adverse effects. Mitomycin / therapeutic use. Treatment Outcome


10. Hiura M, Nogawa T, Matsumoto T, Yokoyama T, Shiroyama Y, Wroblewski J: Long-term survival in patients with para-aortic lymph node metastasis with systematic retroperitoneal lymphadenectomy followed by adjuvant chemotherapy in endometrial carcinoma. Int J Gynecol Cancer; 2010 Aug;20(6):1000-5
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  • [Title] Long-term survival in patients with para-aortic lymph node metastasis with systematic retroperitoneal lymphadenectomy followed by adjuvant chemotherapy in endometrial carcinoma.
  • OBJECTIVE: The purposes of this study were to assess modified radical hysterectomy including systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy in patients with para-aortic lymph node (PAN) metastasis in endometrial carcinoma and to identify the multivariate independent prognostic factors for long-term survival during the past 10 years.
  • METHODS: Between December 1987 and December 2002, we performed modified radical hysterectomy with bilateral salpingo-oophorectomy including systematic pelvic and para-aortic lymphadenectomy and peritoneal cytology in 284 endometrial carcinoma patients according to the classification of the International Federation of Gynecology and Obstetrics (stage IA, n = 66; stage IB, n = 96; stage IC, n = 33; stage IIA, n = 5; stage IIB, n = 20; stage IIIA, n = 28; stage IIIC, n = 28; and stage IV, n = 8) who gave informed consents at our institute.
  • Patients with PLN metastasis received adjuvant chemotherapy, and adjuvant radiation was not part of our institutional protocol.
  • RESULTS: The overall incidence of retroperitoneal lymph node metastasis assessed by systematic pelvic and para-aortic lymphadenectomy was 12.0% (34/284) in stages I to IV endometrial carcinoma, and incidences of PLN and PAN metastases were 9.2% (26/284) and 7.4% (21/284), respectively.
  • Univariate analysis of prognostic factors revealed that International Federation of Gynecology and Obstetrics clinical stage (P < 0.0001), histological finding (P = 0.0292), myometrial invasion (P < 0.0001), adnexal metastasis (P < 0.0001), lymphovascular space invasion (P < 0.0001), tumor diameter (P = 0.0108), peritoneal cytology (P = 0.0001), and retroperitoneal lymph node metastasis (P < 0.0001) were significantly associated with 10-year overall survival.
  • Survival was not associated with age (P = 0.1558) or cervical involvement (P = 0.1828).
  • CONCLUSIONS: It is suggested that surgery with systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy could improve long-term survival in patients with PAN metastasis, although there are only 21 patients with PAN metastasis.
  • [MeSH-major] Carcinoma / mortality. Carcinoma / secondary. Chemotherapy, Adjuvant. Endometrial Neoplasms / mortality. Endometrial Neoplasms / therapy. Retroperitoneal Neoplasms / secondary. Retroperitoneal Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Analysis of Variance. Aorta, Abdominal. Biopsy, Needle. Cohort Studies. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Hysterectomy / methods. Immunohistochemistry. Lymph Node Excision / methods. Lymph Nodes / pathology. Lymph Nodes / surgery. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Retroperitoneal Space. Retrospective Studies. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 20683408.001).
  • [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] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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11. Havrilesky LJ, Secord AA, O'Malley DM, Broadwater G, Bae-Jump V, Cohn DE, Gehrig PA: Multicenter analysis of recurrence and survival in stage IIIA endometrial cancer. Gynecol Oncol; 2009 Aug;114(2):279-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multicenter analysis of recurrence and survival in stage IIIA endometrial cancer.
  • OBJECTIVE: To determine factors related to recurrence and survival in women with stage IIIA endometrial cancer; to examine outcomes of women with IIIA1 disease.
  • METHODS: Multi-institutional analysis of women with stage IIIA endometrial carcinoma undergoing hysterectomy, bilateral salpingo-oophorectomy, lymphadenectomy, and pelvic cytology between 1980 and 2008.
  • RESULTS: 98 women underwent surgical staging for stage IIIA endometrial carcinoma.
  • Adjuvant treatment was given to 88%: radiotherapy--21%, chemotherapy - 19%, chemotherapy and radiotherapy--19%, hormonal therapy--16%, and intraperitoneal P-32 - 11%.
  • Patients with IIIA1 disease were less likely to receive chemotherapy or radiotherapy than those with IIIA2 disease (p=0.0035).
  • Older age (Hazard ratio 1.24; 95% CI 1.00-1.54), non-Caucasian race (HR 5.35; 95% CI 1.96-14.5), and cervical metastases (HR 3.3; 95% CI 1.3-8.7) predicted lower RFDSS in multivariate analysis.
  • Among 24 patients meeting NCCN's observation criteria (IIIA1, non-serous, and FIGO grade 1-2), 0/12 receiving adjuvant treatment recurred, while 1/12 not receiving adjuvant treatment recurred.
  • CONCLUSIONS: Surgically assessed stage IIIA endometrial adenocarcinoma recurs in approximately 20-25% of cases.
  • A subset of stage IIIA1 with very low risk factors may be appropriate candidates for observation.
  • [MeSH-major] Endometrial Neoplasms / pathology. Endometrial Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Hysterectomy. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Ovariectomy. Radiotherapy, Adjuvant. Survival Rate. Treatment Outcome

