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Sample records for advanced cervical carcinoma

  1. Concomitant chemo radiation in the treatment of advanced cervical carcinoma

    International Nuclear Information System (INIS)

    The study results of non randomized radio chemotherapy in the cervix cancer treatment are cheering and clinically the answers are faster. However only some randomized studies using hydroxyurea showed a benefit in survival term. The association tolerance of 5 FU with cisplatin is generally acceptable but we don't know yet the long-range toxicity. Finally we'll have to determine in which quantity, the pelvis control improvement should be able to increase the survival rate, because the metastases are frequent in these carcinoma advanced forms. 59 refs., 2 tabs

  2. Role of percutaneous nephrostomy in advanced cervical carcinoma with obstructive uropathy: A case series

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    Kamlesh Mishra

    2009-01-01

    Full Text Available Aims and Objective: Over 70% of the cases present in advanced stages of the disease and are associated with poor prognosis and high mortality rates. In many of them, it is difficult to offer definitive treatment as they present in uremia due to associated obstructive uropathy. There are no clear-cut guidelines for performing percutaneous nephrostomy (PCN in patients of advanced cervical cancer. The results are unpredictable in terms of benefits achieved in these cases. Thus, we evaluated our experiences with PCN in the management of cervical cancer patients presenting with obstructive uropathy. Material and Methods: 15 patients of cervical cancer with obstructive uropathy and deranged renal functions were retrospectively evaluated for the role of PCN in their management Results: PCN was done in 15 patients of advanced cervical cancer. The mean age of patients was 44.5 years. Twelve (80% patients presented primarily with advanced cervical carcinoma and obstructive uropathy. Three (20% were already treated. Symptomatic improvement and significant fall of mean serum creatinine value from 7.5 mg% to 0.9 mg% over a period of 1-3 weeks was noted post PCN. Out of 12 patient with primary untreated advanced disease, curative treatment was possible in 3, palliative radiotherapy/chemo-therapy in 7 and only symptomatic treatment in 2 cases, after obstructive uropathy was managed with PCN insertion. Out of 3 already treated patients, 2 were disease free after curative radiotherapy/surgery. PCN was done to prevent permanent kidney damage in them. One patient was defaulter of curative radiotherapy. She had progressive residual disease. Complications like hemorrhage (20%, infection (26%, reinsertion for dislodgment/misplacement (53%, percutaneous leak or perinephric leak (20%, blockage of PCN (33% were noticed. Conclusion: In spite of inherent, albeit manageable complications, PCN is a simple and safe technique. One of the major benefits observed was

  3. A comparison of concurrent chemoradiotherapy and radiotherapy in Chinese patients with locally advanced cervical carcinoma: a multi-center study

    International Nuclear Information System (INIS)

    We investigated the efficacy of concurrent chemoradiotherapy (CCRT) over radiotherapy (RT) in Chinese patients with locally advanced cervical carcinoma. Between January 2005 and January 2008, 192 patients with squamous cell carcinoma of the cervix were included in the study: 96 in arm A (CCRT with 20 mg/m2 cisplatin for 5 days) and 96 in arm B (RT). The overall response rate was the primary endpoint. The secondary endpoints included overall survival, progression-free survival, and toxicity. The 5-year overall response rate was 67% and 53% for the CCRT and RT arms, respectively, and the difference was statistically significant, while the median overall survival was 68 months (range 3-85 months) and 61 months (range 4-83 months), respectively (P = 0.009). In addition, the median progression-free survival for CCRT was 62 months (range 3-83 months), whereas it was 51 months (range 4-81 months) for the RT arm (P = 0.025). The toxicity profile, both acute and late, was comparable in both arms. In summary, we demonstrate that CCRT was effective and better tolerated than RT alone in Chinese patients with locally advanced cervical carcinoma.

  4. GENETIC INSTABILITY IN CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    赵旻; 伍欣星; 邱小萍; 李晖; 戴天力; 谭云

    2002-01-01

    Objective: The role of human papillomavirus (HPV) in the development of cervical carcinoma has been clearly established but other factors could be involved in cervical tumorigenesis such as loss of heterozygosity (LOH) and microsatellite instability (MI). The aim of the present study was to investigate the genetic instability in cervical carcinoma tissues and provide evidence for discoveringnew tumor suppressor genes and screening diagnostic molecular marker of cervical carcinoma. Methods: Fifty primary cervical carcinoma samples from high-incidence area were analyzed by PCR for HPV16 infection, LOH and microsatellite instability. Results: HPV16 was detected in 88% of the cases. Sixty-six percent of total cases showed LOH with no more than 3 different loci per case. The highest frequency of the allelic loss was found in D18S474 (18q21, 40.5%). MI was detected in 4 cases (8%) only. Conclusion: Different percentages of LOH on specific chromosomal regions were found and MI was very infrequent in cervical carcinoma. The putative suppressor gene(s) could be located on specific chromosome regions such as 18q, and genetic instability could be involved in cervical tumorigenesis.

  5. Invasive cervical carcinoma (Stages IB-IIB)

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    In the patients with invasive cervical carcinoma, the accurate assessment of parametrial invasion greatly affects the therapeutic choice between surgery and radiation therapy. As a matter of fact, surgery is usually performed only in the patients with carcinoma confined to the cervix, whereas those with parametrial involvement, or more advanced stages, are treated with radiation therapy. This prospective study was aimed at investigating the comparative adequecy of CT and MR imaging in assessing parametrial status in the patients with invasive cervical cancer. Twenty-one consecutive patients, with histologic diagnosis of cervical carcinoma, were investigated. All of them were clinically considered as having invasive cervical cancer (FIGO stage IB-IIB) and subsequently underwent surgery. In all cases, detailed histology of the parametrium was obtained. Pathological data were compared with CT and MR findings in all cases. As for assessing parametrial involvement by cancer, CT had 62% accuracy, 63% sensitivity, and 60% specificity, versus MR imaging 81% accuracy, 69% sensitivity, and 80% specificify. Therefore, MR imaging appears to be superior to CT in assessing the parametrial status of patients with invasive cervical carcinoma; the method yields valuable information for treatment planning

  6. PROGNOSTIC FACTORS IN CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    路平; 梁秋冬; 魏磊; 郑全庆

    2002-01-01

    Objective: To evaluate factors for prognosis of cervical carcinoma. Methods: Expressions of mn23- HI, erbB3 and erbB4 were examined by immunohistochemical staining. The apoptosis was detected in situ by the TdT mediated duip-biotin nick end-labeling (TUNEL) technique. Mitotic cell were counted by HE dyeing. Results: FIGO stage and lymph node metastasis were the most important factors for evaluating prognosis in adenocarcinoma or squamous cell carcinoma. AI/MI was positively correlated with 5-year survival of cervical carcinoma. Positive expression of nm23-H1 combed with negative expression of erbB4 [nm23-H1(+)/erbB4(-)] predicted good prognosis for adeno-carcinoma. In multivariable Cox regression analysis, only FIGO stage and AI/MI were into equation. Conclusion: FIGO stage and AI/MI were independent evaluating parameter for adenocarcinoma or squamous cell carcinoma.

  7. Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma

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    Wootton, Jeffery H.; Hsu, I-Chow Joe; Diederich, Chris J. [Thermal Therapy Research Group, Department of Radiation Oncology, University of California, San Francisco, California 94115 (United States) and Joint Graduate Group in Bioengineering, University of California, Berkeley and San Francisco, California 94115 (United States)

    2011-02-15

    Purpose: The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Methods: Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6-7.4 MHz that are unsectored (360 deg.), bisectored (2x180 deg.), or trisectored (3x120 deg.) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. Results: The CTV in HDR brachytherapy plans extends 20.5{+-}5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4{+-}7.3 mm from the tandem. Simulations indicate that for 60

  8. ERCC1 mRNA levels can predict the response to cisplatin-based concurrent chemoradiotherapy of locally advanced cervical squamous cell carcinoma

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate whether the excision repair cross-complementation group 1 (ERCC1) mRNA expression could predict treatment response of patients with locally advanced cervical squamous cell carcinoma (LACSCC) who underwent cisplatin-based concurrent chemoradiotherapy (CCCRT). A total of sixty LACSCC patients, treated with radical CCCRT from a single institution were evaluated. ERCC1 mRNA expression was determined by quantitative real-time RT-PCR in pre-treatment tumor tissues. The association of ERCC1 status with clinicopathological characteristics (age, histological grade, tumor size, parametrial invasion, lymph node metastasis and FIGO stage) and treatment response were analyzed. No significant association between ERCC1 mRNA expression and clinicopathological characteristics were observed. Patients with low ERCC1 mRNA level had a significantly higher rate of complete response (86.21%) than patients with high level of ERCC1 expression (19.36%; p < 0.001). In the logistic regression analysis, low ERCC1 mRNA level retained an independent role in predicting complete response to CCCRT (P < 0.001). An ERCC1 expression level of 0.0901 was determined as an optimal cutoff value to identify complete response patients to CCCRT treatment. The sensitivity for detection of a complete response was 81.48% with a specificity of 96.97% (area under the curve, 0.893; 95% confidence interval, 0.804–0.983). This is the first analysis of the association between ERCC1 mRNA levels and treatment response in patients with LACSCC. Low ERCC1 mRNA level appears to be a highly specific predictor of response to CCCRT in LACSCC

  9. The role of MR imaging in invasive cervical carcinoma

    International Nuclear Information System (INIS)

    In this article the role of MR imaging in the management of cervical cancer is reviewed and illustrated. The appearance of the normal uterine cervix and of cervical carcinoma is shown. Important factors for optimal MR imaging of cervical carcinoma are reviewed. The value of MR imaging in the staging of cervical carcinoma is illustrated by showing parametrial invasion and lymph node involvement. Finally, the value of MR imaging staging is compared with clinical staging, CT staging, and surgical findings. The role of new imaging techniques, such as fast dynamic enhanced MR imaging, is described. (orig.)

  10. Cervical invasion of endometrial carcinoma - evaluation by parasagittal MR imaging

    International Nuclear Information System (INIS)

    Twenty-seven consecutive patients were examined by T2-(1800/70 ms) and postcontrast T1-weighted (600/15) spin echo (SE) or dynamic (200/15) SE MR imaging to determine the usefulness of parasagittal MR imaging in assessing cervical invasion of endometrial carcinoma. The images were obtained in a direction parallel to the longitudinal axis of the uterus (parasagittal). The cervical epithelium, being hyperintense on the late phase dynamic and postcontrast T1-weighted SE images, had disappeared partially or totally in all 4 patients with cervical invasion. The enhanced cervical epithelium was completely seen in one patient with the tumor protruding into the cervical canal in a polyp-like form without cervical epithelial invasion. The same was also seen in the 22 patients with the tumor remaining in the corpus cavity. The enhanced parasagittal MR images facilitated the evaluation of the extent of the endometrial carcinoma. (orig.)

  11. Radiosensitivity testing of primary cervical carcinoma

    International Nuclear Information System (INIS)

    Biopsies from 89 patients with cervical carcinoma were studied using a clonogenic assay to obtain values for the surviving fraction at 2 Gy (SF2). Heterogeneity in intrinsic radiosensitivity was investigated by independently processing multiple biopsies from 18 tumors. No significant differences between intratumour SF2 values were demonstrated (p = 0.30). The results have shown that intra-tumour heterogeneity is not a limitation to radiosensitivity testing using the Courteney-Mills assay. A wide range of values (0.13-0.97) for SF2 was obtained with a mean value of 0.47 ± 0.18 (± 1 S.D., CV = 38%) for 52 squamous cell carcinomas and 0.59 ± 0.27 for four adenocarcinomas. There were statistically significant differences between the individual tumours (P 2 results it appears to be the surviving fractions below about 0.40 and those above about 0.7 which show significant differences in radiosensitivity between pairs of tumours (p = 0.05). Also 36% of the values of SF2 show significant differences from the mean SF2 of all tumours. The storage of tumour cell suspensions in liquid nitrogen improved the colony-forming efficiency (CFE) but it did not alter the radiosensitivity. (author). 26 refs.; 5 figs.; 1 tab

  12. Fludeoxyglucose F 18 PET Scan, CT Scan, and Ferumoxtran-10 MRI Scan Before Chemotherapy and Radiation Therapy in Finding Lymph Node Metastasis in Patients With Locally Advanced Cervical Cancer or High-Risk Endometrial Cancer

    Science.gov (United States)

    2015-11-09

    Cervical Adenocarcinoma; Cervical Adenosquamous Cell Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Stage I Endometrial Carcinoma; Stage IB Cervical Cancer; Stage II Endometrial Carcinoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Endometrial Carcinoma; Stage IVA Cervical Cancer

  13. Combined measurement of tumor perfusion and glucose metabolism for improved tumor characterization in advanced cervical carcinoma. A PET/CT pilot study using [15O]water and [18F]fluorodeoxyglucose

    International Nuclear Information System (INIS)

    The aim of this pilot study was (1) to evaluate the combination of [18F]fluorodeoxyglucose (FDG) and [15O]water for detection of flow-metabolism mismatch in advanced cervical carcinomas, i.e., increased glycolysis at low blood flow, as a possible parameter for prediction of response to treatment, and (2) to propose a method for automated quantification of its spatial extent. The study retrospectively included 10 women with advanced cervical carcinoma in whom PET with both FDG and [15O]water had been performed prior to therapy. The metabolically active tumor volume was delineated automatically in the FDG images. For computation of the regional blood flow in the tumor, a recovery corrected image-derived arterial input function was used. A tumor voxel was classified as mismatched when the voxel SUV of FDG was larger than the median tumor SUV and the voxel perfusion (K1) was smaller than the median perfusion. The absolute mismatch volume (aMMV) was defined as the volume of all mismatched voxels in ml, and the relative mismatch volume (rMMV) as the ratio of the aMMV to the metabolic tumor volume in percent. The tumors were quite heterogeneous with respect to both FDG uptake and perfusion. The aMMV clustered into 2 groups: ''large aMMV'' ≥ 10 ml in 40 % of patients and ''small aMMV'' ≤ 5 ml in 60 % of patients. The rMMV ranged from 12.7-24.9 %. There was no correlation between rMMV and metabolic tumor volume. There was a tendency (p = 0.126) for an association between rMMV and histological grading, rMMV being about 20 % higher in G3 than in G2 tumors. rMMV did not correlate with SUV or perfusion. These results suggest that combined PET with FDG and [15O]water allows detection and quantitative characterization of flow-metabolism mismatch in advanced cervical carcinomas. (orig.)

  14. Relationship between Cell Proliferation and Apoptosis in Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To study the relationship between cell proliferation and apoptosis in cervical carcinoma and its clinical significance.Methods The cell proliferation and apoptosis of cervical epithelial cells in archival formalin-fixed,paraffin-embedded tissue sections of normal cervix ,cervical intraepithelial neoplasms(CN) and cervical squamous carcinoma were tested by using immunohistochemistry assay and DNA nick end-labeling technigue.The proliferation index(PI) and apoptosis index(AI) were calculated and their correlation with clinical and pathological data was analyzed. Results PI was gradually increased,but the AI and AI/PI ratio decreased from normal cervical epithelium,CIN to cervical carcinoma. There was no significant relationship among cell proliferation,apoptosis,clinical stages and pathological grades.High AI was always asso-ciated with a poor prognosis of the patients. Conclusion Cell proliferation and apoptosis allow to distinguish among normal epithelium,CIN and cervical carcinoma and are useful for the assessment of the malignant potential of tumor tissues.

  15. Imaging advances in upper cervical vertebral disease

    International Nuclear Information System (INIS)

    Upper cervical vertebral has complex anatomic structure and some diseases may involve this vital center area of human body. Most of the diseases, such as trauma, malformation, and degeneration, need to be treated with surgery to recover the function of cervical vertebral. The accurate evaluation is crucial before and after the surgery. In the past few years, CT, MRI, and ultra-sound play important roles in the evaluation of upper cervical vertebral diseases and planning treatment. Comprehensive evaluation with multidisciplinary approach is advocated. In this paper we reviewed the anatomy and clinic treatments; summarized the latest imaging advances in upper cervical vertebral disease; discussed the perspective of comprehensive evaluation with multidisciplinary approach. (authors)

  16. Persistence of endometrial activity after radiation therapy for cervical carcinoma

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    Radiation therapy is a proved treatment for cervical carcinoma; however, it destroys ovarian function and has been thought to ablate the endometrium. Estrogen replacement therapy is often prescribed for patients with cervical carcinoma after radiation therapy. A review of records of six teaching hospitals revealed 16 patients who had endometrial sampling for uterine bleeding after standard radiation therapy for cervical carcinoma. Fifteen patients underwent dilatation and curettage, and one patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy when a dilatation and curettage was unsuccessful. Six patients had fibrosis and inflammation of the endometrial cavity, seven had proliferative endometrium, one had cystic hyperplasia, one had atypical adenomatous hyperplasia, and one had adenocarcinoma. Although the number of patients who have an active endometrium after radiation therapy for cervical carcinoma is not known, this report demonstrates that proliferative endometrium may persist, and these patients may develop endometrial hyperplasia or adenocarcinoma. Studies have indicated that patients with normal endometrial glands have an increased risk of developing endometrial adenocarcinoma if they are treated with unopposed estrogen. Patients who have had radiation therapy for cervical carcinoma should be treated with estrogen and a progestational agent to avoid endometrial stimulation from unopposed estrogen therapy

  17. Peritumoral interstitial fluid flow velocity predicts survival in cervical carcinoma

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    Background and purpose: High tumor interstitial fluid pressure (IFP) is associated with poor outcome in locally advanced carcinoma of the uterine cervix. We have recently developed a noninvasive assay of the IFP of tumors, and in this assay, the outward interstitial fluid flow velocity at the tumor surface (v0) is measured by Gd-DTPA-based DCE-MRI and used as a parameter for IFP. Here, we investigated the independent prognostic significance of v0 in cervical cancer patients given cisplatin-based concurrent chemoradiotherapy with curative intent. Patients: The study involved 62 evaluable patients from a cohort of 74 consecutive patients (Stage IB through IIIB) with a median follow-up of 5.5 years. Results: The actuarial disease-free survival (DFS) and overall survival (OS) at 5 years were 67% and 76%, respectively. Significant associations were found between v0 dichotomized about the median value and DFS and OS, both in the total patient cohort and a subcohort of 40 Stage IIB patients. Multivariate analysis involving stage, tumor volume, lymph node status, and v0 revealed that only v0 provided independent prognostic information about DFS and OS. Conclusion: This investigation demonstrates a strong, independent prognostic impact of the pretreatment peritumoral fluid flow velocity in cervical cancer

  18. Cervical carcinoma and sexual behavior: collaborative reanalysis of individual data on 15,461 women with cervical carcinoma and 29,164 women without cervical carcinoma from 21 epidemiological studies

    DEFF Research Database (Denmark)

    Kjær, Susanne Krüger

    2009-01-01

    sexual partners and age at first sexual intercourse from 21 studies, or groups of studies, including 10,773 women with invasive cervical carcinoma, 4,688 women with cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ, and 29,164 women without cervical carcinoma. Relative risks for.......27 [95% confidence interval (95% CI), 1.98-2.61] and increased to 2.78 (95% CI, 2.22-3.47) after additional conditioning on reproductive factors. The risk of invasive cervical carcinoma increased with earlier age at first intercourse (P for linear trend <0.001). The relative risk for age at first...

  19. Enterobius vermicularis infestation masquerading as cervical carcinoma: A cytological diagnosis.

    Science.gov (United States)

    Raju, Kalyani; Verappa, Seema; Venkataramappa, Srinivas Murthy

    2015-01-01

    Although prevalence of Enterobius vermicularis (EV) infestation in Intestines ranges from 35% to 70%, its prevalence in female genital tract is not known despite several incidental findings. Acute inflammatory cells in the background of cervical Pap smear indicate infestation and should not be neglected as contamination. A 40-year-woman presented with white vaginal discharge persistent for past 1 year. Local examination showed hypertrophied cervix with eversion of both lips and hard consistency of the anterior lip of cervix. A clinical diagnosis of cervical carcinoma was made. However, cervical Pap smear indicated EV eggs in an inflammatory background, treatment to which resulted in completely recovery. PMID:26283859

  20. A Phase II Study of Bevacizumab in Combination With Definitive Radiotherapy and Cisplatin Chemotherapy in Untreated Patients With Locally Advanced Cervical Carcinoma: Preliminary Results of RTOG 0417

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    Schefter, Tracey E., E-mail: tracey.schefter@ucdenver.edu [University of Colorado-Denver, Aurora, CO (United States); Winter, Kathryn [RTOG Statistical Center, Philadelphia, PA (United States); Kwon, Janice S. [University of British Columbia and BC Cancer Agency, Vancouver, BC (Canada); Stuhr, Kelly [Anschutz Cancer Pavilion, Aurora, CO (United States); Balaraj, Khalid [King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Yaremko, Brian P. [University of Western Ontario, London Regional Cancer Program, London, ON (Canada); Small, William [The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (United States); Gaffney, David K. [University of Utah Health Science Center, Salt Lake City, UT (United States)

    2012-07-15

    Purpose: Concurrent cisplatin-based chemoradiotherapy (CRT) is the standard treatment for locally advanced cervical cancer. RTOG 0417 was a Phase II study exploring the safety and efficacy of the addition of bevacizumab to standard CRT. Methods and Materials: Eligible patients with bulky tumors (Stage IB-IIIB) were treated with once-weekly cisplatin (40 mg/m{sup 2}) chemotherapy and standard pelvic radiotherapy and brachytherapy. Bevacizumab was administered at 10 mg/kg intravenously every 2 weeks for three cycles. Treatment-related serious adverse event (SAE) and other adverse event (AE) rates within the first 90 days from treatment start were determined. Treatment-related SAEs were defined as any Grade {>=}4 vaginal bleeding or thrombotic event or Grade {>=}3 arterial event, gastrointestinal (GI) bleeding, or bowel/bladder perforation, or any Grade 5 treatment-related death. Treatment-related AEs included all SAEs and Grade 3 or 4 GI toxicity persisting for >2 weeks despite medical intervention, Grade 4 neutropenia or leukopenia persisting for >7 days, febrile neutropenia, Grade 3 or 4 other hematologic toxicity, and Grade 3 or 4 GI, renal, cardiac, pulmonary, hepatic, or neurologic AEs. All AEs were scored using the National Cancer Institute Common Terminology Criteria (CTCAE) v 3.0 (MedDRA version 6.0). Results: A total of 60 patients from 28 institutions were enrolled between 2006 and 2009, and of these, 49 patients were evaluable. The median follow-up was 12.4 months (range, 4.6-31.4 months).The median age was 45 years (range, 22-80 years). Most patients had FIGO Stage IIB (63%) and were of Zubrod performance status of 0 (67%). 80% of cases were squamous. There were no treatment-related SAEs. There were 15 (31%) protocol-specified treatment-related AEs within 90 days of treatment start; the most common were hematologic (12/15; 80%). 18 (37%) occurred during treatment or follow-up at any time. 37 of the 49 patients (76%) had cisplatin and bevacizumab

  1. A case of radiation induced carcinoma of the cervical esophagus

    International Nuclear Information System (INIS)

    A patient with carcinoma of the cervical esophagus who visited a hospital with a complaint of difficulty in swallowing was reported. This patient was a 50 year old woman. It was 32 years since she had had external irradiation with x- ray over the neck for Basedow's disease at the age of 18. From the age of 30, she had had hypothyroidism and had used thyroid. She became aware of difficulty in swallowing in October, 1976. Then this symptom progressed gradually, and she also had hoarseness. She visited a hospital in August, 1977. At the first medical examination, pigmentation and atrophic changes in the neck induced by radiation were observed, and some lymphnodes with the size of a red bean were palpated. Esophageal roentogenography revealed circular and spiral type lesion in the cervical esophagus, which was 4 cm in length and had a clear boundary. Endoscopic examination revealed circular stenotic lesion. This lesion was diagnosed as squamous cell carcinoma by biopsy. Total of 3,000 rad of Linac x-ray was irradiated over the neck and the clavicle before operation. Operation findings revealed fibrosis, atrophy, and hardening of the thyroid gland caused by radiation. Carcinoma with the size 35 mm x 18 mm was limited to the cervical esophagus, and the degree of the progress was A2, N2, M0 (Pl0). Histological findings revealed moderately differentiated squamous cell carcinoma and its metastases to the right supraclaviclar lymphnodes. This carcinoma was diagnosed as radiation-induced carcinoma of the cervical esophagus, because this patient had had irradiation over the neck, locally marked atrophic changes and scar remained, and carcinoma occurred in the area which had been irradiated with x-ray. (Tsunoda, M.)

  2. Expression of IMP3 protein in cervical carcinoma and the significance of its relationship with MVD

    Institute of Scientific and Technical Information of China (English)

    Ming Li; Ya-Jun Zhang

    2015-01-01

    Objective:To study the expressions of IMP3 and MVD in normal cervical tissue, CIN, and squamous cell carcinoma of cervix and investigate their relationship with the occurrence and development of cervical carcinoma.Methods:Immunohistochemistry S-P method was used to detect the expressions of IMP3 and MVD in 50 cervical invasive carcinoma tissues, 35 CIN tissues and 15 cervicitis tissues respectively.Results: There were significant differences in pair wise comparison of the expressions of IMP3 and MVD in cervical carcinoma, CIN and normal cervical tissues (P<0.05). IMP3 and MVD value were highly expressed in cervical carcinoma tissues, and were correlated with clinical staging, lymphatic metastasis and differentiation degree of cervical carcinoma (P<0.05); IMP3 and MVD value were correlated with their expressions in cervical carcinoma tissues (r=0.323P=0.022).Conclusion: IMP3 and MVD are associated with the occurrence as well as the invasion and metastasis of cervical carcinoma, and can be used as a proper indicator of the malignancy degree and prognosis of cervical carcinoma.

  3. Cervical carcinoma: Changing trends in management

    International Nuclear Information System (INIS)

    The most important improvement in the treatment of patients with invasive carcinoma of the uterine cervix during th elast decades can mainly be ascribed to the fact that most patients are nowadays diagnosed at an early stage. However, refinements of surgery and radiotherapy most certainly have decreased the morbidity of treatment; besides this, the optimal use of each modality as well as the combination of both methods may have led to some, albeit small, increase in curing rate. In this report the clinical experience in 472 patients is described. Since any improvement in results can only be achieved after a careful analysis of failures, special attention is paid to the pattern of recurrence. In stage IB or IIA with proven absence of pelvic lymph node metastases, prognosis is excellent. In case of pelvic metastases, however, prognosis is rather bad, especially if more than one grup of lymph nodes is involved. Since many recurrences in this group are still confined to the para-aortic region, some improvement is to be expected by extending the postoperative irradiation field to the para-aortic lymph nodes. With advancing stage or larger tumor volume, the relative chance of intrapelvic recurrence increases. In this category of patients, all efforts should be directed to optimize locoregional treatment; the use of radiosensitizing agents and especially the combination of cytostatics followed by radiotherapy may be useful. Extension of the treatment to the paraaortic nodes is only worthwhile in case of initial favourable response of the primary tumor. (orig.)

  4. RTOG 0417: Efficacy of Bevacizumab in Combination With Definitive Radiation Therapy and Cisplatin Chemotherapy in Untreated Patients With Locally Advanced Cervical Carcinoma

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    Schefter, Tracey, E-mail: tracey.schefter@ucdenver.edu [University of Colorado, Denver, Aurora, Colorado (United States); Winter, Kathryn [RTOG Statistical Center, Philadelphia, Pennsylvania (United States); Kwon, Janice S. [University of British Columbia and BC Cancer Agency, Vancouver, British Columbia (Canada); Stuhr, Kelly [University of Colorado, Denver, Aurora, Colorado (United States); Balaraj, Khalid [King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Yaremko, Brian Patrick [Western University, London Regional Cancer Program, London, Ontario (Canada); Small, William [Loyola University Chicago Stritch School of Medicine, Chicago, Illinois (United States); Sause, William [Intermountain Medical Center, Murray, Utah (United States); Gaffney, David [University of Utah Health Sciences Center, Salt Lake City, Utah (United States)

    2014-01-01

    Purpose: Radiation Therapy Oncology Group 0417 was a phase II study that explored the safety and efficacy of the addition of bevacizumab to chemoradiation therapy. The safety results have been previously reported. Herein we report the secondary efficacy endpoints of overall survival (OS), locoregional failure (LRF), para-aortic nodal failure (PAF), distant failure (DF), and disease-free survival (DFS). Methods and Materials: Eligible patients with bulky Stage IB-IIIB disease were treated with once-weekly cisplatin (40 mg/m{sup 2}) chemotherapy and standard pelvic radiation therapy and brachytherapy. Bevacizumab was administered at 10 mg/kg intravenously every 2 weeks for 3 cycles during chemoradiation. For OS, failure was defined as death of any cause and was measured from study entry to date of death. LRF was defined as any failure in the pelvis. PAF was defined as any para-aortic nodal failure. DF was analyzed both including and excluding PAF. DFS was measured from study entry to date of first LRF. DF was measured with or without PAF or death. OS and DFS were estimated by the Kaplan-Meier method, and LRF and DF rates were estimated by the cumulative incidence method. Results: 49 eligible patients from 28 institutions were enrolled between 2006 and 2009. The median follow-up time was 3.8 years (range, 0.8-6.0 years). The surviving patients had a median follow-up time of 3.9 years (range, 2.1-6.0 years). Most patients had tumors of International Federation of Gynecology and Obstetrics Stage IIB (63%), and 80% were squamous. The 3-year OS, DFS, and LRF were 81.3% (95% confidence interval [CI], 67.2%-89.8%), 68.7% (95% CI, 53.5%-79.8%), and 23.2% (95% CI, 11%-35.4%), respectively. The PAF, DF without PAF, and DF with PAF at 3 years were 8.4% (95% CI, 0.4%-16.3%), 14.7% (95% CI, 4.5%-24.9%), and 23.1% (95% CI 11.0%-35.2%), respectively. Conclusion: In this study, bevacizumab in combination with standard pelvic chemoradiation therapy for locally advanced cervical

  5. MRI and PET Imaging in Predicting Treatment Response in Patients With Stage IB-IVA Cervical Cancer

    Science.gov (United States)

    2016-06-24

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Cervical Undifferentiated Carcinoma; Recurrent Cervical Carcinoma; Stage IB2 Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  6. Intestinal damage and malabsorption after treatment for cervical carcinoma

    International Nuclear Information System (INIS)

    Sixty-two patients with cervical carcinoma were treated in 1966 to 1968. Thirty-two patients who were alive in 1982 were reevaluated concerning intestinal function. An initial low folate value associated with the disease did not correlate with prognosis. A late low folate value indicated malabsorption and not recurrence of the carcinoma. Malabsorption was found in 5/23 patients (22%) and 3 of these (13%) had vitamin B12 deficiency. Intestinal damage in tumour free patients occurred in 2/62 (3%) patients. It is suggested that late silent complications such as malabsorption should be looked for in the preventive care of these patients. (Auth.)

  7. Molecular Backgrounds of ERAP1 Downregulation in Cervical Carcinoma

    OpenAIRE

    Mehta, Akash M.; Michelle Osse; Sandra Kolkman-Uljee; Gert Jan Fleuren; Jordanova, Ekaterina S.

    2015-01-01

    The antigen processing machinery (APM) plays an important role in immune recognition of virally infected and transformed cells. Defective expression of the APM component ERAP1 is associated with progression and poor clinical outcome in cervical carcinoma. However, the underlying mechanisms of ERAP1 protein downregulation remain to be established. We investigated ERAP1 mRNA expression levels in 14 patients with established ERAP1 protein downregulation. To further examine the possible pretransc...

  8. The Prevalence and pattern of HPV-16 immunostaining in uterine cervical carcinomas in Ethiopian women: a pilot study

    Directory of Open Access Journals (Sweden)

    Mona M Rashed

    2011-03-01

    Full Text Available INTRODUCTION: Cancer of the cervix uteri is the second most common cancer among women worldwide. The association of human papillomavirus (HPV infection with cervical carcinogenesis is well documented. This is a pilot study aiming to studying the prevalence and the pattern of Human Papilloma Virus Type 16 (HPV16 by immunostaining in the tissues of cervical carcinomas of Ethiopian women. METHODS: 20 specimens of uterine cervical carcinomas were studied histopathologically and immunohistochemically for HPV16. RESULTS: Histologically the specimens were classified as: Ten cases were Non Keratinized Squamous cell carcinoma (NKSCC, six cases were Keratinized Squamous Cell Carcinoma (KSCC and four cases were Adenocarcinoma (ADC. Immunohistochemistry study showed positivity in eleven cases (55%; seven cases (35% were non-keratinized squamous cell carcinoma; three cases (15% were keratinized squamous cell carcinoma and one case (5% belonged to the adenocarcinomas. CONCLUSION: This study reveals a significant detection of HPV in Ethiopian women by the use of advanced techniques such as Immunohistochemistry (IHC. The data of this study suggested that the marked expression of the HPV 16 was in the less differentiated uterine cervix carcinomas

  9. Plasma proteome analysis of cervical intraepithelial neoplasia and cervical squamous cell carcinoma

    Indian Academy of Sciences (India)

    Mee Lee Looi; Saiful Anuar Karsani; Mariati Abdul Rahman; Ahmad Zailani Hatta Mohd Dali; Siti Aishah Md Ali; Wan Zurinah Wan Ngah; Yasmin Anum Mohd Yusof

    2009-12-01

    Although cervical cancer is preventable with early detection, it remains the second most common malignancy among women. An understanding of how proteins change in their expression during a particular diseased state such as cervical cancer will contribute to an understanding of how the disease develops and progresses. Potentially, it may also lead to the ability to predict the occurrence of the disease. With this in mind, we aimed to identify differentially expressed proteins in the plasma of cervical cancer patients. Plasma from control, cervical intraepithelial neoplasia (CIN) grade 3 and squamous cell carcinoma (SCC) stage IV subjects was resolved by two-dimensional gel electrophoresis and the resulting proteome profiles compared. Differentially expressed protein spots were then identified by mass spectrometry. Eighteen proteins were found to be differentially expressed in the plasma of CIN 3 and SCC stage IV samples when compared with that of controls. Competitive ELISA further validated the expression of cytokeratin 19 and tetranectin. Functional analyses of these differentially expressed proteins will provide further insight into their potential role(s) in cervical cancer-specific monitoring and therapeutics.

  10. Endogenous sex steroids and risk of cervical carcinoma: results from the EPIC study

    DEFF Research Database (Denmark)

    Rinaldi, Sabina; Plummer, Martyn; Biessy, Carine;

    2011-01-01

    Epidemiologic data and animal models suggest that, despite the predominant role of human papillomavirus infection, sex steroid hormones are also involved in the etiology of invasive cervical carcinoma (ICC).......Epidemiologic data and animal models suggest that, despite the predominant role of human papillomavirus infection, sex steroid hormones are also involved in the etiology of invasive cervical carcinoma (ICC)....

  11. A PRELIMINARY STUDY ON SURVIVIN AND BCL-2 EXPRESSION IN CERVICAL CARCINOMAS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To study the expression of a novel inhibitor of apptosis and survivin in cervical carcinoma and its relationship to the expression of Bcl-2.Methods Using SP immunohistochemical technique, we examined the expression of survivin and Bcl-2 in 59 cervical invasive squamous cell carcinomas.Results Survivin was expressed in 41 of 59 cases(69.5%) of cervical carcinomas. In contrast, no expression of survivin in normal cervical tissues was observed. Overexpression of survivin was related to the tumor grade and clinical stage. Survivin positive cases were strongly associated with Bcl-2 expression(80% versus 35.7%;P<0.005).Conclusion Apoptosis inhibition by survivin abnormal expression, alone or in cooperation with Bcl-2, may participate in the onset and progression of cervical carcinoma. Survivin is a new diagnostic/therapeutic target in cervical cancer.

  12. Inhibitory effects of Arhgap6 on cervical carcinoma cells.

    Science.gov (United States)

    Li, Junping; Liu, Yang; Yin, Yihua

    2016-02-01

    Ras homology GTPase activation protein 6 (Arhgap6), as a member of the rhoGAP family of proteins, performs vital functions on the regulation of actin polymerization at the plasma membrane during several cellular processes. The role of Arhgap6 in the progression and development of cancer remains nearly unknown. This study aimed at exploring the effects of Arhgap6 on cervical carcinoma. Human cervical cancer cells HeLa and SiHa were transduced with a lentivirus targeting Arhgap6 (Arhgap6+), while CaSki and C4-1 cells were transfected with miRNA. Cell proliferation was identified by Cell Counting Kit-8 (CCK-8). Cell cycle distribution and cell apoptosis were identified by flow cytometry. The capacity of cell migration, invasion, and adhesion were detected by Transwell assay. Further, quantitative real-time PCR (qRT-PCR) and western blot were used to analyze the expression levels of Arhgap6 and several tumor-related genes. Co-immunoprecipitation assay was performed to validate the interaction between Arhgap6 and Rac3 (Ras-related C3 botulinum toxin substrate 3). Results showed that Arhgap6 inhibited cell proliferation, migration, invasion, and adhesion of cervical carcinoma, induced cell apoptosis, and caused cell cycle arrest in the G0/G1 phase (n = 3, p < 0.05). Expression of the tumor suppressor genes and oncogenes were up- and down-regulated respectively by Arhgap6, and Rac3 was proved to be the target of Arhgap6. Besides, in in vivo assays, tumor size and weight were destructed in Arhgap6+ athymic nude mouse. This study indicated that Arhgap6 may play a role in the treatment of cervical cancer as a tumor supressor. PMID:26628301

  13. Staging of Cervical Lymph Nodes in Oral Squamous Cell Carcinoma

    DEFF Research Database (Denmark)

    Norling, Rikke; Buron, Birgitte Marie Due; Therkildsen, Marianne Hamilton;

    2014-01-01

    INTRODUCTION: Clinical staging of patients with oral squamous cell carcinoma (OSCC) is crucial for the choice of treatment. Computed tomography (CT) and/or magnetic resonance imaging (MRI) are typically recommended and used for staging of the cervical lymph nodes (LNs). Although ultrasonography (US...... patients (6%) were over-staged by US. CONCLUSION: The addition of US to the clinical work-up of patients with cN0 OSCC increases the detection of metastases, thus US potentially reduces the number of patients requiring a secondary neck surgery after sentinel node biopsy....

  14. Preliminary comparative proteomics study of cervical carcinoma tissues with different sensitivity to concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    Objective: To investigate the proteomics differences between the high-sensitivity(HS) and the low-sensitivity(LS) groups of cervical carcinoma treated by concurrent chemoradiotherapy, and to confirm the sensitivity associated proteins in intermediate stage and advanced cervical carcinoma. Methods: Fresh carcinoma tissues were collected from 10 untreated cervical carcinoma patients. According to the response to concurrent chemoradiotherapy, the tissues were classified into HS group and LS group. In the first part of our experiment, protein separation was performed using two-dimensional gel electrophoresis (2-DE) with Amersham 18 cm linear pH 3-10 immobilized pH gradient(IPG) strips. The images of the gels were analyzed by PD-quest 7.0 software to find the differentially expressed protein-spots in each group. Then the differentially expressed protein-spots were incised from the gels and digested by trypsin. The peptide mass fingerprintings (PMF) was acquired by matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). The proteins were identified by data searched in the Mascot-database. Two differentially expressed proteins were assayed by western blot and immunohistochemical methods. Results: Most of the gels were clear and successfully analyzed by PD-quest 7.0 software. Most of the protein-spots concentrated on the area of 20-100 KDa(Mw) and pH4-8. The average number of the protein-spots was 781 ± 74 in HS group and 766 ± 52 in LS group. The match rate was 87.6% between the two groups. Eight proteins highly in HS group but lowly expressed in LS group included hemoglobin subunit beta, caspase-14 precursor, calmodulindike, S100-A9 protein(MRP-14), galectin-7, HSKERC4, keratin 19 and actin. Ten proteins highly in LS group but lowly expression in HS group included anti HBs antibody light-chain Fab, lamin-B1, WARS protein, flavin reductase, glutamate dehydrogenase 1, nuclear matrix protein 238, retinal dehydrogenase 1, AF165172

  15. Association of antigen processing machinery and HLA class I defects with clinicopathological outcome in cervical carcinoma

    OpenAIRE

    Mehta, Akash M.; Jordanova, Ekaterina S.; Kenter, Gemma G; Ferrone, Soldano; Fleuren, Gert- Jan

    2007-01-01

    HLA class I loss is a significant mechanism of immune evasion by cervical carcinoma, interfering with the development of immunotherapies and cancer vaccines. We report the systematic investigation of HLA class I and antigen processing machinery component expression and association with clinical outcome. A tissue microarray containing carcinoma lesions from 109 cervical carcinoma patients was stained for HLA class I heavy chains, β2-microglobulin, LMP2, LMP7, LMP10, TAP1, TAP2, ERAP1, tapasin,...

  16. The CT evaluation of cephalic and cervical adenoid cystic carcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate the CT manifestations of cephalic and cervical adenoid cystic carcinoma (ACC). Methods: Thirty-three cases of ACC were analyzed retrospectively. Of all cases, 22 cases underwent operation and 11 cases received radiotherapy. The manifestations of CT were evaluated and compared with the clinical and pathologic results. Results: Tumors originated from parotid gland (5 cases), floor of mouth (5 cases), nasal cavity and nasopharynx (5 cases), tongue (4 cases), palate (3 cases), tracheas (3 cases), submandibular gland (2 cases), tonsilla (2 cases), maxillary sinus (2 cases), and cheek (2 cases), respectively. The CT manifestations included: (1)ethmoid density in 21 cases, partial ethmoid density in 5 cases. (2)the morphology of ACC was irregular and the growth of the tumor was amorphous in 17 cases, and the margin of the tumor was vague in 20 cases. (3)ACC often grew along the nerve with infiltration, which caused destruction of the skull base in 5 cases and atrophy of mastication muscles and/or buccinator in 3 cases. Conclusion: (1)The characteristics of cephalic and cervical adenoid cystic carcinoma on CT scans were ethmoid density, infiltrated growth, growing along the nerve with infiltration, and submucous growth. Among them, the most important manifestation, which could lead to the histologic diagnosis on CT, was ethmoid density. (2)The range of ACC was usually underestimated on CT. (3)The manifestation of tumor growth along the nerve could be apparently displayed on MRI

  17. Molecular backgrounds of ERAP1 downregulation in cervical carcinoma.

    Science.gov (United States)

    Mehta, Akash M; Osse, Michelle; Kolkman-Uljee, Sandra; Fleuren, Gert Jan; Jordanova, Ekaterina S

    2015-01-01

    The antigen processing machinery (APM) plays an important role in immune recognition of virally infected and transformed cells. Defective expression of the APM component ERAP1 is associated with progression and poor clinical outcome in cervical carcinoma. However, the underlying mechanisms of ERAP1 protein downregulation remain to be established. We investigated ERAP1 mRNA expression levels in 14 patients with established ERAP1 protein downregulation. To further examine the possible pretranscriptional mechanisms of ERAP1 downregulation, ERAP1 DNA mutation status was analyzed alongside existing data on various single nucleotide polymorphisms. Moreover, loss of heterozygosity at various loci in the ERAP1 gene was investigated. In cases with ERAP1 protein downregulation, ERAP1 mRNA quantities were found to be significantly lower than in a cohort with normal ERAP1 protein expression (P = 0.001). Loss of heterozygosity was demonstrated to occur in up to 50% of tumors with ERAP1 downregulation. Our data indicate that ERAP1 downregulation is associated with loss of heterozygosity. These data provide the first insight into in vivo mechanisms of ERAP1 downregulation in cervical carcinoma. PMID:26146606

  18. Molecular Backgrounds of ERAP1 Downregulation in Cervical Carcinoma

    Directory of Open Access Journals (Sweden)

    Akash M. Mehta

    2015-01-01

    Full Text Available The antigen processing machinery (APM plays an important role in immune recognition of virally infected and transformed cells. Defective expression of the APM component ERAP1 is associated with progression and poor clinical outcome in cervical carcinoma. However, the underlying mechanisms of ERAP1 protein downregulation remain to be established. We investigated ERAP1 mRNA expression levels in 14 patients with established ERAP1 protein downregulation. To further examine the possible pretranscriptional mechanisms of ERAP1 downregulation, ERAP1 DNA mutation status was analyzed alongside existing data on various single nucleotide polymorphisms. Moreover, loss of heterozygosity at various loci in the ERAP1 gene was investigated. In cases with ERAP1 protein downregulation, ERAP1 mRNA quantities were found to be significantly lower than in a cohort with normal ERAP1 protein expression P=0.001. Loss of heterozygosity was demonstrated to occur in up to 50% of tumors with ERAP1 downregulation. Our data indicate that ERAP1 downregulation is associated with loss of heterozygosity. These data provide the first insight into in vivo mechanisms of ERAP1 downregulation in cervical carcinoma.

  19. Relationship between Microsatellite Alterations of RASSF1A Gene and Development of Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    ZHAO Fu-xi; YAN Jie; LIU Run-hua; WANG Xi-ying; CUI Ke

    2007-01-01

    Objective: To explore the relationship between microsatellite alterations of RASSF1A gene and the development of cervical carcinoma, and its relationship with HPV16 infection. Methods: Two sites of microsatellite polymorphism of RASSF1A gene were selected. Polymerase chain reaction (PCR) technique was used to detect LOH and MSI in 50 cases of cervical carcinoma and 40 cases of cervical intraepithelial neoplasia (CIN), and to detect the infection state of HPV16. Results: At D3S1478 and D3S4604, the LOH rates of cervical carcinomas were 32.6% (14/43) and 48.9% (23/47), the MSI rates were 14% (6/43) and 19.1% (9/47), respectively. The LOH rates of CINs were 31.4% (11/35) and 39.5% (15/38), the MSI rates were 11.4% (4/35) and 15.8% (6/38), respectively. There were no significant differences between cervical carcinomas and CINs in respect to their positive rates of LOH and MSI at D3S1478 and D3S4604 (P>0.05). There were significant differences in LOH rates at D3S1478 and D3S4604 between the stage Ⅰ-Ⅱ and Ⅲ-Ⅳ cervical carcinomas and between the well/moderately differentiated cervical carcinomas and the poorly differentiated cervical carcinomas (P<0.05). The positive rates of LOH and MSI for CIN Ⅲ and noninvasive cervical carcinomas were higher than those in CIN Ⅰ-Ⅱ. The rates of the infection of HPV16 in cervical cancer was obviously higher than that in CIN and in normal cervical tissues (P<0.05), and the incidence of LOH of RASSF1A gene was higher in HPV16(+) than that in HPV16(-) (P<0.05). Conclusion: The RASSF1A gene change is a relatively late event in cervical carcinomas. The detection of LOH and MSI of RASSF1A gene might be helpful to the early diagnosis and the screening of cervical carcinoma. It might also be useful for predicting the prognosis of cervical carcinoma.

  20. Influence of Clinical and Pathologic Parameters on Prognosis of Cervical Carcinoma in China

    Institute of Scientific and Technical Information of China (English)

    LUPing; LIANGQiudong; ZHENGQuanqing

    2003-01-01

    Objective: To explore the influence of clinical and pathologic parameters on the prognosis of squamous cell carcinoma and adenocarcinoma. Methods: 702 cases of cervical carcinoma were retrospec-tively studied. Cox regression model was informed in multi-variable analysis. Results: The retrospective analysis showed that 630 out of 702 cases of cervical carcinoma were squamous cell carcinoma, cumulative rate 89.4% and 72 case were adenocarcinoma, cumulative rate 10.6% respectively. The 5-year survival rate was lower for patients with adenocarcinoma than for patients with squamous cell carcinoma (58.3% vs 57.3%), but there was no significant difference. Cox regression model showed that the variable into equation for squamous cell carcinoma included tumor grade of differentiation, lymph node metastasis and FIGO stage, but only lymph node metastasis and FIGO stage for adenocarcinoma. Conclusion: FIGO stage and lymph node metastasis was independent parameter evaluating prognosis of cervical carcinoma.

  1. Bevacizumab improves survival for patients with advanced cervical cancer

    Science.gov (United States)

    Patients with advanced, recurrent, or persistent cervical cancer that was not curable with standard treatment who received the drug bevacizumab (Avastin) lived 3.7 months longer than patients who did not receive the drug, according to an interim analysis

  2. Examestane in advanced or recurrent endometrial carcinoma

    DEFF Research Database (Denmark)

    Lindemann, Kristina; Malander, Susanne; Christensen, René dePont;

    2014-01-01

    We evaluated the efficacy and safety of the aromatase inhibitor exemestane in patients with advanced, persistent or recurrent endometrial carcinoma.......We evaluated the efficacy and safety of the aromatase inhibitor exemestane in patients with advanced, persistent or recurrent endometrial carcinoma....

  3. Preoperative staging of cervical carcinoma with MR imaging: a reappraisal of diagnostic accuracy and pitfalls

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the diagnostic accuracy and pitfalls of MR imaging in preoperative staging of cervical cancer. Magnetic resonance imaging was performed to determine the tumor staging for 41 patients with cervical carcinoma emphasizing tumor size, parametrial invasion, vaginal invasion, and lymph node metastases. According to the correlation of MR findings with surgical-pathological features, there was less than 5 mm discrepancy in the size in 29 of 34 tumors (85.3%) that were larger than 1 cm. In assessing parametrial invasion, vaginal invasion and lymph node metastases, MR imaging had an accuracy of 95, 83, and 86%, respectively. In determining stage of disease and differentiating operable (≤stage IIA) from advanced disease (≥stage IIB), MR imaging had an accuracy of 82.9 and 93%. Pitfalls leading to staging errors included difficulties in differentiating cancer foci from surrounding tissue edema and detecting microscopic tumor extension. Magnetic resonance imaging is accurate in the evaluation of parametrial invasion and differentiation of operable from advanced disease. The ability of MR imaging to detect microscopic extra-cervical tumor extension and differentiate cancer foci from surrounding tissue edema is not as reliable. (orig.)

  4. Palliative radiotherapy for cervical carcinoma, a systematic review

    International Nuclear Information System (INIS)

    Purpose: Worldwide, particularly in developing countries, many women present with advanced stage cervical cancer for which palliative radiotherapy is the treatment of choice or may be the only available treatment. The purpose of this study was to determine from the literature the optimal palliative radiation scheme for the treatment of advanced cervical cancer. Design: A systematic literature review up to January 2010 was performed in Medline, Embase, the Cochrane database, CinHL and Google Scholar using a combination of synonyms for: cervical cancer, palliative treatment and radiation therapy. No limitations were applied for language or study types. For included papers data were extracted and described. Results: Only eight papers were identified and none compared the results of different fractionation schemes. Most used observational retrospective study design with considerable sources of bias. No studies used validated endpoints for symptom relief nor did they include measures of the quality of life. Several papers described the experience with single or multiple monthly 10 Gy doses or with a higher total dose delivered in 2-4 fractions within 48 h to 1 week. Studies report varying amounts of relief from bleeding. The effect on other symptoms such as pain and discharge is not evaluable. Acute and late toxicity is poorly documented. Conclusion: There is a dearth of information in the current literature to guide selection of an optimal palliative radiation schedule for treatment of patients with advanced cervical cancer. Based on this review and information from other solid tumors, there is no evidence to support the common belief that better and longer palliation is achieved with a high dose delivered in multiple smaller fractions. There is a clear need for comparative studies of different radiation fractionation schedules in order to identify an optimal palliative radiation scheme. These studies require the use of validated endpoints to measure specific symptom

  5. TERT promoter hot spot mutations are frequent in Indian cervical and oral squamous cell carcinomas.

    Science.gov (United States)

    Vinothkumar, Vilvanathan; Arunkumar, Ganesan; Revathidevi, Sundaramoorthy; Arun, Kanagaraj; Manikandan, Mayakannan; Rao, Arunagiri Kuha Deva Magendhra; Rajkumar, Kottayasamy Seenivasagam; Ajay, Chandrasekar; Rajaraman, Ramamurthy; Ramani, Rajendren; Murugan, Avaniyapuram Kannan; Munirajan, Arasambattu Kannan

    2016-06-01

    Squamous cell carcinoma (SCC) of the uterine cervix and oral cavity are most common cancers in India. Telomerase reverse transcriptase (TERT) overexpression is one of the hallmarks for cancer, and activation through promoter mutation C228T and C250T has been reported in variety of tumors and often shown to be associated with aggressive tumors. In the present study, we analyzed these two hot spot mutations in 181 primary tumors of the uterine cervix and oral cavity by direct DNA sequencing and correlated with patient's clinicopathological characteristics. We found relatively high frequency of TERT hot spot mutations in both cervical [21.4 % (30/140)] and oral [31.7 % (13/41)] squamous cell carcinomas. In cervical cancer, TERT promoter mutations were more prevalent (25 %) in human papilloma virus (HPV)-negative cases compared to HPV-positive cases (20.6 %), and both TERT promoter mutation and HPV infection were more commonly observed in advanced stage tumors (77 %). Similarly, the poor and moderately differentiated tumors of the uterine cervix had both the TERT hot spot mutations and HPV (16 and 18) at higher frequency (95.7 %). Interestingly, we observed eight homozygous mutations (six 228TT and two 250TT) only in cervical tumors, and all of them were found to be positive for high-risk HPV. To the best of our knowledge, this is the first study from India reporting high prevalence of TERT promoter mutations in primary tumors of the uterine cervix and oral cavity. Our results suggest that TERT reactivation through promoter mutation either alone or in association with the HPV oncogenes (E6 and E7) could play an important role in the carcinogenesis of cervical and oral cancers. PMID:26700669

  6. Relationship between the Expression of Telomerase and Human Papillomavirus Infection in Invasive Uterine Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    SIMA Ni; CAI Liping; ZHU Yuanfang; WANG Wei; WANG Shixuan; MA Ding

    2007-01-01

    Telomerase activity was examined in invasive cervical carcinoma to assess whether it is activated during cervical malignant transformation and to look for its possible association with human papillomavirus (HPV) infection. Histologically confirmed invasive cervical carcinomas and benign cervices were assayed for telomerase activity by using a modified telomere repeat amplification protocol (TRAP). The same cases were subjected to polymerase chain reaction (PCR) detection of HPV by using consensus primers and type-specific (HPV types 16 and 18) primers. Telomerase activity was detected in 40 of 45 (88.9%) invasive cervical carcinomas and 2 (all chronic cervicitis) of 50 (4%) benign cervical lesions. HPV was detected in 36 (24 HPV-16 and 4 HPV-18 cases) of 45 (80%) invasive cervical carcinomas and 20 (11 HPV-16 and 1 HPV-18 cases) of 50 (40%) benign cervical changes. There was a significant correlation between the expression of telomerase with histological grade (φ=0.44, P<0.005), but no correlation was found between telomerase expression and HPV-18 (P>0.05). Although larger sample studies are needed, there seems to be a clear association between telomerase upregulation and HPV status, mainly HPV-16 infection.

  7. THE OVEREXPRESSION AND SIGNIFICANCE OF CYCLIN D1 AND P53 IN CERVICAL SQUAMOUS CELL CARCINOMAS

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective:To investigate the significance of overexpresson of eyclin D1 and P53 protein in cervical squamous cell carcinomas.Methods:Fifty cases of invasive cervical squamous cell carcinomas and 10 Cases of normal cervical squamous epithelia were investigated with immunihistochemical technique.Results:The overexpressioin of cyclin D1 and P53 in invasive cervical carcinomas was 70% and 50%,respectively,There was no overexpression of them in the control group.The overexpression of cyclin D1 in grade Ⅱand Ⅲ was much higher than that in grade I(P<0.05),The overexpresson of cyclin D1 in stage Ⅲof cervical carcinoma was significantly higher than that in stage Ⅱ(P<0.05).The overexpression of P53 in grade -Ⅱand gradeⅢ of cervical carcinoma was remarkably higher than that in grade I(P<0.05),Conclusion:The action point of both cyclin D1 and P53 may be at G1/S transtition.The overexpression of them was associated with development and progression of cervical carcinoma probably in different mechanisms and different pathways.

  8. [Induction chemotherapy for locally advanced cervical cancer].

    Science.gov (United States)

    Morkhov, K Yu; Nechushkina, V M; Kuznetsov, V V

    2015-01-01

    The main methods of treatment for cervical cancer are surgery, radiotherapy or their combination. During past two decades chemotherapy are increasingly being used not only in patients with disseminated forms of this disease but also in patients undergoing chemoradiotherapy or as induction therapy. Possibilities of adjuvant chemotherapy for cervical cancer are being studied. According to A.D.Kaprin and V.V. Starinskiy in 2013 in Russia, 32% of patients with newly diagnosed cervical cancer underwent only radiation therapy, 32%--combined or complex treatment, 27.3%--only surgery, and just 8.7%--chemoradiotherapy. PMID:26087600

  9. Comparison of europium and chromium release assays: cytotoxicity in healthy individuals and patients with cervical carcinoma.