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  • (PMID = 19446319.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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12. Onishi H, Yamaguchi M, Kuriyama K, Tsukamoto T, Ishigame K, Ichikawa T, Aoki S, Yoshikawa T, Araki T, Nambu A, Araki T, Hashi A, Yasumizu T, Hoshi K, Ito H: Effect of concurrent intra-arterial infusion of platinum drugs for patients with stage III or IV uterine cervical cancer treated with radical radiation therapy. Cancer J Sci Am; 2000 Jan-Feb;6(1):40-5
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] Effect of concurrent intra-arterial infusion of platinum drugs for patients with stage III or IV uterine cervical cancer treated with radical radiation therapy.
  • PURPOSE: The purpose of this study was to explore the effect of concurrent intra-arterial infusion of platinum drugs in patients with stage III or IV uterine cervical cancer treated with radical radiation therapy.
  • PATIENTS AND METHODS: Thirty-three patients with advanced (stage IIIA, 2; IIIB, 28; IVA, 3) uterine cervical squamous cell carcinoma were randomized into a concurrent intra-arterial infusion of platinum drugs with radiation therapy (IAPRT) group (18 patients) and a radiation therapy alone group (15 patients).
  • After altering intrapelvic blood flow by embolization of the superior and inferior gluteal arteries under pelvic angiography, intra-arterial infusion of platinum drug through catheters inserted into both internal iliac arteries was performed concurrently with radiation therapy.
  • One-shot infusion of cisplatin (100 mg/m2) twice with a 2- to 3-week interval was performed in eight patients, weekly infusion of carboplatin (100 mg/m2) via a reservoir five to six times was performed in four patients, and daily shot of cisplatin (10 mg/body) or 21 days via a reservoir was performed in six patients.
  • Radiation therapy consisted of external-beam irradiation of 50 Gy/25 fractions/5 weeks for the whole pelvis with midline block after 30 Gy and intracavitary high-dose-rate brachytherapy using tandem and ovoids of 24 Gy/4 fractions/4 weeks to point A.
  • RESULTS: The local complete response rate of the IAPRT group was 94% and was significantly higher than that of the radiation therapy group (67%).
  • There were no significant differences in local response in the three drug delivery methods.
  • Two- and 5-year overall survival rates were 54.5% and 44.4% in the IAPRT group, and 74.5% and 50.0% in the radiation therapy group, respectively.
  • In the IAPRT group, grade 3 or 4 acute bowel complications were seen in 33% of patients, grade 3 or 4 late bowel complications were seen 44%, and grade 3 or 4 myelosuppression was seen in 33%, and these complications were seen more in the IAPRT group than in the radiation therapy group and caused death in some patients.
  • CONCLUSIONS: IAPRT had a better local response than radiation therapy but showed no proof of control over recurrence and had a poorer survival than radiation therapy.
  • There were many local recurrences and distant metastases, contrary to the better first response of the IAPRT group over the radiation therapy group.
  • Complications of the IAPRT group were very severe and made the patient's performance status and prognosis worse than in the radiation therapy group.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Disease-Free Survival. Embolization, Therapeutic. Female. Humans. Infusions, Intra-Arterial. Middle Aged. Neoplasm Staging. Survival Analysis

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  • (PMID = 10696738.001).
  • [ISSN] 1081-4442
  • [Journal-full-title] The cancer journal from Scientific American
  • [ISO-abbreviation] Cancer J Sci Am
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] UNITED STATES
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13. Chura JC, Shukla K, Argenta PA: Brain metastasis from cervical carcinoma. Int J Gynecol Cancer; 2007 Jan-Feb;17(1):141-6
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] Brain metastasis from cervical carcinoma.
  • The aim of this study was to describe the features of patients with brain metastasis from cervical cancer.
  • Twelve patients with brain metastasis from cervical cancer were identified.
  • Information regarding symptoms, treatment, and survival was analyzed.
  • Median patient age at initial diagnosis of cervical cancer was 43.5 years (range 29-57 years) compared with 44.5 years (range 31-58 years) at identification of brain metastasis.
  • Six patients had FIGO stage IB disease; three had stage IIB disease; and one each had stage IIIA, IIIB, and IVB disease.
  • The median interval from diagnosis of cervical cancer to identification of brain metastasis was 17.5 months (range 1.1-96.1 months).
  • Five patients who received chemotherapy after brain irradiation had a median survival of 4.4 months compared to 0.9 months for those who received no additional treatment after brain irradiation (P= .016).
  • Most patients with brain metastasis from cervical cancer presented with neurologic sequelae.
  • Survival after diagnosis of brain metastasis was poor; however, patients who received chemotherapy after brain irradiation appeared to have improved survival.
  • [MeSH-major] Brain Neoplasms / secondary. Brain Neoplasms / therapy. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / therapy

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  • (PMID = 17291245.001).
  • [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] Journal Article
  • [Publication-country] United States
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14. Krasna MJ, Gamliel Z, Burrows WM, Sonett JR, Kwong KF, Edelman MJ, Hausner PF, Doyle LA, DeYoung C, Suntharalingam M: Pneumonectomy for lung cancer after preoperative concurrent chemotherapy and high-dose radiation. Ann Thorac Surg; 2010 Jan;89(1):200-6; discussion 206
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pneumonectomy for lung cancer after preoperative concurrent chemotherapy and high-dose radiation.
  • BACKGROUND: We studied the clinical characteristics and outcomes of patients undergoing pneumonectomy after preoperative concurrent chemoradiation for non-small cell lung cancer.
  • METHODS: Clinical records of patients with non-small cell lung cancer who underwent pneumonectomy at our institution between 1995 and 2005 after preoperative concurrent chemoradiation were reviewed retrospectively.
  • Of the 21 men and 8 women who were treated, 1 had stage IIB (T3N0M0) and the remainder had stage IIIA or IIIB non-small cell lung cancer.
  • Mean total radiation dose was 61.1 Gy.
  • Recurrences have been found in 11 patients (38%), including brain metastases (n = 6), bone metastases (n = 4), liver metastases (n = 2), and cervical lymph node metastases (n = 2).
  • One patient had a contralateral new primary lung cancer develop 70 months after undergoing pneumonectomy.
  • Median survival time has not been reached.
  • The frequency of disease recurrence in the brain underscores the need to evaluate the role of prophylactic cranial radiation in non-small cell lung cancer.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / surgery. Pneumonectomy / methods
  • [MeSH-minor] Adult. Aged. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Radiation Dosage. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • [Copyright] 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20103235.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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15. Diaz JJ Sr, Thomas MB, Hernandez E: Outcome analysis of stage II and III cervical carcinoma: Importance of optimal radiation therapy. J Clin Oncol; 2009 May 20;27(15_suppl):e16562

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcome analysis of stage II and III cervical carcinoma: Importance of optimal radiation therapy.
  • : e16562 Background: The objective of our study was to conduct an outcome analysis of patients with stage II and III cervical cancer (CC) treated in our institution.
  • We sought to asses the effectiveness and toxicity of carboplatin concomitant with pelvic irradiation and the importance of compliance with treatment.
  • METHODS: A retrospective chart review was conducted of all patients with stage II and III CC treated at Temple University Hospital from January 2001 to December 2006.
  • RESULTS: Forty-eight patients with stage II and III CC without radiographic evidence of extra-pelvic disease (IIA = 11, IIB = 15, IIIA = 4, IIIB = 18) were treated during the period under study.
  • Four (8%) patients had adenocarcinoma and 44 (92%) had squamous cell carcinoma.
  • Nonsurgical therapy consisting of radiation (RT) with or without chemotherapy (CT) was offered to all patients.
  • Optimal dose of RT was defined as a minimal cervical dose exceeding 7000 cGy, point A dose of 8000-9000 cGy and treatment duration not exceeding 56 days.
  • The pelvic failure (PF) and distal failure (DF) were 38% and 26%, respectively.
  • The estimate of probability of 5-year pelvic failure rate in patients who received optimal therapy and patients who received suboptimal therapy was 23% vs. 48% (p = 0.2) .
  • The most important predictor of optimal radiation was compliance with treatment plan.
  • CONCLUSIONS: Optimal RT is crucial for successful treatment of advanced CC.

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  • (PMID = 27961530.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Bhosle SM, Huilgol NG, Mishra KP: Apoptotic index as predictive marker for radiosensitivity of cervical carcinoma: evaluation of membrane fluidity, biochemical parameters and apoptosis after the first dose of fractionated radiotherapy to patients. Cancer Detect Prev; 2005;29(4):369-75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Apoptotic index as predictive marker for radiosensitivity of cervical carcinoma: evaluation of membrane fluidity, biochemical parameters and apoptosis after the first dose of fractionated radiotherapy to patients.
  • BACKGROUND: This study was aimed to develop possible predictive response of cervical carcinoma in stage IIIA and B patients by evaluating the changes in physical parameter, such as, membrane fluidity, biochemical parameters, such as, intracellular calcium, antioxidant enzymes [superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx)] and apoptotic cell death in cervical cancer cells from patients after treating with the first fractionated dose of 2 Gy in radiation therapy protocol.
  • METHODS: Biopsies of cervical carcinoma patients were collected before and 24h after first fractionated radiation dose of 2 Gy.
  • Cell suspensions and tissue of cervix cancer biopsies were used to measure various physical and biochemical parameters.
  • RESULTS AND CONCLUSIONS: A negative correlation was found to exist between observed fluidity of membrane/SOD level with the degree of apoptosis in cervical cells.
  • These results suggest that changes in membrane fluidity, SOD and calcium level were involved in the mechanism of radiation induced cervical apoptosis as measured by TUNEL assay.
  • Moreover, apoptotic sensitivity of these cells after the first dose of radiation treatment showed a direct correlation with the radiation treatment outcome in patients after completion of radiotherapy protocol (70 Gy) in the clinic suggesting that apoptotic index may form a basis for prognosis in radiotherapy in stage III cervix cancer patients.
  • [MeSH-major] Apoptosis / radiation effects. Biomarkers, Tumor / radiation effects. Dose Fractionation. Membrane Fluidity / radiation effects. Radiation Tolerance / radiation effects. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Calcium / radiation effects. Catalase / radiation effects. Dose-Response Relationship, Radiation. Female. Glutathione Peroxidase / radiation effects. Humans. In Situ Nick-End Labeling. Middle Aged. Neoplasm Staging. Predictive Value of Tests. Superoxide Dismutase / drug effects. Treatment Outcome