    Science.gov (United States)

    von Zons, P; Crowley-Nowick, P; Friberg, D; Bell, M; Koldovsky, U; Whiteside, T L

    1997-03-01

    Natural killer (NK) and lymphokine-activated killer (LAK) cell activities were measured in peripheral blood obtained from healthy women to compare a standard 51Cr release assay with a nonradioactive europium (Eu3+) release assay based on time-resolved fluorescence. The two types of cytotoxicity assays were first compared in paired determinations performed on 28 samples of peripheral blood mononuclear cells obtained from healthy women who had normal pap smears or no biopsy evidence of cervical squamous intraepithelial lesions (SIL). Target cells (NK-sensitive K562 and NK-resistant Raji cell lines) were labeled with Eu3+ only, 51Cr only, or both labels and compared in cytotoxicity assays using fresh or interleukin 2 (IL-2)-activated effector cells. Spontaneous release in the Eu3+ release assay was comparable to that observed in the 51Cr release assay, but maximum Eu3+ release always exceeded that of 51Cr. In 4-h assays, specific release of Eu3+ from target cells was more rapid than that of 51Cr, consistently resulting in 30 to 40% higher levels of activity. However, a significant linear correlation (P release in 4-h assays. The Eu3+ release assay was then used to measure NK and LAK activities in the peripheral blood of women with cervical SIL or cervical squamous cell carcinoma (SCC). Mean NK activity of women with advanced SIL (121 lytic units [LU]) or SCC (93 LU) was found to be similar to that of controls (101 LU) or patients with normal cervical biopsies (90 LU), as was the ability to generate IL-2-stimulated NK activity. However, LAK activity during 18 h of incubation in the presence of IL-2 was reduced in patients with cervical SCC (P release assays for routine evaluation of cytotoxicity are discussed. PMID:9067656

  10. Hypoxia downregulates Ku70/80 expression in cervical carcinoma tumors

    International Nuclear Information System (INIS)

    Hypoxia may inhibits the NHEJ DNA repair through downregulating Ku70/80 expression and combined with an increased angiogenesis and altered p53 expression would be responsible for tumor progression in cervical carcinoma

  11. Staging of cervical endometrial carcinoma using magnetic resonance imaging

    International Nuclear Information System (INIS)

    To demonstrate the benefits of magnetic resonance imaging (MRI) for the staging of endometrial carcinoma and to compare the results of the spin echo (SE) sequence in T2 with the results of the pos gadolinium intravenous study. We have studied 51 women diagnosed with endometrial carcinoma by means of a D and C and confirmed surgically using T1 equipment. All of them have had SE T1 axial sequences, SE in protonic density (PD) and T'' on an axial and sagittal plane carried out on them and 32 cases were studied after the administration of gadolinium intravenously (i. V.). We have valued the depth of the myometrial infiltration and the cervical invasion. The positive predictive value (PPV) and the negative predictive value (VPV) of the MRI to value the deep infiltration of the endometrium were 87.9% and 77.8% respectively. In the 32 cases where we administered gadolinium we obtained a PPV of 90% and a NPV of 83.8%, in both the SE T2 study and the contrast study. In the diagnosis of the cervical invasion we have obtained PPV and NPV values of 75% and 88.1% respectively. In the group of the 32 cases that had the contrast agent administered, we have obtained the same results in both the series: PPV of 80% and NPV of 85.2%. We have found a high correlation index between the staging using MRI and pathological anatomy, especially in stages I and II of the IFGO (International Federation of Gynecology and Obstretics) classification. The use of gadolinium has not varied the results obtained with the SE T2 series. (Author) 18 refs

  12. Expression and Clinical Significance of HMGB1 and RAGE in Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To study the expression level and clinical significance of HMGB1 and RAGE in cervical squamous epithelial carcinoma.METHODS Real time quantitative polymerase chain reaction (qRT-PCR)was employed to examine the expression of HMGB1 (high mobility group box protein1), and RAGE (receptor for advanced glycation endproducts)in 60 cervical squamous epithelial carcinomas (CSEC), their paraneoplastic tissues (PS) and 30 normal cervix tissues (NCS).RESULTS The expression of HMGB1 in the CSEC samples and PS was similar (P>0.05), but higher compared to NCS (P<0.05). Overexpression of HMGB1 in the CESC tissues was significantly correlated with the tumor (P<0.05), and the presence of metastasis (P<0.01), but not correlated with the tumor diameter or tumor grade. RAGE expression was not significantly different among these tissue types, and showed no significant correlation with the the tumor stage, diameter or grade. But there was a significant positive correlation between RAGE expression and CSEC metastasis.CONCLUSION The results suggest that HMGB1 may be related to the proliferation, progression and metastasis of CSEC. The relationship of HMGB1/RAGE may be of importance for CSEC metastasis. HMGB1 presents a new potential gene target for prevention and treatment of CSEC.Study of HMGB1/RAGE expression will offer an experimental foundation for understanding the pathogenesis of CSES.

  13. Whole pelvic helical tomotherapy for locally advanced cervical cancer: technical implementation of IMRT with helical tomothearapy

    International Nuclear Information System (INIS)

    To review the experience and to evaluate the treatment plan of using helical tomotherapy (HT) for the treatment of cervical cancer. Between November 1st, 2006 and May 31, 2009, 10 cervical cancer patients histologically confirmed were enrolled. All of the patients received definitive concurrent chemoradiation (CCRT) with whole pelvic HT (WPHT) followed by brachytherapy. During WPHT, all patients were treated with cisplatin, 40 mg/m2 intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0). The mean survival was 25 months (range, 3 to 27 months). The actuarial overall survival, disease-free survival, locoregional control and distant metastasis-free rates at 2 years were 67%, 77%, 90% and 88%, respectively. The average of uniformity index and conformal index was 1.06 and 1.19, respectively. One grade 3 of acute toxicity for diarrhea, thrombocytopenia and three grade 3 leucopenia were noted during CCRT. Only one grade 3 of subacute toxicity for thrombocytopenia was noted. There were no grade 3 or 4 subacute toxicities of anemia, leucopenia, genitourinary or gastrointestinal effects. Compared with conventional whole pelvic radiation therapy (WPRT), WPHT decreases the mean dose to rectum, bladder and intestines successfully. HT provides feasible clinical outcomes in locally advanced cervical cancer patients. Long-term follow-up and enroll more locally advanced cervical carcinoma patients by limiting bone marrow radiation dose with WPHT technique is warranted

  14. A pri-miR-218 variant and risk of cervical carcinoma in Chinese women

    International Nuclear Information System (INIS)

    MicroRNA (miRNA)-related single nucleotide polymorphisms (SNPs) may compromise miRNA binding affinity and modify mRNA expression levels of the target genes, thus leading to cancer susceptibility. However, few studies have investigated roles of miRNA-related SNPs in the etiology of cervical carcinoma. In this case–control study of 1,584 cervical cancer cases and 1,394 cancer-free female controls, we investigated associations between two miR-218-related SNPs involved in the LAMB3-miR-218 pathway and the risk of cervical carcinoma in Eastern Chinese women. We found that the pri-miR-218 rs11134527 variant GG genotype was significantly associated with a decreased risk of cervical carcinoma compared with AA/AG genotypes (adjusted OR=0.77, 95% CI=0.63-0.95, P=0.015). However, this association was not observed for the miR-218 binding site SNP (rs2566) on LAMB3. Using the multifactor dimensionality reduction analysis, we observed some evidence of interactions of these two SNPs with other risk factors, especially age at primiparity and menopausal status, in the risk of cervical carcinoma. The pri-miR-218 rs11134527 SNP was significantly associated with the risk of cervical carcinoma in Eastern Chinese women. Larger, independent studies are warranted to validate our findings

  15. A pri-miR-218 variant and risk of cervical carcinoma in Chinese women

    Directory of Open Access Journals (Sweden)

    Shi Ting-Yan

    2013-01-01

    Full Text Available Abstract Background MicroRNA (miRNA-related single nucleotide polymorphisms (SNPs may compromise miRNA binding affinity and modify mRNA expression levels of the target genes, thus leading to cancer susceptibility. However, few studies have investigated roles of miRNA-related SNPs in the etiology of cervical carcinoma. Methods In this case–control study of 1,584 cervical cancer cases and 1,394 cancer-free female controls, we investigated associations between two miR-218-related SNPs involved in the LAMB3-miR-218 pathway and the risk of cervical carcinoma in Eastern Chinese women. Results We found that the pri-miR-218 rs11134527 variant GG genotype was significantly associated with a decreased risk of cervical carcinoma compared with AA/AG genotypes (adjusted OR=0.77, 95% CI=0.63-0.95, P=0.015. However, this association was not observed for the miR-218 binding site SNP (rs2566 on LAMB3. Using the multifactor dimensionality reduction analysis, we observed some evidence of interactions of these two SNPs with other risk factors, especially age at primiparity and menopausal status, in the risk of cervical carcinoma. Conclusions The pri-miR-218 rs11134527 SNP was significantly associated with the risk of cervical carcinoma in Eastern Chinese women. Larger, independent studies are warranted to validate our findings.

  16. Invasive cervical carcinoma (stage IB-IIB): assessment with MR imaging

    International Nuclear Information System (INIS)

    In patients with cervical carcinoma the selection of the optimal therapy depends on the precise preoperative assessment of the extent of disease. Currently, decisions regarding the management of these patients are made on the basis of clinical (FIGO) staging that has 50% mean error rate. To investigate the value of MR imaging in staging patients with invasive cervical cancer, we performed 25 MR examinations on 23 patients with histologic diagnosis of cervical cancer. All patients were clinically considered as having stage IB or IIB disease and underwent radical hysterectomy, providing specimens for pathologic correlation. The overall accuracy of MR imaging in staging cervical carcinoma (stage IB-IIB) was 78.1%. MR imaging seems to be the most reliable preoperative modality for staging invasive cervical cancer

  17. PARP-1 Val762Ala polymorphism is associated with risk of cervical carcinoma.

    Directory of Open Access Journals (Sweden)

    Feng Ye

    Full Text Available PARP-1 is a nuclear enzyme that plays an important role in DNA repair, recombination, proliferation and the genome stability. The PARP-1 Val762Ala polymorphism has been associated with increased risk of developing cancers of the prostate, esophagus and lung. The aim of this study was to determine whether the PARP-1 Val762Ala polymorphism is associated with the risk of cervical carcinoma. MA-PCR was used to genotype the PARP-1 Val762Ala polymorphism in 539 women with cervical carcinoma, 480 women with CIN and 800 controls. The genotyping method was confirmed by the DNA sequencing analysis. The PARP-1 Val762Ala polymorphism was not associated with the risk of CIN. However, women carrying the PARP-1 Ala762Ala genotype were significantly susceptible to cervical carcinoma (OR: 2.70, 95% CI: 1.47-3.70, and the similar results were also found in squamous cell carcinoma (OR: 2.56, 95% CI: 1.47-3.70. In HPV positive population, the PARP-1 Ala762Ala genotype was also associated with increased risk of cervical carcinoma (OR: 5.56, 95% CI: 2.08-14.3. Our results indicate that the PARP-1 Ala762Ala genotype increases the risk of cervical carcinoma.

  18. Effect of intraarterial and systemic chemotherapy for stage IIb cervical carcinoma: assessment of therapeutic response using MR imaging

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of intraarterial chemotherapy(IAC) and systemic chemotherapy(SC) in cases of locally advanced cervical carcinoma, and to assess the accuracy of magnetic resonance(MR) imaging for determining parametrial invasion after IAC or SC. Among 44 patients with stage IIb cervical carcinoma, IAC was performed in 25 and SC in 19. MR images obtained before and after IAC or SC were prospectively analyzed with regard to tumor volume and parametrial invasion, and tumor response to chemotherapy was classified as complete, partial, or progressive. Forty-one patients underwent radical hysterectomy within two weeks of the second MR examination, and postoperative pathologic findings were correlated with radiologic findings. The average reduction rate of tumor volume in the IAC and SC group was 89.2% and 66.3%, respectively. Between the two groups, there was no statistically significant difference(p>0.05). In the IAC group, 13 patients showed a complete response and 11 a partial response, and in one there was progression. In the SC group, eight patients showed a complete response and nine a partial response, and in two there was progression. The accuracy of MR imaging for determining parametrial invasion after chemotherapy was 87.8%. In each patient there was close correlation between MR imaging and pathologic findings. There was no statistically significant difference in tumor reduction between the IAC and SC group. After chemotherapy for stage IIb cervical carcinoma, MR imaging is a valuable modality for determining surgical candidates.=20

  19. New advances in hepatocellular carcinoma

    Science.gov (United States)

    Pascual, Sonia; Herrera, Iván; Irurzun, Javier

    2016-01-01

    Hepatocellular carcinoma (HCC) is the leading cause of deaths in cirrhotic patients and the third cause of cancer related deaths. Most HCC are associated with well known underlying risk factors, in fact, HCC arise in cirrhotic patients in up to 90% of cases, mainly due to chronic viral hepatitis and alcohol abuse. The worldwide prevention strategies are conducted to avoid the infection of new subjects and to minimize the risk of liver disease progression in infected patients. HCC is a condition which lends itself to surveillance as at-risk individuals can readily be identified. The American and European guidelines recommended implementation of surveillance programs with ultrasound every six months in patient at-risk for developing HCC. The diagnosis of HCC can be based on non-invasive criteria (only in cirrhotic patient) or pathology. Accurately staging patients is essential to oncology practice. The ideal tumour staging system in HCC needs to account for both tumour characteristics and liver function. Treatment allocation is based on several factors: Liver function, size and number of tumours, macrovascular invasion or extrahepatic spread. The recommendations in terms of selection for different treatment strategies must be based on evidence-based data. Resection, liver transplant and interventional radiology treatment are mainstays of HCC therapy and achieve the best outcomes in well-selected candidates. Chemoembolization is the most widely used treatment for unresectable HCC or progression after curative treatment. Finally, in patients with advanced HCC with preserved liver function, sorafenib is the only approved systemic drug that has demonstrated a survival benefit and is the standard of care in this group of patients. PMID:27028578

  20. New advances in hepatocellular carcinoma.

    Science.gov (United States)

    Pascual, Sonia; Herrera, Iván; Irurzun, Javier

    2016-03-28

    Hepatocellular carcinoma (HCC) is the leading cause of deaths in cirrhotic patients and the third cause of cancer related deaths. Most HCC are associated with well known underlying risk factors, in fact, HCC arise in cirrhotic patients in up to 90% of cases, mainly due to chronic viral hepatitis and alcohol abuse. The worldwide prevention strategies are conducted to avoid the infection of new subjects and to minimize the risk of liver disease progression in infected patients. HCC is a condition which lends itself to surveillance as at-risk individuals can readily be identified. The American and European guidelines recommended implementation of surveillance programs with ultrasound every six months in patient at-risk for developing HCC. The diagnosis of HCC can be based on non-invasive criteria (only in cirrhotic patient) or pathology. Accurately staging patients is essential to oncology practice. The ideal tumour staging system in HCC needs to account for both tumour characteristics and liver function. Treatment allocation is based on several factors: Liver function, size and number of tumours, macrovascular invasion or extrahepatic spread. The recommendations in terms of selection for different treatment strategies must be based on evidence-based data. Resection, liver transplant and interventional radiology treatment are mainstays of HCC therapy and achieve the best outcomes in well-selected candidates. Chemoembolization is the most widely used treatment for unresectable HCC or progression after curative treatment. Finally, in patients with advanced HCC with preserved liver function, sorafenib is the only approved systemic drug that has demonstrated a survival benefit and is the standard of care in this group of patients. PMID:27028578

  1. Carcinoma of the cervical esophagus treated with radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, W.M.; Parsons, J.T.; Vogel, S.B.; Cassisi, N.J.; Million, R.R.

    1988-07-01

    This is an analysis of 34 patients with carcinoma of the cervical esophagus treated with radiation therapy with curative intent at the University of Florida between September 1966 and May 1985. All patients have a minimum 2-year follow-up and 28 (82%) have at least 5 years of follow-up. Patients were staged according to the recommendations of the AJCC. Patients who died within 2 years of treatment with the primary site continuously disease-free were excluded from the local control analysis; all patients were included in the analysis of complications and survival. Irradiation resulted in control of the primary lesion in 1 of 2 patients who presented with T1 lesions, in 4 of the 12 patients with T2 lesions, and 3 of 17 patients who presented with T3 lesions. One patient with a T3 lesion that recurred locally was successfully salvaged by an operation. The 5-year absolute survival rates by stage were as follows: no patients with stage I lesions survived; of 11 stage II patients, one survived; and of 16 stage III patients, three survived. Interestingly, all four of the 5-year survivors were women.

  2. Carcinoma of the cervical esophagus treated with radiation therapy

    International Nuclear Information System (INIS)

    This is an analysis of 34 patients with carcinoma of the cervical esophagus treated with radiation therapy with curative intent at the University of Florida between September 1966 and May 1985. All patients have a minimum 2-year follow-up and 28 (82%) have at least 5 years of follow-up. Patients were staged according to the recommendations of the AJCC. Patients who died within 2 years of treatment with the primary site continuously disease-free were excluded from the local control analysis; all patients were included in the analysis of complications and survival. Irradiation resulted in control of the primary lesion in 1 of 2 patients who presented with T1 lesions, in 4 of the 12 patients with T2 lesions, and 3 of 17 patients who presented with T3 lesions. One patient with a T3 lesion that recurred locally was successfully salvaged by an operation. The 5-year absolute survival rates by stage were as follows: no patients with stage I lesions survived; of 11 stage II patients, one survived; and of 16 stage III patients, three survived. Interestingly, all four of the 5-year survivors were women

  3. The observation of clinical efficacy of recombinant human erythropoietin injection combined with radiotherapy in the advanced cervical squamous cell carcinoma%重组人红细胞生成素注射液联合放疗治疗中晚期宫颈鳞癌的临床观察

    Institute of Scientific and Technical Information of China (English)

    濮娟; 王成师; 郁汉旭

    2012-01-01

    目的 探讨重组人红细胞生成素注射液联合放疗治疗中晚期宫颈鳞癌的近期疗效和不良反应.方法 选取2008年5月至2011年4月间收治的中晚期宫颈鳞癌患者125例,随机分为观察组和对照组.观察组在放疗前一周开始给予重组人红细胞生成素注射液,对照组予放疗.观察疗效,记录胃肠道反应、骨髓抑制情况、泌尿系统反应、肝肾功能改变、局部皮肤损伤情况.结果 观察组的完全缓解率(CR)、部分缓解率(PR)和总有效率(RR)高于对照组,血红蛋白减少的比例低于对照组,胃肠道反应、泌尿系统损伤、皮肤损伤两组差异无统计学意义.结论 重组人红细胞生成素注射液联合放疗能提高中晚期宫颈鳞癌的疗效,减少血红蛋白减少的发生,值得进一步研究和应用.%Objective To analysis the curative effect and adverse reaction of recombinant human erythropoietin injection combined with radiotherapy in the advanced cervical squamous cell carcinoma. Methods The 125 cases of advanced cervical squamous cell carcinoma who treated from May 2008 to April 2011 were randomly divided into observation group and control group. The patients of observation group was given recombinant human erythropoietin injection before radiotherapy a week, the patients of control group received radiotherapy treatment. Observation curative effect, recorded gastrointestinal reaction, bone marrow inhibition, urinary system, liver and kidney function, change reaction of local skin damage. Results The complete remission rate, response rate and the total efficiency of observation group patients were higher than control group, decreased hemoglobin ratio lower than control group. The reaction of gastrointestinal tract, u-rinary system injury, skin damage of two groups, no significant difference. Conclusions Recombinant human erythropoietin injection combined with radiotherapy can improve curative effect in advanced cervical cancer, reduce

  4. Evaluation of urologic morbidity after radiotherapy for cervical carcinoma by urodynamic examinations and patient voiding schemes: a prospective study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranov, Ingrid R; Bagi, Per;

    2002-01-01

    To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma.......To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma....

  5. Cervical metastases of oral maxillary squamous cell carcinoma: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Wen-Bo; Peng, Xin

    2016-04-01

    Cervical treatment of oral maxillary squamous cell carcinoma (SCC) remains controversial. We determined the metastases incidence and evaluated its predictive factors. Systematic review and meta-analysis was conducted of 23 Chinese and English-language articles retrieved from PubMed, Ovid, Embase, Cochrane Library, China National Knowledge Infrastructure, and Chinese Scientific and Technological Journal databases. Total cervical metastases and occult metastases rate was 32% and 21%, respectively. Positive lymph node detection was likeliest from levels I to III. The maxillary gingival metastases rate was higher than that of the hard palate. Advanced-stage tumors had higher metastatic risk than early-stage tumors. Well-differentiated tumors had a significantly higher metastases rate than medium and poor-differentiation tumors. N0 cases had survival benefit compared with N+ cases. Metastases rate of oral maxillary SCC correlates significantly with T classification and pathological stage. T and N classifications impact outcome significantly. Therefore, levels I to III selective neck dissection is recommended for patients with T3/4 cN0 disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2335-E2342, 2016. PMID:26890607

  6. Detection of Merkel cell polyomavirus in cervical squamous cell carcinomas and adenocarcinomas from Japanese patients

    Directory of Open Access Journals (Sweden)

    Imajoh Masayuki

    2012-08-01

    Full Text Available Abstract Background Merkel cell polyomavirus (MCPyV was identified originally in Merkel cell carcinoma (MCC, a rare form of human skin neuroendocrine carcinoma. Evidence of MCPyV existence in other forms of malignancy such as cutaneous squamous cell carcinomas (SCCs is growing. Cervical cancers became the focus of our interest in searching for potentially MCPyV-related tumors because: (i the major histological type of cervical cancer is the SCC; (ii the uterine cervix is a common site of neuroendocrine carcinomas histologically similar to MCCs; and (iii MCPyV might be transmitted during sexual interaction as demonstrated for human papillomavirus (HPV. In this study, we aimed to clarify the possible presence of MCPyV in cervical SCCs from Japanese patients. Cervical adenocarcinomas (ACs were also studied. Results Formalin-fixed paraffin-embedded tissue samples from 48 cervical SCCs and 16 cervical ACs were examined for the presence of the MCPyV genome by polymerase chain reaction (PCR and sequencing analyses. PCR analysis revealed that 9/48 cervical SCCs (19% and 4/16 cervical ACs (25% were positive for MCPyV DNA. MCPyV-specific PCR products were sequenced to compare them with reference sequences. The nucleotide sequences in the MCPyV large T (LT-sequenced region were the same among MCPyV-positive cervical SCCs and AC. Conversely, in the MCPyV viral protein 1 (VP1-sequenced region, two cervical SCCs and three cervical ACs showed several nucleotide substitutions, of which three caused amino acid substitutions. These sequencing results suggested that three MCPyV variants of the VP1 were identified in our cases. Immunohistochemistry showed that the LT antigen was expressed in tumor cells in MCPyV-positive samples. Genotyping of human HPV in the MCPyV-positive samples revealed that infected HPVs were HPV types 16, 31 and 58 for SCCs and HPV types 16 and 18 for ACs. Conclusions This study provides the first observation that MCPyV coexists in a subset

  7. Metabonomic signature analysis of cervical carcinoma and precancerous lesions in women by 1H NMR spectroscopy

    OpenAIRE

    Hasim, Ayshamgul; ALI, MAYINUER; MAMTIMIN, BATUR; Ma, Jun-Qi; Li, Qiao-Zhi; ABUDULA, ABULIZI

    2012-01-01

    1H nuclear magnetic resonance (NMR)-based metabonomics has been used to characterize the metabolic profiles of cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC). Principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLS-DA) were used to model the systematic variation related to patients with CIN or CSCC with healthy controls. Potential metabolic biomarkers were identified using database comparisons, and the one-way a...

  8. RELATIONSHIP BETWEEN CYCLIN G1 AND HUMAN PAPILLOMA VIRUS INFECTION IN CERVICAL INTRAEPITHELIAL NEOPLASIA AND CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To evaluate the overexpression of cyclin G1 in cervical intraepithelial neoplasia (CIN) and cervical carcinoma, and the correlation between cyclin G1 and high-risk human papilloma virus (HPV) infection.Methods All of the specimens were obtained from the Department of Pathology of China-Japan Friendship Hospital from January 2000 to August 2004. We detected the expression of cyclin G1 with immunohistochemistry, HPV16/18infection with in situ hybridization, and high-risk HPV infection with Hybrid capture system Ⅱ (HC-Ⅱ) in normal group (25 cases), CIN Ⅰ (48 cases), CIN Ⅱ (56 cases), CIN Ⅲ (54 cases), and invasive cervical squamous-cell carcinoma (SCC, 31 cases).Results The positive rates of cyclin G1 expression in CIN (77. 85%) and SCC cervical tissues (87.10%) were significantly higher than normal (8.00%,P<0.01), and the intensities of cyclin G1 expression in CIN (40.60%)and SCC cervical tissues (61.51%) were significantly higher than normal (2.72%,P<0.05). The positive rates and intensities of cyclin G1 expression increased gradually with the grade of cervical lesions. High-risk HPV infection rates were higher in CIN and SCC than normal groups (P<0.05). There was a positive correlation between cyclin G1 expression and high-risk HPV infection detected with HC-Ⅱ (Kendall's tau-b =0.316, 0.269, 0.352, and 0. 474 in CIN Ⅰ, CINⅡ, CIN Ⅲ, and SCC, respectively, P<0.05).Conclusions Cyclin G1 is overexpressed in CIN and SCC. Cyclin G1 may be a biomarker for detecting CIN and SCC. Cyclin G1 may play an important role in the oncogenesis of CIN and SCC by high-risk HPV infection.

  9. Staging uterine cervical carcinoma with low-field MR imaging

    International Nuclear Information System (INIS)

    To assess the validity of low-field MR in staging cervical cancer compared to clinical staging. Material and Methods: A total of 95 women entered the study over a 3-year period. MR examinations with a 0.1 T resistive magnet using a body coil and clinical staging according to the FIGO recommendations were performed within 2 weeks from clinical diagnosis. T1- and T2-weighted sequences were obtained in transversal and sagittal acquisitions, and an additional T1 before and after contrast (randomisation to 0.1 or 0.3 mmol/kg b.w. gadodiamide). Treatment decisions on surgery or radiation therapy were made solely on the clinical staging. Results: Sixty-one patients were found to be eligible for surgery. In 5 women, the pathological results revealed a more advanced stage of the disease than assessed by clinical staging. MR correctly staged 4 of the 5 but otherwise tended to overstate the disease. Contrast enhancement significantly reduced this trend (p<0.05) regardless of the contrast medium dose used. Divided into two groups, an operable (less than stage 2b) and an inoperable group (more than stage 2a), the clinical staging correctly classified 57 patients (accuracy 92%) compared to 52 patients with MR using contrast enhancement (accuracy 84%). The specificity was no higher than 31%, whereas the reproducibility of the MR assessment was fairly good with kappa values around 0.65 for both intra- and interobserver variations. Conclusion: In the present set-up, clinical assessment was superior to low-field MR in staging cervical cancer. When using contrast enhancement, the staging accuracies of low-field MR were comparable to the ones reported for techniques with higher tesla values, whereas the specificity and reproducibility errors were lower. The method, therefore, needs to be optimised

  10. THE OVEREXPRESSION OF APOPTOSIS -RELATED GENES OF P53 AND BCL-2 IN CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To investigate the significance of overexpression of P53 and bcl-2 protein in carcinogenesis of cervix. Methods 10 cases of cervical intraepithelial neoplasis(CIN) and 57 cases of invasive cancer were investigated with immunohistochemistry technique. Results The overexpresion of P53 protein in CIN and cervical cancer was significantly higher than that of control, respectively (P<0.01). But there was no significant difference between CIN and cervical cancer(P>0. 05). The immunoreactivity of bcl-2 in CIN was much more higher than that of control (P<0.05). The positive rate and immunoreactivity of bcl-2 in cervical carcinoma were both remarkably higher than those of control (P<0. 01) ,but there was no significant difference between CIN and cervical carcinoma (P>0. 05). It was also found that there was a remarkably positive correlation between the overexpression of bcl-2 and P53 (P<0.01). Conclusion Because of the loss of wtP53 function,the expression of bcl-2 can not be down-reguated,which is associated with the pathogenesis and development of cervical carcinoma.

  11. Radiation therapy for advanced laryngeal carcinoma

    International Nuclear Information System (INIS)

    From 1967 through 1985, 92 patients with T3 and T4 laryngeal carcinoma were treated with radiation at Osaka University Hospital. Of 92 patients, patients with 14 T3 and 29 T4 carcinoma were treated with a total dose of 60 Gy or more, and those with 14 T3 and 21 T4 carcinoma were treated with a total dose of 40 to 58 Gy and followed by total laryngectomy. Other 14 patients were palliatively treated with a total dose less than 60 Gy without surgery. The 5-year local control rates for T3 and T4 carcinoma treated with radical radiation were 48% and 24%, respectively. The 5-year cause-specific survival rates for T3 carcinoma treated with radical and preoperative radiotherapy were 48% and 71%, and corresponding figures for T4 carcinoma were 52% and 43%. There were no statistically significant differences between cause-specific survival rates of radical and preoperative groups. The 5-year cause-specific survival rates for T3N0 and T4N0 cases treated with radical radiation were 83% and 56%, and corresponding figures for T3N+ and T4N+ cases were 13% and 45%. Voice preservation rates of T3 and T4 patients treated with radical radiation were about 1/2 and 1/4, respectively. Considering the QOL of patients, radiotherapy for advanced carcinoma of larynx should be considered as a primary treatment especially for N0 cases. (author)

  12. Behavioral factors explaining the low risk for cervical carcinoma in Utah Mormon women.

    Science.gov (United States)

    Gardner, J W; Sanborn, J S; Slattery, M L

    1995-03-01

    We used data from a population-based case-control study conducted in Utah from 1984 to 1987 to determine whether the low incidence of cervical carcinoma in Mormon women can be explained by adherence to their religious teachings, which proscribe smoking and extramarital sexual relations. Mormon women had substantially lower risk for cervical carcinoma than non-Mormons [odds ratio (OR) = 0.39; 95% confidence interval (CI) = 0.28-0.54]; this low risk was confined to those who attended church frequently. The protective effect disappeared after controlling for differences in age, sexual behavior, and smoking (OR = 1.22; 95% CI = 0.80-1.87). PMID:7742409

  13. PARP-1 Val762Ala Polymorphism Is Associated with Risk of Cervical Carcinoma

    OpenAIRE

    Ye, Feng; Cheng, Qi; Hu, Yuting; Jing ZHANG; Chen, Huaizeng

    2012-01-01

    PARP-1 is a nuclear enzyme that plays an important role in DNA repair, recombination, proliferation and the genome stability. The PARP-1 Val762Ala polymorphism has been associated with increased risk of developing cancers of the prostate, esophagus and lung. The aim of this study was to determine whether the PARP-1 Val762Ala polymorphism is associated with the risk of cervical carcinoma. MA-PCR was used to genotype the PARP-1 Val762Ala polymorphism in 539 women with cervical carcinoma, 480 wo...

  14. Treatment results of different radiotherapy for 763 patients with advanced cervical cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of different radiotherapy protocols in the treatment of advanced cervical cancer. Methods: From 1976 to 2006, 763 patients with stage III cervical cancer (722 with squamous cell carcinoma and 41 with adenocarcinoma) were treated by radiotherapy in our hospital. 113 patients were treated by two-field whole pelvic irradiation in conventional fractionation plus brachytherapy (CF group), 44 by four-field whole pelvic irradiation in accelerated hyperfractionation plus brachytherapy (AHF group), and 606 by concomitant four-field unconventional fractionation radiotherapy and brachytherapy( FRT group). Sixty-one patients were treated by radiotherapy and chemotherapy. Among 350 patients who had complete data, the shore-term efficacy and toxicities were compared. Results: For patients in CF, AHF and FRT groups, the 3-year overall survival rates (OS) were 65.7%, 66.8% and 44.3%, respectively (P=0.000), and the 5-year OS were 65.7%, 66.8% and 36.3%, respectively (P=0.000). The 10-year OS were 43.3% and 31.9% in CF and FRT groups(P=0.200). For squamous cell carcinoma,the OS was higher of patients with chemotherapy than those without. In 350 patients who had complete data, the local control rates of CF, AHF and FRT groups were 83.0%, 93.2% and 86.1%, respectively (χ2=2.70, P =0.259); AHF group had the lowest side effect rate, especially skin reaction (9.1%, χ2=20.25, P= 0.002); CF group had the lowest acute bone marrow suppression rate (χ2=25.95, P=0.000); for squamous cell carcinoma, the OS was higher in patients with chemotherapy than those without; the acute bone marrow and intestinal toxicities were more in patients with chemotherapy than those without. Conclusions: CF and AHF groups have similar 5-year OS of patients with advanced cervical cancer. AHF group has less toxicities, shorter treatment course and a trend of better local control. Concurrent chemoradiation could improve survival and local control of the patients with

  15. Combination of neck dissection for cervical metastasis and irradiation of primary tumors for carcinomas of the mesopharynx, hypopharynx, and larynx

    International Nuclear Information System (INIS)

    Carcinomas of the mesopharynx, hypopharynx, and larynx with early-stage primary tumor and with cervical lymph node metastasis, were treated by neck dissection for cervical metastasis and definitive irradiation of the primary tumor. In this study, the primary sites of the 16 cases were the mesopharynx (10), the hypopharynx (3), and the larynx (3). Twelve cases of early T stages (T1 or T2) and 15 cases of advanced N stages (N2 or N3) were chosen for this treatment concept. Neck lesions were controlled in all cases and all the primary tumors showed complete response at the end of the initial treatment. One case of mesopharyngeal cancer died due to recurrence of the primary tumor and one case of hypopharyngeal cancer died due to complicated lung cancer. The treatment modality for cases of early primary cancer and advanced cervical lymph node metastasis requires well-balanced strategies for both lesions. In these cases, optimal prognosis was obtained because of careful patient selection. The treatment strategy described in this paper should be considered for cases of early T tumors and advanced N tumors. (author)

  16. Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement

    OpenAIRE

    Wang, Yue; Wang, Guang; Wei, Li-Hui; Huang, Ling-Hui; Wang, Jian-Liu; Wang, Shi-Jun; Li, Xiao-Ping; Shen, Dan-Hua; Bao, Dong-Mei; Gao, Jian

    2011-01-01

    Neoadjuvant chemotherapy (NACT), which can reduce the size and therefore increase the resectability of tumors, has recently evolved as a treatment for locally advanced cervical cancer. NACT has been reported to decrease the risk of pathologic factors related to prognosis of cervical cancer. To further assess the effects of NACT on surgery and the pathologic characteristics of cervical cancer, we reviewed 110 cases of locally advanced cervical cancer treated with radical hysterectomy with or w...

  17. CLINICAL BEHAVIOR OF UTERINE CERVICAL CARCINOMA IN AN IMMUNOCOMPROM ISED RENAL TRANSPLANT RECIPIENT WITH LITERATURE ON THE INCIDENCE, PATHOGENESIS AND CLINICAL BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Adi Lakshmi

    2015-04-01

    Full Text Available Incidence of malignancy is 2 - 31% in patients who had renal transplant . Due to advances in immunosuppression the incidence of graft versus host reaction and rejection of transplant are rare . Due to increase in survival of immune suppressed transplant patients , they are prone for acute immune disorders , in fections and malignancies . Literature on cancer after kidney transplantation is limited . The incidence of malignancies in recipients of kidney transplantation patients is higher compared to general population . We report a case of 38 yr s old female renal tr ansplant recipient who presented to us with carcinoma cervix . She had a very aggressive disease and rapid progression of malignancy in spite of aggressive treatment . Here we are discussing this case of renal transplant patient with cervical carcinoma with the review of literature about the incidence , pathogenesis and clinical behavior of cervical carcinoma in immunocompromised renal transplant recipients .

  18. Genotype distribution of human papillomavirus (HPV) in histological sections of cervical intraepithelial neoplasia and invasive cervical carcinoma in Madrid, Spain

    International Nuclear Information System (INIS)

    Human Papillomavirus (HPV) genotype distribution and co-infection occurrence was studied in cervical specimens from the city of Madrid (Spain), as a contribution to the knowledge of Human Papillomavirus genotype distribution and prevalence of carcinogenic HPV types in cervical lesions in Spain. A total of 533 abnormal specimens, from the Hospital General Universitario “Gregorio Marañón” of Madrid, were studied. These included 19 benign lesions, 349 cervical intraepithelial neoplasias 1 (CIN1), 158 CIN2-3 and 7 invasive cervical carcinomas (ICC). HPV genotyping was performed using PCR and tube array hybridization. We detected 20 different HPV types: 13 carcinogenic high-risk HPV types (HR-HPVs), 2 probably carcinogenic high-risk HPV types (PHR-HPVs) and 5 carcinogenic low-risk HPV types (LR-HPVs). The most frequent HPV genotypes found in all specimens were HPV16 (26.0%), 31 (10.7%) and 58 (8.0%). HPV 18 was only detected in 5.0%. Co-infections were found in 30.7% of CIN 1 and 18.4% cases of CIN2-3. The highest percentage of HR HPVs was found in those specimens with a CIN2-3 lesion (93.7%). As our study shows the current tetravalent vaccine could be effective in our geographical area for preventing all the invasive cervical carcinomas. In addition, upon the estimates of the important presence of other HR-HPV types – such as 31, 58, 33 and 52 – in different preneoplasic lesions the effectiveness of HPV vaccination in our geographical area, and others with similar genotype distribution, should be limited

  19. Chemotherapy and radiotherapy in locally advanced cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Brunet, J. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Alonso, C. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Llanos, M. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Lacasta, A. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Fuentes, J. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Mendoza, L.A. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Badia, J.M. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Delgado, E. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Ojeda, B. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain)

    1995-12-31

    Radiotherapy has been standard therapy for locally advanced squamous cell cervical cancer. Neoadjuvant chemotherapy is being studied to improve responses and survival. We report a phase II study in locally advanced squamous cell cervical cancer (FIGO stages III and IV A) using chemotherapy with bleomycin, methotrexate and cisplatin (BMP) followed by radical radiotherapy. Of the 35 patients, 31 in stage III and 4 in stage IV A, 3 complete responses (CR) and 22 partial responses (PR) were achieved after chemotherapy treatment. Thirty-one patients completed radiotherapy; 19 achieved CR and 4 PR. Five-year actuarial survival for the entire group was 45% (95% confidence interval, 37-53%) with a median survival of 56 months. Patients with CR had a significantly better survival: The 5-year actuarial survival was 74% (95% CI, 59-89%). Recurrence developed at 4 to 19 patients. The most frequent side-effects were nausea and vomiting. Myelosuppression and impaired renal function also occurred. There was no evidence of radiotherapy toxicity enhancement. The stage and Karnofsky index were significant prognostic factors. It is concluded that MBP chemotherapy in advanced cervical cancer is effective and, followed by radiotherapy, allows a good control of this tumor. The group of patients with complete response have a low rate of recurrences and a long survival chance. (orig.).

  20. Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer

    International Nuclear Information System (INIS)

    Background and purpose: The aim of this retrospective study was to analyze the outcome of patients with locally advanced cervical carcinoma treated by adjuvant radiochemotherapy and to determine risk factors for local and distant relapse. Furthermore, acute and late effects of treatment were recorded. Patients and methods: A total of 72 patients with FIGO stages I-III cervical carcinoma were treated by radical hysterectomy, pelvic lymphadenectomy, and postoperative radiochemotherapy. Only patients with positive pelvic lymph nodes, parametrial involvement, positive margins, or tumor bulk were eligible. Patients were irradiated with a standard pelvic field (50.4 Gy in 28 fractions). The majority of patients received platinum-based chemotherapy. Results: After a median follow-up of 37 months, estimated 1-, 2-, and 4-year disease-free survival (DFS) and overall survival (OS) rates were 89%, 80%, 68% and 95%, 88%, 76%, respectively. Nine of the 72 patients had pelvic recurrences including only 1 isolated local failure; 23 of the 72 patients presented with distant relapse. The majority of relapses occurred within the first 3 years after adjuvant treatment. The number of positive pelvic lymph nodes (> 1) was the strongest prognostic factor for DFS. Treatment was well tolerated with transient acute hematologic (∝30%) and gastrointestinal (∝30%) grade 3 toxicity. Small bowel obstruction (∝6%) was the only important late sequelae. Conclusion: Adjuvant radiochemotherapy in patients with advanced cervical cancer and several risk factors is highly effective to prevent local relapse. Future efforts to improve outcome should be placed on improvement of systemic control especially in subgroups with high-risk features for distant relapse. Combined treatment was well tolerated with moderate acute and late toxicity. (orig.)

  1. Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Heinzelmann, F.; Henke, G.; Grafenstein, M. von; Weidner, N.; Paulsen, F.; Bamberg, M.; Weinmann, M. [Tuebingen Univ. (Germany). Dept. of Radiation Oncology; Staebler, A. [Tuebingen Univ. (Germany). Div. of Gynecologic Pathology; Brucker, S. [Tuebingen Univ. (Germany). Dept. of Gynecology

    2012-07-15

    Background and purpose: The aim of this retrospective study was to analyze the outcome of patients with locally advanced cervical carcinoma treated by adjuvant radiochemotherapy and to determine risk factors for local and distant relapse. Furthermore, acute and late effects of treatment were recorded. Patients and methods: A total of 72 patients with FIGO stages I-III cervical carcinoma were treated by radical hysterectomy, pelvic lymphadenectomy, and postoperative radiochemotherapy. Only patients with positive pelvic lymph nodes, parametrial involvement, positive margins, or tumor bulk were eligible. Patients were irradiated with a standard pelvic field (50.4 Gy in 28 fractions). The majority of patients received platinum-based chemotherapy. Results: After a median follow-up of 37 months, estimated 1-, 2-, and 4-year disease-free survival (DFS) and overall survival (OS) rates were 89%, 80%, 68% and 95%, 88%, 76%, respectively. Nine of the 72 patients had pelvic recurrences including only 1 isolated local failure; 23 of the 72 patients presented with distant relapse. The majority of relapses occurred within the first 3 years after adjuvant treatment. The number of positive pelvic lymph nodes (> 1) was the strongest prognostic factor for DFS. Treatment was well tolerated with transient acute hematologic ({proportional_to}30%) and gastrointestinal ({proportional_to}30%) grade 3 toxicity. Small bowel obstruction ({proportional_to}6%) was the only important late sequelae. Conclusion: Adjuvant radiochemotherapy in patients with advanced cervical cancer and several risk factors is highly effective to prevent local relapse. Future efforts to improve outcome should be placed on improvement of systemic control especially in subgroups with high-risk features for distant relapse. Combined treatment was well tolerated with moderate acute and late toxicity. (orig.)

  2. Prognostic Significance of p16 Expression in Advanced Cervical Cancer Treated With Definitive Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to evaluate the prognostic significance of p16 immunohistochemistry (IHC) in patients with advanced cervical cancer treated with radiation therapy. Materials and Methods: This was a retrospective study of 126 patients with International Federation of Gynecology and Obstetrics Stages Ib1–IVb cervical cancer treated with radiation. Concurrent cisplatin chemotherapy was given to 108 patients. A tissue microarray (TMA) was constructed from the paraffin-embedded diagnostic biopsy specimens. Immunoperoxidase staining was performed on the TMA and a p16 monoclonal antibody was utilized. IHC p16 extent was evaluated and scored in quartiles: 0 = no staining, 1 = 1–25% of cells staining, 2 = 26 to 50%, 3 = 51 to 75%, and 4 = 76 to 100%. Results: The p16 IHC score was 4 in 115 cases, 3 in 1, 2 in 3 and 0 in 7. There was no relationship between p16 score and tumor histology. Patients with p16-negative tumors were older (mean age at diagnosis 65 vs. 52 years for p16-positive tumors; p = 0.01). The 5-year cause-specific survivals were 33% for p16-negative cases (score = 0) compared with 63% for p16-positive cases (scores 1, 2, 3 or 4; p = 0.07). The 5-year recurrence-free survivals were 34% for those who were p16-negative vs. 57% for those who were p16-positive (p = 0.09). In addition, patients with p16-positive tumors (score > 0) were more likely to be complete metabolic responders as assessed by the 3-month posttherapy 18 [F]-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomograph compared with patients with p16-negative tumors (p = 0.03). Conclusion: p16 expression is predictive of improved survival outcome after chemoradiation therapy for advanced-stage invasive cervical carcinoma. Further testing will be needed to evaluate p16-negative cervical tumors.

  3. Loss of a novel mucin-like epithelial glycoprotein in oral and cervical squamous cell carcinomas

    DEFF Research Database (Denmark)

    Nielsen, P A; Mandel, U; Therkildsen, M H;

    1997-01-01

    layers of buccal epithelium and was also found in larynx, esophagus, vagina, and exocervix, but not in epidermis. Data showed that gp230 was distinct from MUC1 or CD44. It is interesting that in most cases gp230 was not expressed in squamous cell carcinomas of buccal and cervical mucosa. A few moderately...

  4. Early-stage cervical carcinoma, radical hysterectomy, and sexual function. A longitudinal study

    DEFF Research Database (Denmark)

    Jensen, Pernille T; Groenvold, Mogens; Klee, Marianne C;

    2004-01-01

    BACKGROUND: Limited knowledge exists concerning the impact of radical hysterectomy (RH) alone on the sexual function of patients with early-stage cervical carcinoma. The authors investigated the longitudinal course of self-reported sexual function after RH. METHODS: The current study was comprise...

  5. Characterization of a novel human papillomavirus DNA in the cervical carcinoma cell line ME180.

    Science.gov (United States)

    Reuter, S; Delius, H; Kahn, T; Hofmann, B; zur Hausen, H; Schwarz, E

    1991-01-01

    The human cervical carcinoma cell line ME180 was examined for human papillomavirus (HPV) DNA and RNA. The integrated DNA of a presumably new HPV type showing a relationship closer to HPV39 than to HPV18 was cloned and sequenced. HPV sequences from the E6-E7-E1 region are expressed as poly(A)+ RNAs. Images PMID:1716694

  6. Cervical Lymph Node Metastasis: Unusual Presentation of Adenoid Cystic Carcinoma - Diagnosed By FNAC

    Directory of Open Access Journals (Sweden)

    Archana Buch

    2015-01-01

    Full Text Available Adenoid cystic carcinoma (ACC is a rare neoplasm that usually arises from minor salivary glands. It is characteristically locally infiltrative, exhibiting perineural invasion, has a tendency for local recurrence and prolonged clinical course. A 60 year old male, chronic smoker presented with swelling of the left cervical lymph node since two months. Examination revealed a solitary firm, non tender, non mobile left cervical swelling measuring 2 x 1 cm. Fine Needle Aspiration Cytology (FNAC was done from the cervical lymph node. The diagnosis of metastatic deposits of ACC was given. Detail examination of the oral cavity revealed a small swelling at the floor of the mouth. Biopsy of the swelling confirmed ACC on histopathological examination. An unusual feature of adenoid cystic carcinoma is the low incidence of metastases to regional lymph nodes. The case is presented to highlight its unusual presentation and utility of FNAC in rapid diagnosis.

  7. Short-term pretreatment DCE-MRI in prediction of outcome in locally advanced cervical cancer

    International Nuclear Information System (INIS)

    Background and purpose: Several investigators have indicated that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has the potential to provide biomarkers for personalized treatment of cervical carcinoma. However, some clinical studies have suggested that treatment failure is associated with low tumor signal enhancement, whereas others have reported associations between high signal enhancement and poor outcome. The purpose of this investigation was to clear up these conflicting reports and to provide a method for identifying biomarkers that easily can be implemented in routine DCE-MRI diagnostics. Methods: The study involved 85 patients (FIGO stage IB through IVA) treated with concurrent chemoradiotherapy. Low-enhancing tumor volume (LETV) and low-enhancing tumor fraction (LETF), defined as the volume and fractional volume of low-enhancing voxels, respectively, were calculated from signal intensities recorded within 1 min after contrast administration by using two methods reported to give conflicting conclusions. Results: Multivariate analysis involving tumor volume, lymph node status, FIGO stage, and LETV or LETF revealed that LETV and LETF provided independent prognostic information on treatment outcome, independent of the method of calculation. Conclusion: Low signal enhancement is associated with poor prognosis in cervical carcinoma, and biomarkers predicting poor outcome can be provided by short-term DCE-MRI without advanced image analysis

  8. pO2 Fluctuation Pattern and Cycling Hypoxia in Human Cervical Carcinoma and Melanoma Xenografts

    International Nuclear Information System (INIS)

    Purpose: Blood perfusion in tumors is spatially and temporally heterogeneous, resulting in local fluctuations in tissue oxygen tension (pO2) and tissue regions showing cycling hypoxia. In this study, we investigated whether the pO2 fluctuation pattern and the extent of cycling hypoxia differ between tumor types showing high (e.g., cervical carcinoma xenograft) and low (e.g., melanoma xenograft) fractions of connective tissue-associated blood vessels. Methods and Materials: Two cervical carcinoma lines (CK-160 and TS-415) and two melanoma lines (A-07 and R-18) transplanted into BALB/c nu/nu mice were included in the study. Tissue pO2 was measured simultaneously in two positions in each tumor by using a two-channel OxyLite fiber-optic oxygen-sensing device. The extent of acute and chronic hypoxia was assessed by combining a radiobiological and a pimonidazole-based immunohistochemical assay of tumor hypoxia. Results: The proportion of tumor regions showing pO2 fluctuations, the pO2 fluctuation frequency in these regions, and the relative amplitude of the pO2 fluctuations were significantly higher in the melanoma xenografts than in the cervical carcinoma xenografts. Cervical carcinoma and melanoma xenografts did not differ significantly in the fraction of acutely hypoxic cells or the fraction of chronically hypoxic cells. However, the ratio between fraction of acutely hypoxic cells and fraction of chronically hypoxic cells was significantly higher in melanoma than in cervical carcinoma xenografts. Conclusions: Temporal heterogeneity in blood flow and tissue pO2 in tumors may depend on tumor histology. Connective tissue surrounding microvessels may stabilize blood flow and pO2 and, thus, protect tumor tissue from cycling hypoxia.

  9. Therapeutic efficacy of natural dipeptide carnosine against human cervical carcinoma cells.

    Science.gov (United States)

    Pandurangan, Muthuraman; Enkhtaivan, Gansukh; Kim, Doo Hwan

    2016-09-01

    Natural substances have been attracted several researchers in the recent years, because of its potential antioxidant, anti-inflammatory and anti-cancer properties. We have investigated the effect of carnosine on cell viability, apoptosis, DNA damage, reactive oxygen species (ROS) and caspase 3 enzyme expression in human cervical carcinoma and Madin-Darby Kidney Cells (MDCK) cells. Carnosine inhibited cancer cell growth up to 23%. ROS level was increased up to 30 and 31% in MDCK and HeLa cells respectively. Tunnel assay showed 42 and 14% of positive apoptotic cells in cancer and normal cells respectively. The alteration in mitochondrial and nuclear morphology was determined. The extended lace-like network of normal mitochondria found in control cells. Carnosine treatment significantly altered the mitochondrial morphology of normal cervical carcinoma cell. Mitochondria were condensed clump structures in carnosine treated cancer cells. Carnosine reduced the number of colonies of cervical carcinoma cells. Caspase 3 expression was corresponded to the appearance of immunofluorescence in the cytoplasm. Caspase 3 expression was gradually increased in cervical carcinoma cells. In Silico, docking study was performed to recognize the binding activity of carnosine against a subunit of the caspase 3, and carnosine was able to bind to the drug binding pocket of caspase 3. The glide energy is -5.2 kcal/mol, suggesting the high binding affinity of carnosine to caspase 3. Taking all these data together, the natural dipeptide L-carnosine could be a suitable antiproliferative agent in cervical carcinoma cells. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27000946

  10. Sorafenib in advanced hepatocellular carcinoma

    DEFF Research Database (Denmark)

    Køstner, Anne Helene; Sørensen, M; Olesen, René Krøjgaard;

    2013-01-01

    Advanced HCC is a clinical challenge with limited treatment options. The multikinase inhibitor sorafenib is the first and only agent showing a survival benefit in these patients. In this study we evaluate the efficacy and tolerability of sorafenib in an unselected patient population. Furthermore we...

  11. Predictors of cervical cancer being at an advanced stage at diagnosis in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Rasch, Vibeke; Pukkala, Eero;

    2011-01-01

    Cervical cancer is the second most common cancer among women in Sudan, with more than two-thirds of all women with invasive cervical cancer being diagnosed at an advanced stage (stages III and IV). The lack of a screening program for cervical cancer in Sudan may contribute to the late presentation...... of this cancer, but other factors potentially associated with advanced stages of cervical cancer at diagnosis are unknown. The purpose of this research was to investigate the relationship between age, marital status, ethnicity, health insurance coverage, residence in an urban vs a rural setting, and stage (at...... diagnosis) of cervical cancer in Sudan....

  12. Cervical Spine Osteomyelitis and Epidural Abscess after Chemoradiotherapy for Hypopharyngeal Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Yushi Ueki

    2014-01-01

    Full Text Available Osteomyelitis of mandible as a delayed adverse event following radiation therapy has been widely reported; however, osteomyelitis of the cervical spine has rarely been reported. In this study, we reported our experience with a case of cervical spine osteomyelitis and epidural abscess after concurrent chemoradiotherapy (CCRT for hypopharyngeal carcinoma. The case involved a 68-year old man who underwent radical CCRT after a diagnosis of stage IVb, T4bN2cM0 posterior hypopharyngeal wall carcinoma. At 7 months after completing the initial therapy, the patient complained of severe pain in the neck and both shoulders and reduced muscular strength in the extremities. A large defect was found on the mucosa of posterior hypopharyngeal wall. On cervical magnetic resonance imaging, cervical spine osteomyelitis and an epidural abscess were observed. Because antimicrobial therapy was not effective, hyperbaric oxygen therapy was administered. Abscess reduction and improvement of the mucosal defect were observed. Because cervical spine complications after CCRT can be fatal upon worsening, adequate attention must be given.

  13. Clinical study of 28 cases of cervical lymph node metastasis from an unknown primary carcinoma

    International Nuclear Information System (INIS)

    From 1989 to 2005, 28 patients-20 men and 8 women-with cervical lymph node metastasis from an unknown primary carcinoma were treated and studied retrospectively. In histological diagnosis, open biopsy was conducted in 11 patients and non-open biopsy (fine needle aspiration (FNA) or frozen section diagnosis during surgery) in 17. Blind biopsy under general anesthesia was conducted in 10 patients, showing one primary tumor in the nasopharynx. Tonsillectomy for diagnosis was not done. In region of maximum-size lymph node metastasis, the upper cervical region accounted for 22 cases (79%). The N stage of cervical lymph nodes was as follows: N2a in 4, N2b in 14, N2c in 3, and N3 in 7. The histopathological diagnosis of cervical lymph node was as follows: squamous cell carcinoma in 21, adenocarcinoma in 3, mucoepidermoid carcinoma in 2, and others in 2. Therapy was as follows: only neck dissection in 7, neck dissection with postoperative radiation therapy in 13, and irradiation and chemotherapy in 8. All patients treated with irradiation and chemotherapy had been judged to be inoperable. Seven patients were found to have a subsequent primary tumor. Primary tumor sites were as follows: tonsils in 3 and upper gingiva, base of tongue, lung, and nasopharynx in 1 each. Fluorodeoxyglucose-positron emission tomography (FDG-PET) was conducted in 7 patients but revealed no primary tumor. Overall 5-year survival in this study was 46%. We should pay particular attention to the tonsils for detecting primary tumors in patients with cervical metastasis from an unknown primary carcinoma. (author)

  14. Stating of cervical carcinoma using magnetic resonance imaging; Estadificacion del carcinoma de cervix por resonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Oleaga, L.; Vela, M. C.; Grande, J.; Cura del, J. L.; Grande, D. [Hospital de Basurto. Bilbao (Spain)

    1999-07-01

    The infiltration of the parametrium represents one of the most important factors that determine the prediction and treatment of cervical carcinoma. Our objetive is to evaluate the utility of magnetic resonance imaging (MRI) in the staging of cervical carcinomas, to establish the reliability of this technique and to carry out a comparative study of the sequences used to demonstrate the parametrial invasion. We have carried out a retrospective study on 44 patients diagnosed with cervix neoplasia, using clinical exploration and performing a biopsy. the MRI studies have been carried out using a 1 Tesla magnet and the sequences used have been SE T1, Se proton density (PD) and T2 and dynamic GRE after administering gadolinium intravenously in the axial and sagital projections. The stages determined by MRI have been compared to the anatomopathological stages of the surgical specimens in cases where surgery was carried out and with the clinical stage in cases where no radical surgery was carried out. A diagnosis value of MRI has been determined to demonstrate the parametrial invasion, comparing the SE T2 sequence with the dynamic GE sequence with gadolinium. We calculate the volume of the tumour in the MRI studies to evaluate the difference of the volume between patients with tumoral stages that are clinically surgical and not surgical. MRI determines the invasion of the parametrium with a sensitivity of 88.8%, a specificity of 80% a positive value of 76.1%, a negative predictive value of 90.9% and a reliability of 83.7%. For the SE T2 sequences the sensitivity was 86.6%, the specifity 80%, the posistive predictive value 81.25%, the negative predictive value 85.7% and the reliability 83.3%. For the dynamic GE sequence with intravenous gadolinium the sensitivity was 86.6%, the specifity 86.6%, the posistive predictive value 86.6%, the negative predictive value 86.6% and the reliability 86.6%. The use of the dynamic GE sequence after the intravenous administration of

  15. Cervical intraepithelial neoplasia and squamous cell carcinoma of the anus in sexually active women.

    OpenAIRE

    Dixon, A. R.; Pringle, J. H.; Holmes, J. T.; Watkin, D. F.

    1991-01-01

    Twenty-five patients with squamous cell carcinoma (SCC) of the anus have presented over an 8 year period; 18 were female. Six of 9 patients aged under 50 years were female. Five of these women had been treated for a previous cervical malignancy (2 invasive) and 4 practised anal intercourse; human papillomavirus (HPV) type 16 DNAs were isolated from their arcival anal/cervical paraffin sections. Signals were confined to the nuclei of the invasive anal SCC cells and the transformation zone of t...

  16. Applicability of Preoperative Nuclear Morphometry to Evaluating Risk for Cervical Lymph Node Metastasis in Oral Squamous Cell Carcinoma

    OpenAIRE

    KARINO, MASAAKI; Nakatani, Eiji; HIDESHIMA, Katsumi; Nariai, Yoshiki; Tsunematsu, Kohji; Ohira, Koichiro; Kanno, Takahiro; Asahina, Izumi; Kagimura, Tatsuo; Sekine, Joji

    2014-01-01

    Background We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical ...