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  • (PMID = 16125335.001).
  • [ISSN] 0361-090X
  • [Journal-full-title] Cancer detection and prevention
  • [ISO-abbreviation] Cancer Detect. Prev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; EC 1.11.1.6 / Catalase; EC 1.11.1.9 / Glutathione Peroxidase; EC 1.15.1.1 / Superoxide Dismutase; SY7Q814VUP / Calcium
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17. Yalman D, Aras AB, Ozkök S, Duransoy A, Celik OK, Ozsaran Z, Haydaroğlu A: Prognostic factors in definitive radiotherapy of uterine cervical cancer. Eur J Gynaecol Oncol; 2003;24(3-4):309-14
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 definitive radiotherapy of uterine cervical cancer.
  • PURPOSE: To determine the prognostic factors related to local control and survival in 257 patients with uterine cervical cancer treated with definitive radiotherapy (RT).
  • MATERIALS AND METHODS: The medical records of 257 patients treated with definitive RT from January 1987 to December 1998 were reviewed retrospectively.
  • Pretreatment and treatment parameters were analyzed to determine their prognostic value onlocal control and survival.
  • Squamous cell carcinoma was the most common histologic type (89.1%).
  • The distribution per FIGO Stage was IIA: 13.2%; IIB: 54.9%; IIIA: 3.9%; IIIB: 19.8%; IVA: 8.2%.
  • Ninety-eight patients (38.1%) were treated with external RT alone; 134 (52.1%) received both external RT and intracavitary brachytherapy; 21 (8.2%) received external RT and chemotherapy and four (1.6%) received external RT, intracavitary brachytherapy and chemotherapy.
  • In univariate analysis the prognostic factors identified for local progression-free survival were histology (p = 0.008), FIGO stage (p < 0.001), initial hemoglobin (Hgb) level (p = 0.001), total radiation dose (p = 0.039), use of brachytherapy (p = 0.001) and of chemotherapy (p = 0.037) and enlarged paraaortic nodes (p = 0.016).
  • In multivariate analysis the prognostic factors were FIGO stage (p = 0.014), initial Hgb level (p = 0.040), and use of brachytherapy (p = 0.013).
  • The prognostic factors identified for disease-free survival were histology (p = 0.011), FIGO stage (p < 0.001), initial Hgb level (p < 0.001), use of brachytherapy (p = 0.001) and of chemotherapy (p = 0.014) in univariate analysis; and FIGO stage (p < 0.001), initial Hgb level (p = 0.017), total tumor dose (p = 0.034), use of brachytherapy (p = 0.006) and of chemotherapy (p = 0.021) in multivariate analysis.
  • Factors influencing overall survival were FIGO stage (p < 0.001), initial Hgb level (p = 0.006), overall treatment time (p = 0.028), total tumor dose (p = 0.007), use of brachytherapy (p < 0.001), enlarged paraaortic (p < 0.001) and pelvic nodes (p = 0.004) in univariate analysis; and FIGO stage (p < 0.001), overall treatment time (p = 0.031), enlarged paraaortic (p = 0.007) and pelvic lymph nodes (p = 0.043) in multivariate analysis.
  • CONCLUSION: Definitive RT is an effective treatment for patients with uterine cervical cancer.
  • There are many prognostic factors influencing treatment outcome.
  • Brachytherapy and chemotherapy must be added in appropriate patients to improve the outcome.
  • Future prospective trials should be undertaken to confirm the validity of these factors and to individualize the treatment strategy for every patient.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Brachytherapy / methods. Carcinoma, Squamous Cell / radiotherapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Analysis of Variance. Biopsy, Needle. Disease-Free Survival. Dose-Response Relationship, Radiation. Female. Humans. Middle Aged. Multivariate Analysis. Neoplasm Staging. Probability. Prognosis. Radiotherapy Dosage. Retrospective Studies. Risk Factors. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 12807246.001).
  • [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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18. Ozsaran Z, Yalman D, Yürüt V, Aras A, Ozsaran A, Hanhan M, Haydaroğlu A: Radiochemotherapy for patients with locally advanced cervical cancer: early results. Eur J Gynaecol Oncol; 2003;24(2):191-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiochemotherapy for patients with locally advanced cervical cancer: early results.
  • PURPOSE: Radiotherapy is the standard treatment for locally advanced cervical cancer.
  • Recent results of the prospective randomized trials have shown an overall survival and local control advantage for cisplatin-based therapy given concurrently with radiation therapy.
  • Thirty-nine patients who received concurrent chemoradiation between October 1999 and December 2000 were evaluated for treatment response, local control and toxicity.
  • MATERIALS AND METHODS: Thirty-nine patients with Stage IB through IVA cervical carcinoma received weekly cisplatin (40 mg/m2) concurrent with radiotherapy.
  • Total external radiotherapy dose was 64.8 Gy with 1.8 Gy daily fractions in patients who received only external radiotherapy.
  • Midline shielding was performed at 50.4 Gy in patients who were going to receive brachytherapy and the total external radiotherapy dose was 54-59.4 Gy.
  • A total dose of 8.5-18 Gy was applied to point A.
  • Distribution by stages were as follows: Stage IB 5.1%, IIA 28.2%, IIB 43.6%, IIIA 7.7%, IIIB 12.8% and IVA 2.6%.
  • Histologically 33 (84.6%) were epidermoid carcinoma, one was adenocarcinoma, two were undifferentiated carcinoma, one was malignant epithelial tumor.
  • In two patients histological type could not be specified.
  • Four patients had local recurrence and three developed distant metastases.
  • During or after radiochemotherapy 46.2% of the patients developed toxicity due to chemotherapy.
  • CONCLUSION: Concurrent chemoradiation for locally advanced cervical cancer is the treatment of choice in suitable patients providing high response rates with acceptable toxicity.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / radiotherapy. 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. Combined Modality Therapy. Female. Humans. Middle Aged. Treatment Outcome. Vomiting / chemically induced

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  • (PMID = 12701977.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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19. Adachi S, Ogasawara T, Tsubamoto H, Oku H, Hori Y, Tsuji Y, Takemura T, Koyama K: Intravenous nedaplatin and intraarterial cisplatin with transcatheter arterial embolization for patients with locally advanced uterine cervical cancer. Int J Clin Pharmacol Res; 2001;21(3-4):105-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intravenous nedaplatin and intraarterial cisplatin with transcatheter arterial embolization for patients with locally advanced uterine cervical cancer.
  • Nedaplatin is a platinum analog that has less renal toxicity and higher efficacy for uterine cervical cancer than cisplatin.
  • Intraarterial cisplatin has been shown to be more effective than intravenous cisplatin in the treatment of cervical cancer.
  • To improve the prognosis of cervical cancer, we studied combination chemotherapy of intravenous nedaplatin and intraarticular cisplatin with transcatheter arterial embolization (TAE).
  • The criteria for selecting patients for this study were as follows: age 16-75 years, stage Ib2-IV according to the classification of the International Federation of Gynecology and Obstetrics (FIGO), performance status between 0 and 2, a creatinine clearance of >40 ml/min, adequate bone marrow and adequate renal and hepatic function.
  • FIGO stage was Ib2 in seven patients, IIa in seven patients, IIb in four, IIIa in one, IIIb in seven and IVa in six.
  • Twenty-four patients had squamous cell carcinoma, three had adenocarcinoma and five had adenosquamous carcinoma.
  • Nedaplatin (30-70 mg/m2) was administered intravenously on day 1 and cisplatin (70 mg/m2) was administered intraarticularly via both uterine arteries on day 3 using the Seldinger method.
  • This course of treatment was repeated every 3 weeks for 2-3 cycles.
  • Response to the therapy was defined by magnetic resonance imaging.
  • These results show that this combination chemotherapy effected a high response rate.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Balloon Occlusion / methods. Cisplatin / administration & dosage. Organoplatinum Compounds / administration & dosage. Uterine Cervical Neoplasms / drug therapy. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adult. Aged. Antineoplastic Agents / administration & dosage. Carcinoma, Adenosquamous / drug therapy. Carcinoma, Adenosquamous / mortality. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / mortality. Female. Follow-Up Studies. Humans. Infusions, Intra-Arterial. Infusions, Intravenous. Middle Aged. Survival Rate

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  • (PMID = 12067139.001).
  • [ISSN] 0251-1649
  • [Journal-full-title] International journal of clinical pharmacology research
  • [ISO-abbreviation] Int J Clin Pharmacol Res
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; Q20Q21Q62J / Cisplatin
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20. Kawase S, Okuda T, Ikeda M, Ishihara S, Itoh Y, Yanagawa S, Ishigaki T: Intraarterial cisplatin/nedaplatin and intravenous 5-fluorouracil with concurrent radiation therapy for patients with high-risk uterine cervical cancer. Gynecol Oncol; 2006 Sep;102(3):493-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraarterial cisplatin/nedaplatin and intravenous 5-fluorouracil with concurrent radiation therapy for patients with high-risk uterine cervical cancer.
  • OBJECTIVE: The purpose of this study was to determine the effectiveness of the combination of intraarterial and intravenous concurrent chemoradiation therapy (CIAIV-CCRT) for the treatment of high-risk uterine cervical cancer.
  • METHODS: Between January 2000 and November 2004, we reviewed 45 cervical cancer patients treated by CIAIV-CCRT.
  • The numbers of patients with stage IB2, IIA, IIB, IIIA, IIIB, and IVA were 3, 6, 14, 1, 17, and 4, respectively.
  • Patients with stage III and IVA or patients with tumors >3 cm in diameter were enrolled in this study.
  • Two sessions of CCRT were administered every 3 weeks using a combination of 70 mg/m2 x h(-1) cisplatin or 50 mg/m2 x h(-1) nedaplatin via the bilateral uterine artery and 2800 mg/m2 x 96 h(-1) 5-fluorouracil intravenously.
  • Patients concurrently received external beam radiation therapy and brachytherapy.
  • A nonrandomized control group of 47 patients who underwent radiation therapy alone between 1993 and 2000 was used for comparison.
  • CONCLUSION: These preliminary results suggest that CIAIV-CCRT can improve the prognosis of patients with high-risk cervical cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Fluorouracil / administration & dosage. Organoplatinum Compounds / administration & dosage. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Infusions, Intra-Arterial. Injections, Intravenous. Middle Aged. Radiotherapy, Adjuvant. Survival Analysis