  17. Low Doses of Gamma Rays Reduce the Sensitivity of Cervical Carcinoma Cells to Subsequent Treatment with Cisplatin

    International Nuclear Information System (INIS)

    One of the major challenges of modern genetics is to apply recent advances in mutation research to improve the accuracy of the estimates of the genetic risk for humans. Because of the important implications for radiation protection, biological effects of low-dose radiation have been a focus of research in recent years. Previously we have found that human cervical carcinoma HeLa cells irradiated repeatedly with low doses of gamma rays (HeLa1500 cells) became resistant to cisplatin. In this study we examine whether this effect was caused by inhibition of apoptosis. In HeLa and HeLa1500 cells we determined the induction of apoptosis following the treatment with cisplatin (i) by counting apoptotic cells with characteristic morphological changes, (ii) by analysing the expression of apoptotic genes involved in cytochrome c/Apaf-1/caspase-9 and in Fas/FasL pathways by Western blot method, and (iii) by estimating the activities of caspases by commercial caspase detection kits. Our results show that low doses of gamma rays induced alterations in human cervical carcinoma cells that were reflected in inhibition of p53-independent cisplatin-induced apoptosis due to reduced activity of caspase 3. (author)

  18. Food consumption pattern in cervical carcinoma patients and controls

    Directory of Open Access Journals (Sweden)

    Labani Lakshmi

    2009-01-01

    Full Text Available Background: The uterine cervix is the second most common site of cancer among Indian women.Though the human papillomavirus has been demonstrated to be a causative agent for this cancer, a variety of other risk factors are in play, such as sexual and reproductive patterns, socioeconomic, hygienic practices, and diet. The accumulated evidence suggests that cervical cancer is preventable and is highly suitable for primary prevention. The dietary intake of antioxidants and vitamins like vitamin A, carotenoids, vitamin C, folacin and tocopherol is found to have protective effects against cancer of the cervix. Dietary data regarding cervical cancer are still scanty. Objective: The present study was therefore undertaken to study the dietary pattern among uterine cervical cancer patients and normal controls. Materials and Methods: A total of 60 consecutive patients and 60 controls were enrolled from a referral hospital during the year 2004. A schedule inclusive of the food frequency pattern and 24-h dietary recall along with the general information was administered to all the enrolled subjects to describe findings on the food consumption pattern along with other important factors. Results: The mean intake of energy, protein, vitamins, etc., between the cases and controls was not significantly different except for the vitamin C level. Serum vitamin E was found to have lower average in patients as compared to controls. The nutrient intake of cervical cancer patients and controls was grossly deficient in the socioeconomic group studied. With regard to the macronutrient intake, calorie and protein intakes showed a deficit of around 50% when compared to RDA. Conclusion: The food consumption profile was not significantly different between cervical cancer patients and normal controls.

  19. {sup 18}F-FDG PET in stage IB/IIB cervical adenocarcinoma/adenosquamous carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chou, Hung-Hsueh; Lai, Chyong-Huey; Wu, Tzu-I; Chen, Ming-Yu.; Chang, Ting-Chang [Chang Gung Memorial Hospital and Chang Gung University, Department of Obstetrics and Gynaecology, Taoyuan (China); Chang, Hsiu-Ping; Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine, Taoyuan (China); Ng, Koon-Kwan [Chang Gung Memorial Hospital and Chang Gung University, Department of Diagnostic Radiology, Taoyuan (China); Hsueh, Swei [Chang Gung Memorial Hospital and Chang Gung University, Department of Pathology, Taoyuan (China); Hong, Ji-Hong [Chang Gung Memorial Hospital and Chang Gung University, Department of Radiation Oncology, Taoyuan (China)

    2010-04-15

    The diagnostic and prognostic value of {sup 18}F-FDG PET in cervical adenocarcinoma/adenosquamous carcinoma (AC/ASC) is unclear. The aim of this study was to assess the value of PET in the management of cervical AC/ASC. Patients with resectable FIGO stage IB/IIB cervical AC/ASC receiving a preoperative MRI scan and a PET or PET/CT scan before radical surgery were eligible. Diagnostic efficacy was compared by receiver operating characteristic (ROC) analysis. Correlations between clinicopathological parameters and outcome and maximum standardized uptake values (SUVmax) of FDG uptake were evaluated. The study group comprised 83 patients (mean age 48.3{+-}9.7 years) Five-year overall survival was 85.5%, with a median follow-up time of 38.6 months (range 2.8-87.2 months). Pelvic lymph node (PLN) and paraaortic lymph node (PALN) metastases were seen in 32.5% and 8.4% of patients, respectively. The difference in diagnostic efficacy in identifying metastatic PALN between PET and MRI was significant (PET versus MRI, area under the curve 0.832 versus 0.607, p=0.039). SUVmax in primary tumour was correlated with LN metastasis and deep stromal invasion. Overall survival was significantly related to FIGO stage, PLN metastasis, deep cervical stromal invasion, tumour size measured by MRI, and SUVmax of the primary cervical tumour. PET provided significantly better diagnostic efficacy than MRI in detecting PALN metastasis. Poor prognostic factors in cervical AC/ASC were SUVmax of the primary cervical tumour >5.3, stage IIB, deep cervical stromal invasion, tumour size measured by MRI {>=}40 mm, and PLN metastasis. (orig.)

  20. 18F-FDG PET in stage IB/IIB cervical adenocarcinoma/adenosquamous carcinoma

    International Nuclear Information System (INIS)

    The diagnostic and prognostic value of 18F-FDG PET in cervical adenocarcinoma/adenosquamous carcinoma (AC/ASC) is unclear. The aim of this study was to assess the value of PET in the management of cervical AC/ASC. Patients with resectable FIGO stage IB/IIB cervical AC/ASC receiving a preoperative MRI scan and a PET or PET/CT scan before radical surgery were eligible. Diagnostic efficacy was compared by receiver operating characteristic (ROC) analysis. Correlations between clinicopathological parameters and outcome and maximum standardized uptake values (SUVmax) of FDG uptake were evaluated. The study group comprised 83 patients (mean age 48.3±9.7 years) Five-year overall survival was 85.5%, with a median follow-up time of 38.6 months (range 2.8-87.2 months). Pelvic lymph node (PLN) and paraaortic lymph node (PALN) metastases were seen in 32.5% and 8.4% of patients, respectively. The difference in diagnostic efficacy in identifying metastatic PALN between PET and MRI was significant (PET versus MRI, area under the curve 0.832 versus 0.607, p=0.039). SUVmax in primary tumour was correlated with LN metastasis and deep stromal invasion. Overall survival was significantly related to FIGO stage, PLN metastasis, deep cervical stromal invasion, tumour size measured by MRI, and SUVmax of the primary cervical tumour. PET provided significantly better diagnostic efficacy than MRI in detecting PALN metastasis. Poor prognostic factors in cervical AC/ASC were SUVmax of the primary cervical tumour >5.3, stage IIB, deep cervical stromal invasion, tumour size measured by MRI ≥40 mm, and PLN metastasis. (orig.)

  1. Down-regulation of the expression of CCAAT/enhancer binding protein α gene in cervical squamous cell carcinoma

    International Nuclear Information System (INIS)

    Cervical carcinoma is the second most common cancer and is an important cause of death in women worldwide. CCAAT/enhancer binding proteins (C/EBPs) are a family of transcription factors that regulate cellular differentiation and proliferation in a variety of tissues. However, the role of C/EBPα gene in cervical cancer is still not clear. We investigated the expression of C/EBPα gene in cervical squamous cell carcinoma. C/EBPα mRNA level was measured by real-time quantitative RT-PCR in cervical cancer tissues and their adjacent normal tissues. C/EBPα protein level was measured by immunohistochemistry. Methylation in the promoter of C/EBPα gene was detected by MALDI TOF MassARRAY. We transfected HeLa cells with C/EBPα expression vector. C/EBPα expression in HeLa cells was examined and HeLa cell proliferation was measured by MTT assay and HeLa cells migration was analyzed by matrigel-coated transwell migration assays. There were significant difference in C/EBPα protein expression between chronic cervicitis and cervical carcinoma (P < 0.001). CEBPα mRNA level was significantly lower in cervical cancer tissues than in normal cervical tissues (P < 0.01). Methylation of the promoter of CEBPα gene in CpG 5, CpG-14.15, CpG-19.20 were significantly higher in cervical cancer than in normal cervical tissues (P < 0.05, P < 0.01, P < 0.05, respectively). CEBPα pcDNA3.1 construct transfected into HeLa cells inhibited cell proliferation and decreased cell migration. Our results indicate that reduced C/EBPα gene expression may play a role in the development of cervical squamous cell carcinoma

  2. Peutz-Jeghers syndrome with small intestinal malignancy and cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    Lian-Jie Li; Zhi-Qing Wang; Bao-Ping Wu

    2008-01-01

    We report a case of 30-year-old woman with PeutzJeghers syndrome (P.1S).Because of small intestinal obstruction,she received the small intestinal polypectomy in 2001,and the pathological diagnosis was Peutz-Jeghers polyp canceration (mucinous adenocarcinoma,infiltrating full-thickness of the intestine).The patient did not feel uncomfortable after 6 mo of chemotherapy and other management.We kept a follow-up study on her and found that she suffered from cervical cancer in 2007,with a pathological diagnosis of cervical adenosquamous carcinoma.The patient presented with typical features of PJS,but without a family history.The PJS accompanied with both small intestinal and cervical malignancies has not been reported so far in the world.

  3. Renal metastasis from cervical carcinoma presenting as a renal cyst: A case report

    OpenAIRE

    FAN, GANG; Xie, Yu; PEI, XIAMING; Lei, Jian; YE, MINGJI; ZENG, GONGQIAN; LI, FEIPING; XIONG, YINGYING; HAN, WEIQIN

    2015-01-01

    In the present study, the case of a 51-year-old female with a metastatic tumor in the left kidney originating from cervical carcinoma, is reported. The patient had undergone chemoradiotherapy for stage IIB squamous-cell carcinoma of the uterine cervix 3 years earlier. Computed tomography (CT) identified low-density left renal nodules, which were diagnosed post-operatively as renal cysts during the follow-up conducted 2 years later. The next year, the patient was admitted to the Hunan Provinci...

  4. A phantom for measuring the isodose distribution in intracavitary radiotherapy of cervical carcinoma

    International Nuclear Information System (INIS)

    A nonuniform tissue equivalent anthropomorphic phantom of female hip, which was intended for measuring the isodose distributions in intracavitary radio therapy of cervical carcinoma, was developed. It was made of bone and muscle equivalent materials. CT number of normal organs and tissues in pelvis cavity and lower abdomen of the female were measured with CT scanner and compared with those values obtained from home-made phantom under same scan conditions. The electron density effective atomic number, mass density and CT number of equivalent muscle were as essentially same as real muscle. The clinical application of this phantom showed that its construction is reasonable, convenient in use and suitable for measuring isodose distributions for different programs of intracavitary radio therapy of cervical carcinoma

  5. Brachytherapy emulating robotic radiosurgery in patients with cervical carcinoma

    International Nuclear Information System (INIS)

    To evaluate the technique, dosimetry, dose-volume-histograms (DVHs) and acute toxicity for CyberKnife® boost irradiation instead of intra-cervical brachytherapy in patients with cervical cancer. Eleven who were not suitable for brachytherapy with FIGO stage IIB-IIIB cervical cancer underwent primary chemoradiation. After fiducial implantation, T2 contrast-enhanced planning MRI and CT scans at 2-mm slice thickness were collected in the treatment position. The clinical target volume was defined as cervix + macroscopic residual tumour on MRI. Five fractions of 6 Gy each were prescribed to the target volume with a covering single dose 6 Gy. DVH parameters were evaluated for the target and organs at risk. Acute toxicity was documented once a week. DmeanPTV ranged from 33.6-40 Gy, median 36.7 Gy with a coverage of the PTV calculated to 100% of the prescribed dose ranging from 93.0-99.3% (median 97.7%). For the PTV the median CN was 0.78 (range, 0.66 to 0.87) and the median CI was 1.28 (range 1.15 to 1.52). Gastrointestinal (GI) and genitourinary (GU) toxicity was mild. There was no grade 3 or higher GI and GU toxicity. After 6 months of follow up, there were no local recurrences. For the complete treatment, a median EQD2 to 1 cc and 2 cc of the bladder wall was 98.8 Gy and 87.1 Gy, respectively. Median EQD2 to 1 cc and 2 cc of the rectal wall was 72.3 Gy and 64 Gy, respectively, correlating with a risk < 10% for Grade 2–4 late toxicity. CyberKnife robotic radiosurgery in patients with cervical cancer provides excellent target coverage with steep dose gradients toward normal tissues and safe DVH parameters for bladder, rectum and sigmoid. Acute toxicity was mild. Longer follow-up is needed to evaluate the oncological equality

  6. Experience of prevention of radiation injuries of rectum and urinary bladder in cervical carcinoma patients

    International Nuclear Information System (INIS)

    Methods of preventing radiation injuries of rectum and urinary bladder in cervical carcinoma patients after concomitant radiotherapy are developed; they are based on the bond application of dimenthylsulphoxide (DMSO) and metronidazole (MZ) solved in DMSO. It is show that the application of DMSO in radiotherapy significantly decreases the rate and severity of radiation injuries of rectum and urinary bladder. MZ application entrances radiation injurious effect on the tumor

  7. Papillomavirus genomes in human cervical carcinoma: Analysis of their integration and transcriptional activity

    International Nuclear Information System (INIS)

    Eighty-four biopsies derived from cervical tissues were analyzed for the presence of human papillomavirus (HPV) DNA types 6, 16 and 18 using Southern blot hybridization. HPV 6 was found in none of the cervical biopsies, and HPV types 16 and 18 were found in 44% of them. The rate of HPV 16/18 positive samples increased proportionally to the severity of the lesion. In normal tissue there were no positive samples, in mild and moderate dysplasia HPV 16/18 was present in 20% and in severe dysplasia and invasive carcinomas in 37 and 50%, respectively. In biopsies from 13 cases with squamous cell carcinoma of the uterine cervix and CIN III lesions HPV 16 was integrated within the host genome. It was concluded that the virus could be integrated at variable, presumably randomly selected chromosomal loci and with different number of copies. Transcription of HPV 16 and 18 was detected in one cervical cancer in HeLa cells, respectively. These results imply that HPV types 16 and 18 play an etiological role in the carcinogenesis of human cervical epithelial cells. (author)

  8. Carcinoma of the cervical stump: comparison of radiation therapy factors, survival and patterns of failure with carcinoma of the intact uterus

    International Nuclear Information System (INIS)

    Eighty-nine patients with previously untreated invasive carcinoma of the cervical stump were seen at Yale-New Haven Hospital from 1953 through 1977. This represented 9.4% of the carcinomas of the cervix seen during this time period. Eighty-five of the 89 patients (95.5%) had ''true'' cancers of the cervical stump diagnosed 2 years or more after subtotal hysterectomy, while 4 of the 89 patients (4.5%) had ''coincident'' cancers diagnosed within 2 years of the subtotal hysterectomy. All cervical cancers were staged by the F.I.G.O. classification. Patient characteristics, methods of management, failure sites and survival of patients with carcinoma of the cervical stump were compared to those patients with carcinoma in the intact uterus. Patients with cervical stump cancers were treated in a similar manner to those with carcinomas of the intact uterus, using a combination of external beam irradiation and intracavitary radium. The stump cancer patients had a similar stage distribution to the patients with cancers of the intact uterus but, on the average, they were older and received less irradiation. The patterns of failure were similar on a stage for stage basis, but the survival and disease-free survival for stump cancer patients were superior to those of the patients with carcinoma of the intact uterus

  9. Preoperative chemoradiotherapy for advanced lower rectal carcinoma

    International Nuclear Information System (INIS)

    Preoperative chemoradiotherapy in combination with radiation of 30 Gy and chemotherapy with oral uracil-tegafur for 14 patients with advanced lower rectal carcinoma was performed. Tumors were located at RaRb in 5 cases, RbRa in 2, Rb in 3, and RbP in 4 with a mean diameter of 3.8 cm. Preoperative lymphnodes were diagnosed as cN0 in 8 cases, cN1 (metastases of perirectal nodes) in 4, cN1 (perirectal and along superior rectal artery nodes) in 1, and cN3 (perirectal and lateral nodes) in 1. Efficacy for primary carcinomas was evaluated as Partial Response in 9 cases, Stable Disease in 5 and perirectal nodes were down-sized in 4 without down-sizing of either along superior rectal artery nodes or lateral nodes. Margins of primary carcinomas to anal verge were prolonged in 7 cases with a mean prolongation of 0.81 cm. Autonomic nerve-preserving resections with lymphadenectomy of perirectal and along superior rectal artery nodes were performed. Histopathologically efficacy for primary tumors was diagnosed to as not effective in 9 cases, partially effective in 5, and all lymphnodes were combined with necroses and fibrosis. Preoperative chemoradiotherapy is safe for preserving autonomic nerves and serves to preserve the sphincter. A forthcoming study with more appropriate radiation, chemotherapy and lymphadenectomy is being considered. (author)

  10. Superselective intraarterial chemotherapy into bilateral uterine arteries in uterine cervical carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Hyun Jung; Choi, Guk Myeong; Park, Sun Won; Kim, Tae Kyoung; Chung, Jin Wook; Park, Jae Hyung [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    To assess the efficacy of superselective intra-arterial chemotherapy(SSIAC) via the bilateral uterine arteries in cases of cervical carcinoma. Eighteen patients with stage 2 {sub a}(n=10), 2 {sub b}(n=7), or 3 {sub a}(n=1) cervical carcinoma underwent one(n=2) or two(n=16) courses of preoperative SSIAC with Vincristine, Cisplatin, and Mitomycin C. We estimated the extent of reduction of tumor volume and improvement of stage, comparing pre-SSIAC MRI to postoperative results. Tumor vascularity, as seen on uterine arteriography, and procedural complications, were also evaluated. A marked reduction in tumor volume was observed in all patients, an average reduction volume of 94.7%. Improvement of stage was noted in 16 patients, and in six of these, no residual viable tumor or microinvasive residual tumor was seen. On angiography, tumor hypervascularity was demonstrated in seven patients, but its degree was not substantially related to therapeutic response. In no case did significant systemic complications of result from chemotherapy; in one patient, however, we experienced a serious complication of necrotizing cystitis due to malpositioning of a catheter in the superior vesical artery. SSIAC via the bilateral uterine arteries is an effective complementary modality for the treatment of various stages of cervical carcinoma.

  11. Complications after radiotherapy and radical hysterectomy in early-stage cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Gerdin, E. [Univ. Hospital, Dept. of Obstetrics and Gynecology, and Gynecologic Oncology, Uppsala (Sweden); Cnattingius, S. [Univ. Hospital, Dept. of Social Medicine, Uppsala (Sweden); Johnson, P. [Univ. Hospital, Dept. of Obstetrics and Gynecology, Uppsala (Sweden)

    1995-08-01

    Objective: To evaluate the overall complications, major as well as minor, in patients treated for early-stage cervical carcinoma as related to treatment parameters. Methods: In this retrospective study, 167 consecutive patients with early-stage cervical carcinoma treated with preoperative radiotherapy and radical hysterectomy were investigated. Clinical data were collected from the medical files. Results: Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tract infection. After one year, the urinary tract complications dominated; voidance difficulties and incontinence being most common. Gastrointestinal complications occurred in 15% of patients. Lymphedema appeared during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperative irradiation. Some form of late sequelae remained in every fifth patient, and every fourth patient, aged 23-44 years, periodically suffered from vasomotor symptoms despite estrogen replacement therapy. Conclusion: The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made to evaluate effective treatments designed to minimize risk to the patients. (au) 29 refs.

  12. High-risk human papilloma virus genotypes in cervical carcinoma of Serbian women: Distribution and association with pathohistological findings.

    Science.gov (United States)

    Stamenković, Miodrag; Knežević, Aleksandra; Knežević, Ivana; Kuzmanović, Igor; Karalić, Danijela; Milenković, Sanja; Jovanović, Tanja

    2016-09-01

    A significant role of high-risk Human papilloma viruses (HR HPV) in the development of cervical carcinoma is well known. HR HPV 16 and 18 account for approximately 70% of all cases of cervical cancer worldwide. The incidence of cervical cancer in Serbia, is one of the highest in Europe. The aim of our study was to investigate the distribution of HR HPV types in cervical carcinoma of Serbian women, as well as association between the HPV types and pathohistological findings. The study included 80 archival cervical cancer tissues from the same number of patients. The presence of HPV DNA was determined using MY09/MY11 primers for L1 gene and GP1/GP2 primers for E1 gene. HPV was detected in 78.75% tissues. HR HPV genotypes found in the decreasing order of frequency were: HPV16 (80.39%), HPV33 (7.84%), HPV58 (5.88%), HPV18 (1.96%), HPV45 (1.96%) and HPV53 (1.96%). The examined tissues were 91.25% squamous cell carcinomas and 8.75% adenocarcinoma. The high frequency of HPV 16 was observed in both types of carcinoma (80.8% and 75%, respectively) while the prevalence of HPV18 was low. These results may contribute to the implementation of cervical carcinoma prevention program in Serbia, including the selection of the most appropriate vaccine and immunization program. PMID:27461126

  13. Cancer and treatment related pains in patients with cervical carcinoma

    Directory of Open Access Journals (Sweden)

    Das Saikat

    2005-01-01

    Full Text Available Pain in carcinoma cervix is a multidimensional experience with sensory, affective and cognitive-evaluative components. Many patients do not receive adequate pain management because of a lack of proper assessment, misconceptions regarding the pharmacologic and non pharmacologic methods of pain management and failure to distinguish between different types of pain. In our audit pelvic and nodal recurrence were the commonest cause of pain presenting as as pelvic pain, [42%], lumbosacral plexopathy [40%] and abdominal pain [34%] [n = 30]. Pain on defaecation caused by rectal obstruction, and suprapubic pain due to pyometra can be relieved by colostomy and drainage. Very little literature is available on the pain syndromes associated with carcinoma cervix. The present article is a review of cancer and treatment related pains in carcinoma cervix.

  14. Sentinel node lymphoscintigraphy for cervical and vulvar carcinomas - technical and patient consideration

    International Nuclear Information System (INIS)

    Full text: Sentinel Node Lymphoscintigraphy (SNL) is a technique that while still investigative, is widely used in many clinical centers in melanoma and breast carcinoma SNL also has the potential to assist management of patients with cervical and vulvar carcinomas. The SNL procedure for gynaecological cancers requires some modifications with respect to technical preparation and patient care At the Mercy and Freemason's Private Hospitals 22 SNLs have been performed for gynaecological malignancies - 10 for cervical carcinoma, 11 for vulvar carcinoma and 1 for carcinoma of the vagina. Emla cream was applied for vulval lesions 1 hour prior to the procedure. A speculum was required to enable direct paracervical or paratumoural injection for cervical and vaginal cancers 2-4 x 0.1ml injections of 10MBq 99mTc-Antimony Colloid were injected around the lesion Dynamic images of 15sec/frame were acquired for a minimum of 1 hour to identify the sentinel node Patent blue dye V and a hand held gamma probe were used in surgery to localise sentinel nodes. Sentinel nodes were identified on imaging in 18/22 patients Follow-up of surgery results was available in 13 patients. Nodes were identified in surgery in all of those patients. One of the nodes was positive for metastases, and in no cases were non sentinel nodes positive where the sentinel node was negative. The procedure was generally well tolerated. SNL is a promising technique in lower genital tract gynaecological malignancies, requiring some modifications in technical preparation and patient care. The studies have afforded an insight into patterns of drainage and it is likely that this procedure will provide valuable assistance in managing this group of patients. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  15. Therapeutic effect of intra-arterial chemotherapy with DDP and 5-FU via bilateral uterine arteries for advanced uterine cervical cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic effect of intra-arterial chemotherapy with Ddp and 5-Fu via bilateral uterine arteries for advanced uterine cervical cancer. Methods: During the period of Jan. 2006-Jan. 2009, initial intra-arterial chemotherapy by using a combination of Ddp and 5-Fu via bilateral uterine arteries was performed in 72 patients (mean age 42.9 years) with advanced uterine cervical caner. Of 72 patients, stage I b2 cervical cancer was confirmed in 28, stage II a in 12 and stage II b in 32. Pathologically, cervical squamous cell carcinoma was seen in 56 and cervical adenocarcinoma in 16 patients. Ultrasonography and physical examination were conducted both before and after intra-arterial chemotherapy. The therapeutic results,complications,the surgical resection rate and the pathologic findings were observed and statistically analyzed. Results: Fifty-four patients received one treatment course and 18 patients received two treatment courses. The over all response rate was 77.8%. The response rates of patients with I b2, II a and II b cervical cancer were 92.9%, 83.3% and 62.5% respectively, the difference between three groups was statistically significant (P < 0.05). And the response rates of patients with squamous cell carcinoma and adenocarcinoma were 85.7% and 50.0% respectively, the difference between the two was statistically significant (P < 0.05). The most common side-effects included gastrointestinal symptoms and bone marrow suppression. Thirty-four patients received radical hysterectomy,among them, 22 (78.6%) had stage I b2, 8 (66.7%) had stage II a and 4 (12.5%) had stage II b cervical cancer (P < 0.05). Pathologic exam found no vaginal invasion and ovarian metastasis in all 34 patients. The occurrence of metastasis to lymph nodes and para uterine infiltration were 17.6% and 11.8% respectively. Conclusion: Intra-arterial chemotherapy with a combination of DDP and 5-Fu via bilateral uterine arteries can safely and effectively reduce the

  16. Matrix Metalloproteinase-2, Squamous Cell Carcinoma Antigen, and Tissue Polypeptide-Specific Antigen Expression in Egyptian Patients with Cervical Carcinoma: Relationship with Prognosis

    Directory of Open Access Journals (Sweden)

    Maha Imam Ahmed

    2004-01-01

    Full Text Available Matrix metalloproteinases (MMPs, a family of proteolytic enzymes produced by both stromal and tumor cells, appear to have a key role in the events leading to local invasion and metastasis by malignant neoplasms. In the present study, we evaluated the role of MMP-2, squamous cell carcinoma antigen (SCCA, and tissue polypeptide – specific antigen (TPS in cervical neoplasia. Using Western blotting and enzyme immunoassay (EIA, we analyzed 50 patients with cervical carcinoma (CC and 25 normal controls for expression of MMP-2 in tissue cell lysates. We also quantified SCCA and TPS with microparticle immunoassay and EIA, respectively. The results were correlated with human papilloma virus (HPV infection, clinicopathological findings, and disease outcome. The cutoff point for each marker was estimated from receiver operating characteristic curves. Logistic regression analysis was performed to estimate the odds ratio (OR and 95% confidence interval (CI for each marker. MMP-2, SCCA, and TPS protein expression were significantly higher in patients with CC than in normal controls. While TPS was the best marker for discriminating between patients and controls, MMP-2 was associated with an advanced tumor stage (OR, 13.9 [95% CI, 1.4-133.9] and poor histological grade (OR, 10.2 [95% CI, 1.7-60.5]. Moreover, independent of the effect of an advanced CC stage and grade, the patients' age, and the presence of HPV infection, MMP-2 was considered a strong predictor for CC recurrence (OR, 8.1 [95% CI, 1.3- 49.1]. Tissue markers may be used to select high-risk patients for early detection of and adjuvant therapy for recurrence. Our MMP-2 findings are particularly relevant to the development of protease inhibitors as a new cancer therapy approach.

  17. Serum squamous cell carcinoma antigen and CYFRA 21-1 in cervical cancer treatment

    International Nuclear Information System (INIS)

    Purpose: To analyze whether serum squamous cell carcinoma (SCC) antigen and cytokeratin-19 fragments (CYFRA) levels can assist in selecting patients with locally advanced cervical cancer who will benefit from combined treatment or additive surgery. Methods and Materials: Of 114 patients with cervical cancer Stage IB-IV, the first 39 patients received radiotherapy, the following 75 patients received identical radiotherapy plus concomitant chemotherapy (3 cycles of carboplatin and 5-fluorouracil). SCC antigen and CYFRA 21-1 serum levels were measured before treatment, after therapy, and during follow-up. Baseline tumor markers were related to tumor stage and size and clinical outcome. Results: Before treatment, SCC antigen was elevated (>1.9 μg/L) in 60% and CYFRA 21-1 (>2.2 μg/L) in 46% of patients. For all patients, disease-free survival (DFS) was better after combined treatment (67% vs. 43%, p<0.0005). For patients with elevated baseline SCC antigen, DFS was better after combination therapy (67% vs. 27%, p=0.001) which resulted more frequently in a normal SCC antigen (93% vs. 65%, p=0.004). In contrast, in those with a normal baseline CYFRA 21-1, combined therapy resulted in a better DFS (p=0.04). Patients who achieved a normal SCC antigen or CYFRA 21-1 after treatment had a better DFS (respectively 63 vs. 17% and 64 vs. 30%). Elevated SCC antigen posttreatment indicated residual tumor in 11/12 patients (92%), elevated CYFRA 21-1 in 7/10 patients (70%). Forty-seven patients had a tumor recurrence. At recurrence, SCC antigen was raised in 70% and CYFRA 21-1 in 69%. Conclusions: In patients with an elevated pretreatment SCC antigen, SCC antigen normalized more frequently with combined treatment and those patients had a better DFS. Elevated SCC antigen or CYFRA 21-1 levels after treatment completion indicated residual tumor in respectively 92% and 70%. The presence of elevated posttreatment levels of SCC antigen or CYFRA 21-1 indicates the need for additional

  18. Oxygenation status of cervical carcinomas before and during spinal anesthesia for application of brachytherapy

    International Nuclear Information System (INIS)

    Background and Purpose: To date, no information is available concerning the impact of spinal anesthesia on the oxygenation status of carcinomas of the uterine cervix. The aim of this study was therefore to determine the influence of spinal anesthesia on the oxygenation status of cervical carcinomas. Patients and Methods: In ten patients with cervical carcinoma who received spinal anesthesia for a first application of brachytherapy, intratumoral pO2 measurements (pO2 histography system, Eppendorf-Netheler-Hinz, Hamburg, Germany) were performed. Systemic parameters were documented prior to and during spinal anesthesia. Patients breathed room air spontaneously. For further evaluation, all intratumoral pO2 values were pooled, and overall median pO2 values and fractions of hypoxic pO2 values ≤ 5 mm Hg were calculated. Overall median pO2 values in the subcutis were also calculated. Results: There were no significant changes of systemic parameters, median subcutaneous pO2 values, median intratumoral pO2 values, and the fractions of hypoxic pO2 values ≤ 5 mm Hg in the tumor upon administration of spinal anesthesia. The variability of measured pO2 values increased during spinal anesthesia, although substantial changes in the oxygenation status were only seen in individual cases (n = 2). Conclusion: This study shows for the first time that the oxygenation status of cervical carcinomas, in general, is not influenced by spinal anesthesia prior to application of brachytherapy. To conclude, the data presented suggest that reliable pO2 measurements can be performed under spinal anesthesia. At the same time, since no substantial changes in tumor oxygenation were observed, spinal anesthesia should not affect the O2-related efficacy of high-dose-rate brachytherapy. (orig.)

  19. Oxygenation status of cervical carcinomas before and during spinal anesthesia for application of brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Weitmann, H.D.; Knocke, T.H.; Poetter, R. [Dept. of Radiotherapy and Radiobiology, Univ. of Vienna, General Hospital of Vienna (Austria); Gustorff, B. [Dept. of Anesthesia and General Intensive Care B, Univ. of Vienna, General Hospital of Vienna (Austria); Vaupel, P. [Inst. of Physiology and Pathophysiology, Univ. of Mainz (Germany)

    2003-09-01

    Background and Purpose: To date, no information is available concerning the impact of spinal anesthesia on the oxygenation status of carcinomas of the uterine cervix. The aim of this study was therefore to determine the influence of spinal anesthesia on the oxygenation status of cervical carcinomas. Patients and Methods: In ten patients with cervical carcinoma who received spinal anesthesia for a first application of brachytherapy, intratumoral pO{sub 2} measurements (pO{sub 2} histography system, Eppendorf-Netheler-Hinz, Hamburg, Germany) were performed. Systemic parameters were documented prior to and during spinal anesthesia. Patients breathed room air spontaneously. For further evaluation, all intratumoral pO{sub 2} values were pooled, and overall median pO{sub 2} values and fractions of hypoxic pO{sub 2} values {<=} 5 mm Hg were calculated. Overall median pO{sub 2} values in the subcutis were also calculated. Results: There were no significant changes of systemic parameters, median subcutaneous pO{sub 2} values, median intratumoral pO{sub 2} values, and the fractions of hypoxic pO{sub 2} values {<=} 5 mm Hg in the tumor upon administration of spinal anesthesia. The variability of measured pO{sub 2} values increased during spinal anesthesia, although substantial changes in the oxygenation status were only seen in individual cases (n = 2). Conclusion: This study shows for the first time that the oxygenation status of cervical carcinomas, in general, is not influenced by spinal anesthesia prior to application of brachytherapy. To conclude, the data presented suggest that reliable pO{sub 2} measurements can be performed under spinal anesthesia. At the same time, since no substantial changes in tumor oxygenation were observed, spinal anesthesia should not affect the O{sub 2}-related efficacy of high-dose-rate brachytherapy. (orig.)

  20. Analysis of Clinical Treatment Efficiency for 179 Geriatric Women with Stage I or II Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    YongwenHuang; MengdaLi; FuyuanLiu; YanfangLi

    2004-01-01

    OBJECTIVE To evaluate the efficiency of surgery plus radiotherapy and chemotherapy versus radiotherapy plus chemotherapy in the treatment of older patients with stage I or II cervical carcinoma and to seek suitable treatment for such patients. METHODS The clinical data of 179 elderly women with stage la or lib cervical cancer were analyzed retrospectively. One hundred and thirty-four cases underwent radical hysterectomy followed by adjuvant radiotherapy and/or chemotherapy (Group 1). Forty-five cases underwent radiation therapy plus adjuvant chemotherapy (Group 2). RESULTS The 5-year survival rates in group 1 and group 2 were 78.3% and 49.1%(P=0.04), respectively. The incidence of complications in group1 was 47.0%. Three patients died of complications after radical hysterectomy. The incidence of complications in group 2 was 75.6%. CONCLUSION Elderly patients with stage I or II cervical carcinoma should receive an operation if possible. In addition they should receive adjuvant treatments according to their personal conditions, and be treated with appropriate adjuvant chemo-and/or radiotherapy.

  1. SU-E-P-18: Intensity-Modulated Radiation Therapy for Cervical Esophageal Squamous Cell Carcinoma

    International Nuclear Information System (INIS)

    Purpose: To retrospectively analyze the outcomes and prognostic factors of cervical esophageal squamous cell carcinoma (SCC) treated with intensity modulated radiation therapy (IMRT). Methods: Thirty-seven patients with cervical esophageal SCC treated with IMRT were analyzed retrospectively. They received 54–66 Gy in 27–32 fractions. Nineteen patients received concurrent (n=12) or sequential (n=7) platinum-based two drugs chemoradiotherapy. Overall survival (OS), local control rates (LCR) and prognostic factors were evaluated. Acute toxicities and patterns of first failures were observed. Results: The median follow-up was 46 months for alive patients. The l-, 3-, 4- and 5-year OS of the all patients were 83.8%, 59.1%, 47.5% and 32.6% respectively. The median survival time was 46 months. The l-, 3-,4- and 5-year LCR were 82.9%, 63.0%, 54.5% and 54.5%, respectively. Univariate and Multivariate analysis all showed that size of GTV was an independent prognostic factor (p=0.033, p=0.039). There were no patients with Grade 3 acute radiation esophagitis and Grade 2–4 acute pneumonitis. The local failure accounted for 70.0% of all treatment-related failures. Conclusion: IMRT is safe and effective in the treatment of cervical esophageal squamous cell carcinoma. Size of GTV is an independent prognostic factor. Local failure still remains the main reason of treatment failures. The authors declare no conflicts of interest in preparing this article

  2. Microinvasive cervical squamous cell carcinoma in Slovenia during the period 2001–2007

    International Nuclear Information System (INIS)

    Microinvasive squamous cell carcinoma (MISCC) comprises a significant portion of all cervical cancers in Slovenia. Criteria of carcinomatous invasion are well described in the literature, however histopathological assessment of MISCC is difficult, because morphological characteristics can overlap with cervical intraepithelial neoplasia grade 3 (CIN 3) and other pathological changes. The aim of our study was to evaluate the reliability of the histopathological diagnosis of MISCC in Slovenia during the period from 2001 to 2007. Data on patients with a histopathological diagnosis of cervical MISCC (FIGO stage IA) in the period of 2001 to 2007 were obtained from the Cancer Registry of Slovenia. Histological slides were obtained from the majority of pathology laboratories in Slovenia. We received 250 cases (69% of all MISCC) for the review; 30 control cases with CIN 3 and invasive squamous cell carcinoma FIGO stage IB were intermixed. The slides were coded and reviewed. Among 250 cases originally diagnosed as MISCC, there was an agreement with MISCC diagnosis in 184 (73.6%) cases (of these 179/184 (97.3%) cases were FIGO stage IA1 and 5/184 (2.7%) cases were FIGO stage IA2). Among 179 FIGO stage IA1 cases 117 (65.4%) showed only early stromal invasion. The retrospective review of cases diagnosed as MISCC during the period 2001–2007 in Slovenia showed a considerable number of overdiagnosed cases. Amongst cases with MISCC confirmed on review, there was a significant proportion with early stromal invasion (depth of invasion less than 1 mm)

  3. Gene expression profiling reveals activation of the FA/BRCA pathway in advanced squamous cervical cancer with intrinsic resistance and therapy failure

    International Nuclear Information System (INIS)

    Advanced squamous cervical cancer, one of the most commonly diagnosed cancers in women, still remains a major problem in oncology due to treatment failure and distant metastasis. Antitumor therapy failure is due to both intrinsic and acquired resistance; intrinsic resistance is often decisive for treatment response. In this study, we investigated the specific pathways and molecules responsible for baseline therapy failure in locally advanced squamous cervical cancer. Twenty-one patients with locally advanced squamous cell carcinoma were enrolled in this study. Primary biopsies harvested prior to therapy were analyzed for whole human gene expression (Agilent) based on the patient’s 6 months clinical response. Ingenuity Pathway Analysis was used to investigate the altered molecular function and canonical pathways between the responding and non-responding patients. The microarray results were validated by qRT-PCR and immunohistochemistry. An additional set of 24 formalin-fixed paraffin-embedded cervical cancer samples was used for independent validation of the proteins of interest. A 2859-gene signature was identified to distinguish between responder and non-responder patients. ‘DNA Replication, Recombination and Repair’ represented one of the most important mechanisms activated in non-responsive cervical tumors, and the ‘Role of BRCA1 in DNA Damage Response’ was predicted to be the most significantly altered canonical pathway involved in intrinsic resistance (p = 1.86E-04, ratio = 0.262). Immunohistological staining confirmed increased expression of BRCA1, BRIP1, FANCD2 and RAD51 in non-responsive compared with responsive advanced squamous cervical cancer, both in the initial set of 21 cervical cancer samples and the second set of 24 samples. Our findings suggest that FA/BRCA pathway plays an important role in treatment failure in advanced cervical cancer. The assessment of FANCD2, RAD51, BRCA1 and BRIP1 nuclear proteins could provide important information

  4. Clinical characteristics of women diagnosed with carcinoma who tested positive for cervical and anal high-risk human papillomavirus DNA and E6 RNA

    OpenAIRE

    Veo, Carlos A. R.; Saad, Sarhan S.; José Humberto T. G. Fregnani; Scapulatempo Neto, Cristovam; Tsunoda, Audrey Tieko; Resende, Júlio César Possati; Lorenzi, Adriana Tarlá; Mafra, Allini; Cinti, Claudia; Longatto Filho, Adhemar

    2015-01-01

    High-risk human papillomavirus (hrHPV) is an essential cause of cervical carcinoma and is also strongly related to anal cancer development. The hrHPV E6 oncoprotein plays a major role in carcinogenesis. We aimed to evaluate the frequency of hrHPV DNA and E6 oncoprotein in the anuses of women with cervical carcinoma. We analyzed 117 women with cervical cancer and 103 controls for hrHPV and the E6 oncogene. Positive test results for a cervical carcinoma included 66.7 % with hrHPV-16 and 7.7 % w...

  5. Case report from Mayo Clinic. Locally advanced Bartholin gland carcinoma

    International Nuclear Information System (INIS)

    Tumors of the Bartholin gland are rare, comprising less than 5% of all vulvar malignancies. Treatment is largely based on that of vulvar and anal squamous cell carcinomas. A case of invasive, grade 4, poorly differentiated squamous cell carcinoma of the Bartholin gland is presented. Our patient, a 47-year-old woman, had a history significant for cervical intraepithelial neoplasia treated with conization, type 2 diabetes mellitus, and tobacco use. The course of treatment included preoperative radiotherapy plus 5-fluorouracil and cisplatin chemotherapy, followed by restaging and posterior exenteration in combination with vaginal reconstruction. (author)

  6. Is extended-field concurrent chemoradiation an option for radiologic negative paraaortic lymph node, locally advanced cervical cancer?

    International Nuclear Information System (INIS)

    The aim was to evaluate whether extended-field concurrent chemoradiation (EF-CCRT) leads to results better than those obtained by standard whole-pelvis concurrent chemoradiation (WP-CCRT) in locally advanced cervical cancer with radiologic negative paraaortic lymph nodes (PALNs). A total of 102 patients with histopathologically proven squamous cell carcinoma, adenocarcinoma, or adenosquamous cell carcinoma, and radiologic negative PALN locally advanced cervical cancer, stage IIB-IVA, were accrued between July 2007 and April 2008 and were randomly assigned to WP-CCRT (50 patients) or EF-CCRT (52 patients), followed by high-dose rate brachytherapy. Data regarding the safety profile, response rates, and occurrence of local, PALN, or distant failure were recorded. During a median follow-up time of 60 months (18–66), 74/102 patients completed the treatment protocol and were analyzed. Overall PALN, distant-metastasis control, disease-free survival, and overall survival rates were 97.1%, 86.9%, 80.3%, and 72.4% in EF-CCRT respectively in comparison with WP-CCRT (82.1%,74.7%, 69.1%, and 60.4%), with P-values of 0.02, 0.03, 0.03 and 0.04 respectively. No difference in acute toxicity profile was seen between the groups, and late toxicities were mild and minimal. Prophylactic EF-CCRT can be a reasonable option in patients with locally advanced cervical cancer with radiologic positive pelvic lymph nodes and radiologic negative PALN

  7. A phase II randomized trial comparing radiotherapy with concurrent weekly cisplatin or weekly paclitaxel in patients with advanced cervical cancer

    International Nuclear Information System (INIS)

    This is a prospective comparison of weekly cisplatin to weekly paclitaxel as concurrent chemotherapy with standard radiotherapy for locally advanced cervical carcinoma. Between May 2000 and May 2004, 31 women with FIGO stage IB2-IVA cervical cancer or with postsurgical pelvic recurrence were enrolled into this phase II study and randomized to receive on a weekly basis either 40 mg/m2 Cisplatin (group I; 16 patients) or 50 mg/m2 paclitaxel (group II; 15 patients) concurrently with radiotherapy. Median total dose to point A was 74 Gy (range: 66-92 Gy) for group I and 66 Gy (range: 40-98 Gy) for group II. Median follow-up time was 46 months. Patient and tumor characteristics were similar in both groups. The mean number of chemotherapy cycles was also comparable with 87% and 80% of patients receiving at least 4 doses in groups I and II, respectively. Seven patients (44%) of group I and 8 patients (53%) of group II developed tumor recurrence. The Median Survival time was not reached for Group I and 53 months for group II. The proportion of patients surviving at 2 and 5 years was 78% and 54% for group I and 73% and 43% for group II respectively. This small prospective study shows that weekly paclitaxel does not provide any clinical advantage over weekly cisplatin for concurrent chemoradiation for advanced carcinoma of the cervix

  8. Endovaginal contrast MRI in cervical, endometrial and vaginal carcinomas. Critical appraisal

    International Nuclear Information System (INIS)

    The author analyzes the usefulness of endovaginal contrast (EC) for MRI staging (FIGO) of gynecological cancers. In cervical carcinoma the EC-MRI may improve differentiation between IB and IIA stages, without therapeutic implications. In rare cases, not clinically obvious, the EC-MRI may contribute to define between IIA and IIIA stages, with therapeutic implications. The EC-MRI diagnostic value to detect or exclude parametrial invasion (stage IIB) has not been clarified. The EC-MRI may be useful in some recurrent cervical cancers improving the assessment of the regional tumor extent (forniceal or vaginal invasion). In endometrial carcinoma the EC-MRI may contribute to a better detection of vaginal invasion (stage IIIB), without a substantial treatment modification. In vaginal carcinoma the EC-MRI may improve the accuracy in demonstration of tumoral extent (Stage I vs II), without therapeutic implications. Finally the EC-MRI may be useful in post irradiation oncologic complications such as vesicovaginal or vesicorectal fistulae. Larger series are required to determine the precise indications for vaginal contrast medium and its auxiliary role for tumor staging

  9. Evaluation of Rectal Dose During High-Dose-Rate Intracavitary Brachytherapy for Cervical Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Sha, Rajib Lochan [Department of Radiation Physics, Indo-American Cancer Institute and Research Centre, Hyderabad (India); Department of Physics, Osmania University, Hyderabad (India); Reddy, Palreddy Yadagiri [Department of Physics, Osmania University, Hyderabad (India); Rao, Ramakrishna [Department of Radiation Physics, MNJ Institute of Oncology and Regional Cancer Center, Hyderabad (India); Muralidhar, Kanaparthy R. [Department of Radiation Physics, Indo-American Cancer Institute and Research Centre, Hyderabad (India); Kudchadker, Rajat J., E-mail: rkudchad@mdanderson.org [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2011-01-01

    High-dose-rate intracavitary brachytherapy (HDR-ICBT) for carcinoma of the uterine cervix often results in high doses being delivered to surrounding organs at risk (OARs) such as the rectum and bladder. Therefore, it is important to accurately determine and closely monitor the dose delivered to these OARs. In this study, we measured the dose delivered to the rectum by intracavitary applications and compared this measured dose to the International Commission on Radiation Units and Measurements rectal reference point dose calculated by the treatment planning system (TPS). To measure the dose, we inserted a miniature (0.1 cm{sup 3}) ionization chamber into the rectum of 86 patients undergoing radiation therapy for cervical carcinoma. The response of the miniature chamber modified by 3 thin lead marker rings for identification purposes during imaging was also characterized. The difference between the TPS-calculated maximum dose and the measured dose was <5% in 52 patients, 5-10% in 26 patients, and 10-14% in 8 patients. The TPS-calculated maximum dose was typically higher than the measured dose. Our study indicates that it is possible to measure the rectal dose for cervical carcinoma patients undergoing HDR-ICBT. We also conclude that the dose delivered to the rectum can be reasonably predicted by the TPS-calculated dose.

  10. Radiation induced cell death in cervical squamous cell carcinoma. An immunohistochemical and ultrastructural study

    International Nuclear Information System (INIS)

    To study the process of cell death in cervical squamous cell carcinoma (SCC) after radiation, an ultrastructural and immunohistochemical study was performed. Paraffin-embedded tissue blocks of biopsy samples pre- and post-radiation stage III SCC (n=15) were collected. Irradiation caused varying ultrastructural changes including nuclear and cytoplasmic disorganization suggesting cell necrosis. Immunohistochemically, the pre-radiation specimens showed no positive reaction for tumor necrosis factor-alpha (TNF-α), tumor necrosis factor-receptor (TNF-γ) or Fas. C-fos, p53 and bcl-2 showed positive reactions in only a few non-irradiated specimens. All of the irradiated specimens showed a positive reaction for TNF-α, and variable positive reactions were observed for TNF-γ, Fas, p53, c-fos and bcl-2. These results suggest that TNF-α, TNF-γ, and c-fos are responsible for radiation induced cell death in cervical SCC. (author)

  11. Risk stratification of patients with advanced squamous cell carcinoma of cervix treated by radiotherapy alone

    International Nuclear Information System (INIS)

    Purpose: To identify prognostic factors for local and distant relapse and perform risk stratification for patients with advanced cervical cancer treated with radiotherapy (RT) alone. Methods and Materials: A total of 1031 patients with Stage IB-IVA squamous cell carcinoma of the cervix treated with full-course RT but without any chemotherapy were included for analysis. Of these, 311 patients with nonbulky Stage IB-IIA disease were designated the reference group and the other 720 patients were the study group. The associations of stage, squamous cell carcinoma antigen (SCC-ag) level, hemoglobin level, age, cell differentiation, and pelvic lymph node status with treatment failure were evaluated. The independent prognostic factors were identified by multivariate analysis. The study group was further stratified into subgroups using combinations of these risk factors. Results: In the study group, independent risk factors for local relapse were advanced stage and age 2, and positive pelvic lymph nodes. The 5-year distant relapse-free survival rate was 83% for patients with bulky Stage IB-IIA and IIB disease, SCC-ag level 2, and positive lymph nodes. Conclusion: The risk of treatment failure in advanced-stage cervical cancer patients treated by RT alone can be more precisely predicted by risk stratification. A certain subgroup of patients had better control than the others. The benefit of treating these relatively low-risk patients with additional treatment such as concurrent chemotherapy should be further evaluated in prospective studies or meta-analyses

  12. Tattoo-pigmented cervical lymph node that masqueraded as the sentinel lymph node in oral squamous cell carcinoma.

    Science.gov (United States)

    Pinto, Amith; Wieshmann, Hulya; Triantafyllou, Asterios; Shaw, Richard

    2015-11-01

    We describe a case of a pigmented cervical lymph node mimicking the sentinel node during sentinel lymph node biopsy (SLNB) on a patient with oral squamous cell carcinoma (OSCC). The patient had extensive tattoos on his neck. This pigmented lymph node was not identified to be the sentinel lymph node using static and dynamic lymphoscintigraphy. Subsequent histological analysis revealed tattoo pigment within this lymph node. It is important during cervical SLNB to be aware that cutaneous tattoos can pigment lymph nodes. PMID:26188933

  13. Differences in genetic variation in antigen-processing machinery components and association with cervical carcinoma risk in two Indonesian populations

    OpenAIRE

    Mehta, Akash M.; Spaans, Vivian M.; Mahendra, Nyoman Bayu; Osse, Elisabeth M.; Vet, Jessica N. I.; Purwoto, Gatot; Surya, I G D; Cornian, Santoso; Peters, Alexander A.; Fleuren, Gert J.; Jordanova, Ekaterina S.

    2015-01-01

    Genetic variation of antigen-processing machinery (APM) components has been shown to be associated with cervical carcinoma risk and outcome in a genetically homogeneous Dutch population. However, the role of APM component single nucleotide polymorphisms (SNPs) in genetically heterogeneous populations with different distributions of human papillomavirus (HPV) subtypes remains unclear. Eleven non-synonymous, coding SNPs in the TAP1, TAP2, LMP2, LMP7 and ERAP1 genes were genotyped in cervical ca...

  14. Dosimetric analysis at ICRU reference points in HDR-brachytherapy of cervical carcinoma

    International Nuclear Information System (INIS)

    In vivo dosimetry in bladder and rectum as well as determining doses on suggested reference points following the ICRU report 38 contribute to quality assurance in HDR-brachytherapy of cervical carcinoma, especially to minimize side effects. In order to gain information regarding the radiation exposure at ICRU reference points in rectum, bladder, ureter and regional lymph nodes those were calculated (digitalisation) by means of orthogonal radiography of 11 applications in patients with cervical carcinoma, who receiver primary radiotherapy. In addition, the doses at the ICRU rectum reference point was compared to the results of in vivo measurements in the rectum. The in vivo measurements were by factor 1.5 below the doses determined for the ICRU rectum reference point (4.05±0.68 Gy versus 6.11±1.63 Gy). Reasons for this were: Calibration errors, non-orthogonal radiographs, movement of applicator and probe in the time span between X-ray and application, missing connection of probe and anterior rectal wall. The standard deviation of calculations at ICRU reference points was on average ±30%. Possible reasons for the relatively large standard deviation were difficulties in defining the points, identifying them on radiographs and the different locations of the applicators. Although 3 D CT, US or MR based treatment planning using dose volume histogram analysis is more and more established, this simple procedure of marking and digitising the ICRU reference points lengthened treatment planning only by 5 to 10 minutes. The advantages of in vivo dosimetry are easy practicability and the possibility to determine rectum doses during radiation. The advantages of computer-aided planning at ICRU reference points are that calculations are available before radiation and that they can still be taken into account for treatment planning. Both methods should be applied in HDR-brachytherapy of cervical carcinoma. (orig.)

  15. Differences in genetic variation in antigen-processing machinery components and association with cervical carcinoma risk in two Indonesian populations.

    Science.gov (United States)

    Mehta, Akash M; Spaans, Vivian M; Mahendra, Nyoman Bayu; Osse, Elisabeth M; Vet, Jessica N I; Purwoto, Gatot; Surya, I G D; Cornian, Santoso; Peters, Alexander A; Fleuren, Gert J; Jordanova, Ekaterina S

    2015-06-01

    Genetic variation of antigen-processing machinery (APM) components has been shown to be associated with cervical carcinoma risk and outcome in a genetically homogeneous Dutch population. However, the role of APM component single nucleotide polymorphisms (SNPs) in genetically heterogeneous populations with different distributions of human papillomavirus (HPV) subtypes remains unclear. Eleven non-synonymous, coding SNPs in the TAP1, TAP2, LMP2, LMP7 and ERAP1 genes were genotyped in cervical carcinoma patients and healthy controls from two distinct Indonesian populations (Balinese and Javanese). Individual genotype and allele distributions were investigated using single-marker analysis, and combined SNP effects were assessed by haplotype construction and haplotype interaction analysis. Allele distribution patterns in Bali and Java differed in relation to cervical carcinoma risk, with four ERAP1 SNPs and one TAP2 SNP in the Javanese population showing significant association with cervical carcinoma risk, while in the Balinese population, only one TAP2 SNP showed this association. Multimarker analysis demonstrated that in the Javanese patients, one specific haplotype, consisting of the ERAP1-575 locus on chromosome 5 and the TAP2-379 and TAP2-651 loci on chromosome 6, was significantly associated with cervical carcinoma risk (global P = 0.008); no significant haplotype associations were found in the Balinese population. These data indicate not only that genetic variation in APM component genes is associated with cervical carcinoma risk in Indonesia but also that the patterns of association differ depending on background genetic composition and possibly on differences in HPV type distribution. PMID:25796583

  16. Integration of functional and morphological MR data for preoperative 3D visualisation of tumours. Cervical carcinoma

    International Nuclear Information System (INIS)

    Purpose: The goal of this exemplary study was to integrate morphological and functional MRI to establish computer-based, preoperative therapy planning for tumors, instancing cervical carcinoma. Results: Segmentation of organs and vessels as well as tissue differentiation yielded a morphological visualisation of anatomical structures that were overlaid with pharmacokinetic parameters derived from dynamic MRI, subsequently. Thereby, three-dimensional, arbitrary views on the functional data were displayed. Conclusions: Image analysis and visualisation of the acquired MR data establishes both a morphologic and functional evaluation of suspect lesions and adjacent organs. By integrating morphologic and functional MRI additional information can be gathered that possibly impinge on preoperative planning. (orig./AJ)

  17. Effect of combined radiotherapy in cervical carcinoma on digestive tract function

    International Nuclear Information System (INIS)

    By radionuclide and radioimmunological examinations the function of small intestine, pancreas and liver was tested in 257 patients with cervical carcinoma and in healthy women. Previously before irradiation disorders such as the decrease of intestinal absorption of vitamin B12 and the hyperfunction of the pancreatic islets were noticed. The combined radiotherapy caused distinct disorders of enteral fat and vitamin B12 resorption, decreased the output of gastrin and resulted in impairment of pancreas and liver functions. A compensatory process developed some months post irradiation. The complete recovery of some functions did not occur even 2 - 5 years after radiotherapy. (author)

  18. RESPONSE OF EARLY STAGE BULKY CERVICAL SQUAMOUS CARCINOMA TO PREOPERATIVE ADJUVANT CHEMOTHERAPY

    Institute of Scientific and Technical Information of China (English)

    Hua Linghu; Xiao-rong Xu; Yao-yu Mei; Jun-ying Tang; Liang-dan Tang; Tong Sun

    2004-01-01

    Objective To investigate the potential role of preoperative adjuvant chemotherapy on early stage cervical squamouscarcinoma with bulky tumor.Methods One hundred and forty-five patients with cervical squamous cancer stages Ⅰb-Ⅱa were investigated, among which 17 patients with bulky tumors (≥4 cm) were managed by cisplatin-based chemotherapy for 1-2 courses followed by radical hysterectomy and pelvic lymphadenectomy (BC group). The change of tumor size, pelvic lymph nodes metastasis, cervical wall invasion, the involvement of surgical specimen margin, and the blood loss during operation were assessed after operation and compared with those in 51 patients with bulky tumors (BN group) and 77 patients with small local tumors (S group)who underwent surgery directly.Results (1) The tumor size of 17 patients in BC group were decreased in various degrees after chemotherapy, with 13 patients of clinical effectiveness (76.47%). And the responsiveness pertained to neither histological differentiation nor size of local tumors. (2) Post-operative histology has showed that patients in BC and BN group have higher incidence of lymph node metastasis and deep cervical infiltration (5/68 and 3/68, respectively) than in S group (1/77 and 1/77, respectively) while with no statistical significance. (3) Blood loss during operation in BC group was less than BN and S group. (4) Seventeen patients, including those underwent surgeries of vaginal prolongation and/or ovarian transposition, appeared disease-free survival within the follow-up time.Conclusions Most of patients with bulky early stage cervical squamous carcinoma are sensitive to cisplatin-based chemotherapy, which could greatly reduce local tumor size and in turn facilitate the following operation by well controlling blood loss.