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  • (PMID = 16478629.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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21. 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 age was 44 years (range, 23-70); stages: IB2: 1, IIB: 9, IIIA: 1, IIIB: 4.
  • 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


22. Eifel PJ, Moughan J, Erickson B, Iarocci T, Grant D, Owen J: Patterns of radiotherapy practice for patients with carcinoma of the uterine cervix: a patterns of care study. Int J Radiat Oncol Biol Phys; 2004 Nov 15;60(4):1144-53
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  • [Title] Patterns of radiotherapy practice for patients with carcinoma of the uterine cervix: a patterns of care study.
  • PURPOSE: To determine the influence of research findings and evolving technology on the practice of radiotherapy in patients with carcinoma of the cervix.
  • METHODS AND MATERIALS: Radiation oncology facilities were randomly selected from two strata: those that treated <500 and those that treated >/=500 new cancer patients annually.
  • Most estimates were based on the 383 patients who had received their initial therapy at a surveyed facility (excluding the 59 patients who were referred for brachytherapy only after initial treatment at another facility).
  • RESULTS: Overall, 40.5%, 25.4%, and 33.9% of patients had Stage IA-IIA, IIB, or IIIA-IVA disease, respectively.
  • We estimated that 27.5% of patients were treated at facilities that treated <==2 patients with intact cervical cancer annually; 43% were treated at facilities that treated <500 new patients annually.
  • Patients treated at small facilities were significantly more likely to have received a total dose to Point A of <80 Gy, to have had their treatment protracted to >70 days, and to have undergone adjuvant hysterectomy or chemotherapy.
  • In large facilities, radiotherapy was less likely to be protracted to >70 days in the 1996-1999 survey than in the 1992-1994 survey (p < 0.0001); however, in small facilities, treatment was more likely to be protracted than in the earlier survey (p = 0.06), contributing to increasing disparities between the treatments given in large and small facilities.
  • The proportion of patients receiving chemotherapy as part of their initial treatment in 1996-1999 (34.6%) was not significantly different statistically from that in 1992-1994 (25.6%; p = 0.3).
  • However, in 1999, 63% of patients had received chemotherapy compared with 19%, 28%, and 26% in 1996, 1997, and 1998, respectively.
  • The details and confirmation of chemotherapy administration were rarely documented in the radiation oncology clinic notes and hospital records.
  • CONCLUSION: The sharp increase in the use of chemotherapy in 1999 suggested rapid application of the results from randomized trials.
  • The practice at small facilities appears to differ significantly from that at larger facilities in several respects, with a statistically significantly larger proportion of treatments at small facilities failing to meet current guidelines for optimal treatment.
  • [MeSH-major] Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adult. Aged. Antineoplastic Agents / therapeutic use. Brachytherapy / trends. Carcinoma, Adenosquamous / drug therapy. Carcinoma, Adenosquamous / pathology. Carcinoma, Adenosquamous / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / therapeutic use. Female. Humans. Hysterectomy. Middle Aged

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  • (PMID = 15519786.001).
  • [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 / CA 56435
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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23. Marnitz S, Köhler C, Füller J, Hinkelbein W, Schneider A: Uterus necrosis after radiochemotherapy in two patients with advanced cervical cancer. Strahlenther Onkol; 2006 Jan;182(1):45-51
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  • [Title] Uterus necrosis after radiochemotherapy in two patients with advanced cervical cancer.
  • BACKGROUND: Simultaneous platinum-based radiochemotherapy is the standard of care for patients with advanced or node-positive cancer of the uterine cervix.
  • A large body of literature concerning therapy-related acute and late morbidity is available.
  • CASE REPORT: Two patients are reported who were treated by combined chemoradiation between 2004 and 2005 for histologically confirmed cervical cancer following laparoscopic staging.
  • Both patients were diagnosed with squamous cell cancer of the cervix FIGO stage IIB (T2b pN1 pM1 LYM G2) and FIGO IIIA (T3a pN1 M0 G2), respectively.
  • Patient #2 underwent 5 x 5 Gy brachytherapy covering the tumor.
  • Following chemoradiation, both patients developed pelvic pain and an elevation of C-reactive protein (CRP) in the presence of a normal leukocyte count.
  • CONCLUSION: In patients with persisting or incident pelvic pain, questionable findings in imaging techniques and/or elevated inflammation parameters following completion of chemoradiation for cervical cancer, differential diagnosis should include radiogenic necrosis of the uterus and other pelvic organs.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Radiation Injuries / etiology. Radiotherapy / adverse effects. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy. Uterus / pathology. Uterus / radiation effects
  • [MeSH-minor] Adult. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Brachytherapy. Cervix Uteri / pathology. Cisplatin / administration & dosage. Cisplatin / therapeutic use. Combined Modality Therapy. Female. Humans. Hysterectomy. Iridium Radioisotopes / therapeutic use. Laparoscopy. Middle Aged. Necrosis. Neoplasm Staging. Ovariectomy. Radiotherapy Dosage. Radiotherapy, Conformal. Time Factors


24. 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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  • [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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25. Cetina L, Garcia-Arias A, Uribe Mde J, Candelaria M, Rivera L, Oñate-Ocaña L, Coronel J, Dueñas-Gonzalez A: Concurrent chemoradiation with carboplatin for elderly, diabetic and hypertensive patients with locally advanced cervical cancer. Eur J Gynaecol Oncol; 2008;29(6):608-12
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  • [Title] Concurrent chemoradiation with carboplatin for elderly, diabetic and hypertensive patients with locally advanced cervical cancer.
  • INTRODUCTION: Chemoradiation based on cisplatin is the standard treatment of locally advanced cervical cancer, however, a subset of patients are either elderly and/or have comorbidities such as diabetes and hypertension.
  • PATIENTS AND METHODS: We reviewed the files of 59 patients with locally advanced cervical cancer who were treated with primary chemoradiation with weekly carboplatin.
  • The majority of cases were squamous cell carcinoma (88.14%), and distribution according to FIGO Stage was IB2 8.4%, IIA 13.5%, IIB 52.5%, IIIA 3.3% and IIIB 18.6%; Overall, 100% and 91% of patients completed external beam and intracavitary therapy.
  • CONCLUSIONS: Weekly carboplatin concurrent with pelvic radiation is well tolerated in patients with locally advanced carcinoma of the cervix who are older than 70 years and/or have diabetes mellitus and/or high blood pressure, however, the apparently slighty lower survival observed cautions against its routine use.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carboplatin / therapeutic use. Diabetes Complications. Hypertension / complications. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy


26. 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
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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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27. Chen Y, Xu H, Li Y, Wang D, Li J, Yuan J, Liang Z: The outcome of laparoscopic radical hysterectomy and lymphadenectomy for cervical cancer: a prospective analysis of 295 patients. Ann Surg Oncol; 2008 Oct;15(10):2847-55
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  • [Title] The outcome of laparoscopic radical hysterectomy and lymphadenectomy for cervical cancer: a prospective analysis of 295 patients.
  • OBJECTIVES: Cervical carcinoma is likely to become one of the most important indications for laparoscopic radical surgery.
  • In our institution, the laparoscopic radical hysterectomy and transperitoneal approach for lymphadenectomy have become the standard techniques for invasive cervical cancer.
  • METHODS: Between February 2001 and June 2007 we performed laparoscopic radical hysterectomies for cervical cancer in 295 patients.
  • The mean operation time was 162 min (range, 110-350), which included the learning curves of 3 surgeons.
  • The overall disease-free survival was 95.2% for Ia, 96.2% for Ib, 84.5% for IIa, 79.4% for IIb, 66.7% for IIIa, and 60.0% for IIIb.
  • CONCLUSION: Laparoscopic radical hysterectomy is a routine, effective treatment for patients with Ia2-IIb cervical carcinoma.
  • With more experience it is envisaged that IIb stage patients can be managed safely offering all the benefits of minimal surgery to the patients.
  • [MeSH-major] Hysterectomy. Laparoscopy. Lymph Node Excision. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / secondary. Adenocarcinoma / surgery. Adult. Aged. Carcinoma, Adenosquamous / drug therapy. Carcinoma, Adenosquamous / secondary. Carcinoma, Adenosquamous / surgery. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / surgery. Disease-Free Survival. Female. Follow-Up Studies. Humans. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Postoperative Complications / etiology. Postoperative Complications / pathology. Prognosis. Prospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 18649105.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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28. 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


29. Yamashita H, Nakagawa K, Tago M, Shiraishi K, Nakamura N, Ohtomo K: Treatment results and prognostic analysis of radical radiotherapy for locally advanced cancer of the uterine cervix. Br J Radiol; 2005 Sep;78(933):821-6
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  • [Title] Treatment results and prognostic analysis of radical radiotherapy for locally advanced cancer of the uterine cervix.
  • This study investigated treatment results and prognostic factors in radical radiotherapy for stage IIB-IVA cervical cancer.
  • This is a retrospective analysis of 71 patients with cancer of the uterine cervix treated radically with external beam radiotherapy and high-dose-rate intracavitary brachytherapy between June 1991 and May 2004.
  • In 47/71 (66%) of patients' chemotherapy was combined with radiotherapy.
  • The median follow-up time was 34.8 months.
  • The median age was 57 years (range 26-78 years) There were 21 patients (30%) in stage IIB, 3 (4%) stage IIIA, 40 (56%) stage IIIB, and 7 (10%) stage IVA.
  • The 5-year overall survival rate was 83.5%, 77.0%, and 42.9% for stage IIB, III, and IVA, respectively.
  • Federation Internationale de Gynocologie et d'Obstetrique (FIGO) classification stage and pelvic and para-aortic nodal status significantly affected survival in univariate analysis, but no treatment-related factor was found to be significant in multivariate analysis.
  • In this study para-aortic nodal status was the most important prognostic factor in the radical radiotherapy of cervical cancer.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Uterine Cervical Neoplasms / radiotherapy