  19. Clinical and survival impact of FDG PET in patients with suspicion of recurrent cervical carcinoma

    International Nuclear Information System (INIS)

    The aim of this retrospective study was to evaluate the contribution of 18F-FDG PET to the clinical management and survival outcome of patients suspected of recurrent cervical carcinoma and in line with the hypothesis that early diagnosis of recurrent cervical cancer may improve overall survival. A total of 40 patients underwent conventional imaging (CI) and FDG PET/CT for suspected cervical cancer. Clinical management decisions were recorded with CI and additional PET/CT. Discordances and concordances between CI and PET/CT results were compared to the final diagnosis as based on histopathology analysis or follow-up considered as the gold standard. The final diagnosis was established pathologically (n=25) or by median clinical follow-up for 48 months after the PET (n=15). The PET/CT was positive in 76% (20/26) of patients compared to 19% (6/26) with CI. Globally PET/CT modified the treatment plan in 55% (22/40) of patients and in 75% (18/24) when the CI was negative prior to PET/CT. These changes led to the use of previously unplanned therapeutic procedures in 37.5% (15/40). When FDG PET was positive for recurrence (>3 foci), the median overall survival was 12 months (2-70) compared to patients with PET findings with ≤1 focus for which the median survival was not attained (p=0.007). A multivariate analysis of prognostic factors demonstrated that abnormal FDG uptake (>3 foci) was the most significant factor (p<0.03) for death from cervical cancer. FDG PET is a valuable tool in the case of suspected recurrence of cervical cancer on account of its impact on treatment planning and especially in predicting patient outcome. (orig.)

  20. Predictors of cervical cancer being at an advanced stage at diagnosis in Sudan

    Directory of Open Access Journals (Sweden)

    Ibrahim A

    2011-11-01

    Full Text Available Ahmed Ibrahim1, Vibeke Rasch2, Eero Pukkala3, Arja R Aro1 1Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark; 2Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark; 3Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland Background: Cervical cancer is the second most common cancer among women in Sudan, with more than two-thirds of all women with invasive cervical cancer being diagnosed at an advanced stage (stages III and IV. The lack of a screening program for cervical cancer in Sudan may contribute to the late presentation of this cancer, but other factors potentially associated with advanced stages of cervical cancer at diagnosis are unknown. The purpose of this research was to investigate the relationship between age, marital status, ethnicity, health insurance coverage, residence in an urban vs a rural setting, and stage (at diagnosis of cervical cancer in Sudan. Methods: This was a cross sectional study of 197 women diagnosed with different stages of cervical cancer. Data was obtained from the cancer registry unit at the Radiation and Isotopes Centre in Khartoum for all women diagnosed with cervical cancer in 2007. Results: There was an association between older age and advanced stage (at diagnosis of cervical cancer (odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01–1.05. Being of African ethnicity was associated with 76% increased odds (OR: 1.76, 95% CI: 1.01–3.05, living in a rural area was associated with 13% increased odds (OR: 1.13, 95% CI: 1.78–5.50, and being uninsured was associated with an almost eight-fold increase in odds (OR: 7.7, 95% CI: 3.76–15.38. Marital status and education level were not associated with an advanced stage of cervical cancer at diagnosis. Conclusion: Women with cervical cancer who are elderly, not covered by health insurance, of African ethnicity, and living in a rural area

  1. Patterns of Relapse and Management Options in Unknown Primary Cervical Metastatic Carcinoma

    Institute of Scientific and Technical Information of China (English)

    PENGHanwei; GUOZhuming; ZENGZongyuan; CHENFujin; LIHao; WEIMaowen; WUGuohao; ZHANGQuan; YANGAnkui

    2005-01-01

    Objective: To analyze the patterns of relapse and management options in unknown primary cervical metastatic carcinoma (UPCMC) as well as to discuss its treatment strategies. Methods: Clinical data of 111 cases of eligible UPCMC were retrospectively studied. Neck control, primary relapse and longterm survival were compared among different groups. Results: Primary carcinomas ultimately appeared in 12 cases (10.8%, 12/111). Neck control rate was a6.9%. Overall 5-year survival rate was 41.4%. Neck control, N stage and primary control were prognostic factors for UPCMC. Neck control was affected by N stage and whether or not comprehensive radiotherapy was administered. Conclusion: UPCMC should primarily be treated by radiotherapy except for cases with N1 or N2 insensitive to radiation. Bilateral necks radiotherapy is the optimal choice in terms of neck radiotherapy. Selective total pharyngeal irradiation is recommended for potential primary treatment.

  2. Sexual function after surgical and radiation therapy for cervical carcinoma

    International Nuclear Information System (INIS)

    One hundred women treated for carcinoma of the cervix were interviewed more than one year later to establish the effects of radiation or surgical therapy on sexual function. Forty-three had received irradiation, 44 nonradical surgery, six combined surgery and irradiation, and seven radical surgery. The irradiation and nonradical surgery groups were each further subdivided into subgroups of patients aged 30 to 49 for age-controlled comparison. Patients in the irradiation group had statistically significant decreases in sexual enjoyment, ability to attain orgasm, coital opportunity, frequency of intercourse, and coital desire. The group who had nonradical surgical procedures had no significant change in sexual function after treatment. Similar results were found in both age-controlled subgroups, eliminating age as a major etiologic factor. Marked vaginal alterations were recorded in the majority of irradiated patients, but were not present among the groups treated with nonradical surgery. The vaginal changes alone could not be held accountable for the significant decrease in sexual function among women who received pelvic irradiation. The origin of decreased sexual desire after radiation therapy is complex, and not yet completely understood. We propose therapeutic programs to help women deal with the emotional and physical consequences of pelvic irradiation

  3. A study on cervical node metastasis of carcinoma of tongue

    International Nuclear Information System (INIS)

    To assess the treatment modality for neck nodal metastasis of lingual cancer, the treatment result of interstitial brachytherapy was analyzed, along with that of surgery lingual resection with neck dissection after preoperative radiotherapy (RT). Two hundred twenty-nine cases primarily with lingual squamous cell carcinoma were treated from 1978 to 1995 in our institute. One hundred eighty-one cases were treated with interstitial radiotherapy, on the other hand, 48 cases with surgery following preoperative RT. The most frequent nodal metastases were the submandibular and upper internal deep jugular chain of nodes. Since the N factor was related to the cause of death in 63% of the deaths, control for involvement of regional lymph nodes was found as the most important prognostic factor. Although the ''observing policy'' was used for regional nodal metastases in the cases of brachytherapy, our concept did not significantly affect the treatment results. Therefore, elective node dissection seemed to be unnecessary in the case whose primary tumor was expected to control by brachytherapy. (author)

  4. The anti-aging gene KLOTHO is a novel target for epigenetic silencing in human cervical carcinoma

    Directory of Open Access Journals (Sweden)

    Yang Inchul

    2010-05-01

    Full Text Available Abstract Background Klotho was originally characterized as an anti-aging gene that predisposed Klotho-deficient mice to a premature aging-like syndrome. Recently, KLOTHO was reported to function as a secreted Wnt antagonist and as a tumor suppressor. Epigenetic gene silencing of secreted Wnt antagonists is considered a common event in a wide range of human malignancies. Abnormal activation of the canonical Wnt pathway due to epigenetic deregulation of Wnt antagonists is thought to play a crucial role in cervical tumorigenesis. In this study, we examined epigenetic silencing of KLOTHO in human cervical carcinoma. Results Loss of KLOTHO mRNA was observed in several cervical cancer cell lines and in invasive carcinoma samples, but not during the early, preinvasive phase of primary cervical tumorigenesis. KLOTHO mRNA was restored after treatment with either the DNA demethylating agent 2'-deoxy-5-azacytidine or histone deacetylase inhibitor trichostatin A. Methylation-specific PCR and bisulfite genomic sequencing analysis of the promoter region of KLOTHO revealed CpG hypermethylation in non-KLOTHO-expressing cervical cancer cell lines and in 41% (9/22 of invasive carcinoma cases. Histone deacetylation was also found to be the major epigenetic silencing mechanism for KLOTHO in the SiHa cell line. Ectopic expression of the secreted form of KLOTHO restored anti-Wnt signaling and anti-clonogenic activity in the CaSki cell line including decreased active β-catenin levels, suppression of T-cell factor/β-catenin target genes, such as c-MYC and CCND1, and inhibition of colony growth. Conclusions Epigenetic silencing of KLOTHO may occur during the late phase of cervical tumorigenesis, and consequent functional loss of KLOTHO as the secreted Wnt antagonist may contribute to aberrant activation of the canonical Wnt pathway in cervical carcinoma.

  5. An unexpected reason for elevated human chorionic gonadotropin in a young woman. Cervical squamous carcinoma.

    Science.gov (United States)

    Mustafa, Aynur; Bozdag, Zehra; Tepe, Neslihan B; Ozcan, Husiyen C

    2016-08-01

    Human chorionic gonadotropin has been used for decades, in addition to specific investigations, to detect pregnancy, trophoblastic tumors, as well as congenital defects. Rarely, it can be elevated in  non-trophoblastic tumors such as squamous cell cancers and germ cell tumors. A 33-year-old Asian Syrian female had irregular menses accompanied with feelings of heaviness in the vagina. In addition to routine investigations, we measured the serum beta human chorionic gonadotropin (ß-HCG) level (based on the patient's complaint of amenorrhea), which was 50.05 ml UI/ml. Cervical biopsy revealed a non-keratinized large cell squamous carcinoma. After excluding other causes, ß-hCG elevation was explained by the ectopic secretion of cancer cells line. Cervical biopsy was suggestive of large cell non-keratinizing squamous cell carcinoma and positive for human chorionic gonadotropin on immunohistochemistry. As a result, we manage the possibility of ectopic secretion of ß-HCG from non- trophoblastic disease. PMID:27464870

  6. Effect of bortezomib on migration and invasion in cervical carcinoma HeLa cell

    Institute of Scientific and Technical Information of China (English)

    Chong Shi; Guo-Bin Zhang; Shu-Wang Yin

    2015-01-01

    Objective: To explore the effect of bortezomib on migration and invasion of cervical carcinoma HeLa cell and specific molecular mechanism. Methods:The effect of bortezomib on the viability of HeLa cell was measured by MTT assay. The effect of bortezomib on cell migration and invasion was measured by Transwell assay and invasion experiment respectively. The activation of Akt/mTOR signaling pathway and expression level of MMP2, MMP9 were assayed by western blot. Results:MTT assay indicated bortezomib (2.5μM, 5μM, 10μM) could inhibit HeLa cell viability, and the inhibitory rate was highest at 48 h. Transwell assay and invasion experiment results showed that bortezomib inhibited HeLa cell migration and invasion. Western blotting assays presented bortezomib could suppress the phosphorylation of Akt and mTOR, and down-regulate the expression of MMP2 and MMP9. Conclusions:These results suggested bortezomib could inhibit migration and invasion in cervical carcinoma HeLa cell, which might be related to Akt/mTOR signal pathway.

  7. Effect of bortezomib on migration and invasion in cervical carcinoma HeLa cell

    Institute of Scientific and Technical Information of China (English)

    Chong; Shi; Guo-Bin; Zhang; Shu-Wang; Yin

    2015-01-01

    Objective:To explore the effect of bortezomib on migration and invasion of cervical carcinoma HeLa cell and specific molecular mechanism.Methods:The effect of bortezomib on the viability of HeLa cell was measured by MTT assay.The effect of bortezomib on cell migration and invasion was measured by Transwell assay and invasion experiment respectively.The activation of Akt/mTOR signaling pathway and expression level of MMP2,MMP9 were assayed by western blot.Results:MTT assay indicated bortezomib(2.5 μM.5 μM,10 μM)could inhibit HeLa cell viability,and the inhibitory rate was highest at 48 h.Transwell assay and invasion experiment results showed that bortezomib inhibited HeLa cell migration and invasion.Western blotting assays presented bortezomib could suppress the phosphorylation of Akt and mTOR.and down-regulate the expression of MMP2 and MMP9.Conclusions:These results suggested bortezomib could inhibit migration and invasion in cervical carcinoma HeLa cell,which might be related to Akt/mTOR signal pathway.

  8. Nasopharyngeal carcinoma treated with facial cervical portal and late-course hyperfractionation radiotherapy

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical results and side reactions of nasopharyngeal carcinoma (NPC) treated with facial cervical portal and late-course hyperfractionation radiotherapy. Methods: From July 1996 to December 1997, 93 NPC patients were divided into conventional fractionation and hyperfractionation radio- therapy groups. In 47 patients, facial cervical portal was used until the dose of 36 Gy/20 fraction in 4 weeks, and then followed by hyperfractionation radiotherapy: 1.15-1.2 Gy/fraction, 2 fraction/day, with 6-8 hour interval between, to a total dose of 74.2-76.7 Gy in 7.5 weeks without changing the shape of the portal. Forty-six patients were treated by conventional radiotherapy: 2.0 Gy/fraction, 5 fraction/week, to a total dose of 69-72 Gy in 7.5 weeks. Results: The regression rate was 100%, 96% in hyperfractionation and conventional fractionation radio-therapy group after 6 months of radiotherapy, respectively. The 1-, 3-, and 5-year local control rate was 100%, 98%, 86% in the hyperfractionation radiotherapy group and 98%, 86%, 54% in the conventional fractionation group (P0.05). Conclusions: In nasopharyngeal carcinoma, the local control rate and survival rate are raised by hyperfractionation radiotherapy. But recurrence rate and distant metastasis rate are not significantly different. (authors)

  9. Dexamethasone-induced radioresistance occurring independent of human papilloma virus gene expression in cervical carcinoma cells

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the role of HPV 18 E6 and E7 gene products with respect to radiosensitivity of two cervical carcinoma cell lines. The two cervical carcinoma lines C4-1 and SW 756 were used in which treatment with dexamethasone allows to modulate expression levels of HPV 18 E6 and E7 genes: Upregulation in C4-1, down-regulation in SW 756. Effects of treatment with dexamethasone on plating efficiency and radiosensitivity were assessed using a clonogenic assay. Treatment with dexamethasone increased plating efficiency of the C4-1 cells, but did not affect plating efficiency of SW 756 cells. Treatment with dexamethasone induced enhanced radioresistance in both cell lines. Thus, in C4-1 cells the observed changes in radioresistance correlate to the enhancement in expression of HPV 18 genes E6/E7, whereas in SW 756, a reduced expression correlates negatively with the enhanced radioresistance. (orig./MG)

  10. Is cervical screening preventing adenocarcinoma and adenosquamous carcinoma of the cervix?

    Science.gov (United States)

    Castanon, Alejandra; Landy, Rebecca; Sasieni, Peter D

    2016-09-01

    While the incidence of squamous carcinoma of the cervix has declined in countries with organised screening, adenocarcinoma has become more common. Cervical screening by cytology often fails to prevent adenocarcinoma. Using prospectively recorded cervical screening data in England and Wales, we conducted a population-based case-control study to examine whether cervical screening leads to early diagnosis and down-staging of adenocarcinoma. Conditional logistic regression modelling was carried out to provide odds ratios (ORs) and 95% confidence intervals (CIs) on 12,418 women with cervical cancer diagnosed between ages 30 and 69 and 24,453 age-matched controls. Of women with adenocarcinoma of the cervix, 44.3% were up to date with screening and 14.6% were non-attenders. The overall OR comparing women up to date with screening with non-attenders was 0.46 (95% CI: 0.39-0.55) for adenocarcinoma. The odds were significantly decreased (OR: 0.22, 95% CI: 0.15-0.33) in up to date women with Stage 2 or worse adenocarcinoma, but not for women with Stage1A adenocarcinoma 0.71 (95% CI: 0.46-1.09). The odds of Stage 1A adenocarcinoma was double among lapsed attenders (OR: 2.35, 95% CI: 1.52-3.62) compared to non-attenders. Relative to women with no negative cytology within 7 years of diagnosis, women with Stage1A adenocarcinoma were very unlikely to be detected within 3 years of a negative cytology test (OR: 0.08, 95% CI: 0.05-0.13); however, the odds doubled 3-5 years after a negative test (OR: 2.30, 95% CI: 1.67-3.18). ORs associated with up to date screening were smaller for squamous and adenosquamous cervical carcinoma. Although cytology screening is inefficient at preventing adenocarcinomas, invasive adenocarcinomas are detected earlier than they would be in the absence of screening, substantially preventing Stage 2 and worse adenocarcinomas. PMID:27096255

  11. Locally advanced cervix carcinoma - innovation in combined modality therapy

    International Nuclear Information System (INIS)

    Locally advanced cervical carcinoma continues to be a challenge to the clinician due to local failure as well as systemic metastases. Standard intracavitary and external beam techniques result in local control rates of only 35-65%, with long term survival rates of 25-60% in patients with state IIIA-IVA disease, indicating the need to identify new treatment strategies. Optimization programs for remote-afterloading interstitial brachytherapy allow the delivery of higher local doses of radiation to volumes that more closely approximate tumor target volumes as identified on MR scans, leading to improved therapeutic ratios. Identification of subsets of patients more likely to fail standard therapy, either locally or systemically, may be possible through such techniques as in vivo measurements of hypoxia with Eppendorf oxygen electrodes, interstitial fluid pressure measurements, the Comet assay, and nitroimidazole binding methods. Traditional chemotherapies, administered in either a neoadjuvant role or concomitantly with radiation have been disappointing in prospective trials. A variety of new agents are being investigated to determine if they can increase the frequency or duration of complete response. The taxanes, with response rates of 17-23% by themselves, are being assessed as potential radiosensitizers. The camptotheicin CRT-11 (Irinotecan) has demonstrated activity in platinum resistant cervix cancer, with response rates of 24%. Bioradiotherapeutic approaches, using 13-cis-retinoic acid and interferon-2a, are undergoing phase II studies. Neoangiogenesis inhibitors and vaccines against HPV are also being examined. The aggressive pursuit of techniques that help identify those patients most likely to fail, that allow the delivery of higher radiation doses more safely to the target volume, and that incorporate the use of more effective systemic therapies is necessary to improve the outcome for this disease

  12. Primary human cervical carcinoma cells require human papillomavirus E6 and E7 expression for ongoing proliferation

    International Nuclear Information System (INIS)

    Repression of human papillomavirus (HPV) E6 and E7 oncogenes in established cervical carcinoma cell lines causes senescence due to reactivation of cellular tumor suppressor pathways. Here, we determined whether ongoing expression of HPV16 or HPV18 oncogenes is required for the proliferation of primary human cervical carcinoma cells in serum-free conditions at low passage number after isolation from patients. We used an SV40 viral vector expressing the bovine papillomavirus E2 protein to repress E6 and E7 in these cells. To enable efficient SV40 infection and E2 gene delivery, we first incubated the primary cervical cancer cells with the ganglioside GM1, a cell-surface receptor for SV40 that is limiting in these cells. Repression of HPV in primary cervical carcinoma cells caused them to undergo senescence, but the E2 protein had little effect on HPV-negative primary cells. These data suggest that E6 and E7 dependence is an inherent property of human cervical cancer cells.

  13. Primary human cervical carcinoma cells require human papillomavirus E6 and E7 expression for ongoing proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Magaldi, Thomas G.; Almstead, Laura L. [Department of Genetics, Yale School of Medicine, P.O. Box 208005, New Haven, CT 06520-8005 (United States); Bellone, Stefania [Department of Obstetrics and Gynecology and Reproductive Sciences, Yale School of Medicine, P.O. Box 208063, New Haven, CT 06520-8063 (United States); Prevatt, Edward G. [Department of Genetics, Yale School of Medicine, P.O. Box 208005, New Haven, CT 06520-8005 (United States); Santin, Alessandro D. [Department of Obstetrics and Gynecology and Reproductive Sciences, Yale School of Medicine, P.O. Box 208063, New Haven, CT 06520-8063 (United States); Yale Comprehensive Cancer Center, P.O. Box 208028, New Haven, CT 06520-8028 (United States); DiMaio, Daniel, E-mail: daniel.dimaio@yale.edu [Department of Genetics, Yale School of Medicine, P.O. Box 208005, New Haven, CT 06520-8005 (United States); Department of Therapeutic Radiology, Yale School of Medicine, P.O. Box 208040, New Haven, CT 06520-8040 (United States); Department of Molecular Biophysics and Biochemistry, Yale School of Medicine, P.O. Box 208024 (United States); Yale Comprehensive Cancer Center, P.O. Box 208028, New Haven, CT 06520-8028 (United States)

    2012-01-05

    Repression of human papillomavirus (HPV) E6 and E7 oncogenes in established cervical carcinoma cell lines causes senescence due to reactivation of cellular tumor suppressor pathways. Here, we determined whether ongoing expression of HPV16 or HPV18 oncogenes is required for the proliferation of primary human cervical carcinoma cells in serum-free conditions at low passage number after isolation from patients. We used an SV40 viral vector expressing the bovine papillomavirus E2 protein to repress E6 and E7 in these cells. To enable efficient SV40 infection and E2 gene delivery, we first incubated the primary cervical cancer cells with the ganglioside GM1, a cell-surface receptor for SV40 that is limiting in these cells. Repression of HPV in primary cervical carcinoma cells caused them to undergo senescence, but the E2 protein had little effect on HPV-negative primary cells. These data suggest that E6 and E7 dependence is an inherent property of human cervical cancer cells.

  14. Heat shock transcription factor1gene silenced with RNAi to enhance radio-sensitivity of cervical carcinoma cell

    International Nuclear Information System (INIS)

    In order to suppress HSF1 gene expression using RNA interference technique and explore the changes of the radiation sensitivity of cervical carcinoma cells, HSF1-pSilencer2.1-U6neo for siRNA expression was transfected into cervical carcinoma cells by lipofectamine. HSF1mRNA expression was detected by real time poly- merase chain reaction and flow cytometry was employed to evaluate HSFlprotein expression. In addiction, the radiation sensitivity of cervical carcinoma cells was assessed by clone forming assay. The results show that HSF1mRNA expression of the cells transfected HSF1A-pSilencer2.1-U6neo descends obviously compared with control. Mean- while the radiation sensitivity of Hela cells increases with the descension of HSF1 gene expression. Experiment has been confirmed that siRNA plasmid expression vector HSF1A-pSilencer2.1-U6neo successfully suppresses HSF1gene expression. Plasmid expression vector of HSF1 gene siRNA can be use to enhance the radio-sensitivity of cervical carcinoma cells and may be used as a powerfully adjunct method for conventional radiotherapy. (authors)

  15. New strategies in advanced cervical cancer: from angiogenesis blockade to immunotherapy.

    Science.gov (United States)

    Tewari, Krishnansu S; Monk, Bradley J

    2014-11-01

    Cervical cancer remains unique among solid tumor malignancies. Persistent infection with oncogenic subtypes of the human papillomavirus (HPV) results in carcinogenesis, predominantly occurring at the cervical transformation zone where endocervical columnar cells undergo metaplasia to a stratified squamous epithelium. The molecular cascade involving viral oncoproteins, E6 and E7 and their degradative interactions with cellular tumor suppressor gene products, p53 and pRb, respectively, has been precisely delineated. The precursor state of cervical neoplasia may last for years allowing for ready detection through successful screening programs in developed countries using cervical cytology and/or high-risk HPV DNA testing. Prophylactic HPV L1 capsid protein vaccines using virus-like-particle technology have been developed to prevent primary infection by the most common high-risk HPVs (16 and 18). Women who lack access to health care and those who undergo sporadic screening remain at risk. Although radical surgery (including fertility-sparing surgery) is available for patients with early-stage cancers, and chemoradiation plus high-dose-rate brachytherapy can cure the majority of those with locally advanced disease, patients with metastatic and nonoperable recurrent cervical cancer constitute a high-risk population with an unmet clinical need. On August 14, 2014, the FDA approved the antiangiogenesis drug bevacizumab for women with advanced cervical cancer. This review will highlight advances in translational science, antiangiogenesis therapy and immunotherapy for advanced disease. PMID:25104084

  16. Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    Science.gov (United States)

    2016-03-25

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma

  17. Nivolumab versus Everolimus in Advanced Renal-Cell Carcinoma

    DEFF Research Database (Denmark)

    Motzer, Robert J; Escudier, Bernard; McDermott, David F;

    2015-01-01

    %). CONCLUSIONS: Among patients with previously treated advanced renal-cell carcinoma, overall survival was longer and fewer grade 3 or 4 adverse events occurred with nivolumab than with everolimus. (Funded by Bristol-Myers Squibb; CheckMate 025 ClinicalTrials.gov number, NCT01668784.).......BACKGROUND: Nivolumab, a programmed death 1 (PD-1) checkpoint inhibitor, was associated with encouraging overall survival in uncontrolled studies involving previously treated patients with advanced renal-cell carcinoma. This randomized, open-label, phase 3 study compared nivolumab with everolimus...... in patients with renal-cell carcinoma who had received previous treatment. METHODS: A total of 821 patients with advanced clear-cell renal-cell carcinoma for which they had received previous treatment with one or two regimens of antiangiogenic therapy were randomly assigned (in a 1:1 ratio) to...

  18. The association of apoptotic protein expressions sensitive to apoptosis gene, p73 and p53 with the prognosis of cervical carcinoma

    Directory of Open Access Journals (Sweden)

    Mega Tiber P

    2014-11-01

    Full Text Available Pinar Mega Tiber,1 Latife Baloglu,2 Sevgi Ozden,3 Zerrin Ozgen,4 Hazan Ozyurt,3 Makbule Eren,3 Oya Orun11Department of Biophysics, Marmara University, School of Medicine, Maltepe, Istanbul, Turkey; 2Laboratory Medicine, Karolinska Institute Biomedical Laboratory Science, Stockholm, Sweden; 3Clinic of Radiation Oncology, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey; 4Department of Radiation Oncology, Marmara University, School of Medicine, Kaynarca, Istanbul, TurkeyObjective: To evaluate the expressions of several apoptotic pathway proteins in relation to clinical parameters and survival in patients with cervical carcinoma.Methods: A total of 20 patients with clinically advanced staged carcinoma of cervix (International Federation of Gynecology and Obstetrics [FIGO] stage IIB-IVA aged from 40 to 75 years were included in this study. The expression profile of anti-apoptotic protein (sensitive to apoptosis gene [SAG], mitochondrial apoptotic proteins (B-cell lymphoma-extra-large [Bcl-xL] and Bcl-2 homologous antagonist/killer [Bak], and tumor suppressor proteins (p73 and p53 were examined by real-time polymerase chain reaction experiments along with their relation to clinical parameters and survival analyses during follow-up for 5 to 8 years.Results: No significant difference was found in the expressions of SAG, Bcl-xL, Bak, p73 and p53 proteins with respect to stage and grade of tumor. A significant positive correlation was noted between SAG and Bcl-xL genes (r=0.752, P<0.001 and between SAG and Bak genes (r=0.589, P=0.006. Among genes determined to be significantly associated with overall survival in the univariate analysis (P=0.026 for SAG, P=0.002 for Bcl-xL, and P=0.027 for p53, only p53 was identified as the significant predictor in the multivariate analysis (hazard ratio: 8.53, 95% confidence interval: 1.34–54.2, P=0.023.Conclusion: In conclusion, our findings demonstrated a reverse correlation of SAG, Bcl

  19. Programmed cell death as a prognostic indicator for radiation therapy in cervical carcinoma patients: A pilot study

    Directory of Open Access Journals (Sweden)

    Bhosle S

    2005-01-01

    Full Text Available Purpose: In clinical practice, radiation therapy often fails in cervical carcinoma stage IIIB and there is a need to develop a predictive assay for prognosis of radiation treatment outcome in cancer patient. We have attempted to evaluate the relevance of changes in Membrane Fluidity (MF and associated apoptotic cell death in cervical cancer cells after first fractionated dose of radiation therapy to treatment outcome of stage IIIB cervical carcinoma patients. Materials and Methods: Biopsies of 15 patients with histologically proven cervix cancer were collected from the patients before and 24 h after first fractionated radiation dose of 2 grays (Gy. Cell suspension made in Dulbecco′s Modified Eagle′s Medium (DMEM were used for further investigations and cell suspension of cervix cancer patient were used to measure MF by fluorescence polarization method and apoptotic index (AI was determined by Tdt dUTP Nucleotide End Labeling (TUNEL assay. Results: A substantial increase in MF and AI was observed in cervical cancer cells irradiated ex vivo . A significant correlation ( P < 0.001 was found between the changes in AI after first fractionated dose of radiotherapy and treatment outcome of patients. No significant correlation ( P > 0.1 was detected between changes in MF and treatment outcome of patients. Conclusion: Preliminary results showed significant change in MF and a marked increase in percentage apoptosis of cervix cancer cells irradiated ex vivo . The changes in AI after first fractionated dose of radiotherapy in cervical carcinoma patients may provide a predictor of prognosis for radiotherapy in uterine cervical carcinoma patients.

  20. pO{sub 2} Fluctuation Pattern and Cycling Hypoxia in Human Cervical Carcinoma and Melanoma Xenografts

    Energy Technology Data Exchange (ETDEWEB)

    Ellingsen, Christine; Ovrebo, Kirsti Marie; Galappathi, Kanthi; Mathiesen, Berit [Radiation Biology and Tumor Physiology Group, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo (Norway); Rofstad, Einar K., E-mail: einar.k.rofstad@rr-research.no [Radiation Biology and Tumor Physiology Group, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo (Norway)

    2012-07-15

    Purpose: Blood perfusion in tumors is spatially and temporally heterogeneous, resulting in local fluctuations in tissue oxygen tension (pO{sub 2}) and tissue regions showing cycling hypoxia. In this study, we investigated whether the pO{sub 2} fluctuation pattern and the extent of cycling hypoxia differ between tumor types showing high (e.g., cervical carcinoma xenograft) and low (e.g., melanoma xenograft) fractions of connective tissue-associated blood vessels. Methods and Materials: Two cervical carcinoma lines (CK-160 and TS-415) and two melanoma lines (A-07 and R-18) transplanted into BALB/c nu/nu mice were included in the study. Tissue pO{sub 2} was measured simultaneously in two positions in each tumor by using a two-channel OxyLite fiber-optic oxygen-sensing device. The extent of acute and chronic hypoxia was assessed by combining a radiobiological and a pimonidazole-based immunohistochemical assay of tumor hypoxia. Results: The proportion of tumor regions showing pO{sub 2} fluctuations, the pO{sub 2} fluctuation frequency in these regions, and the relative amplitude of the pO{sub 2} fluctuations were significantly higher in the melanoma xenografts than in the cervical carcinoma xenografts. Cervical carcinoma and melanoma xenografts did not differ significantly in the fraction of acutely hypoxic cells or the fraction of chronically hypoxic cells. However, the ratio between fraction of acutely hypoxic cells and fraction of chronically hypoxic cells was significantly higher in melanoma than in cervical carcinoma xenografts. Conclusions: Temporal heterogeneity in blood flow and tissue pO{sub 2} in tumors may depend on tumor histology. Connective tissue surrounding microvessels may stabilize blood flow and pO{sub 2} and, thus, protect tumor tissue from cycling hypoxia.

  1. Reduced expression of autophagy markers correlates with high-risk human papillomavirus infection in human cervical squamous cell carcinoma

    Science.gov (United States)

    WANG, HUA-YI; YANG, GUI-FANG; HUANG, YAN-HUA; HUANG, QI-WEN; GAO, JUN; ZHAO, XIAN-DA; HUANG, LI-MING; CHEN, HONG-LEI

    2014-01-01

    Infection by an oncogenic human papillomavirus (HPV), in particular HPV16 and 18, is a high risk factor for developing cervical cancer; however, viral infection alone is not sufficient for cancer progression. Autophagy is hypothesized to be an important process during carcinogenesis. The aim of the present study was to investigate the association between autophagy and high-risk HPV (hrHPV) infection in human cervical squamous cell carcinomas (SCCs), and to analyze the clinical significance of this association. Quantum dot (QD)-based immunofluorescence histochemistry was used to detect the expression of autophagy markers, Beclin-1 and microtubule-associated proteins 1A/1B light chain 3B (LC3B) proteins, in 104 cases of cervical cancer (including 80 SCCs and 24 adenocarcinomas) and 20 normal cervical tissues. hrHPV (HPV16/18) infection was detected by QDs based fluorescence in situ hybridization in cervical cancers. The results revealed that the expression levels of Beclin-1 and LC3B were significantly lower in cervical cancer cells when compared with those of normal cervical squamous epithelial cells, and were found to negatively correlate with hrHPV infection. The expression levels of Beclin-1 and LC3B were not associated with age, tumor grade, tumor stage, tumor node metastasis stage or lymph node metastasis. However, a positive correlation was identified between Beclin-1 and LC3B protein expression. In addition, the absence of autophagy in combination with hrHPV infection may accelerate the progression of cervical SCC. In conclusion, decreased expression of Beclin-1 and LC3B may be important in cervical carcinogenesis. The hrHPV-host cell interaction may inhibit autophagy, which may aid virus duplication and infection, as well as cervical cancer development. PMID:25202355

  2. Artificial Neural Network System in Evaluating Cervical Lymph Node Metastasis of Squamous Cell Carcinoma

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate cervical lymph node metastasis of oral squamous cell carcinoma patients by MRI film and neural network system. The oral squamous cell carcinoma patients(21 patients, 59 lymph nodes) who have visited SNU hospital and been taken by MRI, were included in this study. Neck dissection operations were done and all of the cervical lymph nodes were confirmed with biopsy. In MR images, each lymph node were evaluated by using 6 MR imaging criteria(size, roundness, heterogeneity, rim enhancement, central necrosis, grouping) respectively. Positive predictive value, negative predictive value, and accuracy of each single MR imaging criteria were calculated. At neural network system, the layers of neural network system consisted of 10 input layer units, 10 hidden layer units and 1 output layer unit. 6 MR imaging criteria previously described and 4 MR imaging criteria (site I-node level 2, site II-other node level, shape I-oval, shape II-bean) were included for input layer units. The training files were made of 39 lymph nodes(24 metastatic lymph nodes, 10 non-metastatic lymph nodes) and the testing files were made of other 20 lymph nodes(10 metastatic lymph nodes, 10 non-metastatic lymph nodes). The neural network system was trained with training files and the output level (metastatic index) of testing files were acquired. Diagnosis from neural network was decided according to 4 different standard metastatic index-68, 78, 88, 98 respectively and positive predictive values, negative predictive values and accuracy of each standard metastatic index were calculated. In the diagnosis of using single MR imaging criteria, the rim enhancement criteria had the highest positive predictive value, 0.95 and the size criteria showed the highest at negative predictive value, 0.77. The highest accurate criteria was heterogeneity with the accuracy of 0.81 and the lowest one was central necrosis with accuracy of 0.59. In the diagnosis of using neural network

  3. HPV types, HIV and invasive cervical carcinoma risk in Kampala, Uganda: a case-control study

    Directory of Open Access Journals (Sweden)

    Kleter Bernhard

    2011-06-01

    Full Text Available Abstract Background While the association of human papillomavirus (HPV with cervical cancer is well established, the influence of HIV on the risk of this disease in sub-Saharan Africa remains unclear. To assess the risk of invasive cervical carcinoma (ICC associated with HIV and HPV types, a hospital-based case-control study was performed between September 2004 and December 2006 in Kampala, Uganda. Incident cases of histologically-confirmed ICC (N=316 and control women (N=314, who were visitors or care-takers of ICC cases in the hospital, were recruited. Blood samples were obtained for HIV serology and CD4 count, as well as cervical samples for HPV testing. HPV DNA detection and genotyping was performed using the SPF10/DEIA/LiPA25 technique which detects all mucosal HPV types by DEIA and identifies 25 HPV genotypes by LiPA version 1. Samples that tested positive but could not be genotyped were designated HPVX. Odds ratios (OR and 95% confidence intervals (CI were calculated by logistic regression, adjusting for possible confounding factors. Results For both squamous cell carcinoma (SCC and adenocarcinoma of the cervix, statistically significantly increased ORs were found among women infected with HPV, in particular single HPV infections, infections with HPV16-related types and high-risk HPV types, in particular HPV16, 18 and 45. For other HPV types the ORs for both SCC and adenocarcinoma were not statistically significantly elevated. HIV infection and CD4 count were not associated with SCC or adenocarcinoma risk in our study population. Among women infected with high-risk HPV types, no association between HIV and SCC emerged. However, an inverse association with adenocarcinoma was observed, while decrease in CD4 count was not associated with ICC risk. Conclusions The ORs for SCC and adenocarcinoma were increased in women infected with HPV, in particular single HPV infections, infections with HPV16- and 18-related types, and high-risk HPV types

  4. Dose evaluation of conventional radiotherapy using facial-cervical fields in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate the dose distribution of the target volume and the cranial base in nasopharyngeal carcinoma (NPC) treated with facial-cervical fields, and to analyze the differences of dose distribution using different isocenters with the CT-simulator and treatment planning system (TPS). Methods: Eleven patients with nasopharyngeal carcinoma were treated by conventional radiotherapy as their primary treatment. All patients were simulated by the conventional simulator and the field borders were marked with thin lead wires on the mask. Then the patients were scanned by the CT-sim with the same immobilization. The planning CT images were transferred to the TPS and the field borders were copied on the DRR, and then GTV and the cranial base were contoured on the coronal CT slices. Two isocenters were chosen, including one in front of the 1 st cervical vertebra to measure the depth of the nasopharynx and the other in front of the 3rd cervical vertebra to measure the depth of the upper neck. The prescription dose of 36 Gy was given in 18 fractions. Dose distributions of GTV and the cranial base were calculated with TPS. Results: The actual dose of 95% volume of GTV was 33.31 -35.54 Gy (median 34.83 Gy) and 31.43 -33.36 Gy (median 32.44 Gy) when the isocenters were set in the nasopharynx and the superior neck, respectively. The corresponding actual dose of 95% volume of the cranial base was 17.76 - 34.60 Gy (median 30.28 Gy) and 16.52 -32.60 Gy (median 28.52 Gy), respectively. Conclusions: For NPC patients treated with conventional radiotherapy using facial-cervical fields, the actual dose of GTV and the cranial base is lower than the prescribed dose whenever the isocenter is set in the nasopharynx or the upper neck,which is more significant in the latter. The isocenter should be set in the nasopharynx when the conventional radiotherapy is applied and a boost of 4- 8 Gy should be given when the cranial base is involved. (authors)

  5. Advances in diagnosis and treatment of metastatic cervical cancer.

    Science.gov (United States)

    Li, Haoran; Wu, Xiaohua; Cheng, Xi

    2016-07-01

    Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases. PMID:27171673

  6. Kinase inhibitors for advanced medullary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Martin Schlumberger

    2012-01-01

    Full Text Available The recent availability of molecular targeted therapies leads to a reconsideration of the treatment strategy for patients with distant metastases from medullary thyroid carcinoma. In patients with progressive disease, treatment with kinase inhibitors should be offered.

  7. Nanoparticle Albumin-Bound Rapamycin in Treating Patients With Advanced Cancer With mTOR Mutations

    Science.gov (United States)

    2016-04-18

    Advanced Malignant Neoplasm; Cervical Squamous Cell Carcinoma; Endometrial Carcinoma; Malignant Uterine Neoplasm; Recurrent Bladder Carcinoma; Recurrent Breast Carcinoma; Recurrent Cervical Carcinoma; Recurrent Head and Neck Carcinoma; Recurrent Malignant Neoplasm; Recurrent Ovarian Carcinoma; Recurrent Prostate Carcinoma; Recurrent Renal Cell Carcinoma; Solid Neoplasm; Stage III Bladder Cancer; Stage III Prostate Cancer; Stage III Renal Cell Cancer; Stage IIIA Breast Cancer; Stage IIIA Cervical Cancer; Stage IIIA Ovarian Cancer; Stage IIIB Breast Cancer; Stage IIIB Cervical Cancer; Stage IIIB Ovarian Cancer; Stage IIIC Breast Cancer; Stage IIIC Ovarian Cancer; Stage IV Breast Cancer; Stage IV Ovarian Cancer; Stage IV Prostate Cancer; Stage IV Renal Cell Cancer; Stage IVA Bladder Cancer; Stage IVA Cervical Cancer; Stage IVB Bladder Cancer; Stage IVB Cervical Cancer

  8. Utility of bone scanning in detecting occult skeletal metastases from cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Katz, R.D.; Alderson, P.O.; Rosenshein, N.B.; Bowerman, J.W.; Wagner, H.N. Jr.

    1979-11-01

    Bone scans were obtained in 100 patients with carcinoma of the cervix in order to search for occult skeletal metastases. Scans revealed metastases in 4 patients with advanced stages of disease, but the scans in 79 patients with Stage 0, I, or II disease were negative. The scans in 14 patients showed renal asymmetry; 11 of these had obstructive uropathy due to tumor invasion or radiation therapy. Bone scanning does not seem warranted as a screening test in asymptomatic patients with Stage 0, I, or II carcinoma. If the test is done, renal symmetry should be carefully evaluated.

  9. Radiation-induced femoral neck fracture in patients cured of cervical carcinoma

    International Nuclear Information System (INIS)

    In the years 1948-1967 8275 patients with cervical carcinoma in various grades of progression were treated at the Institute of Oncology in Warsaw by radiotherapy from external fields. Five-year survival without signs of recurrence was obtained in 4204 cases, 3863 of them were irradiated from external fields with X-rays under conventional conditions, while 341 received Co60 radiotherapy. In 43 patients treated with X-rays and radium and regarded as cured radiological evidence of femoral neck fracture was obtained. These patients account for 1.1% of all cured patients. In the group treated with Co60 radiation in only 1 case femoral neck fracture was observed (0.3%). In the group of cured patients with femoral neck fracture the method of irradiation from external fields, the age, clinical course, radiological appearance of radiation-induced changes and the method of fracture management were analysed. (author)

  10. Osteoradionecrosis of the upper cervical spine: MR imaging following radiotherapy for nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    King, Ann D. [Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China)], E-mail: king2015@cuhk.edu.hk; Griffith, James F.; Abrigo, Jill M. [Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China); Leung Singfai [Department of Clinical Oncology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China); Yau Fungkwai [Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China); Tse, Gary M.K. [Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China); Ahuja, Anil T. [Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China)

    2010-03-15

    Purpose: To document the MRI appearances of radiation-induced abnormalities in the cervical spine following treatment for nasopharyngeal carcinoma (NPC). Methods: Patients with radiation-induced abnormalities in the upper cervical spine were identified from a retrospective analysis of reports from patients undergoing MRI follow-up. Imaging and clinical records of these patients were reviewed. Symmetrical distribution of abnormalities at C1 (anterior arch {+-} adjacent aspect of the lateral masses) and C2 (dens {+-} body especially with a characteristic horizontal rim of marrow preservation above the inferior endplate) were considered typical for osteoradionecrosis (ORN). Results: Abnormalities of C1/2 were identified in 9/884 (1%) patients. The MRI distribution of abnormalities was typical for ORN in four and atypical in five patients. Abnormal soft tissue was present in the atlantoaxial joint in eight patients, forming a florid mass in six. This soft tissue was in direct continuity with the posterior nasopharyngeal wall ulceration via the retropharyngeal region. The final clinical diagnosis was ORN in eight, five of whom had clinical factors which suggested infection could have played a contributory role, and osteomyelitis in one patient. All patients had undergone additional radiotherapy treatment comprising of brachytherapy (7), stereotactic radiotherapy (1) or radiotherapy boost (2) and three had undergone nasopharyngectomy. Conclusion: ORN of the upper cervical spine following radiotherapy for NPC is more common than previously suspected and is seen in patients with additional treatment, especially brachytherapy. MRI features are often atypical and a contributory role of infection in the development of some cases of ORN is postulated.

  11. Metabonomic signature analysis of cervical carcinoma and precancerous lesions in women by (1)H NMR spectroscopy.

    Science.gov (United States)

    Hasim, Ayshamgul; Ali, Mayinuer; Mamtimin, Batur; Ma, Jun-Qi; Li, Qiao-Zhi; Abudula, Abulizi

    2012-06-01

    (1)H nuclear magnetic resonance (NMR)-based metabonomics has been used to characterize the metabolic profiles of cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC). Principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLS-DA) were used to model the systematic variation related to patients with CIN or CSCC with healthy controls. Potential metabolic biomarkers were identified using database comparisons, and the one-way analysis of variance (ANOVA) test was used to examine the significance of the metabolites. Compared with plasma obtained from the healthy controls, plasma from patients with CIN had higher levels of very-low density lipoprotein (VLDL), acetone, unsaturated lipid and carnitine, together with lower levels of creatine, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine, glycine, acetylcysteine, myo-inositol, choline and glycoprotein. Plasma from patients with CSCC had higher levels of acetate and formate, together with lower levels of creatine, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine and tyrosine compared with the plasma of the healthy controls. In addition, compared with the plasma of patients with CIN, the plasma of CSCC patients had higher levels of acetate, formate, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine, tyrosine, acetylcysteine, myo-inositol, glycoprotein, α-glucose and β-glucose, together with lower levels of acetone, unsaturated lipid and carnitine. Moreover, the profiles showed high feasibility and specificity by statistical analysis with OPLS-DA compared to the Thinprep cytology test (TCT) by setting the histopathological outcome as standard. The metabolic profile obtained for cervical cancer is significant, even for the precancerous disease. This suggests a systemic metabolic response to cancer, which may be used to identify potential early diagnostic biomarkers of the cancer and to establish

  12. Therapeutic outcome and prognostic factors in the radiotherapy of recurrences of cervical carcinoma following surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hille, A.; Weiss, E.; Hess, C.F. [Univ. Goettingen (Germany). Dept. of Radiotherapy

    2003-11-01

    Purpose: To evaluate the efficacy of radiotherapy in patients with recurrences of cervical carcinoma. Patients and Methods: 26 patients who underwent radiation therapy for recurrences of cervical carcinoma following surgery between 1989 and 1999 were retrospectively analyzed. 17 patients had inoperable or macroscopic residual tumor. Nine patients had a complete/microscopically incomplete tumor resection. Depending on tumor burden and location of the recurrence, external-beam radiotherapy or a combination with brachytherapy was delivered to a total dose of 50-65 Gy. Results: The 5-year overall survival was 28%, relapse-free survival 24%, pelvic control 48%. Therapeutic outcome was related to the margins of resection, location of recurrence and technique of radiotherapy. In case of surgery without residual or microscopic tumor, the 5-year survival rate was 67%, with macroscopic tumor no patient was alive after 37 months (p = 0.05). 5-year overall survival was 42% for central recurrences, 10% for recurrences with pelvic wall infiltration. Recurrences confined to the vagina or paravaginal tissue had a higher 5-year overall probability as compared to all other patients (57% vs. 14%). All patients treated with combined radiotherapy were alive, whereas all patients treated only with external radiotherapy were dead after 32 months (p = 0.01). Conclusion: The probability of controlling recurrence mostly depends on a small tumor burden with the possibility of brachytherapy and/or complete surgery. Aggressive treatment modalities like radiochemotherapy and/or higher radiation doses are needed, especially for recurrences with infiltration of the pelvic wall and/or with macroscopic tumor. (orig.)

  13. Cervical carcinoma in Algiers, Algeria: human papillomavirus and lifestyle risk factors.

    Science.gov (United States)

    Hammouda, Doudja; Muñoz, Nubia; Herrero, Rolando; Arslan, Annie; Bouhadef, Anissa; Oublil, Malika; Djedeat, Belhout; Fontanière, Bernard; Snijders, Peter; Meijer, Chris; Franceschi, Silvia

    2005-01-20

    We conducted a hospital-based case-control study in Algiers, Algeria. A total of 198 cervical carcinoma (CC) cases (including 15 adeno- and adenosquamous carcinomas) and 202 age-matched control women were included. Human papillomavirus (HPV) DNA in cervical cells was evaluated using a PCR assay. Odds ratios and corresponding confidence intervals were computed by means of unconditional multiple logistic regression models. HPV infection was detected in 97.7% of CC cases and 12.4% of control women (OR = 635). Nineteen different HPV types were found. HPV 16 was the most common type in both CC cases and control women, followed by HPV 18 and 45. Twelve types (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 66 and 73) were found as single infections in CC cases. Multiple HPV infections did not show a higher odds ratio for CC than single infections. In addition to HPV infection, husband's extramarital sexual relationships with other women (OR = 4.8) or prostitutes (OR = 3.2), residing in a rural environment for most of one's life (OR = 4.9) and indicators of poor sanitation or poor hygiene were the strongest risk factors for CC. Oral contraceptive use was unrelated to CC risk, while multiparity emerged as a significant risk factor after adjustment for sexual habits. Intrauterine device users showed a lower CC risk than nonusers. The role of major risk factors, except inside toilet, was confirmed in the analysis restricted to HPV-positive women. The distribution of HPV types in CC cases and control women in Algeria is more similar to the one found in Europe than the one in sub-Saharan Africa, where HPV 16 is less prevalent. A vaccine against HPV 16 and 18 may be effective in more than 3/4 of CCs in Algeria. PMID:15455386

  14. Results of salvage radiotherapy after inadequate surgery in invasive cervical carcinoma patients: A retrospective analysis

    International Nuclear Information System (INIS)

    Purpose: To evaluate the results of salvage radiotherapy (RT) after inadequate surgery in patients with invasive carcinoma of the cervix. Methods and Materials: Between 1996 and 2001, 105 invasive cervical carcinoma patients were treated at our center with external beam RT with or without intracavitary RT after having undergone total/subtotal hysterectomy at outside institutions. Results: The median follow-up was 34 months. The gap between surgery and RT was 23-198 days (median, 80). Clinically visible residual disease was present in 81 patients (77.1%). Total hysterectomy had been done in 82 patients (78%) and subtotal hysterectomy in 23 patients (22%). The 5-year overall survival, disease-free survival, and pelvic control rates of all patients were 55.2%, 53.3%, and 72.4%, respectively. On univariate analysis, older age, total hysterectomy, hemoglobin level >10 g% before RT, nonsquamous histologic type, use of intracavitary RT, a shorter gap between surgery and RT, and the absence of, or a small volume of, residual disease favorably affected the outcome. The 5-year actuarial rate of late toxicity (Radiation Therapy Oncology Group Criteria) was 19% in the rectum, 4.8% in the bladder, 24.8% in the skin, and 14.3% in the small intestine. Conclusions: Inadequate and inappropriate surgery in invasive cervical cancer with resulting gross residual disease is common in India. Factors such as the use of intracavitary RT, the correction of anemia, and a shorter gap between surgery and RT will enable postoperative RT to achieve acceptable results with minimal morbidity

  15. Radiation Therapy Results of Invasive Cervical Carcinoma Found After Inappropriate Hysterectomy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Doo Ho; Kim, Eun Seog; Nam, Kae Hyun; Huh, Seung Jae [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1996-09-15

    Purpose : Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. Methods and Materials : Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcioma in situ (38 cases), severe dysplasia(2), myoma(6), uterine bleeding (4), uterine prolapse (2), and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy form August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients reveived ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. Results : Overall 5-year survival rate and relapse-free survival rate were 83.8%, 86.9% respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were 90.9%, 88.8%, 38.4%, and 100% respectively. There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cncer (stage IA) had no treatment related failure. Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. Conclusion : Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy. Survivals for patients with gross disease

  16. Hyperthermia and PARP1-inhibition for sensitization of radiation and cisplatin treatment of cervical carcinoma cells

    International Nuclear Information System (INIS)

    Ionizing radiation causes single and double strand breaks (SSBs and DSBs). DSBs are among the most critical DNA lesions and can be repaired via either non-homologous end joining (NHEJ) in which PARP1, Ku70 and DNA-PKcs are important, or homologous recombination (HR), where BRCA2 and Rad51 are essential. Hyperthermia disturbs HR by temporary inactivation of BRCA2. Cisplatin disrupts NHEJ and PARP1-inhibitor blocks Poly-(ADP-ribose)polymerase- 1, which is important in SSB repair, NHEJ and backup-NHEJ. Our goal was to investigate the additional effectiveness of hyperthermia and PARP1-inhibition on radiation and/or cisplatin treatment. Cervical carcinoma cells (SiHa) were treated at different temperature levels levels (41.0-43.0℃, PARP1-inhibitor (100 μM; NU1025), gamma-irradiation doses (0-8 Gy) or cisplatin (1'R for 1 h). Clonogenic assays were carried out to measure survival and γH2AX staining was used to visualize DSBs. To elucidate mechanisms of action expression levels of DNA repair proteins BRCA2 and DNA-PKcs were investigated after 42.0℃ (1 h) using western blot. Combined hyperthermia and radiation resulted in an increased number of γH2AX foci as compared to radiation alone. Hyperthermia treatment in combination with cisplatin and PARP1 inhibitor and with radiation and PARP1 inhibitor significantly decreased cell survival. Western blot demonstrated a decreased expression of BRCA2 protein at 30 min after hyperthermia treatment. Adding PARP1-inhibitor significantly improves the effectiveness of combined hyperthermia radiotherapy and combined hyperthermia-cisplatin treatment on cervical carcinoma cells. Hyperthermia affects DNA-DSB repair as is indicated by increased γH2AX foci numbers and decreased BRCA2 expression. (author)

  17. Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma in Japan

    OpenAIRE

    Ryuichi Kita; Toru Kimura; Hiroki Nishikawa; Yukio Osaki

    2012-01-01

    Transcatheter methods such as transcatheter arterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) have an important role in the treatment for advanced hepatocellular carcinoma (HCC). Recently, sorafenib, an inhibitor of tyrosine kinases, has been found to obtain survival benefits in patients with HCC, leading to major advances in the treatment of advanced HCC. However, it is associated with a low tumor response rate, minimal survival advantage, and high rates of ...

  18. Studying the Physical Function and Quality of Life Before and After Surgery in Patients With Stage I Cervical Cancer

    Science.gov (United States)

    2016-02-09

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Lymphedema; Sexual Dysfunction and Infertility; Stage IA1 Cervical Cancer; Stage IA2 Cervical Cancer; Stage IB1 Cervical Cancer

  19. HPV16-E2 induces prophase arrest and activates the cellular DNA damage response in vitro and in precursor lesions of cervical carcinoma

    OpenAIRE

    Xue, Yuezhen; Toh, Shen Yon; He, Pingping; Lim, Thimothy; Lim, Diana; Pang, Chai Ling; Abastado, Jean-Pierre; Thierry, Françoise

    2015-01-01

    Cervical intraepithelial neoplasia (CIN) is caused by human papillomavirus (HPV) infection and is the precursor to cervical carcinoma. The completion of the HPV productive life cycle depends on the expression of viral proteins which further determines the severity of the cervical neoplasia. Initiation of the viral productive replication requires expression of the E2 viral protein that cooperates with the E1 viral DNA helicase. A decrease in the viral DNA replication ability and increase in th...

  20. Squamous cell carcinoma of the rectum 21 years after radiotherapy for cervical carcinoma

    International Nuclear Information System (INIS)

    Squamous cell carcinoma (SCC) of the rectum is an extremely rare malignancy, accounting for 0.1-0.2% of rectal malignancies. It is associated with ulcerative colitis, prior radiation, schistosomiasis, ovarian cancer, endometrial cancer, human papilloma virus, colocutaneous fistulas and colonic duplication. Prior reported cases of SCC of the rectum have involved treatment with brachytherapy and external beam radiation. This case is particularly interesting because of the remote exposure of radiation (21 years previously) and the subsequent development of SCC of the rectum. Although extremely rare, SCC of the rectum can occur decades after radiation exposure. (author)

  1. Assessment of occult cervical lymph node metastasis in primary squamous cell carcinoma of the head and neck by computed tomography

    International Nuclear Information System (INIS)

    To determine the frequency of occult (node negative) cervical lymph node metastasis in primary head and neck squamous cell carcinoma, using contrast enhanced computed tomography (CT). Study Design: Cross sectional descriptive study. Place and Duration of Study: Study was conducted in Department of Radiology, Combined Military Hospital Rawalpindi. Duration of the study was 06 months i.e. from 19th February 2011 to 19th August 2011. Patients and Methods: A total of 141 cases, fulfilling the inclusion criteria, reporting to the radiology department, were included in the study after seeking written informed consent. All patients underwent contrast enhanced CT scan of the neck from base of skull to root of neck using Asteion Whole Body X-ray CT Scanner (Model TSX-021A). Images were evaluated for the presence or absence of cervical lymph node metastasis according to the cervical lymph node metastatic criteria at each level of the neck. Results: Of the 141 patients with clinically no head and neck squamous cell carcinoma, 45.4% were found to have lymph node metastases. Frequency of occult metastases in squamous cell carcinoma of oral cavity was 47.6%, oropharynx 23.5%, larynx 33.3% and hypopharynx 78.6%. Conclusion: In clinically node negative neck, the risk of lymph node metastases is significantly high in patients of head and neck squamous cell carcinoma in our population. All patients presenting with node negative neck should undergo CT scans for early detection of occult metastasis. (author)

  2. Transition of high-grade cervical intraepithelial neoplasia to micro-invasive carcinoma is characterized by integration of HPV 16/18 and numerical chromosome abnormalities.

    NARCIS (Netherlands)

    Hopman, A.H.N.; Smedts, F.; Dignef, W.; Ummelen, M.; Sonke, G.; Mravunac, M.; Vooijs, G.P.; Speel, E.J.; Ramaekers, F.C.S.

    2004-01-01

    Cervical intraepithelial neoplasia (CIN I, II, and III) and cases of CIN III associated with micro-invasive cervical carcinoma (CIN III & mCA) were analysed for evidence of episomal or integrated human papillomavirus (HPV) 16/18 DNA by fluorescence in situ hybridization (FISH). In parallel, numerica

  3. Diffusion Weighted MRI as a predictive tool for effect of radiotherapy in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Haack, Søren; Tanderup, Kari; Fokdal, Lars;

    Diffusion weighted MRI has shown great potential in diagnostic cancer imaging and may also have value for monitoring tumor response during radiotherapy. Patients with advanced cervical cancer are treated with external beam radiotherapy followed by brachytherapy. This study evaluates the value of DW......-MRI for predicting outcome of patients with advanced cervical cancer at time of brachytherapy. Volume of hyper-intensity on highly diffusion sensitive images and resulting ADC value for treatment responders and non-responders is compared. The change of ADC and volume of hyper-intensity over time of BT is also...