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  • (PMID = 16110104.001).
  • [ISSN] 0007-1285
  • [Journal-full-title] The British journal of radiology
  • [ISO-abbreviation] Br J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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30. Rooker S, Van Schil P, Van den Brande F, De Maeseneer M: Current outcome in patients with lung cancer and positive mediastinoscopy. Acta Chir Belg; 2001 Nov-Dec;101(6):273-6
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  • [Title] Current outcome in patients with lung cancer and positive mediastinoscopy.
  • PURPOSE: A retrospective study was undertaken to determine the contemporary treatment and outcome of patients with lung cancer and positive lymph nodes proven at mediastinoscopy.
  • MATERIAL AND METHODS: From 1994 to 1999 a cervical mediastinoscopy was performed in 361 patients.
  • Metastatic lymph nodes from a bronchogenic carcinoma were present in 81 patients; 71 were men.
  • Squamous cell carcinoma and adenocarcinoma were present in 26 patients each (32.1%), large cell carcinoma in 19 patients (23.4%), small cell carcinoma in six patients (7.4%) and other histologies in four patients (5%).
  • Stage IIIA was found in 51 patients (69.9%), IIIB in 17 (23.3%) and IV in 5 (6.8%).
  • Of eight patients no precise stage could be determined (9.9%).
  • Survival time was analyzed according to the Kaplan-Meier method.
  • RESULTS: Forty-four patients (54.3%) were treated by induction chemotherapy, of which 15 were operated on, 11 patients (13.6%) had chemotherapy only, 11 (13.6%) radiotherapy only, 3 (3.7%) combined chemo- and radiotherapy, 1 patient (1.2%) had an operation only, and 11 (13.6%) received palliative treatment.
  • Median survival time (MST) for all 81 patients was 12 months [95% confidence interval (CI) 10-14 months.].
  • MST for the 15 patients treated by induction chemotherapy + surgery was 27 months [95% CI 18-36 months] and for the 15 patients treated by induction chemotherapy + radiotherapy 15 months [95% CI 12-18 months].
  • For the 11 patients who had palliative treatment MST was 6 months [95% CI 4-8 months].
  • In a multivariate Cox analysis only specific treatment (p = 0.0002) and stage (p = 0.02) were found to be significant.
  • CONCLUSIONS: Outcome of patients with lung cancer and positive mediastinoscopy remains poor.
  • In this retrospective study best results were obtained by induction chemotherapy + surgery.
  • [MeSH-major] Carcinoma, Bronchogenic / surgery. Lung Neoplasms / mortality. Lung Neoplasms / surgery. Mediastinoscopy
  • [MeSH-minor] Adenocarcinoma / surgery. Carcinoma, Large Cell / surgery. Carcinoma, Small Cell / surgery. Carcinoma, Squamous Cell / surgery. Chemotherapy, Adjuvant. Humans. Lymphatic Metastasis. Neoplasm Staging. Prognosis. Retrospective Studies. Treatment Outcome

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  • (PMID = 11868502.001).
  • [ISSN] 0001-5458
  • [Journal-full-title] Acta chirurgica Belgica
  • [ISO-abbreviation] Acta Chir. Belg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Belgium
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31. Pötter R, Dimopoulos J, Georg P, Lang S, Waldhäusl C, Wachter-Gerstner N, Weitmann H, Reinthaller A, Knocke TH, Wachter S, Kirisits C: Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer. Radiother Oncol; 2007 May;83(2):148-55
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer.
  • BACKGROUND: To investigate the clinical impact of MRI based cervix cancer brachytherapy combined with external beam radiochemotherapy applying dose volume adaptation and dose escalation in a consecutive group of patients with locally advanced cervix cancer.
  • METHODS: In the period 1998-2003, 145 patients with cervix cancer stages IB-IVA were treated with definitive radiotherapy +/- cisplatin chemotherapy.
  • Total prescribed dose was 80-85 Gy (total biologically equivalent dose in 2 Gy fractions).
  • Since 2001, MRI based treatment planning integrated systematic concepts for High Risk Clinical Target Volume (HR CTV) and organs at risk (OAR), biological modelling, Dose-Volume-Histogram analysis, dose-volume-adaptation (D90, D 2 cm(3)), and dose escalation, if appropriate and feasible.
  • The mean D90 during the whole period was 86 Gy, with a mean D90 of 81 Gy and 90 Gy during the first and second period, respectively (p<<0.01).
  • PFS for distant metastases remained the same during the two treatment periods with 79% and 80%.
  • Overall survival (OS) was 58%, and cancer-specific survival (CSS) was 68% at 3 years.
  • Actuarial late morbidity rate (LENT SOMA, grades 3 and 4) at 3 years was gastrointestinal 4%, urinary 4% and vaginal 5% (stage IIA/IIIA).
  • INTERPRETATION: In locally advanced extensive cervix cancer, local control of > or = 85% can be achieved with low treatment related morbidity (G3/G4), when exploiting the potential of MRI based 3D treatment planning including dose volume adaptation and dose escalation and a combined intracavitary/interstitial brachytherapy, if appropriate.
  • For locally advanced limited disease the MRI based approach will likely result in assuring excellent local control (> or = 95%) and in minimizing treatment related morbidity.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brachytherapy / methods. Cisplatin / therapeutic use. Magnetic Resonance Imaging. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Combined Modality Therapy. Disease Progression. Dose-Response Relationship, Radiation. Female. Humans. Radiotherapy Dosage. Survival Analysis. Treatment Outcome






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