  4. Efficacy of transvaginal contrast-enhanced MRI in the early staging of cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Akata, Deniz; Kerimoglu, Ulku; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Oezmen, Mustafa N.; Akhan, Okan [Hacettepe University School of Medicine, Department of Radiology, Ankara (Turkey); Koese, Faruk [Social Security Hospital, Department of Gynecology, Ankara (Turkey)

    2005-08-01

    The objective of this study was to evaluate the efficacy of transvaginal contrast for local staging of cervical carcinoma. Fifty patients diagnosed with cervical carcinoma prospectively underwent magnetic resonance (MR) imaging before and after vaginal opacification (VO) with a mixture of 25 ml saline and 25 ml barium. T2-weighted (T2W) TSE images in axial and sagittal planes were compared before and after vaginal opacification. Dynamic T1W images in sagittal and fat-suppressed T1W images in transverse planes were also evaluated after intravenous contrast administration. Involvement of vaginal wall, lumen, and fornices; parametrium; rectum; and bladder were noted. Changes in local tumor staging and in treatment planning were also assessed after vaginal opacification. MR results were later compared with surgical pathological findings. Twenty-eight patients who went through surgical staging were included in the study. VO did not change any of the MR interpretations in 14 patients (50%). Correct staging was achieved with T2W TSE images with and without VO (in sagittal and transverse planes) in 78.5% and 50% of the patients, respectively. VO correctly lowered staging in seven and increased it in three patients compared with sagittal standard T2W images. Treatment planning was also changed in four (14%) of these patients. When overall accuracy of MR staging to indicate the appropriate treatment was evaluated, patients would have received the proper treatment in 90% and 79% of the cases when only T2W sagittal images with and without VO were evaluated, respectively. Dynamic gradient-echo images in sagittal planes and postcontrast T1W images in transverse planes evaluated with T2W series after VO, accomplished correct staging in 23 (82%) of the patients. MRI staging in early cervical cancer may be difficult and overestimated, especially if the tumor is slightly extended into the proximal vagina. Use of vaginal contrast medium is an easy, well-tolerated, and effective

  5. A quantitative assessment of standard vs. customized midline shield construction for invasive cervical carcinoma

    International Nuclear Information System (INIS)

    Purpose: An individualized midline shield (MLS) has been advocated for delivering homogeneous radiotherapy for patients with invasive cervical carcinoma. Yet, many radiation oncologists continue to employ a standard block. In the latter instance, any deviation of the cranial-caudal central axis of the tandem from the patient's midline could result in dose inhomogeneity to tumor. A retrospective review of a single university medical center's experience with constructing the MLS was initiated to determine the outcome of using a standard block vs. a customized block that conforms to the 'Point A' isodose line. In addition, participating radiation oncologists associated with the Gynecologic Oncology Group (GOG) were polled to assess if there exists a consensus regarding midline block utilization in the management of cervical cancer patients which could be compared to the institutional study. Methods and Materials: From January 1, 1990 through December 31, 1992, 32 patients with invasive cervical carcinoma who underwent low dose rate brachytherapy at a single institution were identified. Patients were grouped as having a standard block (18 cases), customized block (5 cases), or no block (9 cases). The 'Point A' isodose distribution from the implant was superimposed onto the whole pelvic simulation film and quantitatively compared to the actual or a hypothetical standard block outlined on the same radiograph. In September of 1995, 56 member and affiliated institutions in the GOG were surveyed concerning their use of a MLS, and the results were tabulated in December of 1995. Results: Approximately 72% of all cases 923 out of 32) at the single institution had tandem deviation ranging from 0-230 with a median of 50. This translated into a median percent overdosage to 'Point A' Right of 15% and 'Point A' Left of 12.5%. Although overall survival and incidence of chronic complications have not been affected by type of shielding, patient follow-up is limited with a median of 17

  6. Effect of neoadjuvant chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion

    Institute of Scientific and Technical Information of China (English)

    Chen; Aiping; Ding; Zhaoxia; Xu; Bing; Zhao; Shuping; Dai; Shuzhen

    2007-01-01

    Objective:To evaluate the effect of preoperative chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion.Methods:Sixty two patients with bulky or locally advanced cervical cancer from 1999 to 2004 were underwent internal iliac arterial infusion chemotherapy by using Seldinger technique.Combined regimens were applied including cisplatin as the major drug.Two weeks later,all patients received radical hysterectomy.Results:The local tumor regression rate was 93.55%.Postoperative pathologic examination showed that no cervical tumor residue in stumps were found in 61 of 62 patients who underwent radical hysterectomy.Large quantity of necrotic tissue appeared on primary tumor.In 16 patients with positive lymph nodes,15 demonstrated necrotic lymph nodes.Conclusion:Internal iliac arterial infusion chemotherapy could effectively reduce tumor volume,increase surgical success rate and decrease lymph nodes and subclinical metastasis rates.

  7. Advanced Upper Eyelid Sebaceous Gland Carcinoma with Deep Orbital Extension

    Directory of Open Access Journals (Sweden)

    Rizvi SAR

    2010-03-01

    Full Text Available Sebaceous gland carcinomas (SGC are highly malignant lid tumors which originate from meibomian glands and rarely from the gland of Zeis, sebaceous gland of caruncle, eyebrows and periocular skin. In many cases correct diagnosis of SGC is delayed because of its ability to masquerade as a variety of other ocular conditions.A forty year old male presented with a left upper eyelid swelling with an ulcerated wound on its nasal aspect. A differential diagnosis of sebaceous gland carcinoma or preseptal cellulitis was made. Contrast enhanced computed tomography showed an ill defined soft tissue density mass in the left orbit encasing the whole of the optic nerve. A total exentration was performed. A diagnosis of meibomian gland carcinoma was confirmed on histopathology.This is a report of an advanced sebaceous gland carcinoma with deep orbital extension. An early diagnosis and appropriate treatment may decrease the long term morbidity and extend the survival rate of such patients.

  8. Immortalization of human foreskin keratinocytes by various human papillomavirus DNAs corresponds to their association with cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Woodworth, C.D.; Doniger, J.; DiPaolo, J.A.

    1989-01-01

    Normal human foreskin keratinocytes cotransfected with the neomycin resistance gene and recombinant human papillomavirus (HPV) DNAs (types 16, 18, 31, and 33) that have a high or moderate association with cervical malignancy acquired immortality and contained integrated and transcriptionally active viral genomes. Only transcripts from the intact E6 and E7 genes were detected in at least one cell line, suggesting that one or both of these genes are responsible for immortalization. Recombinant HPV DNAs with low or no oncogenic potential for cervical cancer (HPV1a, -5, -6b, and -11) induced small G418-resistant colonies that senesced as did the nontransfected cells. These colonies contained only episomal virus DNA; therefore, integration of HPV sequences is important for immortalization of keratinocytes. This study suggests that the virus-encoded immortalization function contributes to the pathogenesis of cervical carcinoma.

  9. Immortalization of human foreskin keratinocytes by various human papillomavirus DNAs corresponds to their association with cervical carcinoma

    International Nuclear Information System (INIS)

    Normal human foreskin keratinocytes cotransfected with the neomycin resistance gene and recombinant human papillomavirus (HPV) DNAs (types 16, 18, 31, and 33) that have a high or moderate association with cervical malignancy acquired immortality and contained integrated and transcriptionally active viral genomes. Only transcripts from the intact E6 and E7 genes were detected in at least one cell line, suggesting that one or both of these genes are responsible for immortalization. Recombinant HPV DNAs with low or no oncogenic potential for cervical cancer (HPV1a, -5, -6b, and -11) induced small G418-resistant colonies that senesced as did the nontransfected cells. These colonies contained only episomal virus DNA; therefore, integration of HPV sequences is important for immortalization of keratinocytes. This study suggests that the virus-encoded immortalization function contributes to the pathogenesis of cervical carcinoma

  10. Radiotherapy and healing results of cervical carcinoma at the University Clinic of Freiburg during the years 1964-1973

    International Nuclear Information System (INIS)

    The most important results after 10 years of telecobalt therapy of cervical carcinoma are as follows: When compared with the years 1955-1963, no statistically significant improvement of the healing results could be obtained by introducing the telecobalt therapy. The healing results can be called very good if compared with the results of the whole world compiled in the ANNUAL REPORT. Radium between 4000 and 6000 mgh and at the same time telecobalt between 3000 and 5000 R focal dose are seen as sufficient therapeutical doses for the irradiation of cervical carcinoma. If three radium administrations were effected there were significantly less local relapses at the portio and cervix than with two administrations. Radiation hazards at the intestine showed a significant dependence on the height of the telecobalt dose. An increase in the radiation reaction at the intestine could be noticed from the rectal exposition of 2000 Rad on. (orig./MG)

  11. High immunosuppressive burden in advanced hepatocellular carcinoma patients

    OpenAIRE

    Lugade, Amit A.; Kalathil, Suresh; Miller, Austin; Iyer, Renuka; Thanavala, Yasmin

    2013-01-01

    The accumulation of immunosuppressive cells and exhausted effector T cells highlight an important immune dysfunction in advanced stage hepatocellular carcinoma (HCC) patients. These cells significantly hamper the efficacy immunotherapies and facilitate HCC progression. We have recently demonstrated that the multipronged depletion of immunosuppressive cells potentially restores effector T-cell function in HCC.

  12. Prevalence of Helicobacter pylori infection in advanced gastric carcinoma

    OpenAIRE

    Irami Araújo-Filho; José Brandão-Neto; Laíza Araújo Mohana Pinheiro; Ítalo Medeiros Azevedo; Flávio Henrique Miranda de Araújo Freire; Aldo Cunha Medeiros

    2006-01-01

    BACKGROUD: There is substantial evidence that infection with Helicobacter pylori plays a role in the development of gastric cancer and that it is rarely found in gastric biopsy of atrophic gastritis and gastric cancer. On advanced gastric tumors, the bacteria can be lost from the stomach. AIMS: To analyze the hypothesis that the prevalence of H.pylori in operated advanced gastric carcinomas and adjacent non-tumor tissues is high, comparing intestinal and diffuse tumors according to Lauren's c...

  13. Chemotherapy for advanced hepatocellular carcinoma in the sorafenib age

    OpenAIRE

    Miyahara, Koji; Nouso, Kazuhiro; Yamamoto,Kazuhide

    2014-01-01

    The kinase inhibitor sorafenib is the only systemic therapy proven to have a positive effect on survival of patients with advanced hepatocellular carcinoma (HCC). After development of sorafenib and its introduction as a therapeutic agent used in the clinic, several critical questions have been raised. Clinical parameters and biomarkers predicting sorafenib efficacy are the most important issues that need to be elucidated. Although it is difficult to know the responders in advance using conven...

  14. The Prognosis of Patients with Stage Ib-IIb Node-Positive Cervical Carcinoma after Radical Surgery

    Institute of Scientific and Technical Information of China (English)

    XiCheng; ShumoCai; ZitingLi; MeiqinTang; MuquanXue; RongyuZang

    2004-01-01

    OBJECTIVE To investigate the influence of positive lymph nodes on the prognosis for patients with stage Ib-IIb cervical carcinoma.METHODS Sixty-six patients with stage Ib-IIb cervical carcinoma who underwent a radical hysterectomy and pelvic lymphadenectomy were analyzed retrospectively. The potential prognostic factors were calculated by the Cox proportional hazard model.RFSULTS The 5-year survival of metastasis was 40.7%. The Coxthe patients with pelvic lymph node proportional hazard model analysis showed that cellular differentiation, the number of positive nodes and adjuvant therapy were independent prognostic factors (PO.05). The 5-year survival of the patients who had no adjuvant therapy (12.6%) was much lower than that(53.7%) of those with adjuvant therapy (P0.05).CONCLUSION The prognosis of patients with stage Ib-IIb node-positive cervical carcinoma who underwent radical surgery was poor. Adjuvant therapy can increase the survival rate, decrease the pelvic recurrence and distant metastasis.

  15. Efficacy and prognostic analysis of chemoradiotherapy in patients with thoracic esophageal squamous carcinoma with cervical lymph nodal metastasis alone

    International Nuclear Information System (INIS)

    The prognostic factors of thoracic esophageal squamous carcinoma with cervical lymph nodal metastasis (CLNM) have not been specifically investigated. This study was performed to analyze the efficacy and prognostic factors of chemoradiotherapy for thoracic esophageal carcinoma with CLNM alone. From 2002 to 2011, 139 patients with inoperable esophageal cancer who underwent chemoradiotherapy at the Sun Yat-Sen University were retrospectively analyzed. Median radiation doses were 60 Gy (range: 50–68 Gy). Univariate and multivariate analyses were performed to compare overall survival (OS) and progression-free survival (PFS). The 1- and 3-year OS rates were 68.2% and 27.9%, respectively. The 1- and 3-year PFS rates were 51.9% and 20.1%, respectively. The multivariate analysis demonstrated that response to treatment, T stage, pathological grade, and laterality of cervical lymph nodal metastases were independent prognostic factors for thoracic esophageal carcinoma with CLNM. Concurrent chemoradiotherapy is an important and hopeful treatment option for patients with esophageal cancer with CLNM alone. Our study has revealed that response to treatment, T stage, pathological grade and laterality of cervical lymph nodal metastases are significant prognostic factors for long-term survival

  16. Cytotoxic effects of alkaloids on cervical carcinoma cell lines: a review

    Directory of Open Access Journals (Sweden)

    Priscilla Alencar Fernandes

    2016-07-01

    Full Text Available Cervical cancer is the fourth type of women neoplasia, with thousands of new cases annually. It is closely related to human papillomavirus (HPV infection, which has more than 13 oncogenic types, among them HPV 16 and 18 are implicated in 70% of cervical carcinoma cases. Alkaloids are nitrogenated and naturally occurring compounds, showing several uses in medical treatment, including cytotoxic and antineoplastic activities. In this work we aim to evaluate the cytotoxic and chemotherapeutic potential of alkaloids against cervical cancer. In order to accomplish this purpose, we have made a survey of potentially effective alkaloids with cytotoxic activities over HPV-16+ and HPV-18 + cells (HeLa cells. Through a literature review between the years of 1980 and 2015, we described the major alkaloid sources, distribution in nature and also discussed the mechanisms of action for their cytotoxicity. We found that alkaloids showed efficacy as cytotoxic agents, inhibiting cell growth of the HPV-transformed cells in vitro and in vivo by means of activation of intrinsic and extrinsic pathways of apoptosis, which included the clivage of caspases and PARP-1 (Poli-Adenosyl- Ribose Protease 1, increase in p53 expression, release of cytochrome C and increase of cell death receptors expression like Fas, mainly observed in HeLa (HPV- 18 + cell lines. Moreover, these secondary metabolites helped in modulating the MDR (Multi-Drug Resistance against the cell lines studied, which lead us to suggest their possible use as chemotherapeutic agents on the lesions caused by these virusesKeywords: Cervical cancer. Alkaloids. HPV. Chemotherapy. RESUMOEfeitos citotóxicos de alcaloides sobre linhagens de células do câncer cervical: uma revisãoO câncer cervical é a quarta neoplasia incidente em mulheres, com o surgimento de milhares de novos casos anualmente. Está altamente relacionado à infecção pelo papilomavírus humano (HPV, que apresenta mais de 13 tipos oncog

  17. Aldesleukin in advanced renal cell carcinoma.

    Science.gov (United States)

    Schmidinger, Manuela; Hejna, Michael; Zielinski, Christoph C

    2004-12-01

    Renal cell carcinoma accounts for 2-3% of all malignancies. The most common subtype [85%] is the clear cell variant. A total of 30% of patients present with metastatic disease at diagnosis and another 30-40% will develop metastases during the course of the disease. Conventional cancer treatment is not effective, but cytokines including recombinant interleukin-2 (aldesleukin) have demonstrated clinical activity of various degrees. This drug profile provides a review of the literature on studies using aldesleukin in patients with metastatic renal cell carcinoma. Aldesleukin has been used in different dose schedules applying various administration routes, as either monotherapy or in combination with other cytokines, chemotherapy, endocrine treatment and adoptive cellular immunotherapy. Although a large number of randomized trials have been performed with different treatment strategies, it still remains uncertain whether the dose or combination of aldesleukin with other agents substantially influence treatment outcome. It appears that factors other than those that are treatment related are responsible for the course of the disease. PMID:15606326

  18. Dexamethasone-induced radioresistance occurring independent of human papilloma virus gene expression in cervical carcinoma cells

    Energy Technology Data Exchange (ETDEWEB)

    Rutz, H.P.; Mariotta, M.; Mirimanoff, R.O. [Lab. de Radiobiologie, Service de Radio-Oncologie, CHUV, Lausanne (Switzerland); Knebel Doeberitz, M. von [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Inst. fuer Virusforschung

    1998-02-01

    The aim of this study was to investigate the role of HPV 18 E6 and E7 gene products with respect to radiosensitivity of two cervical carcinoma cell lines. The two cervical carcinoma lines C4-1 and SW 756 were used in which treatment with dexamethasone allows to modulate expression levels of HPV 18 E6 and E7 genes: Upregulation in C4-1, down-regulation in SW 756. Effects of treatment with dexamethasone on plating efficiency and radiosensitivity were assessed using a clonogenic assay. Treatment with dexamethasone increased plating efficiency of the C4-1 cells, but did not affect plating efficiency of SW 756 cells. Treatment with dexamethasone induced enhanced radioresistance in both cell lines. Thus, in C4-1 cells the observed changes in radioresistance correlate to the enhancement in expression of HPV 18 genes E6/E7, whereas in SW 756, a reduced expression correlates negatively with the enhanced radioresistance. (orig./MG) [Deutsch] Das Ziel dieser Studie lag darin, die Rolle der HPV-18-Gene E6 und E7 in bezug auf die Strahlenempfindlichkeit von menschlichen Zervixkarzinomzellen zu untersuchen. Wir verwendeten zwei menschliche Zervixkarzinomzellinien, C4-1 und SW 756, in welchen die Expression der viralen Gene HPV 18 E6 und E7 mit Dexamethason moduliert werden kann: In C4-1 bewirkt die Behandlung mit Dexamethason eine Erhoehung der Expression dieser Gene, in SW 756 eine Verminderung. Die Wirkung auf die Wachstumsfaehigkeit der Zellen und auf die Wachstumshemmung durch die Bestrahlung wurde unter Verwendung eines klonogenen Assays bestimmt. Dexamethason bewirkte eine erhoehte Wachstumsfaehigkeit der C4-1 Zellen, ohne die Wachstumsfaehigkeit der SW-756-Zellen zu beeinflussen, wie schon frueher beschrieben. Die Resistenz beider Zellinien gegenueber Bestrahlung wurde erhoeht. Somit besteht in den C4-1-Zellen eine Korrelation der Expression der viralen Gene mit der Zunahme der Strahlenresistenz, wogegen in den SW-756-Zellen die Abnahme der Expression im Gegensatz zu

  19. Phosphorylated Smad2 in Advanced Stage Gastric Carcinoma

    International Nuclear Information System (INIS)

    Transforming growth factor β (TGFβ) receptor signaling is closely associated with the invasion ability of gastric cancer cells. Although Smad signal is a critical integrator of TGFβ receptor signaling transduction systems, not much is known about the role of Smad2 expression in gastric carcinoma. The aim of the current study is to clarify the role of phosphorylated Smad2 (p-Smad2) in gastric adenocarcinomas at advanced stages. Immunohistochemical staining with anti-p-Smad2 was performed on paraffin-embedded specimens from 135 patients with advanced gastric adenocarcinomas. We also evaluated the relationship between the expression levels of p-Smad2 and clinicopathologic characteristics of patients with gastric adenocarcinomas. The p-Smad2 expression level was high in 63 (47%) of 135 gastric carcinomas. The p-Smad2 expression level was significantly higher in diffuse type carcinoma (p = 0.007), tumours with peritoneal metastasis (p = 0.017), and tumours with lymph node metastasis (p = 0.047). The prognosis for p-Smad2-high patients was significantly (p = 0.035, log-rank) poorer than that of p-Smad2-low patients, while a multivariate analysis revealed that p-Smad2 expression was not an independence prognostic factor. The expression of p-Smad2 is associated with malignant phenotype and poor prognosis in patients with advanced gastric carcinoma

  20. Langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying metastatic thyroid papillary carcinoma.

    Science.gov (United States)

    Ceyran, A Bahar; Senol, Serkan; Bayraktar, Barış; Ozkanlı, Seyma; Cinel, Z Leyla; Aydın, Abdullah

    2014-01-01

    A 37-year-old male case was admitted with goiter. Ultrasonography of thyroid showed a 5 cm cystic nodule in the left lobe with a 1.5 cm solid component. Fine needle aspiration biopsy revealed atypia of undetermined significance or follicular lesion. The patient was operated on. The pathological diagnosis was reported as papillary thyroid carcinoma. The immunohistochemical examination showed multiple foci of Langerhans cell histiocytosis involving both lobes. The patient died due to cardiac arrest with respiratory causes in the early postoperative period. Langerhans cell histiocytosis is a rare primary condition which involves abnormal clonal proliferation of Langerhans cells in various tissues and organs. Thyroid involvement is infrequently seen. Although the etiology is unknown, genetic components may be linked to the disease. It is also associated with a family history of thyroid disease. Papillary thyroid carcinoma is the most common malignant epithelial tumor of the thyroid gland. Langerhans cell histiocytosis presenting with papillary thyroid carcinoma is rare. The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma. PMID:25349760

  1. Adjuvanticity of vitamin A in advanced irradiated cervical cancer

    International Nuclear Information System (INIS)

    For treatment of patients with inoperable cervical cancer (FIGO III) a randomized trial has been initiated. Patients were randomized to receive either conventional irradiation therapy together with vitamin A palmitate (1.5 mill. I.U./day; total dose: 30 mill. I.U.), applied orally, or irradiation alone. When lymphocyte reactivity to PHA (maximum response during therapy) was compared within the groups, it was found, that 66% of the patients who received irradiation combined with vitamin A palmitate, showed an increase in their blastogenic response, while in irradiated patients without vitamin A palmitate a response was seen only in 33%. This difference being statistically significant in comparison to pretreatment values. From immunological data it can be concluded, that vitamin A has an effect on functional response on T-cells. Concerning the clinical outcome, after an observation period of 12 months relapse rates were lower in the vitamin A group, but not significantly reduced. Therefore further follow up is warranted. (orig.)

  2. The Role of Cyclins and Cyclins Inhibitors in the Multistep Process of HPV-Associated Cervical Carcinoma

    International Nuclear Information System (INIS)

    Background: Human papillomavirus (HPV) types 16 and 18 are associated with cervical carcinogenesis. This is possibly achieved through an interaction between HPV oncogenic proteins and some cell cycle regulatory genes. However, the exact pathogenetic mechanisms are not well defined yet. Methods: We investigated 110 subjects (43 invasive squamous cell carcinoma [ISCC], 38 CIN Ill, II CIN II, 18 CIN I) confirmed to be positive for HPV 16 and/or 18 as well as 20 normal cervical tissue (NCT) samples for abnormal expression of cyclin DJ, cyclin E, CDK4, cyclin inhibitors (p2Jwa/; p27, pI6/NK4A) and Ki-67 using immunohistochemistry and differential PCR techniques. Results: There was a significant increase in the expression of Ki-67, cyclin E, CDK4, pJ6/NK4A (p=0003, 0.001,0.001) and a significant decrease in p27K1P/ from NCT to ISCC (p=0.003). There was a significant correlation between altered expression of p27K1P I and p 161NK4A (pKIpl (ρ=0.011) in all studied groups In ISCC, there was significant relationship between standard clinico-pathological prognostic factors and high Ki-67 index, increased cyclin D J and cyclin E, reduced p2 7Kip / and p21 waf Conclusion: I) Aberrations involving p27K/P 1, cyclin E, CDK4 and pJ6/NK4A are considered early events in HPV 16 and IS-associated cervical carcinogenesis (CINI and lI), whereas cyclin DI aberrations are late events (CINIII and ISCC). 2) immunohistochemical tests for pJ61NK4A and cyclin E could help in early diagnosis of cervical carcinoma. 3) Only FIGO stage, cyclin DI, p27K1P1 and Ki-67 are independent prognostic factors that might help in predicting outcome of cervical cancer palients

  3. In Vitro Therapeutic Potential of Tio2 Nanoparticles Against Human Cervical Carcinoma Cells.

    Science.gov (United States)

    Pandurangan, Muthuraman; Enkhtaivan, Gansukh; Young, Jung A; Hoon, Hur Ji; Lee, Hannah; Lee, SooBin; Kim, Doo Hwan

    2016-06-01

    Cellular and physiological responses to the degradation products of titanium implants are key indicators to determine the quality of biocompatibility of implant devices. The present study investigated titanium dioxide (TiO2) nanoparticle-induced cytotoxicity, apoptotic morphological modification, and apoptotic-related gene expressions in the human cervical carcinoma cells. TiO2 nanoparticle-induced cytotoxicity on cancer cells was determined by the sulphorhodamine-B assay. Apoptotic morphological modification such as nuclear fragmentation, rounding, cytoplasm shrinkage, loss of adhesion, and reduced cell volume were observed by an inverted, fluorescence, and confocal laser scanning microscope (CLSM). The DNA fragmentation study showed the occurrence of necrosis and apoptosis in nanoparticle-treated cells. The qPCR study showed the increased p53 and bax mRNA expression in the nanoparticle-treated cells compared to control. In addition, caspase 3 activity was increased in nanoparticle-treated cells, which indicates the increased auto-catalysis. Taking all these data together, it may suggest that TiO2 nanoparticle could inhibit the growth of HeLa cells. PMID:26519422

  4. Screening of biomarkers in cervical squamous cell carcinomas via gene expression profiling.

    Science.gov (United States)

    Chen, Bing; Li, Chundong; Zhang, Lei; Lv, Jiahui; Tong, Ying

    2015-11-01

    In the present study, gene expression profiles of high-grade squamous intraepithelial lesions (HSIL) and invasive cervical squamous cell carcinomas (CSCC) were analyzed using bioinformatic tools to identify key genes and potential biomarkers. Analyses of differentially expressed genes (DEGs) were performed for HSIL vs. normal control and invasive CSCC vs. normal control tissues using the Limma package in R. Pathway enrichment analysis was performed using KOBAS. A protein‑protein interaction (PPI) network for the DEGs in invasive CSCC was constructed using String. Functional enrichment analysis was performed for the DEGs in the PPI network using DAVID. Relevant small molecules were predicted using Cmap. A total of 633 and 881 DEGs were identified in HSIL and invasive CSCC, respectively, and the two groups had 305 DEGs in common. Genes associated with the mitogen-activated protein kinase signaling pathway were enriched in the HSIL, while cell cycle-associated genes were over‑represented in invasive CSCC. The PPI network, containing 72 upregulated genes and 434 edges, was illustrated. Functional enrichment analysis showed that the cell cycle was the most significant gene ontology term. A total of six small molecules associated with the pathology of CSCC were identified, including the anti-cancer drug piperlongumine, which showed a negative correlation. The findings of the present study not only enhanced the current understanding of the pathogenesis of CSCC, but may also be a basis for the development of novel therapies. PMID:26398134

  5. Anti-Proliferative Effect of Copper Oxide Nanorods Against Human Cervical Carcinoma Cells.

    Science.gov (United States)

    Pandurangan, Muthuraman; Nagajyothi, P C; Shim, Jaesool; Kim, Doo Hwan

    2016-09-01

    Metal oxide nanoparticles have been widely investigated for its use in the pharmacological field. The present study was aimed to investigate the cytotoxicity of copper oxide nanorods in human cervical carcinoma cells. The effect of copper oxide nanorods on cell viability was determined by sulforhodamine-B (SRB) assay. The fluorescence and confocal microscopy analyzes showed the cell rounding and nuclear fragmentation following exposure of copper oxide nanorods. Reactive oxygen species (ROS) was increased and could initiate membrane lipid peroxidation, which in turn regulate cytokinetic movements of cells. The messenger RNA (mRNA) expression of p53 and caspase 3 was increased, which further confirms the occurrence of apoptosis at the transcriptional level. Furthermore, caspase-3 enzyme activity was increased, which also confirms the occurrence of apoptosis in tumor cells at the translational level. Taking all our experimental results together, it may suggest that the copper oxide nanorods could be a potential anti-tumor agent to inhibit cancer cell proliferation. PMID:26811107

  6. Control of cervical node metastases from carcinoma of the oral tongue by preoperative irradiation

    International Nuclear Information System (INIS)

    A total of 48 patients with carcinoma of the oral tongue, who were treated with surgery after irradiation of the primary lesion and neck node were analyzed. Twenty-six of 33 patients with clinically negative nodes (N0 Group) and all 15 patients with clinically positive nodes (N1-2 Group) underwent neck dissection. Four patients (15%: 4/26) had occult node metastases. Three patients in the N0 Group (9%: 3/33) subsequently developed metastases to the neck after treatment. Incidence of cervical node metastases in the N0 Group was 21% (7/33). Of the six metastatic nodes in the N0 Group and the 36 metastatic nodes in the N1-2 Group, 14 with IIa, 15 with IIb, three with III and ten with IV ab and c histopathological change (Ohboshi-Shimozato's Classification) were found. The combination of preoperative irradiation and neck dissection for regional lymph nodes of the oral tongue was effective against occult and subsequent metastases. (author)

  7. A brief symptom index for advanced renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Cella David

    2006-09-01

    Full Text Available Abstract Background Our objective was to test a brief, symptom index for advanced renal cell carcinoma, a disease affecting over 38,000 Americans each year and often diagnosed in late stages. Methods We conducted secondary data analyses on patient-reported outcomes of 209 metastatic renal cell carcinoma patients participating in a Phase III clinical trial. Patient-reported outcomes, obtained from the FACT-Biological Response Modifier (FACT-BRM scale, were available at baseline, 2, and 8 weeks. We analyzed data from eight FACT-BRM items previously identified by clinical experts to represent the most important symptoms of advanced renal cell carcinoma. Items comprising this index assess nausea, pain, appetite, perceived sickness, fatigue and weakness, with higher scores indicating fewer symptoms. We determined reliability and validity of the index and estimated a minimally important difference. Results The index had excellent internal reliability at all three time points (alphas ≥ 0.83. Baseline scores were able to discriminate patients across Karnofsky performance status, number of metastatic sites, and risk group categories (ps Conclusion The 8-item index of patient-reported symptoms of renal cell carcinoma appears to be a psychometrically sound measure. It is a brief, reliable, and valid measure that can easily be adapted for use in clinical trials and observational studies.

  8. Impact of additional cervical dedicated 18FDG-PET-CT on the management of head and neck squamous cell carcinoma

    International Nuclear Information System (INIS)

    Aim of the study: To investigate the therapeutic impact of additional cervical dedicated 18F.D.G.-PET-CT on the management of head and neck squamous cell carcinoma (H.N.S.C.C.). Materials and methods: Thirty patients with H.N.S.C.C. underwent a [18F]-F.D.G.-PET-CT standard, whole-body scan completed by a cervical dedicated protocol. Two physicians blindly reviewed the exams and the results were discussed with surgeons to determine the therapeutic impact of the dedicated protocol. Result: Among 30 patients, only four (13%) discordant results were registered by the both observers, and two more by only one observer (k = 0.75, S.D. = 0.08). As to the four patients: 1) a N0 staged patient on whole body (W.B.) exam was upstaged to N2b in cervical PET (obese patient, whole-body exam with poor quality), 2) for a second patient, no node was described on whole-body scan, but one lymph node in each cervical chain was observed in focused PET, with low standardized uptake value (S.U.V. value), 3) in the other two cases, cervical PET scan upstaged from N2a to N2b and from N2a to N2c (S.U.V. < 3), without any influence on treatment management. Conclusion: Our results show that additional cervical dedicated PET-CT does not modify the management of patients with H.N.S.C.C. when compared to whole-body PET-CT, except for particular obese or N0 patients, allowing to reduce patient CT radiation dose and time-consuming PET acquisition. (authors)

  9. Is interferon-α and retinoic acid combination along with radiation superior to chemo-radiation in the treatment of advanced carcinoma of cervix?

    Directory of Open Access Journals (Sweden)

    Basu Partha

    2006-01-01

    Full Text Available Locally advanced cervical cancers comprise a large majority of the gynecologic cancers in India and other developing countries. Concurrent chemo-radiation has improved the survival of high risk stage I and stage II cervical cancers. There is no evidence that the same survival benefit has been achieved with chemo-radiation in stage III and stage IV disease. Interferon-a and Retinoic acid have synergistic anti-proliferative activity. In combination with radiation, they substantially enhance the sensitivity of the squamous carcinoma cells to radiation. Based on these observations from the in vitro studies, a few clinical trials have evaluated the combination of interferon-a and Retinoic acid, concomitant with radiation, to treat cervical cancers. The results from these early trials were encouraging and the combination had minimal toxicities. However, till date, no phase III randomized controlled trial has been done to evaluate this therapeutic modality.

  10. Study of consolidation chemotherapy in advanced epithelial ovarian carcinoma

    Institute of Scientific and Technical Information of China (English)

    Cheng Ning-hai; Huang Hui-fang; Pan Lin-ya; Shen Keng; Wu Ming; Yang Jia-xin

    2007-01-01

    Objective: A prospective randomized study was designed to evaluate the role of consolidation chemotherapy in advanced epithelial ovarian carcinoma.Methods: 50 patients with advanced epithelial ovarian carcinoma treated in our hospital during the period from March 2000 to October 2005 were enrolled in this study.All patients had achieved clinical complete remission by means of standard treatments, and were randomly divided into consolidation chemotherapy group and control group.Relapse rate, and disease-free survival(DFS) time were analyzed in both groups.Results: 24 patients were assigned in consolidation chemotherapy group, and 26 patients in control group.Tumor relapse interval in consolidation group was (26.5±7.4) months, vs.(16.8±7.0) months in control group respectively, P=0.001.Time to relapse(TTR) in consolidation group was (19.2±6.8) months, vs.(10.0±6.9)months in control group, P=0.002.Analysis of DFS time and overall survival time, Log Rank test:P=0.042 and P= 0.062, respectively.Conclusions: Consolidation chemotherapy could be the relevant factor that postpones tumor relapse interval and prolongs DFS time in advanced epithelial ovarian carcinoma patients who had achived chlinical complete remission.But so far the statistic result of our clinical study is beyond the conclusion that consolidation chemotherapy can decrease relapse rate or increase survival rate.Muhicenter randomized clinical trial should be performed to confirm the role of consolidation chemotherapy in advanced epithelial ovarian carcinoma.

  11. Cryotherapy for advanced carcinoma of the trachea and bronchi.

    OpenAIRE

    Maiwand, M O

    1986-01-01

    Cryotherapy was used to relieve symptoms in 75 patients suffering from advanced carcinoma of the trachea or bronchi. In all patients surgical resection, radiotherapy, or chemotherapy had been tried and been unsuccessful or had been thought to be unsuitable because of the patients' poor general condition. In cryotherapy the intraluminal tumour was frozen through a Stortz bronchoscope. Localised necrosis increased the patency of the lumen of the trachea or bronchi, resulting in relief of sympto...

  12. Recent Advances in Tumor Ablation for Hepatocellular Carcinoma

    OpenAIRE

    Kang, Tae Wook; Rhim, Hyunchul

    2015-01-01

    Image-guided tumor ablation for early stage hepatocellular carcinoma (HCC) is an accepted non-surgical treatment that provides excellent local tumor control and favorable survival benefit. This review summarizes the recent advances in tumor ablation for HCC. Diagnostic imaging and molecular biology of HCC has recently undergone marked improvements. Second-generation ultrasonography (US) contrast agents, new computed tomography (CT) techniques, and liver-specific contrast agents for magnetic r...

  13. Para-recurrent lymph node metastasis was a significant predictor for cervical lymph nodes metastasis in thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate correlation factors of cervical lymph nodes metastasis in thoracic esophageal carcinoma. Methods: Local-regional metastasis of lymph node for 126 cases with esophageal squamous cell cancer after surgery from 2004 to 2009 were reviewed. Risk factors of cervical lymph nodes metastasis were examined by multiple Logistic regression analysis. Results: In 126 cases, supraclavicular lymph node metastasis rate was 43.7% (55/126). By logistic regression, none of the primary site, T stage, N stage, histological grade, lymph node metastasis rate, lymph node metastasis degree and number of lymph nodes metastatic field was not the high risk of cervical lymph nodes metastasis. In addition, multivariate analysis found that lymph node metastasis in mediastinum region 1 was high risk factor for lymph node metastasis of region 1 (χ2 =12.14, 9.27, P =0.000, 0.002), lymph node metastasis in region III and region 2 were high risk factors for lymph node metastasis of region IIa (χ2 =14.56, 8.27, 8.02, 3.93, P =0.000, 0.004, 0.005, 0.047). Conclusion: Mediastinal para-recurrent nerve lymph node metastasis is a significant predictor for cervical lymph nodes metastasis. (authors)

  14. Neoadjuvant chemotherapy and radiation therapy in advanced stage nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    To assess the feasibility and the toxicity of the neoadjuvant chemotherapy on the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. We analyzed 77 previously untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with neoadjuvant chemotherapy followed by radiation therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows: AJCC stage 111-2, stage IV-75. Sixty-six patients received infusion of 5-FU (1000 mg/m2, on Day 1-5) and cisplatin (100 mg/m2, on Day 1), eleven patients received infusion of 5.FU (1000 mg/m2, on Day 1-5) and carboplatin (300 mg/m2, on Day 1) as neoadjuvant chemotherapy prior to radiation therapy. The median follow-up for surviving patients was 44 months. The overall chemotherapy response rates were 87%. The toxicities of chemotherapy were mild. Only 3 patients experienced Grade 3 toxicities (1 for cytopenia, 2 for nausea/vomiting). The degree of radiation induced mucositis was not severe, and ten patients developed Grade 2 mucositis. The 5-year overall survival rates were 68% and the 5-year disease free survival rates were 65%. The 5-year freedom from distant metastasis rates were 82% and 5-year locoregional control rates were 75%. This single institution experience suggests that neoadjuvant chemotherapy improves overall survival and disease free survival for patients with advanced stage nasopharyngeal carcinoma without increase of toxicity

  15. Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Masaaki Karino

    Full Text Available BACKGROUND: We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical lymph node metastasis in oral squamous cell carcinoma. METHODS: A digital image system was used to measure the mean nuclear area, mean nuclear perimeter, nuclear circular rate, ratio of nuclear length to width (aspect ratio, and nuclear area coefficient of variation (NACV. Relationships between these parameters and nodal status were evaluated by t-test and logistic regression analysis. RESULTS: Eighty-eight cases of squamous cell carcinoma (52 of the tongue, 25 of the gingiva, 4 of the buccal mucosa, and 7 of the mouth floor were included: 46 with positive node classification and 42 with negative node classification. Nuclear area and perimeter were significantly larger in node-positive cases than in node-negative cases; however, there were no significant differences in circular rate, aspect ratio, or NACV. We derived two risk models based on the results of multivariate analysis: Model 1, which identified age and mean nuclear area and Model 2, which identified age and mean nuclear perimeter. It should be noted that primary tumor site was not associated the pN-positive status. There were no significant differences in pathological nodal status by aspect ratio, NACV, or primary tumor site. CONCLUSION: Our method of preoperative nuclear morphometry may contribute valuable information to evaluations of the risk for lymph node metastasis in oral squamous cell carcinoma.

  16. Transcript Profiling Distinguishes Complete Treatment Responders With Locally Advanced Cervical Cancer 1 2 3 4

    OpenAIRE

    Fernandez-Retana, Jorge; Lasa-Gonsebatt, Federico; Lopez-Urrutia, Eduardo; Coronel-Martínez, Jaime; Cantu de Leon, David; Jacobo-Herrera, Nadia; Peralta-Zaragoza, Oscar; Perez-Montiel, Delia; Reynoso-Noveron, Nancy; Vazquez-Romo, Rafael; Perez-Plasencia, Carlos

    2015-01-01

    Cervical cancer (CC) mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC) have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to th...

  17. Upstream Regulatory Region Alterations Found in Human Papillomavirus Type 16 (HPV-16) Isolates from Cervical Carcinomas Increase Transcription, ori Function, and HPV Immortalization Capacity in Culture▿

    OpenAIRE

    Lace, Michael J.; Isacson, Christina; Anson, James R.; Attila T Lörincz; Wilczynski, Sharon P.; Haugen, Thomas H.; Turek, Lubomír P.

    2009-01-01

    Human papillomavirus (HPV) DNAs isolated from cervical and head and neck carcinomas frequently contain nucleotide sequence alterations in the viral upstream regulatory region (URR). Our study has addressed the role such sequence changes may play in the efficiency of establishing HPV persistence and altered keratinocyte growth. Genomic mapping of integrated HPV type 16 (HPV-16) genomes from 32 cervical cancers revealed that the viral E6 and E7 oncogenes, as well as the L1 region/URR, were inta...

  18. Protein p 16INK4A expression in cervical intraepithelial neoplasia and invasive squamous cell carcinoma of uterine cervix

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    Gupta Ruchi

    2010-01-01

    Full Text Available The association of human papilloma virus (HPV infection and cervical intraepithelial neoplasia (CIN is well recognized. Interaction of HPV oncogenic proteins with cellular regulatory proteins leads to up regulation of p16 INK4A , a CDK inhibitor, which is a biomarker for HPV infection. We investigated p16 expression in CIN and invasive squamous cell carcinoma (SCC which has not been reported in the Indian population previously. Materials and Methods: Retrospective analysis of 100 cases with 20 cases each of histologically normal cervical epithelium, CIN1, 2, 3 and invasive SCC for p16 expression was performed by immunohistochemistry using commercially available mouse monoclonal antibody to p16 (clone 6H12. Statistical Analysis: For differences in expression among groups, statistical analysis was carried out using ANOVA and post hoc test of Scheffe. Results: p16 immunoreactivity was found to be both nuclear and/or cytoplasmic. The normal cervical epithelium was predominantly negative for p16 (18/20. There was a progressive increase of p16 expression with the grade of CIN. In CIN 1, two cases (20% showed nuclear and nucleocytoplasmic positivity respectively. In contrast, diffuse strong nuclear or nucleocytoplasmic expression was observed in 45 and 55% cases of CIN 2 and CIN 3 respectively. All except one squamous cell carcinoma stained strongly positive for p16. The difference in expression between CIN 2/3 and SCC versus normal cervix was found highly significant (p is equal to 0.008 and p less than 0.001. Conclusions: p16 expression correlates excellently with the grade of CIN and is a sensitive marker of cervical intraepithelial neoplasia.

  19. Undetected human papillomavirus DNA and uterine cervical carcinoma. Association with cancer recurrence

    International Nuclear Information System (INIS)

    The time course of human papillomavirus (HPV) DNA clearance was studied in patients with carcinoma of the cervix during follow-up after primary radical radiotherapy (RT). This study investigated the relationship between timing of HPV clearance and RT effectiveness. A total of 71 consecutive patients who were treated for cervical cancer with primary radical radiotherapy and high-dose rate intracavitary brachytherapy with or without chemotherapy were enrolled in the study. Samples for HPV DNA examination were taken before (1) treatment, (2) every brachytherapy, and (3) every follow-up examination. The times when HPV DNA was undetected were analyzed for association with recurrence-free survival. HPV DNA was not detected in 13 patients (18 %) before RT. Of the 58 patients with HPV DNA detected before treatment, HPV DNA was not detected in 34 % during treatment and in 66 % after the treatment. Within 6 months after RT, HPV DNA was detected in 0 % of all patients. The patients were followed up for a median period of 43 months (range 7-70 months). In all, 20 patients were found to develop recurrence. The 3-year cumulative disease-free survival (DFS) rate was 71 ± 5.4 % for all 71 patients. In multivariate analysis, DFS was significantly associated with HPV (detected vs. not detected) with a hazard ratio of 0.07 (95 % confidence interval 0.008-0.6, p = 0.009). In this study, patients in whom HPV was not detected had the worst prognosis. Six months after RT, HPV DNA was detected in 0 % of the patients. Patients in whom HPV DNA could not be detected before treatment need careful follow-up for recurrence and may be considered for additional, or alternative treatment. (orig.)

  20. E2F-Rb Complexes Assemble and Inhibit cdc25A Transcription in Cervical Carcinoma Cells following Repression of Human Papillomavirus Oncogene Expression

    OpenAIRE

    Wu, Lingling; Goodwin, Edward C.; Naeger, Lisa Kay; Vigo, Elena; Galaktionov, Konstantin; Helin, Kristian; DiMaio, Daniel

    2000-01-01

    Expression of the bovine papillomavirus E2 protein in cervical carcinoma cells represses expression of integrated human papillomavirus (HPV) E6/E7 oncogenes, followed by repression of the cdc25A gene and other cellular genes required for cell cycle progression, resulting in dramatic growth arrest. To explore the mechanism of repression of cell cycle genes in cervical carcinoma cells following E6/E7 repression, we analyzed regulation of the cdc25A promoter, which contains two consensus E2F bin...

  1. Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement

    Institute of Scientific and Technical Information of China (English)

    Yue Wang; Guang Wang; Li-Hui Wei; Ling-Hui Huang; Jian-Liu Wang; Shi-Jun Wang; Xiao-Ping Li

    2011-01-01

    Neoadjuvant chemotherapy (NACT),which can reduce the size and therefore increase the resectability of tumors,has recently evolved as a treatment for locally advanced cervical cancer.NACT has been reported to decrease the risk of pathologic factors related to prognosis of cervical cancer.To further assess the effects of NACT on surgery and the pathologic characteristics of cervicat cancer,we reviewed 110 cases of locally advanced cervical cancer treated with radical hysterectomy with or without NACT at the People's Hospital of Peking University between January 2006 and December 2010.Of 110 patients,68 underwent platinum-based NACT prior to surgery (NACT group) and 42 underwent pdmary surgery treatment (PST group).Our results showed 48 of 68 (70.6%) patients achieved a complete response or partial response to NACT.Estimated blood loss,operation time,and number of removed lymph nodes during surgery,as well as complication rates during and after surgery were not significantly different between the NACT group and the PST group.The rates of deep stromal invasion,positive parametria,positive surgical vaginal margins,and lymph node metastasis were not significantly different between the two groups.However,the rate of lymph-vascular space involvement (LVSI) was significantly lower in the NACT group than in the PST group (P = 0.021).In addition,the response rate of NACT was significantly higher in the patients with chemotherapeutic drugs administrated via artery than via vein.Our results suggest that NACT is a safe and effective treatment for locally advanced cervical cancer and significantly decreases the rate of LVSI.

  2. Thymostimulin in advanced hepatocellular carcinoma: A phase II trial

    Directory of Open Access Journals (Sweden)

    Behl Susanne

    2008-03-01

    Full Text Available Abstract Background Thymostimulin is a thymic peptide fraction with immune-mediated cytotoxicity against hepatocellular carcinoma in vitro. In a phase II trial, we investigated safety and efficacy including selection criteria for best response in advanced or metastasised hepatocellular carcinoma. Methods 44 patients (84 % male, median age 69 years not suitable or refractory to conventional therapy received thymostimulin 75 mg subcutaneously five times per week for a median of 8.2 months until progression or complete response. 3/44 patients were secondarily accessible to local ablation or chemoembolisation. Primary endpoint was overall survival, secondary endpoint tumor response or progression-free survival. A multivariate Cox's regression model was used to identify variables affecting survival. Results Median survival was 11.5 months (95% CI 7.9–15.0 with a 1-, 2- and 3-year survival of 50%, 23% and 9%. In the univariate analysis, a low Child-Pugh-score (p = 0.01, a low score in the Okuda- and CLIP-classification (p Conclusion Outcome in our study rather depended on liver function and intrahepatic tumor growth (presence of liver cirrhosis and Okuda stage in addition to response to thymostimulin, while an invasive HCC phenotype had no influence in the multivariate analysis. Thymostimulin could therefore be considered a safe and promising candidate for palliative treatment in a selected target population with advanced hepatocellular carcinoma, in particular as component of a multimodal therapy concept. Trial registration Current Controlled Trials ISRCTN29319366.

  3. Metastatic characteristics of lymph node in cervical region and radiotherapy target volume after dissection of thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    Objective: To investigate the metastatic characteristics of cervical lymph node in thoracic esophageal cancer of two-field lymph node dissection after radical surgery and to provide evidence for postoperative radiotherapy. Methods: Local-regional lymph node metastasis after surgery of 126 cases with esophageal squamous cell carcinoma from 2004 to 2009 were reviewed. Boundaries of cervical lymph node were according to Som, s imaging-based nodal classification system. Enumeration data were compared by χ2 test , and the risk factors of lymph node metastasis were analyzed with Logistic regressive model. Results: Lymph node metastasis rate of cervical region was up to 68.3% in all the cases with local-regional lymph node metastasis (86/126), and lymph node metastasis rate in level I was higher than those in the other levels (43.7%, 55/126). There was obvious difference in lymph node metastasis rate between the right and the left cervical region (53.2% vs 30.2%, χ2 = 13.73, P = 0.000). Moreover, the results also shown that lymph node metastasis rate was notably increased in level I, II and IIIa of the right compared with those of the left, showing statistical significance (43.70% : 15.1%, 17.5% : 7.1%, 17.5% : 5.6%, χ2 = 24.79, 6.22, 8.77, P =0.000, 0.013, 0.003). The sum of lymph node metastasis rate was 95% (82/86) in para-recurrent nerve and medial jugular vein, and 85% (73/86) in para-recurrent nerve. In addition,multivariate analysis showed that lymph node metastasis in level I was high risk factor for lymph node metastasis of level II. Conclusions: Lymph node metastasis of cervical region mainly focused on para-recurrent nerve and medial jugular vein. (authors)

  4. The Expression of Apoptosis-Related Genes Bcl-2 and Bax Protein and Apoptosis Positivity in Cervical Carcinoma during Irradiation

    Institute of Scientific and Technical Information of China (English)

    ZHAODongli; SHIJingsen; LIMingzhong; SONGLiping; WANGShuwen

    2005-01-01

    Objective: To evaluate the apoptosis positivity, the expression of Bcl-2. bax proteins in 30 patients with squamous cell cervix carcinoma before and after radiotherapy. Methods: By using immunohistochemical and TDT-dUTP nick end labelling techniques. 30 cases of squamous cell cervical carcinoma were analyzed. Results: The apoptosis positivity before and after irradiation was 76.7%, and 100% respectively, with the difference being significant (P<0.05); The positive rates of Bcl-2 protein before and after irradiation were 73.3% and 46.7% respectively, with the difference being significant (P<0.05): The positive rates of bax protein before and after irradiation were 86% and 100 respectively, with the difference being significant (P<0.05). Conclusion: bax and Bcl-2 protein play an important role in apoptosis induced by fractionated radiation therapy. Apoptosis induced by irradiation is contributed to upregulation of bax protein or downregulation of Bcl-2 protein.

  5. Up-regulation of expression and lack of 5' CpG island hypermethylation of p16 INK4a in HPV-positive cervical carcinomas

    International Nuclear Information System (INIS)

    High risk type human papilloma viruses (HR-HPV) induce carcinomas of the uterine cervix by expressing viral oncogenes E6 and E7. Oncogene E7 of HR-HPV disrupts the pRb/E2F interaction, which negatively regulates the S phase entry. Expression of tumor suppressor p16ink4a drastically increases in majority of HR-HPV associated carcinomas due to removal of pRb repression. The p16ink4a overexpression is an indicator of an aberrant expression of viral oncogenes and may serve as a marker for early diagnostic of cervical cancer. On the other hand, in 25–57% of cervical carcinomas hypermethylation of the p16 INK4a promoter has been demonstrated using a methylation-specific PCR, MSP. To evaluate a potential usage of the p16 INK4a 5' CpG island hypermethylation as an indicator of tumor cell along with p16ink4a overexpression, we analyzed the methylation status of p16 INK4a in cervical carcinomas Methylation status of p16 INK4a was analyzed by MSP and by bisulfite-modified DNA sequencing. The expression of p16ink4a was analyzed by RT-PCR and by immunohistochemical technique. The extensive methylation within p16 INK4a 5' CpG island was not detected either in 13 primary cervical carcinomas or in 5 cancer cell lines by bisulfite-modified DNA sequencing (including those that were positive by MSP in our hands). The number and distribution of rare partially methylated CpG sites did not differ considerably in tumors and adjacent normal tissues. The levels of the p16 INK4a mRNA were increased in carcinomas compared to the normal tissues independently of the number of partially methylated CpGs within 5'CpG island. The transcriptional activation of p16 INK4a was accompanied by p16ink4a cytoplasmic immunoreactivity in the majority of tumor cells and presence of a varied number of the p16 positive nuclei in different tumors. Hypermethylaion of the p16INK4a 5' CpG island is not a frequent event in HR-HPV-positive cervical carcinomas and cannot be an effective marker

  6. Papillary carcinoma arising in a thyroglossal duct cyst with associated microcarcinoma of the thyroid and without cervical lymph node metastasis: a case report

    OpenAIRE

    Kandogan Tolga; Erkan Nazif; Vardar Enver

    2008-01-01

    Abstract Introduction This is a case report of a 44-year-old woman with papillary carcinoma of a thyroglossal duct cyst. Case presentation A 44 year-old woman presented to the otolaryngology outpatient clinic with an asymptomatic anterior midline neck mass. A cervical ultrasound showed a lesion which appeared to be a thyroglossal duct cyst and surgical resection using Sistrunk's procedure was performed. The histopathologic diagnosis showed papillary carcinoma evolving from a thyroglossal duct...

  7. Induction of c-Met Proto-Oncogene by Epstein-Barr Virus Latent Membrane Protein-1 and the Correlation with Cervical Lymph Node Metastasis of Nasopharyngeal Carcinoma

    OpenAIRE

    Horikawa, Toshiyuki; Sheen, Tzung-Shiahn; Takeshita, Hajime; Sato, Hiroshi; Furukawa, Mitsuru; Yoshizaki, Tomokazu

    2001-01-01

    Nasopharyngeal carcinoma (NPC) is distinctive in head and neck carcinomas for its close association with Epstein-Barr virus and its highly metastatic nature. Up-regulation of cell motility is essential for enhancement of metastatic potential. The expression of c-Met proto-oncogene, a high-affinity receptor for hepatocyte growth factor/scatter factor, has been reported to correlate with metastatic ability of the tumor cell. We observed close association of c-Met expression with cervical lymph ...

  8. Transperineal low-dose rate iridium-192 interstitial brachytherapy in cervical carcinoma stage IIB

    Energy Technology Data Exchange (ETDEWEB)

    Budrukkar, A.N.; Shrivastava, S.K.; Jalali, R.; Agarwal, J.P.; Dinshaw, K.A. [Tata Memorial Hospital, Parel, Mumbai (India). Dept. of Radiation Oncology; Deshpande, D.D.; Nehru, R.M. [Tata Memorial Hospital, Parel, Mumbai (India). Dept. of Medical Physics

    2001-10-01

    Purpose: To assess local control, survival and complications in patients with cervical carcinoma Stage IIB treated radically with transperineal Iridium-192 low-dose rate interstitial brachytherapy following external beam radiotherapy. Patients and Methods: 65 women (age 25-70 years, mean 47 years) with cervical carcinoma Stage IIB were initially treated with external beam radiotherapy on a telecobalt or 6 MW linear accelerator to a dose of 50 Gy delivered in 5-6 weeks. After 2-3 weeks of completing external radiation, patients received interstitial brachytherapy with Iridium-192 (activity 0.5-1 mCi/cm) using a Syed-Neblett perineal template. The median dose delivered to the implant volume was 24 Gy (range 20-32 Gy) delivered at an average dose rate of 0.70 Gy/h (range 0.40-1.20 Gy/h). A point defined at 1.5 cm lateral to the central uterine tandem at the level of os was taken as a representative for assessing the dose to the cervix. Mean doses delivered by interstitial brachytherapy to point A, cervix, point B and rectum were 38 Gy, 34 Gy, 16 Gy and 16 Gy, respectively. Results: At a median follow-up of 53 months, the actuarial disease free survival and overall survival for 65 patients at both 5 and 10 years was 64% and 44%, respectively. Response to radiotherapy was a strong predictor of local control with 82% of patients continuing to have pelvic control after initial complete response. Overall, nine (14%) patients had persistent disease, ten (15%) developed a central recurrence after initial control and three patients developed distant metastasis on follow-up. No patient had any immediate treatment-related complication. Late toxicity included grade I-II rectal reactions in five patients and grade IV bladder complication (vesico-vaginal fistula) in two patients. 5 years after treatment, one patient developed intestinal obstruction, which was relieved after conservative management. Two patients developed vaginal stenosis. The 5- and 10-year disease free survival

  9. Cervical Cancer: Reality and Paradigm Shift

    Directory of Open Access Journals (Sweden)

    Alfredo Quiñones Ceballos

    2014-09-01

    Full Text Available Invasive cervical carcinoma usually reaches its highest frequency between 35-50 years of age. The Cuban prevention program screens the female population aged 25 to 60 years using the Pap smear and reexamines them every three years. Despite this effort, advanced cancer is diagnosed in young women as well as in those 40 to 60 years of age.

  10. EFFECTS OF CURCUMIN ON PROLIFERATION AND APOPTOSIS OF HUMAN CERVICAL CARCINOMA HeLa CELLS IN VITRO

    Institute of Scientific and Technical Information of China (English)

    赵敬; 赵涌

    2004-01-01

    Objective: To investigate the regulatory effect of curcumin on proliferation and apoptosis in human cervical carcinoma cell line HeLa in vitro. Methods: Human cervical carcinoma cell line Hela was cultured in vitro. HeLa cells were treated with 10(50 (mol/L curcumin for 24(72 h and the growth inhibition rates of HeLa cells were measured by MTT method. Cell apoptosis was inspected by electron microscopy. In addition, the expression of bcl-2, bcl-xl and caspase-3 protein in HeLa cell were observed by SP immunohistochemistry. Results: Curcumin inhibited the proliferation of HeLa cells on a dose-depending manner. Peak of subG1 appeared on DNA histogram in FCM. A portion of the cells presented the characteristic morphological changes of apoptosis under the electron microscope. The bcl-2, bcl-xl expression was decreased while Caspase-3 expression was increased. Conclusion: Curcumin could significantly inhibit the growth of HeLa cells; inducing apoptosis through up-regulating Caspase-3 and down-regulating expression of bcl-2 and bcl-xl was probably one of its molecular mechanisms.

  11. Cervical carcinoma with full-thickness stromal invasion. Efficacy of dynamic MR imaging in the assessment of parametrial involvement

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the efficacy of dynamic MR imaging in the assessment of parametrial involvement by cervical carcinoma with full-thickness stromal invasion on thin-section oblique axial T2-weighted images. Dynamic MR images of 24 patients with cervical carcinoma with full-thickness stromal invasion on thin-section oblique axial T2-weighted images were evaluated with pathologic correlation. Dynamic MR imaging was performed using turbo fast low angle shot (FLASH), three-dimensional fast imaging with steady state procession (3D-FISP), or two-dimensional (2D)-FLASH technique. The imaging planes of dynamic MR imaging were oblique axial planes of the uterine cervix. Dynamic MR imaging was performed twice, once for the early phase (40 to 60 sec after the administration of contrast media) and once for the late phase (5 min). Contrast enhancement of the tumor was divided into six types. Type I, cervical stroma with low signal intensity surrounding a tumor with high signal intensity, was seen in the early phase of dynamic MR imaging; type II-RR, the hyperintense rim was seen from the early phase to the late phase; type II-RO, the hyperintense rim was seen in the early phase only; type II-OR, the hyperintense rim was seen in the late phase only; type II-O, the hyperintense rim was not seen at all; and type III, tumor invasion with high signal intensities was seen beyond the cervical stroma in the early phase of dynamic MR imaging. The numbers for each type of cervical carcinoma on dynamic MR images were as follows: type I, four parametrial sites; type II-RR, 0; type II-RO, 0; type II-OR, 13; type II-O, 14; and type III, one. Three-dimensional diameters (transverse, craniocaudal, and anteroposterior) of the primary tumor were measured using dividers. All parametrial sites of type I and type II-OR showed no parametrial involvement. One parametrial site of type III and three parametrial sites of type II-O showed parametrial involvement, and 11 of type

  12. 刺猬蛋白在宫颈癌组织中的表达及其临床意义%Study on the expression level and clinical significance of Sonic Hedgehog in CIN and cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    闵爱萍

    2014-01-01

    目的:检测刺猬蛋白( Sonic Hedgehog,SHH )在正常宫颈、宫颈上皮内瘤变( cervical intraepithelial neoplasia ,CIN)及宫颈癌组织中的表达情况,探讨其与宫颈癌发生发展的关系。方法采用免疫组化SP法,检测正常宫颈组织、CIN及宫颈癌组织中SHH的表达。结果 SHH在宫颈癌组织中高表达。结论 SHH在宫颈癌中的异常表达表明Hedgehog( Hh)信号传导通路可能参与宫颈癌的发生过程。%Objective To detect the expression of Sonic Hedgehog( SHH)protein in normal cervical tissue, cervical intraepithelial neoplasia( CIN)and cervical carcinoma. And to probe the relation of SHH with progress of cervical carcinoma. Methods Detected the expression of SHH protein in normal cervical tissue,CIN and cervical carcinoma by immunohistochemistry. Results SHH protein had a high expression in cervical carcinoma. Conclusion SHH protein in cervical cancer showed that abnormal expression in Hedgehog( Hh)signaling pathways may be involved in the occurrence of cervical cancer process.

  13. Efficacy of {sup 18}F-FDG PET/CT in the evaluation of patients with recurrent cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mittra, Erik; Rodriguez, Cesar A.; Quon, Andrew; Ross McDougall, I.; Iagaru, Andrei [Stanford Hospitals and Clinics, Division of Nuclear Medicine, Stanford, CA (United States); El-Maghraby, Tarek [Cairo University, Nuclear Medicine, Cairo (Egypt); Saad Specialist Hospital, Nuclear Medicine, Al Khobar (Saudi Arabia); Gambhir, Sanjiv S. [Stanford Hospitals and Clinics, Division of Nuclear Medicine, Stanford, CA (United States); Stanford Hospital and Clinics, Division of Nuclear Medicine, Departments of Radiology and Bioengineering, Stanford, CA (United States)

    2009-12-15

    Only a limited number of studies have evaluated the efficacy of {sup 18}F-FDG PET/CT for recurrent cervical carcinoma, which this study seeks to expand upon. This is a retrospective study of 30 women with cervical carcinoma who had a surveillance PET/CT after initial therapy. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated using a 2 x 2 contingency table with pathology results (76%) or clinical follow-up (24%) as the gold standard. The Wilson score method was used to perform 95% confidence interval estimations. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT for the detection of local recurrence at the primary site were 93, 93, 93, 86, and 96%, respectively. The same values for the detection of distant metastases were 96, 95, 95, 96, and 95%, respectively. Seventy-one percent of the scans performed in symptomatic patients showed true-positive findings. In comparison, 44% of scans performed in asymptomatic patients showed true-positive findings. But, all patients subsequently had a change in their management based on the PET/CT findings such that the effect was notable. The maximum standardized uptake value ranged from 5 to 28 (average: 13 {+-} 7) in the primary site and 3 to 23 (average: 8 {+-} 4) in metastases which were significantly different (p = 0.04). This study demonstrates favorable efficacy of {sup 18}F-FDG PET/CT for identification of residual/recurrent cervical cancer, as well as for localization of distant metastases. (orig.)

  14. Efficacy of 18F-FDG PET/CT in the evaluation of patients with recurrent cervical carcinoma

    International Nuclear Information System (INIS)

    Only a limited number of studies have evaluated the efficacy of 18F-FDG PET/CT for recurrent cervical carcinoma, which this study seeks to expand upon. This is a retrospective study of 30 women with cervical carcinoma who had a surveillance PET/CT after initial therapy. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated using a 2 x 2 contingency table with pathology results (76%) or clinical follow-up (24%) as the gold standard. The Wilson score method was used to perform 95% confidence interval estimations. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT for the detection of local recurrence at the primary site were 93, 93, 93, 86, and 96%, respectively. The same values for the detection of distant metastases were 96, 95, 95, 96, and 95%, respectively. Seventy-one percent of the scans performed in symptomatic patients showed true-positive findings. In comparison, 44% of scans performed in asymptomatic patients showed true-positive findings. But, all patients subsequently had a change in their management based on the PET/CT findings such that the effect was notable. The maximum standardized uptake value ranged from 5 to 28 (average: 13 ± 7) in the primary site and 3 to 23 (average: 8 ± 4) in metastases which were significantly different (p = 0.04). This study demonstrates favorable efficacy of 18F-FDG PET/CT for identification of residual/recurrent cervical cancer, as well as for localization of distant metastases. (orig.)

  15. Late urologic morbidity in 177 consecutive patients after radiotherapy for cervical carcinoma: a longitudinal study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranow, Ingrid R.; Skovgaard, Lene Theil;

    2002-01-01

    Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate......Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate...

  16. FDG uptake heterogeneity in FIGO IIb cervical carcinoma does not predict pelvic lymph node involvement

    International Nuclear Information System (INIS)

    Many types of cancer are located and assessed via positron emission tomography (PET) using the 18F-fluorodeoxyglucose (FDG) radiotracer of glucose uptake. There is rapidly increasing interest in exploiting the intra-tumor heterogeneity observed in these FDG-PET images as an indicator of disease outcome. If this image heterogeneity is of genuine prognostic value, then it either correlates to known prognostic factors, such as tumor stage, or it indicates some as yet unknown tumor quality. Therefore, the first step in demonstrating the clinical usefulness of image heterogeneity is to explore the dependence of image heterogeneity metrics upon established prognostic indicators and other clinically interesting factors. If it is shown that image heterogeneity is merely a surrogate for other important tumor properties or variations in patient populations, then the theoretical value of quantified biological heterogeneity may not yet translate into the clinic given current imaging technology. We explore the relation between pelvic lymph node status at diagnosis and the visually evident uptake heterogeneity often observed in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) images of cervical carcinomas. We retrospectively studied the FDG-PET images of 47 node negative and 38 node positive patients, each having FIGO stage IIb tumors with squamous cell histology. Imaged tumors were segmented using 40% of the maximum tumor uptake as the tumor-defining threshold and then converted into sets of three-dimensional coordinates. We employed the sphericity, extent, Shannon entropy (S) and the accrued deviation from smoothest gradients (ζ) as image heterogeneity metrics. We analyze these metrics within tumor volume strata via: the Kolmogorov-Smirnov test, principal component analysis and contingency tables. We found no statistically significant difference between the positive and negative lymph node groups for any one metric or plausible combinations thereof. Additionally

  17. Radiation survival of two human cervical carcinoma cell lines after multifraction irradiation

    International Nuclear Information System (INIS)

    Purpose: Multifraction irradiation may contribute to radiation therapy treatment failure if selection of radiation resistant subpopulations occurs. We sought to determine whether surviving cells following daily fraction irradiation of two human cervical squamous cell carcinoma lines would express different radiation survival characteristics compared to the unirradiated parent. Methods and Materials: A late-passage line (HTB35) and an early-passage line (RECA) received daily 2 Gy x-irradiation. Two new stable HTB35 cell lines were established after 40 and 60 Gy (HTB35-40 and HTB35-60). A single line was established from RECA after 30 Gy (RECA-30). High dose rate (74 cGy/min) acute radiation survival curves were prepared from the three new lines and the unirradiated parents. Potentially lethal damage repair (PLDR) and sublethal damage repair (SLDR) responses were detailed for HTB35, HTB35-40 and HTB35-60. Low dose rate (1.27 cGy/min) survival was measured for HTB35 and HTB35-60. Clones were derived from HTB35 and from HTB35-60 and the surviving fraction at 2 Gy (SF2) values were determined. Results: The two parent lines (HTB35 and RECA) differed in acute radiation survival. The surviving lines following multifraction irradiation (HTB35-40, HTB35-60, and RECA-30) showed no change in acute radiation response compared to the appropriate parent. HTB35-40 and HTB35-60 were repair proficient, demonstrating similar PLDR and SLDR recovery ratios as the parent. Likewise, acute, low dose rate survival of HTB35 and HTB35-60 was similar. Nine clones derived from HTB35 lacked a consistent difference in SF2 compared to the original culture. A single clone of seven derived from HTB35-60 was consistently radiation resistant (SF2 = 0.81 ± 0.06) compared to the original culture (SF2 = 0.50 ± 0.09). Conclusion: No evidence was obtained that cell lines generated following multiple daily fractions of x-irradiation in vitro possessed acute radiation survival or repair characteristics

  18. Hypoxic versus normoxic external-beam irradiation of cervical carcinoma combined with californium-252 neutron brachytherapy. Comparative treatment results of a 5-year randomized study

    Czech Academy of Sciences Publication Activity Database

    Tačev, T.; Vacek, Antonín; Ptáčková, B.; Strnad, V.

    2005-01-01

    Roč. 181, č. 5 (2005), s. 273-284. ISSN 0179-7158 Institutional research plan: CEZ:AV0Z50040507 Keywords : cervical carcinoma * hypoxyradiotherapy * californium-252 Subject RIV: BO - Biophysics Impact factor: 3.490, year: 2005

  19. Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma in Japan

    International Nuclear Information System (INIS)

    Transcatheter methods such as transcatheter arterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) have an important role in the treatment for advanced hepatocellular carcinoma (HCC). Recently, sorafenib, an inhibitor of tyrosine kinases, has been found to obtain survival benefits in patients with HCC, leading to major advances in the treatment of advanced HCC. However, it is associated with a low tumor response rate, minimal survival advantage, and high rates of adverse events. On the other hand, high rates of objective treatment response with HAIC for advanced HCC have been reported, although convincing evidence of it contributing to overall survival in HAIC has been lacking. In Japan, HAIC still tends to be the preferred method for the treatment of advanced HCC, even in patients with poor liver function. However, the choice of chemotherapeutic agents in TACE/HAIC for HCC varies between institutions. In this review, based on studies reported to date in the literature, we refer to current knowledge regarding the chemotherapeutic agents used for TACE/HAIC for HCC in Japan and consider the future perspectives for HAIC for this cancer

  20. Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Nishikawa, Hiroki, E-mail: h-nishikawa@osaka-med.jrc.or.jp; Osaki, Yukio; Kita, Ryuichi; Kimura, Toru [Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka 543-0027 (Japan)

    2012-02-21

    Transcatheter methods such as transcatheter arterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) have an important role in the treatment for advanced hepatocellular carcinoma (HCC). Recently, sorafenib, an inhibitor of tyrosine kinases, has been found to obtain survival benefits in patients with HCC, leading to major advances in the treatment of advanced HCC. However, it is associated with a low tumor response rate, minimal survival advantage, and high rates of adverse events. On the other hand, high rates of objective treatment response with HAIC for advanced HCC have been reported, although convincing evidence of it contributing to overall survival in HAIC has been lacking. In Japan, HAIC still tends to be the preferred method for the treatment of advanced HCC, even in patients with poor liver function. However, the choice of chemotherapeutic agents in TACE/HAIC for HCC varies between institutions. In this review, based on studies reported to date in the literature, we refer to current knowledge regarding the chemotherapeutic agents used for TACE/HAIC for HCC in Japan and consider the future perspectives for HAIC for this cancer.

  1. Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma in Japan

    Directory of Open Access Journals (Sweden)

    Ryuichi Kita

    2012-02-01

    Full Text Available Transcatheter methods such as transcatheter arterial chemoembolization (TACE and hepatic arterial infusion chemotherapy (HAIC have an important role in the treatment for advanced hepatocellular carcinoma (HCC. Recently, sorafenib, an inhibitor of tyrosine kinases, has been found to obtain survival benefits in patients with HCC, leading to major advances in the treatment of advanced HCC. However, it is associated with a low tumor response rate, minimal survival advantage, and high rates of adverse events. On the other hand, high rates of objective treatment response with HAIC for advanced HCC have been reported, although convincing evidence of it contributing to overall survival in HAIC has been lacking. In Japan, HAIC still tends to be the preferred method for the treatment of advanced HCC, even in patients with poor liver function. However, the choice of chemotherapeutic agents in TACE/HAIC for HCC varies between institutions. In this review, based on studies reported to date in the literature, we refer to current knowledge regarding the chemotherapeutic agents used for TACE/HAIC for HCC in Japan and consider the future perspectives for HAIC for this cancer.

  2. APOPTOSIS AND PROLIFERATION OF TUMOR CELLS IN LOCALLY ADVANCED CERVICAL CANCER AFTER NEOADJUVANT INTRAARTERIAL CHEMOTHERAPY

    Institute of Scientific and Technical Information of China (English)

    朱雪琼; 岳天孚; 惠京; 张颖; 王德华

    2003-01-01

    Objective: Through observing the clinical response to neoadjuvant intraarterial chemotherapy in locally advanced cervical cancer and investigating the changes of p53 protein expression, proliferation and apoptosis of tumor cells after chemotherapy, to study the relationship between biological markers and chemotherapeutic response. Methods: 20 women with locally advanced squamous cervical cancer received consecutive infusion chemotherapy of five days of cisplatin and adriamycin via the superselective uterine artery. The response to chemotherapy was evaluated by gynecologic examination and ultrasonography 3 weeks after chemotherapy. The changes of apoptotic index (AI), proliferation index (PI) and p53 expression of tumor cells were detected by immunohistochemical technique. Results: The clinical response rate of locally advanced squamous cervical cancer to uterine artery infusion chemotherapy was 70%. No change of PI was found 3 weeks after treatment, but AI significantly increased from 2.79±0.76 to 4.29±1.13 (P<0.01), and AI/PI from 5.68±1.21 to 9.00±1.95 (P<0.05). On the contrary, the expression of p53 was significantly decreased (P<0.05). Patients who responded to chemotherapy showed higher PI before chemotherapy and significantly increased AI and AI/PI after chemotherapy than non-responders (P<0.05). Conclusion: Higher PI was an indication for neoadjuvant intraarterial chemotherapy. One more cycle of chemotherapy should be given to those who have significantly increased AI or AI/PI after chemotherapy, while definite treatment such as surgery or/and radiotherapy should be immediately given to those patients without increased AI or AI/PI.

  3. Cyclooxygenase-2 (COX-2) expression in locally advanced cervical cancer patients undergoing chemoradiation plus surgery

    International Nuclear Information System (INIS)

    Purpose: To investigate whether cyclooxygenase-2 (COX-2) could be a marker of clinical outcome in cervical cancer patients undergoing concomitant chemoradiation plus surgery. Methods and Materials: The study included 33 locally advanced cervical cancer patients; all underwent neoadjuvant chemoradiation, and responsive patients underwent radical surgery. Immunohistochemistry was performed with rabbit antiserum against COX-2. Results: COX-2 integrated density values (IDVs) in the tumor component ranged from 1.4 to 72.3 (median 15.0); in stromal inflammatory cells, COX-2 IDVs ranged from 1.4 to 96.0 (median 16.0). A statistically significant inverse relation was found between the COX-2 IDVs of the tumor vs. the stromal inflammatory component (r=-0.52, p=0.0017). When the ratio between COX-2 IDV in the tumor vs. the stromal compartment was ≤1, it was considered to indicate cervical tumor with COX-2 expression in the tumor component lower or equivalent to COX-2 expression in the stroma. According to the chosen cutoff value, 17 (51.5%) of 33 were scored as having a high (>1) tumor/stroma COX-2 IDV ratio. Patients with a high tumor/stroma COX-2 IDV ratio had a shorter disease-free survival than did those with a low tumor/stroma COX-2 IDV ratio (p=0.030). Similarly, those with a high tumor/stroma COX-2 IDV ratio had a shorter overall survival (p=0.033). Conclusion: The assessment of COX-2 status in both the tumor and the stromal compartment could provide additional information in the prognostic characterization of cervical cancer patients administered concomitant chemoradiation plus surgery

  4. MicroRNA-21 promotes cell proliferation and down-regulates the expression of programmed cell death 4 (PDCD4) in HeLa cervical carcinoma cells

    International Nuclear Information System (INIS)

    MicroRNAs are involved in cancer-related processes. The microRNA-21(miR-21) has been identified as the only miRNA over-expressed in a wide variety of cancers, including cervical cancer. However, the function of miR-21 is unknown in cervical carcinomas. In this study, we found that the inhibition of miR-21 in HeLa cervical cancer cells caused profound suppression of cell proliferation, and up-regulated the expression of the tumor suppressor gene PDCD4. We also provide direct evidence that PDCD4-3'UTR is a functional target of miR-21 and that the 18 bp putative target site can function as the sole regulatory element in HeLa cells. These results suggest that miR-21 may play an oncogenic role in the cellular processes of cervical cancer and may serve as a target for effective therapies.

  5. Prevalence of Helicobacter pylori infection in advanced gastric carcinoma

    Directory of Open Access Journals (Sweden)

    Irami Araújo-Filho

    2006-12-01

    Full Text Available BACKGROUD: There is substantial evidence that infection with Helicobacter pylori plays a role in the development of gastric cancer and that it is rarely found in gastric biopsy of atrophic gastritis and gastric cancer. On advanced gastric tumors, the bacteria can be lost from the stomach. AIMS: To analyze the hypothesis that the prevalence of H.pylori in operated advanced gastric carcinomas and adjacent non-tumor tissues is high, comparing intestinal and diffuse tumors according to Lauren's classification METHODS: A prospective controlled study enrolled 56 patients from "Hospital Universitário", Federal University of Rio Grande do Norte, Natal, RN, Brazil, with advanced gastric cancer, treated from February 2000 to March 2003. Immediately after partial gastrectomy, the resected stomach was opened and several mucosal biopsy samples were taken from the gastric tumor and from the adjacent mucosa within 4 cm distance from the tumor margin. Tissue sections were stained with hematoxylin and eosin. Lauren's classification for gastric cancer was used, to analyse the prevalence of H. pylori in intestinal or diffuse carcinomas assessed by the urease rapid test, IgG by ELISA and Giemsa staining. H. pylori infected patients were treated with omeprazole, clarithromycin and amoxicillin for 7 days. Follow-up endoscopy and serology were performed 6 months after treatment to determine successful eradication of H. pylori in non-tumor tissue. Thereafter, follow-up endoscopies were scheduled annually. Chi-square and MacNemar tests with 0.05 significance were used. RESULTS: Thirty-four tumors (60.7% were intestinal-type and 22 (39.3% diffuse type carcinomas. In adjacent non-tumor gastric mucosa, chronic gastritis were found in 53 cases (94.6% and atrophic mucosa in 36 patients (64.3%. All the patients with atrophic mucosa were H. pylori positive. When examined by Giemsa and urease test, H. pylori positive rate in tumor tissue of intestinal type carcinomas was

  6. In silico pathway analysis in cervical carcinoma reveals potential new targets for treatment

    Science.gov (United States)

    van Dam, Peter A.; van Dam, Pieter-Jan H. H.; Rolfo, Christian; Giallombardo, Marco; van Berckelaer, Christophe; Trinh, Xuan Bich; Altintas, Sevilay; Huizing, Manon; Papadimitriou, Kostas; Tjalma, Wiebren A. A.; van Laere, Steven

    2016-01-01

    An in silico pathway analysis was performed in order to improve current knowledge on the molecular drivers of cervical cancer and detect potential targets for treatment. Three publicly available Affymetrix gene expression data-sets (GSE5787, GSE7803, GSE9750) were retrieved, vouching for a total of 9 cervical cancer cell lines (CCCLs), 39 normal cervical samples, 7 CIN3 samples and 111 cervical cancer samples (CCSs). Predication analysis of microarrays was performed in the Affymetrix sets to identify cervical cancer biomarkers. To select cancer cell-specific genes the CCSs were compared to the CCCLs. Validated genes were submitted to a gene set enrichment analysis (GSEA) and Expression2Kinases (E2K). In the CCSs a total of 1,547 probe sets were identified that were overexpressed (FDR interaction (PPI) network of 162 nodes (including 20 drugable kinases) and 1626 edges. This PPI-network consists of 5 signaling modules associated with MYC signaling (Module 1), cell cycle deregulation (Module 2), TGFβ-signaling (Module 3), MAPK signaling (Module 4) and chromatin modeling (Module 5). Potential targets for treatment which could be identified were CDK1, CDK2, ABL1, ATM, AKT1, MAPK1, MAPK3 among others. The present study identified important driver pathways in cervical carcinogenesis which should be assessed for their potential therapeutic drugability. PMID:26701206

  7. Temsirolimus in the treatment of advanced renal cell carcinoma

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    Bernard J. Escudier

    2011-12-01

    Full Text Available Temsirolimus is a novel inhibitor of mammalian target of rapamycin (mTOR, which is a central regulator of the response of tumour cells to growth and survival signals. When heavily pretreated patients with advanced solid tumours received intravenous (IV temsirolimus over a broad dose range, antitumour activity was observed in various tumour types, including advanced renal cell carcinoma (RCC. A study of singleagent temsirolimus in patients with cytokine-refractory metastatic RCC subsequently demonstrated antitumour activity and encouraging progression- free survival and overall survival. Temsirolimus was generally well tolerated over the 3 dose levels tested (25 mg, 75 mg or 250 mg weekly as a 30-minute IV infusion. The most frequent grade 3 or 4 treatment-related adverse events reported (n=110 were hyperglycemia (17%, hypophosphatemia (13%, anemia (9%, and hypertriglyceridemia (6%. Results from a randomized phase III study that enrolled previously untreated patients with advanced RCC and poor-prognostic features have recently demonstrated a significant increase in overall survival (p=0.0089 for patients who received temsirolimus 25 mg IV, 30-minute infusion once weekly compared with those who received interferon-alpha up to 18 million units subcutaneously thrice weekly. On the basis of improved survival, temsirolimus can be considered a first-line treatment for patients with advanced RCC.

  8. Neoadjuvant chemotherapy versus primary surgery in advanced ovarian carcinoma

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    Elshamy Maged R

    2005-08-01

    Full Text Available Abstract Background Patients with advanced ovarian cancer should be treated by radical debulking surgery aiming at complete tumor resection. Unfortunately about 70% of the patients present with advanced disease, when optimal debulking can not be obtained, and therefore these patients gain little benefit from surgery. Neoadjuvant chemotherapy (NACT has been proposed as a novel therapeutic approach in such cases. In this study, we report our results with primary surgery or neoadjuvant chemotherapy as treatment modalities in the specific indication of operable patients with advanced ovarian carcinoma (no medical contraindication to debulking surgery. Patients and methods A total of 59 patients with stage III or IV epithelial ovarian carcinomas were evaluated between 1998 and 2003. All patients were submitted to surgical exploration aiming to evaluate tumor resectability. Neoadjuvant chemotherapy was given (in 27 patients where optimal cytoreduction was not feasible. Conversely primary debulking surgery was performed when we considered that optimal cytoreduction could be achieved by the standard surgery (32 patients. Results Optimal cytoreduction was higher in the NACT group (72.2% than the conventional group (62.4%, though not statistically significant (P = 0.5. More important was the finding that parameters of surgical aggressiveness (blood loss rates, ICU stay and total hospital stay were significantly lower in NACT group than the conventional group. The median overall survival time was 28 months in the conventional group and 25 months in NACT group with a P value of 0.5. The median disease free survival was 19 months in the conventional group and 21 months in NACT group (P = 0.4. In multivariate analysis, the pathologic type and degree of debulking were found to affect the disease free survival significantly. Overall survival was not affected by any of the study parameters. Conclusion Primary chemotherapy followed by interval debulking surgery

  9. The Number of Positive Pelvic Lymph Nodes and Multiple Groups of Pelvic Lymph Node Metastasis Influence Prognosis in Stage IA-IIB Cervical Squamous Cell Carcinoma

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    Yu Liu

    2015-01-01

    Full Text Available Background: Pelvic lymph node metastasis (LNM is an important prognostic factor in cervical cancer. Cervical squamous cell carcinoma accounts for approximately 75-80% of all cervical cancers. Analyses of the effects of the number of positive lymph nodes (LNs, unilateral versus bilateral pelvic LNM and a single group versus multiple groups of pelvic LNM on survival and recurrence of cervical squamous cell carcinoma are still lacking. The study aimed to analyze the effects of the number of positive pelvic LNs and a single group versus multiple groups of pelvic LNM on survival and recurrence. Methods: We performed a retrospective review of 296 patients diagnosed with Stage IA-IIB cervical squamous cell carcinoma who received extensive/sub-extensive hysterectomy with pelvic lymphadenectomy/pelvic LN sampling at Peking University People′s Hospital from November 2004 to July 2013. Ten clinicopathological variables were evaluated as risk factors for pelvic LNM: Age at diagnosis, gravidity, clinical stage, histological grade, tumor diameter, lymph-vascular space involvement (LVSI, depth of cervical stromal invasion, uterine invasion, parametrial invasion, and neoadjuvant chemotherapy. Results: The incidence of pelvic LNM was 20.27% (60/296 cases. Pelvic LNM (P = 0.00 was significantly correlated with recurrence. Pelvic LNM (P = 0.00, the number of positive pelvic LNs (P = 0.04 and a single group versus multiple groups of pelvic LNM (P = 0.03 had a significant influence on survival. Multivariate analysis revealed that LVSI (P = 0.00, depth of cervical stromal invasion (P = 0.00 and parametrial invasion (P = 0.03 were independently associated with pelvic LNM. Conclusions: Patients with pelvic LNM had a higher recurrence rate and poor survival outcomes. Furthermore, more than 2 positive pelvic LNs and multiple groups of pelvic LNM appeared to identify patients with worse survival outcomes in node-positive IA-IIB cervical squamous cell carcinoma. LVSI

  10. Recent achievements and acute toxicity after TP concurrent chemoradiotherapy for the advanced cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Qinghua Ke; Shiqiong Zhou; Wei Du; Yong Lei; Min Huang; Fei Luo; Jiyuan Yang

    2012-01-01

    Objective: The aim of our study was to investigate the early outcome of the taxotere and cisplatin chemora-diotherapy to the advanced cervical cancer. Methods: Fifty-six cases with cervical cancer (FIGO IIb to IVa) were divided randomly into two groups in the oncology hospital of Jingzhou from September 2009 to October 2010, radiotherapy alone (28 cases) and radiation plus chemotherapy (TP) group. There was no difference of radiotherapy between the two groups, the RT + C cases who accepted TP regimen during the radiation, and DDP once weekly injection of vain, according to 20 mg/m2 and taxotere once weekly i.v. according to 35 mg/m2. These regimen were given for 4–5 weeks, and some medicine for vomit-ing was given to the RT + C cases. Two groups were received an oral medicine MA 160 mg every day during the treatment. Results: The early outcome: the complete remission rate was 64.3% and partial remission rate was 35.7% in RT + C. The complete remission rate was 32.1% and partial remission rate was 39.3% in RT. The total response rate and complete remis-sion of RT + C group was higher than that of the RT group. There was significant difference between the two groups. In RT + C group, 1-year survive rate was 100.00% (28/28); in RT group, 1-year survive rate was 85.71% (24/28). There was significant difference between the two groups (χ2 = 4.31 > 3.84, P < 0.05). Conclusion: The taxotere and cisplatin chemoradiotherapy can improve the early outcome of the advanced cervical cancer, and the adverse effect are raised, but that can be endured.

  11. Neoadjuvant Chemotherapy and Radical Surgery in Locally Advanced Cervical Cancer During Pregnancy: Case Report and Review of Literature

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    Zohreh Yousefi

    2013-01-01

    Full Text Available For pregnant patients with cervical cancer, treatment recommendations are individualized and dependent on the stage of the disease, gestational age at the time of diagnosis, and the patient's desire as to the cosntinuation of the pregnancy. The aim of this study is to describe the outcome of neoadjuvant chemotherapy with radical surgery and pelvic lymphadenectomy in a woman with cervical cancer who wished to maintain her pregnancy. This is a report of a 26-week pregnant woman with locally advanced cervical cancer stage Ib2 (FIGO who was successfully treated with neoadjuvant chemotherapy Paclitaxel plus platinum, followed by C/S and radical surgery. Her neonate was healthy and had no abnormalities. This case was the first cervical cancer during pregnancy that was treated using this method at the tumor clinic, Mashhad University of Medical Sciences, Iran. Neoadjuvant chemotherapy is an effort to allow time for the fetal to reach viability by preventing the progression of the disease.

  12. A trial of Ro 03-8799 (pimonidazole) in carcinoma of the uterine cervix: an interim report from the Medical Research Council Working Party on advanced carcinoma of the cervix

    International Nuclear Information System (INIS)

    A randomised controlled clinical trial of Ro 03-8799 (pimonidazole) was performed in advanced stage II and stage III squamous cell carcinoma of the uterine cervix. A total of 183 patients were contributed by 15 centres in Western Europe and co-ordinated by the Medical Research Council Trials Office in Cambridge. Analysis has shown poorer local tumour control with a hazard radio (HR) of 2.1 [95% confidence interval (CI) 1.2 to 3.7] and survival with a HR of 1.6 (95% CI 1.0 to 2.5) in the group given the Ro 03-8799. These results were not materially affected after adjustment of stage or haemoglobin levels in stratified analysis or to inadequate radiotherapy being given to the sensitiser group. A true adverse effect caused by the drug is a possible cause and this might be related to a drug-induced impairment of blood supply to the tumour. When compared with results recorded previously for advanced cervical carcinoma treated by radiotherapy, it was apparent that the tumour control and survival in the sensitiser arm was similar, but the control arm showed results superior to those previously recorded. Whatever is the explanation it can certainly be concluded that the radiosensitising drug, pimonidazole, gave no benefit in the radiotherapy of advanced cervical cancer. (author). tabs., figs

  13. Expressions and clinical significance of autophagy-related markers Beclin1, LC3, and EGFR in human cervical squamous cell carcinoma

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    Hu YF

    2015-08-01

    Full Text Available Yun-Feng Hu,1 Xia Lei,2 Hong-Yi Zhang,3 Jun-wei Ma,1 Wei-wei Yang,1 Min-lin Chen,1 Jie Cui,1,4 Hong Zhao1 1Department of Oncology, 2Department of Gynecology, 3Department of Urology, Yan’an University Affiliated Hospital, Yan’an, Shaanxi Province, People’s Republic of China; 4Department of Oncology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of China Purpose: We aimed to investigate the expression of EGFR and the autophagy-related markers Beclin1 and LC3 in cervical cancer.Methods: Beclin1, LC3, and EGFR expression were analyzed in 80 samples of cervical squamous cell carcinoma (SCC, 40 samples of high-grade cervical intraepithelial neoplasia (CIN, and 40 samples of normal cervical tissues by immunohistochemistry. The protein expression rates were analyzed with χ2 and Fisher’s exact tests. Differences in overall survival (OS were determined using the Kaplan–Meier method and log-rank tests.Results: Cervical cancer, high-grade CIN, and normal cervical epithelial cells expressed Beclin1 in 26.2%, 77.5%, and 82.5% of patients, respectively, and expressed LC3 in 28.8%, 70.0%, and 75.0% of patients, respectively. There was a significant difference between cervical SCC and high-grade CIN or normal cervical epithelial cells (P=0.000. Cervical cancer cells, high-grade CIN cells, and normal cervical epithelial cells expressed EGFR in 68.8%, 62.5%, and 12.5% of patients, respectively. There was a significant difference between cervical SCC or high-grade CIN and normal cervical epithelial cells (P=0.000. No significant association between Beclin1 or LC3 or EGFR expression and various clinicopathological parameters was observed in cervical SCC. There was no significant correlation between Beclin1, LC3, EGFR expression, and 5-year OS rates of cervical SCC patients. Beclin1- or LC3-negativity with EGFR-positivity in cervical SCC was associated with a higher Federation International of

  14. Advanced supraglottic carcinoma: a comparative study of sequential treatment policies

    International Nuclear Information System (INIS)

    Data from 131 consecutive patients with operable stage III or IV (American Joint Committee) supraglottic carcinoma were analyzed. Based on existing treatment policies at the time of presentation, patients received either preoperative radiation therapy (RT) (48 patients), surgery alone (42 patients), or postoperative RT (41 patients). Preoperative RT dose levels were either 2000 rad in five fractions (33 patients) or 5000 rad in 25 fractions (15 patients). Postoperative RT dosages were 5000 to 6000 rad in 6 to 6 1/2 weeks. Surgical procedures included either subtotal or total laryngectomy and radical neck dissection. Tumor control was achieved in 21 of 42 patients (50%) treated with surgery alone, 23 of 48 patients (48%) treated with preoperative RT, and 29 of 41 patients (71%) treated with postoperative RT (P . 0.005). The actuarial, recurrence-free survival at 5 years was 36% and 35%, respectively, in the surgery alone or preoperative RT groups as compared to 55% in postoperatively irradiated patients. The authors conclude that advanced but resectable supraglottic carcinomas may be best treated with surgery followed by RT, rather than with surgery alone or with combined preoperative RT and surgery

  15. Epidermal growth factor receptor expression affects the efficacy of the combined application of saponin and a targeted toxin on human cervical carcinoma cells.

    Science.gov (United States)

    Bachran, Diana; Schneider, Stefanie; Bachran, Christopher; Urban, Romy; Weng, Alexander; Melzig, Matthias F; Hoffmann, Corinna; Kaufmann, Andreas M; Fuchs, Hendrik

    2010-09-01

    Cervical cancer is the second most common cancer in women worldwide. Targeting the epidermal growth factor receptor (EGFR) is a very promising approach since it is overexpressed in about 90% of cervical tumors. Here, we quantified the toxic effect of SE, a targeted toxin consisting of epidermal growth factor (EGF) as targeting moiety and the plant toxin saporin-3, on 3 common human cervical carcinoma cell lines (HeLa, CaSki and SiHa) and recently established lines (PHCC1 and PHCC2) from 2 different individuals. A human melanocytic and a mouse cell line served as negative control. Additionally, we combined SE with saponinum album, a saponin composite from Gypsophila paniculata, which exhibited synergistic properties in previous studies. The cell lines, except for SiHa cells, revealed high sensitivity to SE with 50% cell survival in the range of 5-24.5 nM. The combination with saponin resulted in a remarkable enhancement of cytotoxicity with enhancement factors ranging from 9,000-fold to 2,500,000-fold. The cytotoxicity of SE was clearly target receptor specific since free EGF blocks the effect and saporin-3 alone was considerably less toxic. For all cervical carcinoma cell lines, we evinced a clear correlation between EGFR expression and SE sensitivity. Our data indicate a potential use of targeted toxins for the treatment of cervical cancer. In particular, the combination with saponins is a promising approach since efficacy is drastically improved. PMID:20020492

  16. Undetected human papillomavirus DNA and uterine cervical carcinoma. Association with cancer recurrence

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    Okuma, Kae; Yamashita, Hideomi; Nakagawa, Keiichi [University of Tokyo Hospital, Departments of Radiology, Tokyo (Japan); Yokoyama, Terufumi; Kawana, Kei [University of Tokyo Hospital, Departments Obstetrics and Gynecology, Tokyo (Japan)

    2016-01-15

    The time course of human papillomavirus (HPV) DNA clearance was studied in patients with carcinoma of the cervix during follow-up after primary radical radiotherapy (RT). This study investigated the relationship between timing of HPV clearance and RT effectiveness. A total of 71 consecutive patients who were treated for cervical cancer with primary radical radiotherapy and high-dose rate intracavitary brachytherapy with or without chemotherapy were enrolled in the study. Samples for HPV DNA examination were taken before (1) treatment, (2) every brachytherapy, and (3) every follow-up examination. The times when HPV DNA was undetected were analyzed for association with recurrence-free survival. HPV DNA was not detected in 13 patients (18 %) before RT. Of the 58 patients with HPV DNA detected before treatment, HPV DNA was not detected in 34 % during treatment and in 66 % after the treatment. Within 6 months after RT, HPV DNA was detected in 0 % of all patients. The patients were followed up for a median period of 43 months (range 7-70 months). In all, 20 patients were found to develop recurrence. The 3-year cumulative disease-free survival (DFS) rate was 71 ± 5.4 % for all 71 patients. In multivariate analysis, DFS was significantly associated with HPV (detected vs. not detected) with a hazard ratio of 0.07 (95 % confidence interval 0.008-0.6, p = 0.009). In this study, patients in whom HPV was not detected had the worst prognosis. Six months after RT, HPV DNA was detected in 0 % of the patients. Patients in whom HPV DNA could not be detected before treatment need careful follow-up for recurrence and may be considered for additional, or alternative treatment. (orig.) [German] Gegenstand der Untersuchung war der Zeitverlauf der Eliminierung von humaner Papillomvirus-(HPV-)DNA bei Patienten mit Zervixkarzinomen waehrend der Nachfolgeuntersuchungen nach einer primaeren radikalen Strahlentherapie (RT). Diese Studie untersuchte den Zusammenhang zwischen dem Zeitpunkt der

  17. Validade da citologia e da biópsia orientada pela colposcopia no diagnóstico do carcinoma cervical pré-clínico Validity of cytology and colposcopy - guided biopsy for the diagnosis of preclinical cervical carcinoma

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    Aldo Franklin Ferreira Reis

    1999-05-01

    Full Text Available Objetivo: avaliar a eficácia da citologia e da biópsia orientada pela colposcopia na discriminação entre o carcinoma invasor pré-clínico e as lesões intra-epiteliais. Pacientes e Métodos: 441 pacientes submetidas a conização, histerectomia e operação de Wertheim-Meigs, no período de 1978 a 1995, no Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Setor de Patologia Cervical. Foram efetuados os cálculos da sensibilidade, especificidade, valores preditivos, razão de verossimilhança e intervalos de confiança de cada exame, divididos em quatro categorias: normal e inflamatório; displasia leve e displasia moderada; displasia acentuada e carcinoma in situ, e carcinoma microinvasor e invasor. As biópsias foram analisadas como um todo e separadas pelo tipo de colposcopia (satisfatória e insatisfatória. Resultados: a citologia mostrou sensibilidade de 50%, especificidade de 89%, valor preditivo positivo de 63% e valor preditivo negativo de 82%. As razões de verossimilhança foram 4,4 para o diagnóstico de invasão, 0,7 para displasia acentuada e carcinoma in situ, 0,1 para displasia leve e moderada, 2,2 para normal e inflamatório e 0,6 para o conjunto de resultados negativos para invasão. A biópsia orientada pela colposcopia apresentou sensibilidade de 50%, especificidade de 100%, valor preditivo positivo de 100% e valor preditivo negativo de 83%. As razões de verossimilhança foram: tendendo ao ¥ para o resultado de invasão, 0,5 para displasia acentuada e carcinoma in situ, 0,2 para displasia leve e moderada, 0,3 para normal e inflamatório e 0,5 para o conjunto de resultados negativos para invasão. A biópsia orientada pela colposcopia satisfatória com lesão visível mostrou sensibilidade de 59%, especificidade de 100%, valor preditivo positivo de 100% e valor preditivo negativo de 83%. As razões de verossimilhança foram: tendendo ao ¥ para o resultado positivo de invasão, 0

  18. Uptake of the 188Re(V)-DMSA complex by cervical carcinoma cells in nude mice: pharmacokinetics and dosimetry

    International Nuclear Information System (INIS)

    The uptake of the rhenium-188 (188Re(V)-DMSA) complex of dimercaptosuccinic acid by cervical carcinoma cells in nude mice was evaluated. The pharmacokinetics and dosimetry calculations in normal rats were also evaluated. The images obtained in mice did not show significant accumulation in metabolic organs and the biodistribution studies showed that 3.52±0.76% of the injected activity per gram (n=4) was taken up by the tumor. This percentage produces a cumulated activity of 35.63±8.40 MBq h and an equivalent dose per injected activity of 260±8.91 mSv/MBq. Pharmacokinetics and dosimetry of the 188Re(V)-DMSA complex indicate that this radiopharmaceutical could be evaluated in patients with soft tissue tumors, since the risk of radiation damage to the kidney or red bone marrow could not be an obstacle for its application in therapeutic nuclear medicine

  19. Recent Advances in Tumor Ablation for Hepatocellular Carcinoma.

    Science.gov (United States)

    Kang, Tae Wook; Rhim, Hyunchul

    2015-09-01

    Image-guided tumor ablation for early stage hepatocellular carcinoma (HCC) is an accepted non-surgical treatment that provides excellent local tumor control and favorable survival benefit. This review summarizes the recent advances in tumor ablation for HCC. Diagnostic imaging and molecular biology of HCC has recently undergone marked improvements. Second-generation ultrasonography (US) contrast agents, new computed tomography (CT) techniques, and liver-specific contrast agents for magnetic resonance imaging (MRI) have enabled the early detection of smaller and inconspicuous HCC lesions. Various imaging-guidance tools that incorporate imaging-fusion between real-time US and CT/MRI, that are now common for percutaneous tumor ablation, have increased operator confidence in the accurate targeting of technically difficult tumors. In addition to radiofrequency ablation (RFA), various therapeutic modalities including microwave ablation, irreversible electroporation, and high-intensity focused ultrasound ablation have attracted attention as alternative energy sources for effective locoregional treatment of HCC. In addition, combined treatment with RFA and chemoembolization or molecular agents may be able to overcome the limitation of advanced or large tumors. Finally, understanding of the biological mechanisms and advances in therapy associated with tumor ablation will be important for successful tumor control. All these advances in tumor ablation for HCC will result in significant improvement in the prognosis of HCC patients. In this review, we primarily focus on recent advances in molecular tumor biology, diagnosis, imaging-guidance tools, and therapeutic modalities, and refer to the current status and future perspectives for tumor ablation for HCC. PMID:26674766

  20. Surgical approaches towards fertility preservation in young patients with early invasive cervical carcinoma.

    Science.gov (United States)

    Mandic, A; Novakovic, P; Nincic, D

    2009-01-01

    Cervical cancer still remains one of the major problems in developing countries. The last decade of 20th century has seen a trend towards more conservative surgical approaches in the treatment of early-stage disease in young patients. The trend of delaying childbearing, nowadays, increases preservation of fertility, and reproductive function is a major concern when counseling these young women with regard to the effects of treatment for cervical cancer. Radical trachelectomy, either with abdominal or vaginal surgical approach, showed promise as treatment option in young patients with early cervical cancer. The basic principle of such a surgical approach is an operation aiming at preserving the uterine body and removing the cervix, parametrium, with bilateral pelvic lymphadenectomy, and creating a utero-vaginal anastomosis, either laparoscopically or by laparotomy. Both surgical approaches are evaluated after a search of the relevant literature in Pub Med or Medline. PMID:20148446

  1. Involvement of both Cervical Lymph Nodes and Retropharyngeal Lymph Nodes has prognostic value for N1 patients with Nasopharyngeal Carcinoma

    International Nuclear Information System (INIS)

    The N1 definition of 2010 UICC/AJCC staging system for nasopharyngeal carcinoma (NPC) covers quite a large range of nodal pattern. The objective of this research is to investigate prognostic value of lymph nodes related factors including involvement of both cervical lymph nodes (CLNs) and retropharyngeal lymph nodes (RLNs) or not, size and number of cervical lymph nodes (CLNs) in N1 patients with NPC. 142 newly diagnosed non-metastatic N1 patients with NPC, staged according to the 2010 AJCC staging system for NPC were retrospectively enrolled. All patients had undergone contrast-enhanced magnetic resonance imaging (MRI), and received radiotherapy, with or without chemotherapy as their primary treatment. The median follow-up was 48 months. The 5-year local recurrence-free survival (LFS), nodal recurrence-free survival (NFS), local-regional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) of the whole group were 82.3%, 83.0%, 81.0%, 82.1%, 75.3% and 89.8%, respectively. In univariate analysis, patients with both CLNs and RLNs involvement showed a significant lower DMFS, PFS and LRFS than the rest patients (p = 0.004 p = 0.003 and p = 0.034, respectively). Neither size nor number of CLNs affected the survival. In multivariate analysis, involvement of both CLNs and RLNs was an independent prognostic factor for DMFS and PFS (p = 0.019, p = 0.019), but there was no enough evidence confirming its prognostic value for LRFS (p = 0.051). For N1 patients with NPC, involvement of both RLNs and CLNs may be a potentially prognostic factor for distant metastasis and disease progression. The N stage for N1 patients with involvement of both cervical lymph nodes and retropharyngeal lymph nodes might need to be deliberated

  2. Pre-operative contrast enhanced computer tomographic evaluation of cervical nodal metastatic disease in oral squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    P Pandeshwar

    2013-01-01

    Full Text Available Aims: This prospective study was undertaken to evaluate the contrast enhanced computed tomography (CECT criteria in detecting cervical lymph node metastasis in 50 patients with an oral squamous cell carcinoma (OSQCC. Materials and Methods: A total of 50 patients with OSQCC who underwent clinical assessment, routine CECT scanning of cervical lymph node and radical neck dissection were analyzed. Radiologic criteria for diagnosing nodal metastasis in this imaging study were: A nodal size of 1 cm, the presence of central lucency despite the size of the lymph node and grouping of lymph nodes. These criteria were based on modified American Joint Committee on Cancer Radiological Nodal Staging Guidelines. Statistical Analysis: Chi-square test/Fisher Exact test has been used to find the significant association of findings. Diagnostic statistics viz.: Sensitivity, specificity, positive predictive value (PPV, negative predictive value, and diagnostic accuracy were obtained. The results were considered significant when P value was less than 0.05. Results: On using a nodal size of 1 cm and the presence of central nodal necrosis (CNN as radiological criteria for nodal metastasis CT scanning staged 23 of the 27 histopathologically positive necks, providing accuracy of 88%, sensitivity of 92%, and specificity of 84% in detection of nodal metastasis. A significant relationship between the incidence of CNN, different nodal densities, and primary tumor differentiation was observed. Conclusions: The nodal size cut-off of 1-1.5 cm had a maximal sensitivity of 90.91% and PPV of 86.96%. Furthermore, observation of nodal densities in the absence of frank CNN on the CT scan may be necessary especially in low grade primary tumor. CT assessment of cervical node metastasis was found acceptable, although adjuncts like ultrasound guided fine needle aspiration may further increase efficacy of CT scan in nodes lesser than 1 cm in size.

  3. Cervical lymph node metastasis in adenoid cystic carcinoma of oral cavity and oropharynx: A collective international review.

    Science.gov (United States)

    Suárez, Carlos; Barnes, Leon; Silver, Carl E; Rodrigo, Juan P; Shah, Jatin P; Triantafyllou, Asterios; Rinaldo, Alessandra; Cardesa, Antonio; Pitman, Karen T; Kowalski, Luiz P; Robbins, K Thomas; Hellquist, Henrik; Medina, Jesus E; de Bree, Remco; Takes, Robert P; Coca-Pelaz, Andrés; Bradley, Patrick J; Gnepp, Douglas R; Teymoortash, Afshin; Strojan, Primož; Mendenhall, William M; Eloy, Jean Anderson; Bishop, Justin A; Devaney, Kenneth O; Thompson, Lester D R; Hamoir, Marc; Slootweg, Pieter J; Vander Poorten, Vincent; Williams, Michelle D; Wenig, Bruce M; Skálová, Alena; Ferlito, Alfio

    2016-10-01

    The purpose of this study was to suggest general guidelines in the management of the N0 neck of oral cavity and oropharyngeal adenoid cystic carcinoma (AdCC) in order to improve the survival of these patients and/or reduce the risk of neck recurrences. The incidence of cervical node metastasis at diagnosis of head and neck AdCC is variable, and ranges between 3% and 16%. Metastasis to the cervical lymph nodes of intraoral and oropharyngeal AdCC varies from 2% to 43%, with the lower rates pertaining to palatal AdCC and the higher rates to base of the tongue. Neck node recurrence may happen after treatment in 0-14% of AdCC, is highly dependent on the extent of the treatment and is very rare in patients who have been treated with therapeutic or elective neck dissections, or elective neck irradiation. Lymph node involvement with or without extracapsular extension in AdCC has been shown in most reports to be independently associated with decreased overall and cause-specific survival, probably because lymph node involvement is a risk factor for subsequent distant metastasis. The overall rate of occult neck metastasis in patients with head and neck AdCC ranges from 15% to 44%, but occult neck metastasis from oral cavity and/or oropharynx seems to occur more frequently than from other locations, such as the sinonasal tract and major salivary glands. Nevertheless, the benefit of elective neck dissection (END) in AdCC is not comparable to that of squamous cell carcinoma, because the main cause of failure is not related to neck or local recurrence, but rather, to distant failure. Therefore, END should be considered in patients with a cN0 neck with AdCC in some high risk oral and oropharyngeal locations when postoperative RT is not planned, or the rare AdCC-high grade transformation. PMID:27017314

  4. Anti-Tumor Effect of Curcumin on Human Cervical Carcinoma HeLa Cells In Vitro and In Vivo

    Institute of Scientific and Technical Information of China (English)

    ZHAO Jing; ZHAO Yong; ZHANG Yan; CHEN Wei

    2007-01-01

    Objective: To investigate the anti-tumor effect of curcumin on human cervical carcinoma HeLa cells in vitro and in vivo. Methods: (1) Human cervical carcinoma cell line HeLa was cultured in vitro. HeLa cells were treated with 5-50μmol/L curcumin for 24. 48, 72 h and the growth inhibition rates of HeLa cells were measured by MTT method. Cell apoptosis was inspected by electron microscopy and flow cytometry (FCM). (2) A transplanted tumor model by injecting HeLa cells into subcutaneous tissue of BABL/C mice was established and its growth curve was measured. 30 BABL/C mice with tumors were divided into 2 groups at random and 0.2 ml saline or 0.2 ml 250 μmol/L curcumin was injected into abdominal cavity respectively once everyday and lasted for ten days. The changes of tumor volume were measured continuously and tumor inhibition rate was calculated. At last the expressions of caspase-3 and bax protein in transplanted tumors were detected by immunohistochemistry. Results: (1) Curcumin inhibited the proliferation of Lela cells on a dose-depending manner. Apoptosis of cells could be observed by FCM. Partial cells presented the characteristic morphological changes of apoptosis under electron microseope. (2) When 1×107 HeLa cells were inoculated for each mouse, 100% of the mice developed growing tumors after seven days. An inhibition effect was observed in treatment group, and the inhibition rate of curcumin was 74.33%. The expressions of caspase-3 and bax in the transplanted tumors were increased in curcumin group. Conclusion: Curcumin is effective as an anti-cancer drug not only in vitro but also in vivo.

  5. Rapid, sensitive, type specific PCR detection of the E7 region of human papillomavirus type 16 and 18 from paraffin embedded sections of cervical carcinoma

    DEFF Research Database (Denmark)

    Lesnikova, Iana; Lidang, Marianne; Hamilton-Dutoit, Stephen Jacques; Koch, Jørn

    2010-01-01

    ABSTRACT: Human papillomavirus (HPV) infection, and in particularly infection with HPVs 16 and 18 is a central carcinogenic factor in the uterine cervix. We established and optimized a PCR assay for the detection and discrimination of HPV types 16 and 18 in archival formaldehyde fixed and paraffin...... embedded (FFPE) sections of cervical cancer. Tissue blocks from 35 cases of in situ or invasive cervical squamouscell carcinoma and surrogate FFPE sections containing the cell lines HeLa and SiHa were tested for HPV 16 and HPV18 and for the housekeeping gene beta-actin by conventional PCR using type...

  6. Rapid, sensitive, type specific PCR detection of the E7 region of human papillomavirus type 16 and 18 from paraffin embedded sections of cervical carcinoma

    DEFF Research Database (Denmark)

    Lesnikova, Iana; Lidang, Marianne; Hamilton-Dutoit, Steven; Koch, Jørn

    2010-01-01

    ABSTRACT: Human papillomavirus (HPV) infection, and in particularly infection with HPVs 16 and 18, is a central carcinogenic factor in the uterine cervix. We established and optimized a PCR assay for the detection and discrimination of HPV types 16 and 18 in archival formaldehyde fixed and paraffin...... embedded (FFPE) sections of cervical cancer.Tissue blocks from 35 cases of in situ or invasive cervical squamous cell carcinoma and surrogate FFPE sections containing the cell lines HeLa and SiHa were tested for HPV 16 and HPV18 by conventional PCR using type specific primers, and for the housekeeping gene...

  7. Thymostimulin in advanced hepatocellular carcinoma: A phase II trial

    International Nuclear Information System (INIS)

    Thymostimulin is a thymic peptide fraction with immune-mediated cytotoxicity against hepatocellular carcinoma in vitro. In a phase II trial, we investigated safety and efficacy including selection criteria for best response in advanced or metastasised hepatocellular carcinoma. 44 patients (84 % male, median age 69 years) not suitable or refractory to conventional therapy received thymostimulin 75 mg subcutaneously five times per week for a median of 8.2 months until progression or complete response. 3/44 patients were secondarily accessible to local ablation or chemoembolisation. Primary endpoint was overall survival, secondary endpoint tumor response or progression-free survival. A multivariate Cox's regression model was used to identify variables affecting survival. Median survival was 11.5 months (95% CI 7.9–15.0) with a 1-, 2- and 3-year survival of 50%, 23% and 9%. In the univariate analysis, a low Child-Pugh-score (p = 0.01), a low score in the Okuda- and CLIP-classification (p < 0.001) or a low AFP-level (p < 0.001) were associated with better survival, but not therapy modalities other than thymostimulin (p = 0.1) or signs of an invasive HCC phenotype such as vascular invasion (p = 0.3) and metastases (p = 0.1). The only variables independently related to survival in the Cox's regression model were Okuda stage and presence of liver cirrhosis (p < 0.01) as well as response to thymostimulin (p < 0.05). Of 39/44 patients evaluable for response, two obtained complete responses (one after concomitant radiofrequency ablation), five partial responses (objective response 18%), twenty-four stable disease (tumor control rate 79%) and eight progressed. Median progression-free survival was 6.4 months (95% CI 0.8–12). Grade 1 local reactions following injection were the only side effects. Outcome in our study rather depended on liver function and intrahepatic tumor growth (presence of liver cirrhosis and Okuda stage) in addition to response to thymostimulin

  8. A survey on staging and treatment in uterine cervical carcinoma in the Radiotherapy Cooperative Group of the European Organization for Research and Treatment of Cancer

    International Nuclear Information System (INIS)

    The treatment outcome of advanced stage uterine cervical carcinoma remains unsatisfactory. In order to elaborate a novel trial within The Radiotherapy Cooperative Group (RCG) of the European Organization for Research and Treatment of Cancer (EORTC), we conducted a survey in 1997-1998 to determine the variability of pre-treatment assessment and treatment options. The variability of choosing surgery, defined radiation therapy techniques and chemotherapy are investigated, as well as the center's choices of future treatment strategies. Fifty two of 81 RCG centers from the RCG have participated in the survey. As one would expect, there is a large variation in the techniques used for pretreatment evaluation and treatment options. There is no 'standard' for reporting acute and late side effects. Chemotherapy is used neither systematically nor uniformly, and some centers continue to use neadjuvant chemotherapy modalities. Furthermore, the survey reveals that there is a strong demand for the reduction of overall treatment-time, for clinical investigation of novel combined modality treatment strategies, especially chemo-radiation therapy, and also for the use of new radiation sensitizers. We conclude that a more homogeneous approach to the pretreatment evaluation as well as treatment techniques is required in order to allow adequate quality control in any future trial of the RCG in the EORTC. (author)

  9. Systemic Chemotherapy for Advanced Hepatocellular Carcinoma: Past, Present, and Future

    Directory of Open Access Journals (Sweden)

    Masafumi Ikeda

    2015-12-01

    Full Text Available Systemic chemotherapy is one of the most important treatment modalities for advanced hepatocellular carcinoma (HCC. Before the introduction of sorafenib, cytotoxic agents, hormonal therapies, or many combinations of these were the mainly used modalities for systemic chemotherapy of advanced HCC. However, such regimens were of only limited value in clinical practice, because some randomized controlled studies comparing promising regimens with no treatment or doxorubicin alone failed to show any overall survival advantage. In two pivotal phase III placebo-controlled studies, the SHARP trial and the Asia-Pacific trial, sorafenib was demonstrated to significantly delay the time to progression and the overall survival time in patients with advanced HCC. Therefore, sorafenib therapy has come to be acknowledged as a standard therapy for advanced HCC worldwide. After the introduction of sorafenib, a number of phase III trials of various molecular-targeted agents vs. sorafenib as first-line chemotherapy and of various molecular-targeted agents vs. placebo as second-line chemotherapy have been conducted to determine if any of these agents could offer a survival benefit, however, none of the agents examined so far has been demonstrated to provide any survival benefit over sorafenib or placebo. Recently, favorable treatment efficacies have been reported in some clinical trials of molecular-targeted agents in the biomarker-enriched population. Development of individualized cancer treatments using molecular-targeted agents based on the results of genome-sequencing is aggressively ongoing. Furthermore, immune-oncologic agents, such as anti-CTLA-4 antibody and anti-PD-1/PD-L1 antibody, have been reported to provide promising outcomes. Thus, various novel systemic chemotherapeutic agents are currently under development, and further improvements in the treatment outcomes are expected.

  10. Developing a prognostic micro-RNA signature for human cervical carcinoma.

    Directory of Open Access Journals (Sweden)

    Christine How

    Full Text Available Cervical cancer remains the third most frequently diagnosed and fourth leading cause of cancer death in women worldwide. We sought to develop a micro-RNA signature that was prognostic for disease-free survival, which could potentially allow tailoring of treatment for cervical cancer patients. A candidate prognostic 9-micro-RNA signature set was identified in the training set of 79 frozen specimens. However, three different approaches to validate this signature in an independent cohort of 87 patients with formalin-fixed paraffin-embedded (FFPE specimens, were unsuccessful. There are several challenges and considerations associated with developing a prognostic micro-RNA signature for cervical cancer, namely: tumour heterogeneity, lack of concordance between frozen and FFPE specimens, and platform selection for global micro-RNA expression profiling in this disease. Our observations provide an important cautionary tale for future miRNA signature studies for cervical cancer, which can also be potentially applicable to miRNA profiling studies involving other types of human malignancies.

  11. Prevalence of high-risk human papillomavirus types in Mexican women with cervical intraepithelial neoplasia and invasive carcinoma

    Directory of Open Access Journals (Sweden)

    Sánchez-Garza Mireya

    2008-02-01

    Full Text Available Abstract Background Prevalence of high risk (HR human papillomavirus (HPV types in the states of San Luis Potosí (SLP and Guanajuato (Gto, Mexico, was determined by restriction fragment length-polymorphism (RFLP analysis on the E6 ~250 bp (E6-250 HR-HPV products amplified from cervical scrapings of 442 women with cervical intraepithelial neoplasia and invasive carcinoma (280 from SLP and 192 from Gto. Fresh cervical scrapings for HPV detection and typing were obtained from all of them and cytological and/or histological diagnoses were performed on 383. Results Low grade intraepithelial squamous lesions (LSIL were diagnosed in 280 cases (73.1%, high grade intraepithelial squamous lesions (HSIL in 64 cases (16.7% and invasive carcinoma in 39 cases (10.2%. In the 437 cervical scrapings containing amplifiable DNA, only four (0.9% were not infected by HPV, whereas 402 (92.0% were infected HR-HPV and 31 (7.1% by low-risk HPV. RFLP analysis of the amplifiable samples identified infections by one HR-HPV type in 71.4%, by two types in 25.9% and by three types in 2.7%. The overall prevalence of HR-HPV types was, in descending order: 16 (53.4% > 31 (15.6% > 18 (8.9% > 35 (5.6 > 52 (5.4% > 33 (1.2% > 58 (0.7% = unidentified types (0.7%; in double infections (type 58 absent in Gto it was 16 (88.5% > 31 (57.7% > 35 (19.2% > 18 (16.3% = 52 (16.3% > 33 (2.8% = 58 (2.8% > unidentified types (1.0%; in triple infections (types 33 and 58 absent in both states it was 16 (100.0% > 35 (54.5% > 31 (45.5% = 52 (45.5% > 18 (27.3%. Overall frequency of cervical lesions was LSIL (73.1% > HSIL (16.7% > invasive cancer (10.2%. The ratio of single to multiple infections was inversely proportional to the severity of the lesions: 2.46 for LSIL, 2.37 for HSIL and 2.15 for invasive cancer. The frequency of HR-HPV types in HSIL and invasive cancer lesions was 16 (55.0% > 31 (18.6% > 35 (7.9% > 52 (7.1% > 18 (4.3% > unidentified types (3.6% > 33 (2.9% > 58 (0.7%. Conclusion Ninety

  12. Sorafenib in Liver Function Impaired Advanced Hepatocellular Carcinoma

    Institute of Scientific and Technical Information of China (English)

    You-xin Ji; Lei Sun; Zong-chun Zhang; Zhong-fa Zhang; Ke-tao Lan; Ke-ke Nie; Chuan-xin Geng; Shi-chao Liu; Ling Zhang; Xing-jun Zhuang; Xiao Zou

    2014-01-01

    Objective To explore the efficacy and safty of sorafenib in Child-Pugh class B to class C hepatocellular carcinoma (HCC). Methods In this three-center open-label study from November 2011 to May 2013, we randomly assigned 189 patients with advanced Child-Pugh class B or C HCC patients into two groups, one group with 95 patient to receive sorafenib (400 mg a time, twice a day) and the other group with 94 patients to receive best supportive care. The primary end points were progression-free survival and overall survival. Results The median progression-free survival was 2.2 months and 1.9 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.55; 95% confidence interval, 0.40-0.75;P=0.002). The median overall survival was 4.0 months and 3.5 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.48;95%confidence interval, 0.35-0.68;P Conclusions Sorafenib is safe in patients with liver function impaired advanced HCC. It is effective in terms of progression-free survival and overall survival compared with best supportive care. Liver functions are the important predictive factors.

  13. Three-dimensional dose accumulation in pseudo-split-field IMRT and brachytherapy for locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Sun, Baozhou; Yang, Deshan; Esthappan, Jackie; Garcia-Ramirez, Jose; Price, Samantha; Mutic, Sasa; Schwarz, Julie K; Grigsby, Perry W; Tanderup, Kari

    2015-01-01

    -field intensity-modulated radiation therapy (IMRT) and image-guided BT in locally advanced cervical cancer. METHODS AND MATERIALS: Thirty-three patients treated with split-field-IMRT to 45.0-51.2 Gy in 1.6-1.8 Gy per fraction to the elective pelvic lymph nodes and to 20 Gy to the central pelvis region were...

  14. Acute and long-term toxicity following radiotherapy alone or in combination with chemotherapy for locally advanced cervical cancer

    NARCIS (Netherlands)

    Maduro, JH; Pras, E; Willemse, PHB; de Vries, EGE

    2003-01-01

    Randomised studies in locally advanced cervical cancer patients showed that cisplatin should be given concurrently with radiotherapy, because of a better long-term survival compared to radiotherapy alone. This increases the relevance of treatment related toxicity. This review summarises the acute an

  15. Impact of radiation dose and standardized uptake value of (18)FDG PET on nodal control in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Ramlov, Anne; Kroon, Petra S; Jürgenliemk-Schulz, Ina M;

    2015-01-01

    BACKGROUND: Despite local control now exceeding 90% with image-guided adaptive brachytherapy (IGABT), regional and distant metastases continue to curb survival in locally advanced cervical cancer. As regional lymph nodes often represent first site of metastatic spread, improved nodal control could...

  16. Neoadjuvant chemotherapy followed by radiotherapy should not be a standard approach for locally advanced cervical cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate the role of neoadjuvant chemotherapy followed by radiotherapy in locally advanced cervical cancer. Methods and Materials: This study cites all known literature on the subject in the English language. Articles were selected for analysis by MEDLINE and CANCERLINE computer searches. In Phase II trials, the response rates of some selective series were analyzed. However, This article will specially emphasize the result of all Phase III randomized trials. Results: Several investigators did obtain promising results from Phase II trials of neoadjuvant chemotherapy, mostly cisplatin-based combinations, followed by radiotherapy. However, most Phase III trials failed to demonstrate any benefit in terms of loco-regional relapse and/or survival by up-front chemotherapy. Conclusion: The role of neoadjuvant chemotherapy remains to be defined, and the search for more active new agents must be continued. The neoadjuvant setting is still experimental and could not be recommended as a standard treatment at the present

  17. Cervical squamous carcinoma cells are resistant to the combined action of tumor necrosis factor-α and histamine whereas normal keratinocytes undergo cytolysis

    International Nuclear Information System (INIS)

    Previous reports showed that mast cells can typically be found in the peritumoral stroma of cervix carcinomas as well as in many other cancers. Both histamine and TNF-α are potent preformed mast cell mediators and they can act simultaneously after release from mast cells. Thus, the effect of TNF-α and histamine on cervical carcinoma cell lines was studied. TNF-α alone induced slight growth inhibition and cell cycle arrest at G0/G1 phase in SiHa cells, but increased their migration. Histamine alone had no effect on cells. In addition, TNF-α and histamine in combination showed no additional effect over that by TNF-α alone, although SiHa cells were even pretreated with a protein synthesis inhibitor. Furthermore, TNF-α-sensitive ME-180 carcinoma cells were also resistant to the combination effect of TNF-α and histamine. In comparison, TNF-α or histamine alone induced growth inhibition in a non-cytolytic manner in normal keratinocytes, an effect that was further enhanced to cell cytolysis when both mediators acted in combination. Keratinocytes displayed strong TNF receptor (TNFR) I and II immunoreactivity, whereas SiHa and ME-180 cells did not. Furthermore, cervix carcinoma specimens revealed TNF-α immunoreactivity in peritumoral cells and carcinoma cells. However, the immunoreactivity of both TNFRs was less intense in carcinoma cells than that in epithelial cells in cervical specimens with non-specific inflammatory changes. SiHa and ME-180 cells are resistant to the cytolytic effect of TNF-α and histamine whereas normal keratinocytes undergo cytolysis, possibly due to the smaller amount of TNFRs in SiHa and ME-180 cells. In the cervix carcinoma, the malignant cells may resist this endogenous cytolytic action and TNF-α could even enhance carcinoma cell migration

  18. Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Tinkle, Christopher L.; Weinberg, Vivian [Department of Radiation Oncology, University of California, San Francisco, California (United States); Chen, Lee-May [Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California (United States); Littell, Ramey [Gynecologic Oncology, The Permanente Medical Group, San Francisco, California (United States); Cunha, J. Adam M.; Sethi, Rajni A. [Department of Radiation Oncology, University of California, San Francisco, California (United States); Chan, John K. [Gynecologic Oncology, California Pacific Medical Center, San Francisco, California (United States); Hsu, I-Chow, E-mail: ichow.hsu@ucsf.edu [Department of Radiation Oncology, University of California, San Francisco, California (United States)

    2015-08-01

    Purpose: Evaluate the efficacy and toxicity of image guided brachytherapy using inverse planning simulated annealing (IPSA) high-dose-rate brachytherapy (HDRB) boost for locoregionally advanced cervical cancer. Methods and Materials: From December 2003 through September 2009, 111 patients with primary cervical cancer were treated definitively with IPSA-planned HDRB boost (28 Gy in 4 fractions) after external radiation at our institution. We performed a retrospective review of our experience using image guided brachytherapy. Of the patients, 70% had a tumor size >4 cm, 38% had regional nodal disease, and 15% had clinically evident distant metastasis, including nonregional nodal disease, at the time of diagnosis. Surgical staging involving pelvic lymph node dissection was performed in 15% of patients, and 93% received concurrent cisplatin-based chemotherapy. Toxicities are reported according to the Common Terminology Criteria for Adverse Events version 4.0 guidelines. Results: With a median follow-up time of 42 months (range, 3-84 months), no acute or late toxicities of grade 4 or higher were observed, and grade 3 toxicities (both acute and late) developed in 8 patients (1 constitutional, 1 hematologic, 2 genitourinary, 4 gastrointestinal). The 4-year Kaplan-Meier estimate of late grade 3 toxicity was 8%. Local recurrence developed in 5 patients (4 to 9 months after HDRB), regional recurrence in 3 (6, 16, and 72 months after HDRB), and locoregional recurrence in 1 (4 months after HDR boost). The 4-year estimates of local, locoregional, and distant control of disease were 94.0%, 91.9%, and 69.1%, respectively. The overall and disease-free survival rates at 4 years were 64.3% (95% confidence interval [CI] of 54%-73%) and 61.0% (95% CI, 51%-70%), respectively. Conclusions: Definitive radiation by use of inverse planned HDRB boost for locoregionally advanced cervical cancer is well tolerated and achieves excellent local control of disease. However, overall

  19. Syphilis manifesting as a nasopharyngeal carcinoma with cervical lymphadenopathy: A case report

    Science.gov (United States)

    PAN, XINBIN; ZHU, XIAODONG; LI, QINGDI QUENTIN

    2012-01-01

    The present case report describes a case of syphilitic lymphadenopathy and raises the awareness of the differential diagnosis of cervical lymphadenopathy. A 50-year-old male worker presented with a 6-month history of enlarged and growing lymph nodes in the right upper neck and a blood-tinged post-nasal drip. Physical examination showed multiple enlarged lymph nodes located in the right upper neck. On nasopharyngoscopy, a mass was found in the nasopharynx. The histopathology of both the nasopharyngeal mass and the enlarged lymph nodes revealed non-specific inflammation. Rapid plasma reagin test results (titer, 1:1280) and Treponema pallidum particle assay results (titer, 1:2560) were positive. Subsequently, a diagnosis of syphilis was confirmed clinically and serologically. The reaction after penicillin treatment further confirmed the syphilis diagnosis. Thus, syphilis should be considered as a possibility in the differential diagnosis of cervical lymphadenopathy. PMID:22970011

  20. Syphilis manifesting as a nasopharyngeal carcinoma with cervical lymphadenopathy: A case report

    OpenAIRE

    PAN, XINBIN; Zhu, Xiaodong; LI, QINGDI QUENTIN

    2012-01-01

    The present case report describes a case of syphilitic lymphadenopathy and raises the awareness of the differential diagnosis of cervical lymphadenopathy. A 50-year-old male worker presented with a 6-month history of enlarged and growing lymph nodes in the right upper neck and a blood-tinged post-nasal drip. Physical examination showed multiple enlarged lymph nodes located in the right upper neck. On nasopharyngoscopy, a mass was found in the nasopharynx. The histopathology of both the nasoph...

  1. Comparison of europium and chromium release assays: cytotoxicity in healthy individuals and patients with cervical carcinoma.

    OpenAIRE

    von Zons, P; Crowley-Nowick, P; Friberg, D; Bell, M.; Koldovsky, U; Whiteside, T L

    1997-01-01

    Natural killer (NK) and lymphokine-activated killer (LAK) cell activities were measured in peripheral blood obtained from healthy women to compare a standard 51Cr release assay with a nonradioactive europium (Eu3+) release assay based on time-resolved fluorescence. The two types of cytotoxicity assays were first compared in paired determinations performed on 28 samples of peripheral blood mononuclear cells obtained from healthy women who had normal pap smears or no biopsy evidence of cervical...

  2. MR analysis of nasopharyngeal carcinoma: correlation of the pattern of tumor extent at the primary site with the distribution of metastasized cervical lymph nodes. Preliminary results

    International Nuclear Information System (INIS)

    The purpose of this study was to correlate the pattern of tumor extent of nasopharyngeal carcinoma at the primary site on magnetic resonance (MR) imaging with the distribution of cervical lymph node metastasis. MR images of 32 patients with biopsy-proven nasopharyngeal carcinoma were reviewed and classified into five patterns of tumor extent in correlation with the distribution of cervical lymphadenopathy. The assessment of cervical lymph node metastasis was done on the basis of the computed tomography (CT) findings. The tumor volume was also correlated with the occurrence of contralateral lymphadenopathy. Of the 32 patients, five (16 %) presented as type 1, tumor limited to the nasopharyngeal mucosa; 12 (38 %) as type 2 a, tumor which had invaded either lateral side but did not extend over the roof of nasopharynx; three (9 %) as type 2 b, tumor which had invaded bilaterally across the midline but did not extend over the roof of nasopharynx; three (9 %) as type 2 c, tumor which had invaded mainly the skull base but did not cross the midline; and nine (28 %) as type 3, tumor which had extended anteriorly to the nasal cavity without invasion. Twenty-five patients (78 %) demonstrated cervical lymphadenopathy. Patients with type 1, type 2 b and type 3 spread had frequent bilateral cervical lymphadenopathy; those with type 2 a had only ipsilateral lymphadenopathy. There was statistical significance (P < 0.005) regarding the existence of contralateral lymphadenopathy with midline tumors as well as the absence of contralateral cervical lymphadenopathy with non-midline tumors. This study therefore suggests that the distribution of metastasized lymph nodes depends on the pattern of tumor extent at the primary site. (orig.)

  3. Magnetic resonance imaging of cervical carcinoma using an endorectal surface coil

    Energy Technology Data Exchange (ETDEWEB)

    Brocker, Kerstin A., E-mail: kerstin.brocker@med.uni-heidelberg.de [Department of Obstetrics and Gynecology, University of Heidelberg Medical School, Voßstr. 9, 69115 Heidelberg (Germany); Alt, Céline D., E-mail: celine.alt@med.uni-heidelberg.de [Department of Diagnostic and Interventional Radiology, University of Heidelberg Medical School, INF 110, 69120 Heidelberg (Germany); Gebauer, Gerhard, E-mail: gebauer.frauen@marienkrankenhaus.org [Department of Obstetrics and Gynecology, Kath. Marienkrankenhaus Hamburg, Alfredstr. 9, 22087 Hamburg (Germany); Sohn, Christof, E-mail: christof.sohn@med.uni-heidelberg.de [Department of Obstetrics and Gynecology, University of Heidelberg Medical School, Voßstr. 9, 69115 Heidelberg (Germany); Hallscheidt, Peter, E-mail: hallscheidt@yahoo.de [Radiologie Darmstadt am Alice-Hospital, Dieburger Str. 29-31, 64287 Darmstadt (Germany)

    2014-07-15

    Introduction: The objective of this trial is to investigate the diagnostic value of magnetic resonance imaging (MRI) with an endorectal surface coil for precise local staging of patients with histologically proven cervical cancer by comparing the radiological, clinical, and histological results. Materials and methods: Women with cervical cancer were recruited for this trial between February 2007, and September 2010. All the patients were clinically staged according to the FIGO classification and underwent radiological staging by MRI that employed an endorectal surface coil. The staging results after surgery were compared to histopathology in all the operable patients. Results: A total of 74 consecutive patients were included in the trial. Forty-four (59.5%) patients underwent primary surgery, whereas 30 (40.5%) patients were inoperable according to FIGO and underwent primary radiochemotherapy. The mean age of the patients was 50.6 years. In 11 out of the 44 patients concordant staging results were obtained by all three staging modalities. Thirty-two of the 44 patients were concordantly staged by FIGO and histopathological examination, while only 16 were concordantly staged by eMRI and histopathological examination. eMRI overstaged tumors in 14 cases and understaged them in 7 cases. Conclusions: eMRI is applicable in patients with cervical cancer, yet of no benefit than staging with FIGO or standard pelvic MRI. The most precise preoperative staging procedure still appears to be the clinical examination.

  4. Cytological detection of cervical carcinoma with new cytochemical markers and flow microanalysis. [Mithramycin, chromomycin

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, R.H.; King, E.B.; Mayall, B.H.

    1976-04-21

    Human cervical cell samples have been stained with mithramycin or chromomycin A3 in an effort to analyze such preparations for premalignant abnormal cells by flow cytometry. Fluorescence from mithramycin or chromomycin A3-stained cells is similar to the fluorescence from DNA in solution when it is complexed with these same antibiotics. Mithramycin or chromomycin A3-stained cells exhibit nuclear specific fluorescence which, for exponentially grown tissue culture cells, reflects the cellular DNA content. All these facts indicate that DNA is the sole intracellular binding site for these antibiotics. Flow cytofluorometry on mithramycin or chromomycin A3-stained cervical cells using a single parameter, fluorescence intensity per cell, appears to be a poor diagnostic procedure. However, simultaneous analysis of cellular fluorescence and small angle light scatter permits a relatively detailed description of each cell sample and appears to be useful for automated sample diagnosis. Qualitative diagnostic analysis based on comparisons of two parameter histograms agrees moderately well with cytomorphological diagnosis on the same cell samples. A technique for quantitation in comparing two parameter histograms is presented and promises to be useful for further progress in flow analysis of human cervical cell samples.

  5. Magnetic resonance imaging of cervical carcinoma using an endorectal surface coil

    International Nuclear Information System (INIS)

    Introduction: The objective of this trial is to investigate the diagnostic value of magnetic resonance imaging (MRI) with an endorectal surface coil for precise local staging of patients with histologically proven cervical cancer by comparing the radiological, clinical, and histological results. Materials and methods: Women with cervical cancer were recruited for this trial between February 2007, and September 2010. All the patients were clinically staged according to the FIGO classification and underwent radiological staging by MRI that employed an endorectal surface coil. The staging results after surgery were compared to histopathology in all the operable patients. Results: A total of 74 consecutive patients were included in the trial. Forty-four (59.5%) patients underwent primary surgery, whereas 30 (40.5%) patients were inoperable according to FIGO and underwent primary radiochemotherapy. The mean age of the patients was 50.6 years. In 11 out of the 44 patients concordant staging results were obtained by all three staging modalities. Thirty-two of the 44 patients were concordantly staged by FIGO and histopathological examination, while only 16 were concordantly staged by eMRI and histopathological examination. eMRI overstaged tumors in 14 cases and understaged them in 7 cases. Conclusions: eMRI is applicable in patients with cervical cancer, yet of no benefit than staging with FIGO or standard pelvic MRI. The most precise preoperative staging procedure still appears to be the clinical examination

  6. Up-regulation of expression and lack of 5' CpG island hypermethylation of p16 INK4a in HPV-positive cervical carcinomas

    Directory of Open Access Journals (Sweden)

    Frank Georgy A

    2007-03-01

    Full Text Available Abstract Background High risk type human papilloma viruses (HR-HPV induce carcinomas of the uterine cervix by expressing viral oncogenes E6 and E7. Oncogene E7 of HR-HPV disrupts the pRb/E2F interaction, which negatively regulates the S phase entry. Expression of tumor suppressor p16ink4a drastically increases in majority of HR-HPV associated carcinomas due to removal of pRb repression. The p16ink4a overexpression is an indicator of an aberrant expression of viral oncogenes and may serve as a marker for early diagnostic of cervical cancer. On the other hand, in 25–57% of cervical carcinomas hypermethylation of the p16 INK4a promoter has been demonstrated using a methylation-specific PCR, MSP. To evaluate a potential usage of the p16 INK4a 5' CpG island hypermethylation as an indicator of tumor cell along with p16ink4a overexpression, we analyzed the methylation status of p16 INK4a in cervical carcinomas Methods Methylation status of p16 INK4a was analyzed by MSP and by bisulfite-modified DNA sequencing. The expression of p16ink4a was analyzed by RT-PCR and by immunohistochemical technique. Results The extensive methylation within p16 INK4a 5' CpG island was not detected either in 13 primary cervical carcinomas or in 5 cancer cell lines by bisulfite-modified DNA sequencing (including those that were positive by MSP in our hands. The number and distribution of rare partially methylated CpG sites did not differ considerably in tumors and adjacent normal tissues. The levels of the p16 INK4a mRNA were increased in carcinomas compared to the normal tissues independently of the number of partially methylated CpGs within 5'CpG island. The transcriptional activation of p16 INK4a was accompanied by p16ink4a cytoplasmic immunoreactivity in the majority of tumor cells and presence of a varied number of the p16 positive nuclei in different tumors. Conclusion Hypermethylaion of the p16INK4a 5' CpG island is not a frequent event in HR-HPV-positive cervical

  7. CHEMOTHERAPY FOR ADVANCED NASOPHARYNGEAL CARCINOMA WITH METHOTREXATE, VINCRISTINE, CISPLATIN AND ADRIAMYCIN

    Institute of Scientific and Technical Information of China (English)

    苏勇; 张锦明; 夏云飞; 朱荣; 钱朝南; 莫浩元

    2002-01-01

    Objective: To evaluate the efficacy and toxicity of M-VCA (methortrexate 30 mg/m2, vincristine 2 mg, cisplatin 70 mg/m2, adriamycin 30 mg/m2) combination chemotherapy for advanced nasopharyngeal carcinoma. Methods: Thirty-five patients with advanced nasopharyngeal carcinoma, including 11 patients with untreated local advanced nasopharyngeal carcinoma and 24 patients with local-regional recurrent or metastatic nasopharyngeal carcinoma, received the chemotherapy of M-VCA. The cycle was repeated on day 22 for two cycles. All patients completed the chemotherapy courses. Results: The overall response rate was 75%, with untreated local advanced nasopharyngeal carcinomas 11/11(100%), local-regional recurrent nasopharyngeal carcinomas 12/18(67%), lung metastases 8/9(89%), bone metastases 5/9(56%), and liver metastases 1/2(50%). The main side effects included mild to moderate degree alopecia, nausea/vomiting, and neutropenia. Conclusion: M-VCA is well tolerated and has good efficacy for advanced nasopharyngeal carcinoma and is worth investigating further.

  8. Comparison of T2-weighted and contrast-enhanced T1-weighted MR imaging at 1.5 T for assessing the local extent of cervical carcinoma

    International Nuclear Information System (INIS)

    To compare two MR sequences at 1.5 T - T2-weighted and contrast-enhanced T1-weighted images - by using macroscopic sections to determine which image type enables the most accurate assessment of cervical carcinoma. Forty consecutive patients (mean age, 39.2 years) with biopsy-proven cervical carcinoma were included. Each MR sequence was assessed for tumour localisations, tumour margins, and cancer extent with the consensus of two readers, and tumour margins were rated on a five-point scale. MR findings were correlated with histopathological findings. Contrast-to-noise ratios (CNRs) obtained with each image were compared using nonparametric tests. Thirty-one of 40 patients underwent hysterectomies and nine of 40 underwent trachelectomies. In 36 patients, lesions were identified on at least one sequence. The tumours at stage 1B or higher were detected in 94.7% on contrast-enhanced T1-weighted images and in 76.3% on T2-weighted images (P < 0.05). Tumour margins appeared significantly more distinct on contrast-enhanced T1-weighted images than on T2-weighted images (P < 0.001). The CNRs obtained using contrast-enhanced T1-weighted images were significantly higher (P < 0.001) than those obtained using T2-weighted images. Contrast-enhanced T1-weighted imaging is more useful for assessing cervical carcinoma than T2-weighted imaging. (orig.)

  9. Efficacy, Safety, and Biomarkers of Single-Agent Bevacizumab Therapy in Patients with Advanced Hepatocellular Carcinoma

    OpenAIRE

    Boige, Valérie; Malka, David; Bourredjem, Abderrahmane; Dromain, Clarisse; Baey, Charlotte; Jacques, Nathalie; Pignon, Jean-Pierre; Vimond, Nadege; Bouvet-Forteau, Nathalie; De Baere, Thierry; Ducreux, Michel; Farace, Françoise

    2012-01-01

    The safety, efficacy, and potential biomarkers of activity of bevacizumab in patients with advanced hepatocellular carcinoma were assessed. Bevacizumab was active and well tolerated. The clinical value of circulating endothelial cells and interleukin-6 and -8 warrants further investigation.

  10. Tracer kinetic model selection for dynamic contrast-enhanced magnetic resonance imaging of locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Kallehauge, Jesper Folsted; Tanderup, Kari; Duan, Chong;

    2014-01-01

    conditions the Tofts (TM), extended Tofts (ETM), compartmental tissue uptake model (C-TU) and 2-compartment exchange model (2CXM) were the optimal tracer kinetic models (TKMs) for the analysis of DCE-MRI in patients with cervical cancer. Material and methods. Ten patients with locally advanced cervical......-treatment cervical cancers, although this model broke down in a subset of the tumour voxels where overfitting resulted in non-physiological parameter estimates. Due to the possible overfitting of the 2CXM, the C-TU was found more robust and when 2CXM was excluded from comparison the C-TU was the preferred model....... cancer (FIGO: IIA/IIB/IIIB/IVA-1/5/3/1) underwent DCE-MRI prior to radiotherapy. From the two-parameter TM it was possible to extract the forward volume transfer constant (Ktrans) and the extracellular-extravascular volume fraction (ve). From the three-parameter ETM, additionally the plasma volume...

  11. Advanced carcinoma of the larynx: results of surgery and radiotherapy without induction chemotherapy (1980-1985): a multivariate analysis

    International Nuclear Information System (INIS)

    Purpose: Induction chemotherapy has been proposed in the case of advanced laryngeal cancer in order to preserve laryngeal function in those patients who are complete responders. To clarify the treatment policies, a retrospective multicentric analysis of 116 patients with advanced carcinoma of the larynx treated by radical surgery and postoperative radiotherapy was carried out in order to evaluate prognostic factors for local control and survival. Methods and Materials: Between 1980 and 1985, 116 patients with Stage III squamous cell carcinoma of the larynx underwent radical surgery and postoperative radiotherapy with a curative intent. Treatments were very homogenous, and doses delivered were in the range of 50-65 Gy according to nodal involvement and surgical margins status. Results: The local recurrence rate and the local disease-free survival rate at 5 years were 22.5% and 76.3%, respectively. Actuarial survival at 5 years was 68.3% with 44 patients still alive with no evidence of disease (NED) with more than 5 years follow-up. For both overall survival and relapse-free survival, cervical node involvement with capsular rupture was found to be the only significant adverse pronostic factor in univariate and multivariate analysis. No other parameter was predictive either for local recurrence or for survival. Conclusions: Local prognosis and survival depend largely on nodal involvement and capsular rupture while increasing doses of radiation strategy is likely to reduce the risk of local and nodal recurrence. Preservation of functional larynx is certainly an important goal to achieve when treating advanced carcinoma of the larynx, provided that local failure rate and survival be similar. In the unique randomized study previously published in the literature comparing radical surgery and postoperative radiotherapy to induction chemotherapy and radiotherapy, the local-regional failure rate was drastically increased in the chemotherapy arm. Other results from well

  12. Sorafenib in advanced hepatocellular carcinoma: current status and future perspectives

    Directory of Open Access Journals (Sweden)

    Hsu CH

    2014-06-01

    Full Text Available Chih-Hung Hsu,1,4 Ying-Chun Shen,1,2 Yu-Yun Shao,1,4 Chiun Hsu,1,4 Ann-Lii Cheng,1,3,41Department of Oncology, 2Department of Medical Research, 3Department of Internal Medicine, National Taiwan University Hospital, 4Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, TaiwanAbstract: The approval of sorafenib, a multikinase inhibitor targeting primarily Raf kinase and the vascular endothelial growth factor receptor, in 2007 for treating advanced hepatocellular carcinoma (HCC has generated considerable enthusiasm in drug development for this difficult-to-treat disease. However, because several randomized Phase III studies testing new multikinase inhibitors failed, sorafenib remains the standard of first-line systemic therapy for patients with advanced HCC. Field practice studies worldwide have suggested that in daily practice, physicians are adopting either a preemptive dose modification or a ramp-up strategy to improve the compliance of their patients. In addition, accumulating data have suggested that patients with Child–Pugh class B liver function can tolerate sorafenib as well as patients with Child–Pugh class A liver function, although the actual benefit of sorafenib in patients with Child–Pugh class B liver function has yet to be confirmed. Whether sorafenib can be used as an adjunctive therapy to improve the outcomes of intermediate-stage HCC patients treated with transcatheter arterial chemoembolization or early-stage HCC patients after curative therapies is being investigated in several ongoing randomized Phase III studies. An increasing number of studies have reported that sorafenib exerts "off-target" effects, including the modulation of signaling pathways other than Raf/MEK/ERK pathway, nonapoptotic cell death mechanisms, and even immune modulation. Finally, although sorafenib in combination with chemotherapy or other targeted therapies has the potential to improve therapeutic efficacy in

  13. A case of rhabdomyolysis related to sorafenib treatment for advanced hepatocellular carcinoma

    OpenAIRE

    Tsuji, Kunihiro; Takemura, Kenichi; Minami, Keisuke; Teramoto, Ryota; Nakashima, Keisuke; Yamada, Shinya; Doyama, Hisashi; Oiwake, Hisanori; Hasatani, Kenkou

    2013-01-01

    We report on a case of rhabdomyolysis related to sorafenib treatment for advanced hepatocellular carcinoma. A 70-year-old man was admitted to our hospital with fatigue, myalgia and an elevated creatine phosphokinase level. He was diagnosed as rhabdomyolysis related to sorafenib treatment for advanced hepatocellular carcinoma. After discontinuation of sorafenib, his fatigue and myalgia resolved and his creatine phosphokinase level returned to normal. Rhabdomyolysis related to sorafenib treatme...

  14. Concomitant lung metastasis in patients with advanced hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Tian Yang; Jun-Hua Lu; Chuan Lin; Song Shi; Ting-Hao Chen; Rong-Hua Zhao; Yi Wang; Meng-Chao Wu

    2012-01-01

    AIM:To investigate the clinical features and prognostic factors of advanced hepatocellular carcinoma (HCC) patients presenting with lung metastasis at initial diagnosis.METHODS:Between 2001 and 2010,we recruited 76consecutive HCC patients initially presenting with lung metastasis,without co-existing metastasis from other sites.These patients were divided into three groups:untreated group (n =22),single treatment group (n =19),and combined treatment group (n =35).RESULTS:Metastasis of bilateral lung lobes was common and noted in 35 patients (46.1%),and most of patients (59/76,77.6%) presented with multiple lung metastatic nodules.Nineteen patients (25.0%)received single-method treatment,including hepatectomy in 4,transcatheter arterial chemoembolization in 6,radiotherapy in 5,and oral sorafenib in 4.Thirty-five patients (46.1%) received combined treatment modalities.The overall median survival of the all patients was 8.7 ± 0.6 mo; 4.1 ± 0.3,6.3 ± 2.5 and 18.6 ± 3.9 mo,respectively in the untreated group,single treatment group and combined treatment group,respectively,with a significant difference (log-rank test,P < 0.001).Multivariate analysis revealed that Child-Pugh score,the absence or presence of portal vein tumor thrombus,and treatment modality were three independent prognostic factors affecting survival of patients with advanced HCC and concomitant lung metastasis.CONCLUSION:Combined treatment modalities tend to result in a better survival as compared with the conservative treatment or single treatment modality for HCC patients initially presenting with lung metastasis.

  15. SU-E-T-36: An Investigation of the Margin From CTV to PTV Using Retraction Method for Cervical Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Wu, D; Chen, J; Hao, Y; Liao, C; Huang, Y; Mo, Y; Wei, Y [The People' s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi (China)

    2014-06-01

    Purpose: This work employs the retraction method to compute and evaluate the margin from CTV to PTV based on the influence of target dosimetry of setup errors during cervical carcinoma patients treatment. Methods: Sixteen patients with cervical cancer were treated by Elekta synergy and received a total of 305 KV-CBCT images. The iso-center of the initial plans were changed according to the setup errors to simulate radiotherapy and then recalculated the dose distribution using leaf sequences and MUs for individual plans. The margin from CTV to PTV will be concluded both by the method of retracting (Fixed the PTV of the original plan, and retract PTV a certain distance defined as simulative organization CTVnx. The minimum distance value from PTV to CTVnx which get specified doses, namely guarantee at least 99% CTV volume can receive the dose of 95%, is the margin CTV to PTV we found) and the former formula method. Results: (1)The setup errors of 16 patients in X, Y and Z directions were(1.13±2.94) mm,(−1.63±7.13) mm,(−0.65±2.25) mm. (2) The distance between CTVx and PTV was 5, 9 and 3mm in X, Y and Z directions According to 2.5+0.7σ. (3) Transplantation plans displayed 99% of CTVx10- CTVx7 and received 95% of prescription dose, but CTVx6- CTVx3 departed from standard of clinic.In order to protect normal tissues, we selected 7mm as the minimum value of the margin from CTV to PTV. Conclusion: We have test an retraction method for the margin from CTV to PTV evaluation. The retraction method is more reliable than the formula method for calculating the margin from the CTV to the PTV, because it represented practice of treatment, and increasing a new method in this field.

  16. Primary radiotherapy of stage IIA/B-IIIB cervical carcinoma. A comparison of continuous versus sequential regimens

    International Nuclear Information System (INIS)

    Background: comprehensive literature on cervical cancer demonstrates, even today, the need for optimization of the timing of external-beam radiotherapy (EBRT) and high-dose-rate brachytherapy (HDR-BT) in the treatment of stage IIA/B-IIIB cervical carcinoma. Patients and methods: 210 patients with carcinoma of the cervix were treated in the Municipal Center of Oncoradiology between January 1991 and December 1996 (FIGO IIA: n = 10, FIGO IIB: n = 113, and FIGO IIIB: n = 87). Two regimens were compared: sequential radiation therapy (SRT) with 4 x 8 Gy HDR-BT to point A followed by EBRT, and continuous radiation therapy (CRT) in which 5 x 6 Gy HDR-BT to point A, one session per week, was integrated into the EBRT. A total dose of 68-70 Gy to point A and 52-54 Gy to point B was given in EBRT with SRT, five fractions per week were applied. Four fractions per week were applied in CRT, i.e., no EBRT was performed on the day of HDR-BT. Total doses to points A and B were identical in both regimens. Overall treatment time (OTT) amounted to 56 days for SRT and 35 days for CRT. Median follow-up time was 3.4 (2.5-4.2) years. Results: progression-free 5-year-survival (PFS) was 71% in the CRT and 56% in the SRT group. Nevertheless, this difference was not statistically significant (p = 1.00), and the same was found in a subgroup analysis of the different tumor stages, showing, however, an unequivocal trend. Late bladder and rectal injuries occurred in 13% and 25%, respectively. Late rectal injuries were significantly more frequent with SRT than CRT (35 patients in the SRT and 18 patients in the CRT group; p = 0.037). This was due to the higher doses per fraction of HDR-BT in the SRT group. No difference was found regarding late bladder injuries (p = 0.837). Conclusion: for the patients included in this study, no advantage has been found so far in using CRT, i.e., shortening the OTT by weekly integration of HDR-BT into EBRT. Nevertheless, an obvious trend exists. The dose of 8 Gy per

  17. Role of X-ray computed tomography in the evaluation of prognosis of cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Eiko (Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine)

    1991-02-01

    In 129 patients with cervical cancer, CT findings before treatment were analysed on the basis of the outcome during a 5 year follow-up period (75 survivals, and 54 deaths). The incidence of each CT finding in the two groups was as follows. (1) enlargement of the uterine cervix in 40.0% for survivals and 64.8% for deaths; (2) low density area in the cervix in 18.7% and 37.0%; (3) necrotic cavity in 4.0% and 33.3%; (4) pyometra in 8.0% and 31.5%; (5) irregular and indistinct margin of the cervix in 2.7% and 51.9%; (6) abnormal image of parametrium in 25.3% and 87.0%; (7) extension to the vagina in 2.7% and 37.0%; (8) extension toward the bladder in 8.0% and 57.4%; and (9) enlarged lymph node in 0% and 27.8%. CT scores obtained by multivariate analysis for prognostic discrimination of cervical cancer were +1 for (1), -1 for (2), +1 for (3), -3 for (4), +25 for (5), type B +29, C +25, D +10 for (6), +2 for (7), grade I +12, II +7, III +20 for (8), and +18 for (9). The discrimination ratio for the prognosis of cervical cancer was 82.9%. The score obtained by multivariate analysis showed significant increases according with the stage. Even in the same stage, there were significant differences between the scores for survivals and deaths (stage II: p<0.01, stage III: p<0.05). The survival period in the poor prognosis group was correlated with the score, especially when treated with radiotherapy (r=-0.45, p<0.01). (author).

  18. HPV Genotypes Predict Survival Benefits From Concurrent Chemotherapy and Radiation Therapy in Advanced Squamous Cell Carcinoma of the Cervix

    International Nuclear Information System (INIS)

    Purpose: To study the prognostic value of human papillomavirus (HPV) genotypes in patients with advanced cervical cancer treated with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT). Methods and Materials: Between August 1993 and May 2000, 327 patients with advanced squamous cell carcinoma of the cervix (International Federation of Gynecology and Obstetrics stage III/IVA or stage IIB with positive lymph nodes) were eligible for this study. HPV genotypes were determined using the Easychip® HPV genechip. Outcomes were analyzed using Kaplan-Meier survival analysis and the Cox proportional hazards model. Results: We detected 22 HPV genotypes in 323 (98.8%) patients. The leading 4 types were HPV16, 58, 18, and 33. The 5-year overall and disease-specific survival estimates for the entire cohort were 41.9% and 51.4%, respectively. CCRT improved the 5-year disease-specific survival by an absolute 9.8%, but this was not statistically significant (P=.089). There was a significant improvement in disease-specific survival in the CCRT group for HPV18-positive (60.9% vs 30.4%, P=.019) and HPV58-positive (69.3% vs 48.9%, P=.026) patients compared with the RT alone group. In contrast, the differences in survival with CCRT compared with RT alone in the HPV16-positive and HPV-33 positive subgroups were not statistically significant (P=.86 and P=.53, respectively). An improved disease-specific survival was observed for CCRT treated patients infected with both HPV16 and HPV18, but these differenced also were not statistically significant. Conclusions: The HPV genotype may be a useful predictive factor for the effect of CCRT in patients with advanced squamous cell carcinoma of the cervix. Verifying these results in prospective trials could have an impact on tailoring future treatment based on HPV genotype.

  19. HPV Genotypes Predict Survival Benefits From Concurrent Chemotherapy and Radiation Therapy in Advanced Squamous Cell Carcinoma of the Cervix

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Chun-Chieh [Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, School of Medicine, Taoyuan, Taiwan (China); Lai, Chyong-Huey [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Huang, Yi-Ting [Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Chao, Angel; Chou, Hung-Hsueh [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Hong, Ji-Hong, E-mail: jihong@adm.cgmh.org.tw [Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, School of Medicine, Taoyuan, Taiwan (China)

    2012-11-15

    Purpose: To study the prognostic value of human papillomavirus (HPV) genotypes in patients with advanced cervical cancer treated with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT). Methods and Materials: Between August 1993 and May 2000, 327 patients with advanced squamous cell carcinoma of the cervix (International Federation of Gynecology and Obstetrics stage III/IVA or stage IIB with positive lymph nodes) were eligible for this study. HPV genotypes were determined using the Easychip Registered-Sign HPV genechip. Outcomes were analyzed using Kaplan-Meier survival analysis and the Cox proportional hazards model. Results: We detected 22 HPV genotypes in 323 (98.8%) patients. The leading 4 types were HPV16, 58, 18, and 33. The 5-year overall and disease-specific survival estimates for the entire cohort were 41.9% and 51.4%, respectively. CCRT improved the 5-year disease-specific survival by an absolute 9.8%, but this was not statistically significant (P=.089). There was a significant improvement in disease-specific survival in the CCRT group for HPV18-positive (60.9% vs 30.4%, P=.019) and HPV58-positive (69.3% vs 48.9%, P=.026) patients compared with the RT alone group. In contrast, the differences in survival with CCRT compared with RT alone in the HPV16-positive and HPV-33 positive subgroups were not statistically significant (P=.86 and P=.53, respectively). An improved disease-specific survival was observed for CCRT treated patients infected with both HPV16 and HPV18, but these differenced also were not statistically significant. Conclusions: The HPV genotype may be a useful predictive factor for the effect of CCRT in patients with advanced squamous cell carcinoma of the cervix. Verifying these results in prospective trials could have an impact on tailoring future treatment based on HPV genotype.

  20. Intra-Arterial Chemotherapy with Doxorubicin and Cisplatin Is Effective for Advanced Hepatocellular Cell Carcinoma

    OpenAIRE

    Ming-Chun Ma; Yen-Yang Chen; Shau-Hsuan Li; Yu-Fan Cheng; Chih-Chi Wang; Tai-Jan Chiu; Sung-Nan Pei; Chien-Ting Liu; Tai-Lin Huang; Chen-Hua Huang; Yu-Li Su; Yen-Hao Chen; Sheng-Nan Lu; Kun-Ming Rau

    2014-01-01

    Advanced hepatocellular carcinoma (HCC) remains a fatal disease even in the era of targeted therapies. Intra-arterial chemotherapy (IACT) can provide therapeutic benefits for patients with locally advanced HCC who are not eligible for local therapies or are refractory to targeted therapies. The aim of this retrospective study was to analyze the effect of IACT with cisplatin and doxorubicin on advanced HCC. Methods. Patients with advanced HCC who were not eligible for local therapies or were r...

  1. Multiparameter fluorescence mapping of nonprotein sulfhydryl status in relation to blood vessels and hypoxia in cervical carcinoma xenografts

    International Nuclear Information System (INIS)

    Purpose: Aberrant architecture of the tumor vasculature and temporal fluctuations in blood flow can result in tumor hypoxia. The aim of this study was to classify tumor hypoxia based on distance to blood vessels, and to characterize its biologic significance by determining levels of nonprotein sulfhydryls (NPSH) in hypoxic regions located proximally and distally to tumor blood vessels. Methods and Materials: A dual fluorescence method was developed for the spatial colocalization of the vasculature and hypoxia in frozen sections from SiHa cervical carcinoma xenografts. A parallel section was stained with the sulfhydryl stain mercury orange. Composite fluorescence images were generated by imaging and tiling individual fields of view into 2D image arrays. Image arithmetic techniques were combined with feature-based image segmentation to characterize expression of NPSH as a function of the hypoxic tumor microenvironment. Results: NPSH levels were higher in hypoxic areas of the SiHa xenografts (15.1±0.5 vs. 13.5±0.5 integrated optical density [IOD], p<0.03). When tumor hypoxia was classified by distance to the nearest visible blood vessel, significantly higher NPSH levels were found in hypoxic regions close to blood vessels than in regions at a distance from blood vessels. Conclusion: The results of this study indicate differential expression of NPSH levels in regions of hypoxia that are proximal or distal to blood vessels in SiHa tumors

  2. Anti-tumor Effects of a Recombinant Fowlpox Virus Expressing Apoptin on Human Cervical Carcinoma in Vivo and in Vitro

    Institute of Scientific and Technical Information of China (English)

    ZHU Ji-hong; JIN Ning-yi; LI Xiao; SUN Li-li; ZHANG Mu-chun; KAN Shi-fu; LIU Lei; HUANG Hai-yan; YANG Guo-hua; PIAO Bing-guo

    2011-01-01

    Apoptin is a chicken anemia virus-derived,p53-independent,bcl-2-insensitive apoptotic protein with the ability to specifically induce apoptosis of various human tumor cells,but not of normal diploid cells.To explore the application of apoptin in tumor gene therapy,we used a recombinant fowlpox virus expressing apoptin protein (vFV-Apoptin) to investigate the anti-tumor effectes of vFV-Apoptin on human cervical carcinoma(HeLa) cells in vivo and in vitro through 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide(MTT) assay,acridine orage/ethidium bromide(AO/EB) and annexin V staining test,respectively.The results show that vFV-Apoptin inhibites the proliferation of HeLa cells in vitro through inducing the apoptosis of HeLa cells,and the inhibition effect of vFV-Apoptin has a dose-effect and time-effect relationship.The results of animal models show that vFV-Apoptin significantly inhibits tumor growth,extends the lifespan of animals and improves the mean survival.Experimental results indicate that vFV-Apoptin has a potential application in the tumor gene therapy.

  3. Positron emission tomography scan for predicting clinical outcome of patients with recurrent cervical carcinoma following radiation therapy

    Directory of Open Access Journals (Sweden)

    Daya Nand Sharma

    2012-01-01

    Materials and Methods: Twenty two patients of post irradiated recurrent cervical carcinoma (PIRCC were enrolled in this prospective study. 18-fluorodeoxyglucose (FDG PET imaging was performed in each patient before the salvage therapy. The maximum standardized uptake value (SUVmax and metabolic tumor volume (MTV were measured and correlated with cumulative progression free survival (PFS. Results: Median age of patients was 42 years. Majority of patients had stage III disease at the initial presentation and all 22 patients had received prior definitive RT. The median recurrence free period was 11 months. Salvage therapy consisted of surgical resection or re-irradiation depending upon the various clinical and radiological factors. Median SUVmax was 5.8 (range 1.8-50.6 and median MTV was 43 cm 3 (range 5.8-243. The cumulative PFS for all patients was 20% at 30 months. The one-year PFS was 28% for patients with SUVmax value of >5.8 versus 42% for those with SUVmax value of 43 cm 3 versus 45% for those with MTV value of <43 cm 3 (P value 0.8. Conclusion: Our preliminary experience has suggested that FDG uptake on PET scan can predict the clinical outcome of PIRCC patients. Further randomized studies may be conducted with large sample size and longer follow up to establish its definite predictive value.

  4. Whole abdominal irradiation following chemotherapy in advanced ovarian carcinoma

    International Nuclear Information System (INIS)

    One hundred and sixteen patients with advanced ovarian carcinoma, who underwent primary cytoreductive surgery, received 6-11 courses of chemotherapy by cis-platin (50 mg/m2) and adriamycin (50 mg/m2) every 21 days. This was followed by second look laparotomy in 66 patients with no clinical evidence of disease. Consolidation abdominal irradiation was administered to 43 patients. Two techniques of irradiation were employed: between 1980-1983 whole abdominal irradiation was used and patients were to receive 3000 cGy in 4 weeks (Schedule I). Due to myelosuppression only 13 of 26 patients (50%) completed the planned dose of radiation. Between 1983-1985 the target volume was divided into upper and lower parts. First, the lower abdomen received 3000 cGy in 3 weeks, and then the upper abdomen received the same dose (Schedule II). Sixteen of seventeen patients (94%) thus treated, completed the planned dose of radiation. The actuarial survival for all 116 patients was 28% of 5 years. Irradiated patients with negative second look laparotomy had a survival probability of 100% at 24 months. Irradiated patients with microscopic disease at second look operation had an actuarial 5-year survival of 66%. Patients with minimal residual disease at second look laparotomy, receiving consolidation abdominal irradiation, had an actuarial survival of 5% only at 36 months. It is concluded that consolidation radiotherapy is effective in patients with negative or microscopic residual disease at second-look laparotomy. In regard to bone marrow tolerance, split field technique of irradiation is preferred

  5. Ploidy, cytokinetics, and histology features of aggressive versus less aggressive uterine cervical squamous cell carcinomas

    International Nuclear Information System (INIS)

    The authors are investigating the interrelationships of flow cytometric measured ploidy, S-fraction with histology features of uterine cervical squamous cell cancers in an attempt to identify aggressive, high risk tumors and less aggressive tumors. Experimentally, pre-radiotherapy biopsy specimens are being studied using flow ploidy and cell-cycle analysis and microscopic scoring for histology features. The results to date for some 200 patients indicate that there are identifyable aggressive tumors, at high risk for 2 yr local control within each stage of disease and differentiation category (WD, MD, PD). These aggressive tumors usually have high degree DNA abnormalities (triploid or greater), high proliferative activity (%S≥20) compared to the less aggressive tumors characterized by diploid/near diploid DNA content, low to moderate %S (2-19, mean 12). Expression of high S-fraction appears to reflect high growth activity or growth potential and characterizes the aggressive tumors

  6. Influence of chromosomal integration on glucocorticoid-regulated transcription of growth-stimulating papillomavirus genes E6 and E7 in cervical carcinoma cells

    International Nuclear Information System (INIS)

    In most cervical carcinoma cells the E6 and E7 genes of specific human papillomaviruses are transcribed from viral sequences integrated into host cell chromosomes. Glucocorticoids activate the promoter elements of various human papillomaviruses in transient-expression assays. The authors have analyzed the effect of dexamethasone on the transcription rate of human papillomaviruses 18 E6 and E7 genes integrated at different chromosomal sites in four cervical cancer cell lines. Dexamethasone led to an increase in the transcription rate of the integrated E6-E7 sequences in C4-1 and C4-2 cells but led to a decrease in SW 756 cells and did not affect the transcription rate in HeLa cells. It thus appears that dominant regulatory mechanisms presumably depending on the chromosomal integration site are able to override the response of the viral promoter to steroid hormones. The growth rate of all dexamethasone-treated cell lines correlated consistently with the expression of the papillomavirus E6 and E7 genes, supporting their role in the maintenance of the proliferative phenotype of cervical carcinoma cells. Since human papillomaviruses are integrated into the host cell genome at variable, presumably randomly selected chromosomal loci, regulatory mechanisms that influence viral gene expression, and hence cell growth, may differ among cancers of independent clonal origin

  7. Influence of chromosomal integration on glucocorticoid-regulated transcription of growth-stimulating papillomavirus genes E6 and E7 in cervical carcinoma cells

    Energy Technology Data Exchange (ETDEWEB)

    Von Knebel Doeberitz, M.; Bauknecht, T.; Bartsch, D.; Zur Hausen, H. (Inst. fur Virusforshung/ATV, Heidelberg (West Germany))

    1991-02-15

    In most cervical carcinoma cells the E6 and E7 genes of specific human papillomaviruses are transcribed from viral sequences integrated into host cell chromosomes. Glucocorticoids activate the promoter elements of various human papillomaviruses in transient-expression assays. The authors have analyzed the effect of dexamethasone on the transcription rate of human papillomaviruses 18 E6 and E7 genes integrated at different chromosomal sites in four cervical cancer cell lines. Dexamethasone led to an increase in the transcription rate of the integrated E6-E7 sequences in C4-1 and C4-2 cells but led to a decrease in SW 756 cells and did not affect the transcription rate in HeLa cells. It thus appears that dominant regulatory mechanisms presumably depending on the chromosomal integration site are able to override the response of the viral promoter to steroid hormones. The growth rate of all dexamethasone-treated cell lines correlated consistently with the expression of the papillomavirus E6 and E7 genes, supporting their role in the maintenance of the proliferative phenotype of cervical carcinoma cells. Since human papillomaviruses are integrated into the host cell genome at variable, presumably randomly selected chromosomal loci, regulatory mechanisms that influence viral gene expression, and hence cell growth, may differ among cancers of independent clonal origin.

  8. Clinical efficacy of FDG-PET scan in the patients with primary or recurrent gynecologic malignancies: clinical experiences with FDG-PET scan in cervical carcinoma of uterus

    International Nuclear Information System (INIS)

    This study was done to evaluate the clinical feasibility of FDG-PET scan in patients with cervical carcinoma. PET-scans were performed in 74 patients with cervical carcinoma from March, 1998 to September, 1998. Fourteen cases were done at pretreatment period and sixty cases were done at post-treatment follow up period. In this study, the scans were obtained after bladder emptying by foley catheter insertion and diuretics to reduce the tracer activity in the bladder and improve the images of central lesions. We could find some incidental recurrent or metastatic lesions by FDG-PET scan (at pretreatment; 5 cases, at post-treatment; clinically no evidence of disease; 8 cases). FDG-PET scan had high sensitivity (100%) for central lesions and metastatic lymph nodes of cervical cancer but could not precisely define the anatomic location of the cancer and the sensitivity was not superior than MRI. Earlier detection of metastatic lymph nodes was superior than CT/MRI (sensitivity; 100 %) for metastatic lymph nodes. Also we found 3 double primary cancers incidentally (2 lung cancers and 1 thyroid cancer). In conclusion, FDG-FET scan might be useful for the earlier of hidden lesions that cannot be detected by routine conventional methods and differential diagnosis with radiation fibrosis and benign lymph adenophy

  9. Clinical efficacy of FDG-PET scan in the patients with primary or recurrent gynecologic malignancies: clinical experiences with FDG-PET scan in cervical carcinoma of uterus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1998-12-01

    This study was done to evaluate the clinical feasibility of FDG-PET scan in patients with cervical carcinoma. PET-scans were performed in 74 patients with cervical carcinoma from March, 1998 to September, 1998. Fourteen cases were done at pretreatment period and sixty cases were done at post-treatment follow up period. In this study, the scans were obtained after bladder emptying by foley catheter insertion and diuretics to reduce the tracer activity in the bladder and improve the images of central lesions. We could find some incidental recurrent or metastatic lesions by FDG-PET scan (at pretreatment; 5 cases, at post-treatment; clinically no evidence of disease; 8 cases). FDG-PET scan had high sensitivity (100%) for central lesions and metastatic lymph nodes of cervical cancer but could not precisely define the anatomic location of the cancer and the sensitivity was not superior than MRI. Earlier detection of metastatic lymph nodes was superior than CT/MRI (sensitivity; 100 %) for metastatic lymph nodes. Also we found 3 double primary cancers incidentally (2 lung cancers and 1 thyroid cancer). In conclusion, FDG-FET scan might be useful for the earlier of hidden lesions that cannot be detected by routine conventional methods and differential diagnosis with radiation fibrosis and benign lymph adenophy.

  10. Comparative Efficacy of Cisplatin vs. Gemcitabine as Concurrent Chemotherapy for Untreated Locally Advanced Cervical Cancer: A Randomized Trail

    Directory of Open Access Journals (Sweden)

    Dr. Manoj Srivastava

    2007-01-01

    Full Text Available Cisplatin based chemo-radiation is considered the standard of care for most patients with locally advanced cervical cancer. Gemcitabine is a new pyrimidire analogue with high radio sensitizing potency in vitro. This study was undertaken to compare the anti-tumor activity and toxicity of the two drugs. It is a prospective randomized study of 60 patients histologically confirmed locally advanced cervical cancer, FIGO stage IIB - IIIB with no previous treatment. Patients were randomized to receive either weekly Cisplatin 40mg/m2 intravenously or Gemcitabine 100mg/m2 intravenously for 5 cycles concurrent with external beam radiation therapy 50Gy/25# as 5# / weeks, followed by single application of medium does rate intracavitory brachytherapy to deliver 20 Gy at point A, 2 weeks after completion of external beam radiation therapy (EBRT. Toxicity was graded according to WHO criteria. Both subjective and objective responses were measured six weeks after completion of treatment. In Cisplatin arm 28/30 (93.33% patients showed complete clinical regression of tumor whereas in Gemcitabine arm only 21/30 (70% patients showed complete clinical response. Thus immediate response was significantly higher in the cisplatin group as compared to the gemcitabine group (p=0.01. All toxicities except nausea and vomiting were more common and severe in patients receiving Gemcitabine with radiation. To conclude, Cisplatin appears to be better than Gemcitabine when used as a radio sensitizer for untreated locally advanced cervical cancer in terms of response and toxicity.

  11. Retrospective analysis on prognostic impact of adjuvant chemotherapy in the patients with advanced and resectable oral squamous cell carcinoma

    International Nuclear Information System (INIS)

    The effect of adjuvant chemotherapy on oral squamous cell carcinoma (SCC) is unclear mainly because there have been a few studies which evaluate the efficacy of adjuvant chemotherapy. The purpose of this retrospective study was to analyze the efficacy of adjuvant chemotherapy in the patients with advanced and resectable oral SCC. Forty-one patients in whom advanced SCC (stage III and IV) was completely removed were included in this study. The impact of multiple variables including T-classification, degree of differentiation, mode of invasion, number and level of cervical metastatic node, pre- and post-operative radiation therapy, neoadjuvant chemotherapy, and adjuvant chemotherapy on survival and control of local relapse or distant metastasis was assessed using the stepwise Cox proportional hazards model. The level of neck node metastasis (p<0.02) was a significant independent predictor for cause-specific survival and adjuvant chemotherapy was of borderline significance (p=0.07). The number of neck node metastasis (p<0.01) and adjuvant chemotherapy (p<0.01) were significantly related with disease free survival. The results of this retrospective study suggested that adjuvant chemotherapy had a significant benefit in improving disease free survival. (author)

  12. OCCULT CERVICAL METASTASIS OF SQUAMOUS CELL CARCINOMA OF TONGUE AMONG CN0 PATIENTS AND ITS TREATMENT

    Institute of Scientific and Technical Information of China (English)

    WEI Yuan-jian; HU Shun-guang; LIAO Gui-qing; GUO Hai-peng; LIN Jia-xu; QIU Yue-yan

    2005-01-01

    Objective: To explore the treatment of clinically negative neck (CN0) patients with squamous cell carcinoma of the tongue. Methods: 165 CN0 patients with squamous cell carcinoma of the tongue from 1985 to 2002 were investigated retrospectively. Parts of the patients staged at T1, T2 and T3 underwent resection of primary lesion followed by neck observation, and other patients staged above T2 or at T1 but without follow-up were treated with elective neck dissection (END). All patients were followed up for more than 3 y or until their death. Results: Lymphatic metastasis was identified histologically after operation in 33 of 120 patients treated with END, and 9 of 45 patients treated with resection of primary lesion alone. The overall rate of occult lymphatic metastasis was 25.45%, which increased with the elevating of clinical T stage. The overall rate of neck uncontrolled death was 20.00% for observation group and 5.00% for END group, and significant difference was found between them (P<0.05). For T1 patients in the two groups, the rate of neck uncontrolled death was 7.71% and 4.00% respectively, and no significance was found between them (P>0.05). When stage T2 and T3 were considered as middle stage together, significant difference (P<0.05) could be obtained between observation (70.00%) and END group (0%). Conclusion: The occult metastasis rate of squamous cell carcinoma of tongue increases with the elevating of clinical stage, and elective neck dissection could be considered for N0 patients staged over T2 to improve neck control and survival rate; and regional resection alone of primary lesion could be considered for T1N0 patients to improve quality of life if closely followed up is conducted.

  13. Severe reversible toxic encephalopathy induced by cisplatin in a patient with cervical carcinoma receiving combined radiochemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sterzing, F.; Grehn, C.; Dinkel, J.; Krempien, R.; Hartung, G.; Debus, J.; Harms, W. [University of Heidelberg Medical School (Germany). Dept. of Radiation Oncology

    2007-09-15

    Case Report: A 45-year-old patient with cervix carcinoma received combined radiochemotherapy including cisplatin. After a cumulative dose of 240 mg/m{sup 2} the patient suddenly became somnolent and developed a severe tetraparesis and generalized seizures. After ruling out intracranial bleeding, cerebral metastases as well as infectious and metabolic causes of this condition, a severe toxic encephalopathy was diagnosed based on the clinical findings and MRI scans. After symptomatic treatment on the intensive care unit all symptoms were completely reversible. Conclusion: Toxic encephalopathy is a rare but dramatic complication of various cytostatic drugs. With the widespread use of cisplatin this rare disorder should be kept in mind. (orig.)

  14. Transcript Profiling Distinguishes Complete Treatment Responders With Locally Advanced Cervical Cancer1234

    Science.gov (United States)

    Fernandez-Retana, Jorge; Lasa-Gonsebatt, Federico; Lopez-Urrutia, Eduardo; Coronel-Martínez, Jaime; Cantu De Leon, David; Jacobo-Herrera, Nadia; Peralta-Zaragoza, Oscar; Perez-Montiel, Delia; Reynoso-Noveron, Nancy; Vazquez-Romo, Rafael; Perez-Plasencia, Carlos

    2015-01-01

    Cervical cancer (CC) mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC) have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to the conventional treatment employed to treat LACC. Tumor biopsies were profiled with genome-wide high-density expression microarrays. Class prediction was performed in tumor tissues and the resultant gene signature was validated by quantitative reverse transcription–polymerase chain reaction. A 27-predictive gene profile was identified through its association with pathologic response. The 27-gene profile was validated in an independent set of patients and was able to distinguish between patients diagnosed as no response versus complete response. Gene expression analysis revealed two distinct groups of tumors diagnosed as LACC. Our findings could provide a strategy to select patients who would benefit from neoadjuvant radiochemotherapy-based treatment. PMID:25926073

  15. Transcript profiling distinguishes complete treatment responders with locally advanced cervical cancer.

    Science.gov (United States)

    Fernandez-Retana, Jorge; Lasa-Gonsebatt, Federico; Lopez-Urrutia, Eduardo; Coronel-Martínez, Jaime; Cantu De Leon, David; Jacobo-Herrera, Nadia; Peralta-Zaragoza, Oscar; Perez-Montiel, Delia; Reynoso-Noveron, Nancy; Vazquez-Romo, Rafael; Perez-Plasencia, Carlos

    2015-04-01

    Cervical cancer (CC) mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC) have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to the conventional treatment employed to treat LACC. Tumor biopsies were profiled with genome-wide high-density expression microarrays. Class prediction was performed in tumor tissues and the resultant gene signature was validated by quantitative reverse transcription-polymerase chain reaction. A 27-predictive gene profile was identified through its association with pathologic response. The 27-gene profile was validated in an independent set of patients and was able to distinguish between patients diagnosed as no response versus complete response. Gene expression analysis revealed two distinct groups of tumors diagnosed as LACC. Our findings could provide a strategy to select patients who would benefit from neoadjuvant radiochemotherapy-based treatment. PMID:25926073

  16. Transcript Profiling Distinguishes Complete Treatment Responders With Locally Advanced Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Jorge Fernandez-Retana

    2015-04-01

    Full Text Available Cervical cancer (CC mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to the conventional treatment employed to treat LACC. Tumor biopsies were profiled with genome-wide high-density expression microarrays. Class prediction was performed in tumor tissues and the resultant gene signature was validated by quantitative reverse transcription–polymerase chain reaction. A 27-predictive gene profile was identified through its association with pathologic response. The 27-gene profile was validated in an independent set of patients and was able to distinguish between patients diagnosed as no response versus complete response. Gene expression analysis revealed two distinct groups of tumors diagnosed as LACC. Our findings could provide a strategy to select patients who would benefit from neoadjuvant radiochemotherapy-based treatment.

  17. Rigosertib Is a More Effective Radiosensitizer Than Cisplatin in Concurrent Chemoradiation Treatment of Cervical Carcinoma, In Vitro and In Vivo

    International Nuclear Information System (INIS)

    Purpose: To compare rigosertib versus cisplatin as an effective radiosensitizing agent for cervical malignancies. Methods and Materials: Rigosertib and cisplatin were tested in cervical cancer cell lines, HeLa and C33A. A 24-hour incubation with rigosertib and cisplatin, before irradiation (2-8 Gy), was used for clonogenic survival assays. Cell cycle analysis (propidium iodide staining) and DNA damage (γ-H2AX expression) were evaluated by fluorescence-activated cell sorter cytometry. Rigosertib was also tested in vivo in tumor growth experiments on cervical cancer xenografts. Results: Rigosertib was demonstrated to induce a G2/M block in cancer cells. Survival curve comparison revealed a dose modification factor, as index of radiosensitization effect, of 1.1-1.3 for cisplatin and 1.4-2.2 for rigosertib. With 6-Gy irradiation, an increase in DNA damage of 15%-25% was achieved in both HeLa and C33A cells with cisplatin pretreatment, and a 71-108% increase with rigosertib pretreatment. In vivo tumor growth studies demonstrated higher performance of rigosertib when compared with cisplatin, with 53% longer tumor growth delay. Conclusions: Rigosertib was more effective than cisplatin when combined with radiation and caused minimal toxicity. These data support the need for clinical trials with rigosertib in combination therapy for patients with cervical carcinoma

  18. HPV16-E2 induces prophase arrest and activates the cellular DNA damage response in vitro and in precursor lesions of cervical carcinoma.

    Science.gov (United States)

    Xue, Yuezhen; Toh, Shen Yon; He, Pingping; Lim, Thimothy; Lim, Diana; Pang, Chai Ling; Abastado, Jean-Pierre; Thierry, Françoise

    2015-10-27

    Cervical intraepithelial neoplasia (CIN) is caused by human papillomavirus (HPV) infection and is the precursor to cervical carcinoma. The completion of the HPV productive life cycle depends on the expression of viral proteins which further determines the severity of the cervical neoplasia. Initiation of the viral productive replication requires expression of the E2 viral protein that cooperates with the E1 viral DNA helicase. A decrease in the viral DNA replication ability and increase in the severity of cervical neoplasia is accompanied by simultaneous elevated expression of E6 and E7 oncoproteins. Here we reveal a novel and important role for the HPV16-E2 protein in controlling host cell cycle during malignant transformation. We showed that cells expressing HPV16-E2 in vitro are arrested in prophase alongside activation of a sustained DDR signal. We uncovered evidence that HPV16-E2 protein is present in vivo in cells that express both mitotic and DDR signals specifically in CIN3 lesions, immediate precursors of cancer, suggesting that E2 may be one of the drivers of genomic instability and carcinogenesis in vivo. PMID:26474276

  19. Analysis of the prognostic impact of tumor embolization before definitive radiotherapy for cervical carcinoma

    International Nuclear Information System (INIS)

    Purpose To assess whether embolization compromises the radiocurability of primary cervical cancer. Methods and Materials Two hundred fifty-four patients with primary cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stages IB: 47; II: 91; IIIB: 102; IV: 14) were treated with external beam irradiation and Ir-192 high-dose-rate brachytherapy over a period of 15 years. Of these, 24 patients (9.4%) (FIGO stages IB: 1; II: 8; IIIB: 12; IV: 3) had had bilateral embolization of the internal iliac arteries before referral. The median age of the entire cohort was 66 years (range, 34-85 years). Tumor size was >5 cm and paraortic nodes were enlarged (≥1 cm) on pretreatment CAT scan in 39.4% and 9.1% of patients, respectively. All patients with hemoglobin levels (hb-l) ≤11g/dL (28.3%) received packed red cell transfusions (PRCT) before and/or during radiotherapy in an attempt to maintain levels >11g/dL throughout treatment. Cross-table tests were used to compare the distribution of FIGO stage, tumor size, lymph node status, and pretreatment and treatment hb-l of embolized and nonembolized patients. The impact of embolization, along with the above-listed tumor characteristics, on disease-specific survival (DSS), pelvic control (PC), and distant metastases-free survival (MFS) was determined by univariate and multivariate analyses. Results Embolized patients presented at a statistically significant younger median age (55 vs. 67 years; p = 0.003), with larger tumors (66.7% vs. 36.5%; p = 0.007), and lower pretreatment hb-l (75% vs. 23.5%; p < 0.001) than nonembolized patients. There was no significant difference in stage distribution or lymph node status, and although embolized patients responded better to PRCT (50% vs. 29.6%), this difference was not statistically significant. Univariate analysis showed a trend toward decreased DSS (p = 0.09) and PC (p = 0.07) for embolized patients but no effect on MFS, whereas all other variables tested were

  20. Intensity Modulated Proton Beam Radiation for Brachytherapy in Patients With Cervical Carcinoma

    International Nuclear Information System (INIS)

    Purpose: To evaluate intensity modulated proton therapy (IMPT) in patients with cervical cancer in terms of coverage, conformity, and dose–volume histogram (DVH) parameters correlated with recommendations from magnetic resonance imaging (MRI)-guided brachytherapy. Methods and Materials: Eleven patients with histologically proven cervical cancer underwent primary chemoradiation for the pelvic lymph nodes, the uterus, the cervix, and the parametric region, with a symmetric margin of 1 cm. The prescription was for 50.4 Gy, with 1.8 Gy per fraction. The prescribed dose to the parametria was 2.12 Gy up to 59.36 Gy in 28 fractions as a simultaneous boost. For several reasons, the patients were unable to undergo brachytherapy. As an alternative, IMPT was planned with 5 fractions of 6 Gy to the cervix, including the macroscopic tumor with an MRI-guided target definition, with an isotropic margin of 5 mm for planning target volume (PTV) definition. Groupe-Europeen de Curietherapie and European society for Radiotherapy and Oncology (GEC-ESTRO) criteria were used for DVH evaluation. Reference comparison plans were optimized for volumetric modulated rapid arc (VMAT) therapy with the RapidArc (RA). Results: The dose to the high-risk volume was calculated with α/β = 10 with 89.6 Gy. For IMPT, the clinical target volume showed a mean dose of 38.2 ± 5.0 Gy (35.0 ±1.8 Gy for RA). The D98% was 31.9 ± 2.6 Gy (RA: 30.8 ± 1.0 Gy). With regard to the organs at risk, the 2Gy Equivalent Dose (EQD2) (α/β = 3) to 2 cm3 of the rectal wall, sigmoid wall, and bladder wall was 62.2 ± 6.4 Gy, 57.8 ± 6.1 Gy, and 80.6 ± 8.7 Gy (for RA: 75.3 ± 6.1 Gy, 66.9 ± 6.9 Gy, and 89.0 ± 7.2 Gy, respectively). For the IMPT boost plans in combination with external beam radiation therapy, all DVH parameters correlated with <5% risk for grades 2 to 4 late gastrointestinal and genitourinary toxicity. Conclusion: In patients who are not eligible for brachytherapy, IMPT as a boost technique

  1. Intensity Modulated Proton Beam Radiation for Brachytherapy in Patients With Cervical Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Clivio, Alessandro [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Kluge, Anne [Department of Radiation Oncology, Charité University Hospital, Berlin (Germany); Cozzi, Luca, E-mail: lucozzi@iosi.ch [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Köhler, Christhardt [Department of Gynecology, Charité University Hospital, Berlin (Germany); Neumann, Oliver [Department of Radiation Oncology, Charité University Hospital, Berlin (Germany); Vanetti, Eugenio [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Wlodarczyk, Waldemar; Marnitz, Simone [Department of Radiation Oncology, Charité University Hospital, Berlin (Germany)

    2013-12-01

    Purpose: To evaluate intensity modulated proton therapy (IMPT) in patients with cervical cancer in terms of coverage, conformity, and dose–volume histogram (DVH) parameters correlated with recommendations from magnetic resonance imaging (MRI)-guided brachytherapy. Methods and Materials: Eleven patients with histologically proven cervical cancer underwent primary chemoradiation for the pelvic lymph nodes, the uterus, the cervix, and the parametric region, with a symmetric margin of 1 cm. The prescription was for 50.4 Gy, with 1.8 Gy per fraction. The prescribed dose to the parametria was 2.12 Gy up to 59.36 Gy in 28 fractions as a simultaneous boost. For several reasons, the patients were unable to undergo brachytherapy. As an alternative, IMPT was planned with 5 fractions of 6 Gy to the cervix, including the macroscopic tumor with an MRI-guided target definition, with an isotropic margin of 5 mm for planning target volume (PTV) definition. Groupe-Europeen de Curietherapie and European society for Radiotherapy and Oncology (GEC-ESTRO) criteria were used for DVH evaluation. Reference comparison plans were optimized for volumetric modulated rapid arc (VMAT) therapy with the RapidArc (RA). Results: The dose to the high-risk volume was calculated with α/β = 10 with 89.6 Gy. For IMPT, the clinical target volume showed a mean dose of 38.2 ± 5.0 Gy (35.0 ±1.8 Gy for RA). The D{sub 98%} was 31.9 ± 2.6 Gy (RA: 30.8 ± 1.0 Gy). With regard to the organs at risk, the 2Gy Equivalent Dose (EQD2) (α/β = 3) to 2 cm{sup 3} of the rectal wall, sigmoid wall, and bladder wall was 62.2 ± 6.4 Gy, 57.8 ± 6.1 Gy, and 80.6 ± 8.7 Gy (for RA: 75.3 ± 6.1 Gy, 66.9 ± 6.9 Gy, and 89.0 ± 7.2 Gy, respectively). For the IMPT boost plans in combination with external beam radiation therapy, all DVH parameters correlated with <5% risk for grades 2 to 4 late gastrointestinal and genitourinary toxicity. Conclusion: In patients who are not eligible for brachytherapy, IMPT as a boost

  2. SHORT-TIME ANALYSIS FOR ADJUVANT CHEMOTHERAPY IN PATIENTS WITH EARLY-STAGE BULKY CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    令狐华; 徐小蓉; 梅耀宇; 唐均英; 唐良萏; 孙彤

    2003-01-01

    Objective: To investigate the effect of adjuvant chemotherapy on early stage cervical cancer with bulky tumor. Methods: Between Mar 1998 and Aug 2002, 162 patients of cervical cancer with Ib~IIa stage were investigated. 21 patients with bulky tumors (≥4cm) were managed by cisplatin-based chemotherapy followed by radical hysterectomy and pelvic lymphadenectomy (Bulky-chemo group, BC group). The change of tumor size, the depth of stromal invasion, lymph node metastasis and the involvement of surgical specimens were assessed after operation and compared with those in 57 patients with bulky tumors (Bulky-nonchemo group, BN group) and 84 patients with the tumor size less than 4cm (small group, S group) who underwent surgery as the first step of treatment. Chemotherapy with the same regimen was offered for another 1~2 cycles after operation and the survival situation was followed up. Results: The tumor size of 21 patients in BC group were decreased to varying degrees after chemotherapy, 15 patients were shown as clinical effectiveness (71.43%). And the blood loss during operation (352.35(19.01ml) was significantly lower than that in BN group (619.05(35.58ml), t=4.37) and that in S group (568.07(45.23ml, t=3.36) patients. The incidence of lymph node metastasis (9/78) in patients with bulky tumors was greatly higher than those with tumor size less than 4cm (3/84, X2=4.416); its prevalence rate of deep wall infiltration (8/78) was also higher than that of the latter group (2/84), while with no statistical significance (X2=3.089). Histology showed that there was no case of marginal involvement in all patients. The ratio of both deep stromal invasion (1/21) and positive lymph node (2/21) in BC group was lower than that in BN group (7/57, 7/57 respectively), but neither with statistical significance (X2=0.0103 and 0.8193 respectively). Conclusion: Pre-operative chemotherapy can improve decreasing the primary tumor size and facilitate the following radical surgery. While

  3. Prediction of clinical toxicity in localized cervical carcinoma by radio-induced apoptosis study in peripheral blood lymphocytes (PBLs)

    International Nuclear Information System (INIS)

    Cervical cancer is treated mainly by surgery and radiotherapy. Toxicity due to radiation is a limiting factor for treatment success. Determination of lymphocyte radiosensitivity by radio-induced apoptosis arises as a possible method for predictive test development. The aim of this study was to analyze radio-induced apoptosis of peripheral blood lymphocytes. Ninety four consecutive patients suffering from cervical carcinoma, diagnosed and treated in our institution, and four healthy controls were included in the study. Toxicity was evaluated using the Lent-Soma scale. Peripheral blood lymphocytes were isolated and irradiated at 0, 1, 2 and 8 Gy during 24, 48 and 72 hours. Apoptosis was measured by flow cytometry using annexin V/propidium iodide to determine early and late apoptosis. Lymphocytes were marked with CD45 APC-conjugated monoclonal antibody. Radiation-induced apoptosis (RIA) increased with radiation dose and time of incubation. Data strongly fitted to a semi logarithmic model as follows: RIA = βln(Gy) + α. This mathematical model was defined by two constants: α, is the origin of the curve in the Y axis and determines the percentage of spontaneous cell death and β, is the slope of the curve and determines the percentage of cell death induced at a determined radiation dose (β = ΔRIA/Δln(Gy)). Higher β values (increased rate of RIA at given radiation doses) were observed in patients with low sexual toxicity (Exp(B) = 0.83, C.I. 95% (0.73-0.95), p = 0.007; Exp(B) = 0.88, C.I. 95% (0.82-0.94), p = 0.001; Exp(B) = 0.93, C.I. 95% (0.88-0.99), p = 0.026 for 24, 48 and 72 hours respectively). This relation was also found with rectal (Exp(B) = 0.89, C.I. 95% (0.81-0.98), p = 0.026; Exp(B) = 0.95, C.I. 95% (0.91-0.98), p = 0.013 for 48 and 72 hours respectively) and urinary (Exp(B) = 0.83, C.I. 95% (0.71-0.97), p = 0.021 for 24 hours) toxicity. Radiation induced apoptosis at different time points and radiation doses fitted to a semi logarithmic model defined

  4. Neoadjuvant Chemotherapy for Locally Advanced Squamous Carcinoma of Oral Cavity: a Pilot Study.

    OpenAIRE

    Sanambar Sadighi; Amanolah Keyhani; Iraj Harirchi; Ata Garajei; Mahdi Aghili; Ali Kazemian; Maziar Motiee Langroudi; Kazem Zendehdel; Nariman Nikparto

    2015-01-01

    To evaluate the effect of adding neoadjuvant chemotherapy to surgery and radiation therapy for locally advanced resectable oral cavity squamous cell carcinoma, 24 patients with T3 or T4a oral cavity squamous cell carcinoma were randomly assigned to surgery alone or Docetaxel, Cisplatin, and 5-FU (TPF) induction chemotherapy followed by surgery. All patients were planned to receive chemoradiotherapy after surgery. The primary end-points were organ preservation and progression-free-survival. SP...

  5. High-dose-rate brachytherapy for cervical carcinoma patients with narrow vagina

    Energy Technology Data Exchange (ETDEWEB)

    Yorozu, Atsunori; Toya, Kazuhito; Kawase, Takatugu [National Tokyo Medical Center, Tokyo (Japan); Dokiya, Takushi [Saitama Medical Coll., Moroyama (Japan)

    2002-06-01

    We retrospectively analyzed cervical cancer patients with narrow vagina treated by high-dose-rate (HDR) brachytherapy followed by external beam irradiation. Fifty patients were treated with radical radiotherapy between 1992 and 1999 at the National Tokyo Medical Center. All patients received 30 Gy of external whole pelvic irradiation and 20 Gy of pelvic irradiation with a central shield. After 30 Gy of whole pelvic irradiation, 24 Gy of fractionated brachytherapy was applied with a tandem and ovoids, non-rigid type developed in the Cancer Institute, according to the Manchester method. Nineteen patients with a narrow vagina of less than 40 mm in width were compared with 31 other patients (control group). The 5-year cumulative survival rates were 56% in the patients with a narrow vagina and 53% in the control group (P=0.6008). The control rate in the pelvis was not significantly different between the two groups. The cumulative rate of rectal complications of the patients with a narrow vagina was more frequent than the control group (58% vs 29%) (P=0.0924). Severe rectal bleeding was also more frequent in the patients with a narrow vagina. The estimated maximal dose of the rectal wall was significantly higher in patients with a narrow vagina. This result suggests that a lower brachytherapy dose is necessary for patients with narrow vagina considering the rectal sequelae in the case of using our methods. (author)

  6. Age of Diagnosis of Squamous Cell Cervical Carcinoma and Early Sexual Experience

    Science.gov (United States)

    Edelstein, Zoe R.; Madeleine, Margaret M.; Hughes, James P.; Johnson, Lisa G.; Schwartz, Stephen M.; Galloway, Denise A.; Carter, Joseph J.; Koutsky, Laura A.

    2009-01-01

    Background Given the established links between young age at first intercourse (AFI), number of sex partners, high-risk human papillomavirus infection, and squamous cell cervical cancer (SCC), we hypothesized that women diagnosed with SCC at younger ages would be more likely to report young AFI than women diagnosed later in life. Methods We performed a population-based investigation among invasive SCC cases who were diagnosed between 1986 and 2004, were 22 to 53 years old, and lived in the metropolitan Seattle-Puget Sound region (n=333). Using multivariate linear regression, we estimated coefficients and 95% confidence intervals (CI) to assess the association between age at SCC diagnosis and AFI (AFI and SCC diagnosis ranged from 4 to 35 years. In a multivariate model, compared to SCC cases reporting AFI≥19, the mean age of diagnosis was 3.1 years younger for SCC cases reporting AFIAFI 15–18 years (CI: −4.6, −0.6). Although number of sex partners before age 20 was associated with age at SCC diagnosis in a crude analysis, the association was not independent of AFI. However, in the AFI≥19 and AFIAFIAFI, though the effect appeared to be modified by number of sex partners before age 20. PMID:19318437

  7. Risk Factors of Cervical Carcinoma and Countermeasures against Them in Mountainous Area of Wufeng County, China

    Institute of Scientific and Technical Information of China (English)

    TAO Ning; WU Xu-feng; QIU Xiao-ping; ZHAO Min; TAN Yun; WU Xin-xing

    2005-01-01

    Cases (n=44) with squamous cell cervical cancer (SCCA) and age-matched healthy controls (n=176) were analyzed. Significant difference due to human papillomavirus (HPV) infection, ages at the first marriage, ages at the first sexual intercourse, ages at the first birth given to baby, number of gravidities, number of deliveries, Body Mass Index (BMI), education level of women and their husbands (p< 0.05) was observed. According to multivariate logistic regression analysis, four factors have entered the model (p<0.05), including HPV infection [OR (odds ratio)= 26.13, 95%CI (confidence interval)=9.40-72.60], education level of women (OR= 0.41, 95%CI=0.21-0.79), education level of spouses (OR=0.45, 95%CI=0.22- 0.94), BMI (OR= 0.73, 95%CI=0.57-0.93). Moreover, HPV infection is relative to education level of women (r=-0.14), and their spouses (r=-0.21), age at the first marriage (r=-0.20), age at the first birth given to baby (r= -0.20) and BMI (r=-0.15).

  8. Early cervical carcinoma and fertility-sparing treatment options: MR imaging as a tool in patient selection and a follow-up modality.

    Science.gov (United States)

    Noël, Patricia; Dubé, Mireille; Plante, Marie; St-Laurent, Guillaume

    2014-01-01

    Because of the widespread use of cytologic screening programs in industrialized nations, cervical carcinoma is being diagnosed in younger patients and at an earlier stage. The traditional therapy for early-stage disease is radical hysterectomy with pelvic lymphadenectomy, which leads to infertility. In the past 20 years, fertility-sparing therapies, such as cervical conization and radical trachelectomy, have emerged and show good oncologic and obstetric outcomes. The selection criteria for vaginal radical trachelectomy include stages IA2 and IB1, a tumor that is smaller than 2 cm, distance from the internal os of at least 1 cm, limited stromal invasion, and no nodal or extracervical extension. Magnetic resonance (MR) imaging accurately depicts these criteria and is a necessary tool in the preoperative evaluation of patients with cervical carcinoma who are eligible for fertility-sparing surgery. The MR imaging report must provide the following pieces of information for adequate surgical planning: tridimensional diameters of the lesion, uterine and cervical lengths, the degree of stromal invasion, distance from the internal os, and the presence of extracervical or nodal involvement. Because patients also undergo follow-up MR imaging, radiologists must be familiar with the postoperative imaging appearance of the cervix. After trachelectomy, the uterovaginal anastomosis may appear end-to-end or with a neoposterior vaginal fornix. Vaginal wall thickening, hematomas, lymphoceles, and hematometra secondary to isthmic stenosis may be seen. The normal postoperative appearance must be differentiated from recurrent disease, which is seen as a mass with intermediate to high signal intensity in the vaginal vault or parametrium on T2-weighted images. Functional imaging, including diffusion-weighted and dynamic contrast-enhanced imaging, may help characterize recurrence. PMID:25019444

  9. Complete remission of advanced hepatocellular carcinoma by radiofrequency ablation after sorafenib therapy

    OpenAIRE

    Park, Jung Gil; Park, Soo Young; Lee, Hye Won

    2015-01-01

    Sorafenib, a potent multikinase inhibitor, lead to a significant improvement in progression free survival and overall survival in patients with advanced hepatocellular carcinoma (HCC). Though sorafenib has proven its efficacy in advanced stage HCC, there are limited reports on the role of sorafenib allowing for curative treatment by down-staging. We herein report a case of advanced HCC with vascular invasion, which showed treatment response by sorafenib therapy as to allow for radiofrequency ...

  10. Cryotherapy is associated with improved clinical outcomes of sorafenib for the treatment of advanced hepatocellular carcinoma

    OpenAIRE

    Yang, Yongping; LU, YINYING; Wang, Chunping; Bai, Wenlin; Qu, Jianhui; Chen, Yan; Chang, Xiujuan; An, Linjing; Zhou, Lin; Zeng, Zhen; Lou, Min; LV, JIYUN

    2011-01-01

    Sorafenib may prolong survival in patients with advanced hepatocellular carcinoma (HCC), but with limited efficacy. The present study aimed to assess the safety and efficacy of sorafenib combined with cryotherapy (cryoRx) for the treatment of advanced HCC. A total of 104 patients met the following criteria: advanced HCC without distant metastasis, presence of portal vein thrombosis, Child-Pugh class A or B and life expectancy of at least 12 weeks. All patients were randomly assigned to sorafe...

  11. Case analysis of complete remission of advanced hepatocellular carcinoma achieved with sorafenib

    OpenAIRE

    Liu, Daizhong; Liu, Aixiang; Peng, Junping; Hu, Yong; Feng, Xielin

    2015-01-01

    Background To evaluate the feasibility and security of complete remission (CR) of advanced hepatocellular carcinoma (HCC) achieved with sorafenib treatment, and investigate the previously described predictive factors in CR. Methods The case of a patient who achieved CR of advanced HCC with sorafenib treatment was analyzed. The case analysis was performed by a literature review of relevant reports retrieved from the PubMed database. Results A 58-year-old male patient achieved CR of advanced HC...

  12. Optical diagnosis of mammary ductal carcinoma using advanced optical technology

    Science.gov (United States)

    Wu, Yan; Fu, Fangmeng; Lian, Yuane; Nie, Yuting; Zhuo, Shuangmu; Wang, Chuan; Chen, Jianxin

    2015-02-01

    Clinical imaging techniques for diagnosing breast cancer mainly include X-ray mammography, ultrasound, and magnetic resonance imaging (MRI), which have respective drawbacks. Multiphoton microscopy (MPM) has become a potentially attractive optical technique to bridge the current gap in clinical utility. In this paper, MPM was used to image normal and ductal cancerous breast tissues, based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG). Our results showed that MPM has the ability to exhibit the microstructure of normal breast tissue, ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) lesions at the molecular level comparable to histopathology. These findings indicate that, with integration of MPM into currently accepted clinical imaging system, it has the potential to make a real-time histological diagnosis of mammary ductal carcinoma in vivo.

  13. Radio-induced apoptosis of peripheral blood CD8 T lymphocytes is a novel prognostic factor for survival in cervical carcinoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Ordonez, R.; Federico, M. [Hospital Universitario de Gran Canaria Dr. Negrin, Radiation Oncology Department, Las Palmas de Gran Canaria (Spain); Henriquez-Hernandez, L.A.; Pinar, B.; Lloret, M.; Lara, P.C. [Hospital Universitario de Gran Canaria Dr. Negrin, Radiation Oncology Department, Las Palmas de Gran Canaria (Spain); Universidad de Las Palmas de Gran Canaria, Clinical Sciences Department, Las Palmas de Gran Canaria (Spain); Instituto Canario de Investigacion del Cancer (ICIC), Santa Cruz de Tenerife (Spain); Valenciano, A. [Instituto Canario de Investigacion del Cancer (ICIC), Santa Cruz de Tenerife (Spain); Bordon, E. [Universidad de Las Palmas de Gran Canaria, Clinical Sciences Department, Las Palmas de Gran Canaria (Spain); Rodriguez-Gallego, C. [Hospital Universitario de Gran Canaria Dr. Negrin, Immunology Department, Las Palmas de Gran Canaria (Spain)

    2014-02-15

    A close relationship exists between immune response and tumor behavior. This study aimed to explore the associations between radiation-induced apoptosis (RIA) in peripheral blood lymphocytes (PBL) and clinical pathological variables. Furthermore, it assessed the role of RIA as a prognostic factor for survival in cervical carcinoma patients. Between February 1998 and October 2003, 58 consecutive patients with nonmetastatic, localized stage I-II cervical carcinoma who had been treated with radiotherapy (RT) ± chemotherapy were included in this study. Follow-up ended in January 2013. PBL subpopulations were isolated and irradiated with 0, 1, 2 and 8 Gy then incubated for 24, 48 and 72 h. Apoptosis was measured by flow cytometry and the ss value, a parameter defining RIA of lymphocytes, was calculated. Mean follow-up duration was 111.92 ± 40.31 months. Patients with lower CD8 T lymphocyte ss values were at a higher risk of local relapse: Exp(B) = 5.137, confidence interval (CI) 95 % = 1.044-25.268, p = 0.044. Similar results were observed for regional relapse: Exp(B) = 8.008, CI 95 % = 1.702-37.679, p = 0.008 and disease relapse: Exp(B) = 6.766, CI 95 % = 1.889-24.238, p = 0.003. In multivariate analysis, only the CD8 T lymphocyte ss values were found to be of prognostic significance for local disease-free survival (LDFS, p = 0.049), regional disease-free survival (RDFS, p = 0.002), metastasis-free survival (MFS, p = 0.042), disease-free survival (DFS, p = 0.001) and cause-specific survival (CSS p = 0.028). For the first time, RIA in CD8 T lymphocytes was demonstrated to be a predictive factor for survival in cervical carcinoma patients. (orig.)

  14. Radio-induced apoptosis of peripheral blood CD8 T lymphocytes is a novel prognostic factor for survival in cervical carcinoma patients

    International Nuclear Information System (INIS)

    A close relationship exists between immune response and tumor behavior. This study aimed to explore the associations between radiation-induced apoptosis (RIA) in peripheral blood lymphocytes (PBL) and clinical pathological variables. Furthermore, it assessed the role of RIA as a prognostic factor for survival in cervical carcinoma patients. Between February 1998 and October 2003, 58 consecutive patients with nonmetastatic, localized stage I-II cervical carcinoma who had been treated with radiotherapy (RT) ± chemotherapy were included in this study. Follow-up ended in January 2013. PBL subpopulations were isolated and irradiated with 0, 1, 2 and 8 Gy then incubated for 24, 48 and 72 h. Apoptosis was measured by flow cytometry and the ss value, a parameter defining RIA of lymphocytes, was calculated. Mean follow-up duration was 111.92 ± 40.31 months. Patients with lower CD8 T lymphocyte ss values were at a higher risk of local relapse: Exp(B) = 5.137, confidence interval (CI) 95 % = 1.044-25.268, p = 0.044. Similar results were observed for regional relapse: Exp(B) = 8.008, CI 95 % = 1.702-37.679, p = 0.008 and disease relapse: Exp(B) = 6.766, CI 95 % = 1.889-24.238, p = 0.003. In multivariate analysis, only the CD8 T lymphocyte ss values were found to be of prognostic significance for local disease-free survival (LDFS, p = 0.049), regional disease-free survival (RDFS, p = 0.002), metastasis-free survival (MFS, p = 0.042), disease-free survival (DFS, p = 0.001) and cause-specific survival (CSS p = 0.028). For the first time, RIA in CD8 T lymphocytes was demonstrated to be a predictive factor for survival in cervical carcinoma patients. (orig.)

  15. Patterns and variability of tumor oxygenation in human soft tissue sarcomas, cervical carcinomas, and lymph node metastases

    International Nuclear Information System (INIS)

    Purpose: The validity of tumor pO2 measurement as a predictive outcome assay depends upon demonstrating that intrapatient pO2 variation is less than interpatient variation. No consensus exists regarding the appropriate distance between individual measurements. This distance could affect the calculation of the hypoxic fraction (% pO2s 2 heterogeneity in three different sets of patients. Materials and Methods: Fifteen patients with soft tissue sarcoma, nine patients with cervical carcinoma, and eight patients with squamous carcinoma metastatic to lymph nodes underwent pretreatment polarographic pO2 measurements. Two grossly distinct sites were studied in each tumor, and 2-3 linear tracks were measured at each site. Track lengths varied from 20-36 mm. Distance between measured points was either 0.7-0.8 mm or 0.4 mm. Mean pO2, median pO2, and hypoxic fraction were calculated for each track. Data for each patient were also averaged across all tracks obtained for that patient. Track-specific data were used to evaluate intrapatient variation. The range of average values for each patient was used to assess interpatient heterogeneity. The ratio of these measures provided an assessment of within- vs. between-patient heterogeneity. Results: The median number of pO2 measurements/patient was 200 (range: 88-356). The average length of hypoxic regions varied from 4.5-5.6 mm. Median tumor pO2s for the cervix, lymph node, and sarcoma patients were 4.5 mm Hg, 12.6 mm Hg, and 18.0 mm Hg, respectively (p = 0.07). Median hypoxic fractions were 0.61, 0.36, and 0.31, respectively (p = 0.07). Intrapatient heterogeneity was less than interpatient heterogeneity for all parameters in all patients, except for mean pO2 for the cervix patients measured at 0.7-mm increments (1.51). Assessment of oxygenation was not affected by the distance between samples. Conclusions: Heterogeneity of tumor oxygenation within tumors is less than that between tumors. Both 0.4 mm and 0.7-0.8 mm sampling

  16. Oridonin induces apoptosis via PI3K/Akt pathway in cervical carcinoma HeLa cell line

    Institute of Scientific and Technical Information of China (English)

    Hong-zhen HU; Yue-bo YANG; Xiang-dong XU; Hong-wei SHEN; Yi-min SHU; Zi REN; Xiao-mao LI; Hui-ming SHEN; Hai-tao ZENG

    2007-01-01

    Aim:To investigate the apoptosis-inducing effect of oridonin,a diterpenoid isolated from Rabdosia rubescens,in the human cervical carcinoma HeLa cell line.Methods:A morphological analysis,nuclear condensation,and fragmentation of chromatin were monitored using Hoechst 33342 staining. Cell viability was assessed using the 3-(4,5-dimethylthiazol-(2)-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. Cell apoptosis and the apoptosis-related activation in the HeLa cell line were evaluated by flow cytometry and Western blotting. Results:Oridonin suppressed the proliferation of the HeLa cell line in a dose- and time-dependent fashion. Oridonin treatment downregulated the activation of protein kinase B (Akt),the expression of forkhead box class O (FOXO) transcription factor,and glycogen synthase kinase 3 (GSK3). Oridonin also induced the release of cytochrome c accompanied by the activation of caspase-3 and poly-adenosine diphosphate-ribose polymerase cleavage. In addition,Z-D(OMe)-E(OMe)-V-D(OMe)FMK (z-DEVD-fmk),an inhibitor of caspases,prevented caspase-3 activation and abrogated oridonin-induced cell death. Finally,oridonin treatment of the HeLa cell line downregulated the expression of the inhibitor of the apoptosis protein.Conclusion:Our results showed that oridonin-induced apoptosis involved several molecular pathways. Oridonin may suppress constitutively activated targets of phosphatidylinositol 3-kinase (Akt,FOXO,and GSK3) in the HeLa cell line,inhibiting the proliferation and induction of caspase-dependent apoptosis.

  17. Gene Expression Changes in Cervical Squamous Cell Carcinoma After Initiation of Chemoradiation and Correlation With Clinical Outcome

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to investigate early gene expression changes after chemoradiation in a human solid tumor, allowing identification of chemoradiation-induced gene expression changes in the tumor as well as the tumor microenvironment. In addition we aimed to identify a gene expression profile that was associated with clinical outcome. Methods and Materials: Microarray experiments were performed on cervical cancer specimens obtained before and 48 h after chemoradiation from 12 patients with Stage IB2 to IIIB squamous cell carcinoma of the cervix treated between April 2001 and August 2002. Results: A total of 262 genes were identified that were significantly changed after chemoradiation. Genes involved in DNA repair were identified including DDB2, ERCC4, GADD45A, and XPC. In addition, significantly regulated cell-to-cell signaling pathways included insulin-like growth factor-1 (IGF-1), interferon, and vascular endothelial growth factor signaling. At a median follow-up of 41 months, 5 of 12 patients had experienced either local or distant failure. Supervised clustering analysis identified a 58-gene set from the pretreatment samples that were differentially expressed between patients with and without recurrence. Genes involved in integrin signaling and apoptosis pathways were identified in this gene set. Immortalization-upregulated protein (IMUP), IGF-2, and ARHD had particularly marked differences in expression between patients with and without recurrence. Conclusions: Genetic profiling identified genes regulated by chemoradiation including DNA damage and cell-to-cell signaling pathways. Genes associated with recurrence were identified that will require validation in an independent patient data set to determine whether the 58-gene set associated with clinical outcome could be useful as a prognostic assay

  18. Tumor necrosis treatment of ME-180 human cervical carcinoma model with 131I-labeled TNT-1 monoclonal antibody

    International Nuclear Information System (INIS)

    In contrast to normal tissues, many malignant tumors contain a high proportion of dead and dying cells. The loss of membrane integrity that accompanies cellular degeneration permits macromolecules, including antibodies, to freely enter the cell cytoplasm. Based upon these observations, it was hypothesized that monoclonal antibodies to intracellular antigens, which are integral structural components and are retained by degenerating cells, may be used to target a wide range of human malignancies. Previous studies by our laboratory utilizing these principles have demonstrated the feasibility of imaging four different histological types of human cancer in a nude mouse model, using monoclonal antibodies directed against insoluble intranuclear antigens. The present study describes the application of this approach, designated tumor necrosis treatment, for the radioimmunotherapy of transplantable ME-180 human cervical carcinomas in the nude mouse. Groups of tumor-bearing nude mice received three weekly treatments of 150 or 300 microCi of 131I-labeled experimental (TNT-1) or control (Lym-1) monoclonal antibodies. Detailed biodistribution data, dosimetric evaluations, and therapeutic results are presented to demonstrate the effective and preferential targeting of 131I-labeled TNT-1 monoclonal antibody within the tumor. In the experimental groups, the dose delivered to the tumor was sufficient to induce clinical regressions in 88% of treated animals, without evidence of toxicity to normal tissues. Complete regressions were obtained in 25% of the mice treated with high dose TNT-1. Microscopic examination of the implantation sites of these mice demonstrated the presence of acute radiation damage and residual keratin-positive tumor cells showing marked evidence of degeneration

  19. Relationship between total iso-effect dose and number of fractions for the treatment of uterine cervical carcinoma by high dose-rate intracavitary irradiation. Chapter 18

    International Nuclear Information System (INIS)

    Results are compared in Japan for patients with cervical carcinoma treated by either 1) manual afterloading with low intensity 60Co or 137Cs or 2) remote afterloading with high intensity 60Co sources (Ralstron). No significant difference between them was found for the 5-year survival rates. The relationship between the total tumour dose at point A and the results of high and low dose-rate intracavitary treatment of the patients classified by the number of fractions was also investigated. From this, the optimal dose ranges for each of the fractionation schemes of both high and low dose-rate intracavitary irradiation were determined. (U.K.)

  20. Preoperative Prediction of Cervical Lymph Node Metastasis Using Primary Tumor SUVmax on 18F-FDG PET/CT in Patients with Papillary Thyroid Carcinoma

    OpenAIRE

    Jung, Ji-hoon; Kim, Choon-Young; Son, Seung Hyun; Kim, Do-Hoon; Jeong, Shin Young; Lee, Sang-Woo; Lee, Jaetae; Ahn, Byeong-Cheol

    2015-01-01

    Objectives The aim of the current study was to evaluate the value of preoperative 18F-FDG (FDG) PET/CT in predicting cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC). Methods One hundred and ninety-three newly diagnosed PTC patients (M: F = 25:168, age = 46.8 ± 12.2) who had undergone pretreatment FDG PET/CT and had neck node dissection were included in this study. The FDG avidity of the primary tumor and the SUVmax of the primary tumor (pSUVmax) were ana...

  1. Malignant neoplasms of the uterus following radiation therapy for cervical carcinoma:a clinical study of 47 cases%子宫颈癌放疗后子宫体恶性肿瘤47例临床分析

    Institute of Scientific and Technical Information of China (English)

    Shaokang Ma; Lingying Wu

    2009-01-01

    Objective: To study the characteristics and clinical features of uterine neoplasms developed after radiation ther-apy for cervical carcinoma. Methods: Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively reviewed. Results: The median age at uterine neoplasms diagnosis was 62 years (range: 38-77 years), and the median latency period from initial therapy to development of uterine neoplasms was 14 years (range: 5-35 years). Thirty of 47 cases were endometrial carcinoma, of which 3 were uterine papillary serous carcinoma (UPSC). Seventeen of 47 patients were uterine sarcoma, all of those were carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows: stage Ib, 1 case; stage Ic, 2 cases; stage Ⅱ, 6; stage Ilia, 4; stage Ⅲb, 2; stage Ⅲc, 11; stage Ⅳ, 4 cases; grade 1, two cases; grade 2, nine; grade 3 (include 3 UPSC patients), seventeen; unknown grade, two; endometried, 27; UPSC, 3 cases; 7 of 30 cases of endometrial carcinoma had recurrences (23.3%), at median time to recurrence was 24 months, and their median survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine sarcoma, the median survival was 10 months, 6 patients oc-curred recurrence (35.9%), at a median time to recurrence was 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively. Conclusion: The main uterine neoplasms development after radiation therapy for cervical carcinoma is endomethal carcinomas, of which there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor.

  2. Cellular Levels of Oxidative Stress Affect the Response of Cervical Cancer Cells to Chemotherapeutic Agents

    OpenAIRE

    Maria Filippova; Valery Filippov; Williams, Vonetta M; Kangling Zhang; Anatolii Kokoza; Svetlana Bashkirova; Penelope Duerksen-Hughes

    2014-01-01

    Treatment of advanced and relapsed cervical cancer is frequently ineffective, due in large part to chemoresistance. To examine the pathways responsible, we employed the cervical carcinoma-derived SiHa and CaSki cells as cellular models of resistance and sensitivity, respectively, to treatment with chemotherapeutic agents, doxorubicin, and cisplatin. We compared the proteomic profiles of SiHa and CaSki cells and identified pathways with the potential to contribute to the differential response....

  3. P16INK4A is required for cisplatin resistance in cervical carcinoma SiHa cells

    OpenAIRE

    Li, Yueran; Xiao, Songshu; DAN, LIU; Xue, Min

    2014-01-01

    Cervical cancer is the third most commonly diagnosed cancer worldwide and the fourth leading cause of cancer-related mortality in females worldwide, accounting for 10–15% of cancer-related mortalities. Cytological screening and DNA testing for high-risk human papillomavirus (HPV) types have markedly decreased the rates of cervical cancer in developed countries, however, for vulnerable populations without access to health care, cervical cancer remains a considerable problem. Chemotherapeutic a...

  4. Cabozantinib versus Everolimus in Advanced Renal-Cell Carcinoma

    DEFF Research Database (Denmark)

    Choueiri, Toni K; Escudier, Bernard; Powles, Thomas;

    2015-01-01

    antiangiogenic drugs. This randomized, open-label, phase 3 trial evaluated the efficacy of cabozantinib, as compared with everolimus, in patients with renal-cell carcinoma that had progressed after VEGFR-targeted therapy. METHODS: We randomly assigned 658 patients to receive cabozantinib at a dose of 60 mg daily...

  5. Catamnestic studies of radiosurgical combination therapy of advanced carcinoma of the larynx

    International Nuclear Information System (INIS)

    The first part of the study summarizes the post-therapeutical course of development of 165 patients who have been treated for advanced internal and external carcinoma of the larynx with a combined, pre- or postoperative radiosurgical therapy, with particular attention being paid to the frequency of focal or lymph node recidivation, post-therapeutical apparent distant metastases and postoperative complications, and also to tumour-independent mortality. The second part of the study is concerned with the determination of survival rates of patients suffering from advanced carcinoma of the larynx or hypopharynx, following low-dose preoperative irradiation (119 patients) or postoperative irradiation (209 patients). (orig./MG)

  6. Combination of irradiation, carcinostatics, and urokinase for the treatment of uterine cervical carcinoma

    International Nuclear Information System (INIS)

    In the treatment of carcinoma of the cervix uteri, histological changes were studied by dividing patients into 2 groups. One group was treated with radio-therapy and the other was treated with radiotherapy combined with chemotherapy, using antineoplastic agents which were used alone or in combination with urokinase. In regard to radiotherapy alone, Linac 10 MeV x-ray, 60Co-teletherapy, and radium contiguous irradiation were evaluated, and marked changes in cancerous parenchyma were seen with irradiation over 3000 rad. Irradiation of 3000 rad caused destruction of cancer cells, separation of the cells, inclusion of the focus, necrosis of hyalinization, and infiltration of neutrophils and lymphocytes. Approximately 4000 rad caused hyperplasia of the interstitial connective tissues, in addition to the above-mentioned changes. Approximately 5000 rad caused destruction and disappearance of cancer tissues, and approximately 6000 rad caused disappearance of the cancer cells which were then only connective or necrostic tissues. When radiotherapy was combined with BLM and FAMT therapies, degenerative changes were observed in many cases with irradiation of 1200 - 2400 mgh of radium or 1000 - 3000 rad of Linac or 60Co. The addition of urokinase tended to further accelerate the degeneration begun by BLM therapy. (Tsunoda, M.)

  7. Poly(ADP-Ribose) Polymerase in Cervical Cancer Pathogenesis: Mechanism and Potential Role for PARP Inhibitors.

    Science.gov (United States)

    Kotsopoulos, Ioannis C; Kucukmetin, Ali; Mukhopadhyay, Asima; Lunec, John; Curtin, Nicola J

    2016-05-01

    Treatment options for disease recurrence of women treated for locally advanced and advanced cervical cancer are very limited-largely palliative chemotherapy. The low efficacy of the currently available drugs raises the need for new targeted agents. Poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitors (PARPi) have emerged as a promising class of chemotherapeutic agents in cancers associated with defects in DNA repair. Their therapeutic potential in cervical cancer is currently being evaluated in 3 ongoing clinical trials. Here we review the available information regarding all the aspects of PARP in cervical intraepithelial neoplasia and invasive cervical cancer, from expression and the mechanism of action to the role of the polymorphisms in the pathogenesis of the disease, as well as the potential of the inhibitors. We finally propose a new unifying theory regarding the role of PARPs in the development of cervical carcinomas. PMID:26905326

  8. Advanced papillary serous carcinoma of the uterine cervix: a case with a remarkable response to paclitaxel and carboplatin combination chemotherapy

    Directory of Open Access Journals (Sweden)

    Tomoyuki Shirase

    2012-01-01

    Full Text Available Papillary serous carcinoma of the uterine cervix (PSCC is a very rare tumor, and is a recently described variant of cervical adenocarcinoma. We experienced a case of stage IV PSCC. The main tumor existed in the uterine cervix and invaded one third of the inferior part of the anterior and posterior vaginal walls. Furthermore, it had metastasized from the para-aortic lymph nodes to bilateral neck lymph nodes. Immnoreactivity for CA125 was positive, whereas the staining for p53 and WT-1 were negative in both the original tumor and the metastatic lymph nodes. We administered six courses of paclitaxel and carboplatin combination chemotherapy against this advanced PSCC. The PSCC therefore dramatically decreased in size. The main tumor of the uterine cervix showed a complete response by magnetic resonance imaging (MRI, and more than 95% of the tumor cells in the cervix had microscopically disapperared. This is the first report of PSCC in which combination chemotherapy was used and showed a remarkable response.

  9. Molecular basis of arsenite (As+3-induced acute cytotoxicity in human cervical epithelial carcinoma cells

    Directory of Open Access Journals (Sweden)

    Muhammad Nauman Arshad

    2015-04-01

    Full Text Available Background: Rapid industrialization is discharging toxic heavy metals into the environment, disturbing human health in many ways and causing various neurologic, cardiovascular, and dermatologic abnormalities and certain types of cancer. The presence of arsenic in drinking water from different urban and rural areas of the major cities of Pakistan, for example, Lahore, Faisalabad, and Kasur, was found to be beyond the permissible limit of 10 parts per billion set by the World Health Organization. Therefore the present study was initiated to examine the effects of arsenite (As+3 on DNA biosynthesis and cell death. Methods: After performing cytotoxic assays on a human epithelial carcinoma cell line, expression analysis was done by quantitative polymerase chain reaction, western blotting, and flow cytometry. Results: We show that As+3 ions have a dose- and time-dependent cytotoxic effect through the activation of the caspase-dependent apoptotic pathway. In contrast to previous research, the present study was designed to explore the early cytotoxic effects produced in human cells during exposure to heavy dosage of As+3 (7.5 µg/ml. Even treatment for 1 h significantly increased the mRNA levels of p21 and p27 and caspases 3, 7, and 9. It was interesting that there was no change in the expression levels of p53, which plays an important role in G2/M phase cell cycle arrest. Conclusion: Our results indicate that sudden exposure of cells to arsenite (As+3 resulted in cytotoxicity and mitochondrial-mediated apoptosis resulting from up-regulation of caspases.

  10. Apoptosis, intrinsic radiosensitivity and prediction of radiotherapy response in cervical carcinoma

    International Nuclear Information System (INIS)

    Apoptosis is an important mechanism of cell death in tumours and it is seen both prior to and following radiotherapy. In this study patients with proven carcinoma of the cervix had measurement made of the percentage of apoptotic cells (apoptotic index or AI) in pre-therapy biopsies. Measurements of intrinsic radiosensitivity (SF2), already shown to be a predictor of outcome, had previously been made on the same pre-therapy biopsies. Mitotic index (MI) and Ki-67 antigen staining were also recorded as markers for proliferation. Patients were divided into those with an AI above or below the median and in general increasing apoptosis was associated with poor prognosis. The 5-year survival rate for tumours with an AI below the median was 79% and was significantly greater than the rate of 47% for those with an AI above the median (p = 0.003). There was also a significantly increased 5-year local recurrence-free rate for patients with an AI below the median compared with those with an AI above the median (79 versus 61%, p = 0.012). In addition, AI and SF2 acted as independent prognostic indicators. Patients with both an SF2 and AI value above the median did badly (25% 5-year survival, 46% local control) compared with those with an SF2 and AI below the median (80% 5-year survival, 100% local control). Apoptosis showed correlation with MI (n = 66, r = 0.34, p = 0.002) and cell staining for the Ki-67 antigen (n = 57, r = 0.25, p = 0.03), but neither MI nor Ki-67 were related to patient outcome. This suggests that while apoptosis may be a reflection of tumour proliferation this cannot in itself explain the ability of apoptosis to predict clinical outcome for this series of patients. The study raises the possibility of AI and SF2 being used together as predictors of tumour response to radiotherapy

  11. Virilizing Adrenocortical Carcinoma Advancing to Central Precocious Puberty after Surgery

    OpenAIRE

    Kim, Min Sun; Yang, Eu Jeen; Cho, Dong Hyu; Hwang, Pyung Han; Lee, Dae-Yeol

    2015-01-01

    Adrenocortical carcinoma (ACC) in pediatric and adolescent patients is rare, and it is associated with various clinical symptoms. We introduce the case of an 8-year-old boy with ACC who presented with peripheral precocious puberty at his first visit. He displayed penis enlargement with pubic hair and facial acne. His serum adrenal androgen levels were elevated, and abdominal computed tomography revealed a right suprarenal mass. After complete surgical resection, the histological diagnosis was...

  12. Advanced Pyoderma Gangrenosum Previously Treated as Squamous Cell Carcinoma

    OpenAIRE

    Tamara Čuk Radović; Krešimir Kostović; Jaka Radoš; Zrinjka Paštar; Gordana Pavliša; Branka Marinović

    2015-01-01

    Pyoderma gangrenosum is a rare, neutrophilic ulcerative skin disease of unknown etiology often associated with an underlying systemic disease. We present a case of a pyoderma gangrenosum that was initially misdiagnosed and treated as squamous cell carcinoma in another hospital. Multiple surgical treatments triggered postoperative exacerbations and further rapid progression of the lesions. History of pathergy, clinical findings, and histopathological features examined at our Department indicat...

  13. Targeted treatments in advanced renal cell carcinoma: focus on axitinib

    Directory of Open Access Journals (Sweden)

    Verzoni E

    2014-03-01

    Full Text Available Elena Verzoni, Paolo Grassi, Isabella Testa, Roberto Iacovelli, Pamela Biondani, Enrico Garanzini , Filippo De Braud, Giuseppe ProcopioDepartment of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, ItalyAbstract: Antiangiogenesis options have evolved rapidly in the last few years, with an increasing number of agents currently approved by the US Food and Drug Administration and European Medicines Agency. Angiogenesis inhibitors have been shown to be very effective for the treatment of metastatic renal cancer cell. Axitinib is a third-generation inhibitor of vascular endothelial growth factor receptor and is currently being developed for the treatment of various malignancies. The pharmacokinetic properties of axitinib may have a selective therapeutic effect, with minimal adverse reactions and enhanced safety. In a large Phase III study of previously treated patients with metastatic renal cell carcinoma, axitinib achieved a longer progression-free survival than sorafenib with an acceptable safety profile and good quality of life. This review focuses on the pharmacology, pharmacokinetics, and clinical activity of axitinib in the current treatment of renal cell carcinoma. The role of axitinib in the adjuvant and/or neoadjuvant setting needs to be evaluated in further clinical trials.Keywords: axitinib, renal cell carcinoma, vascular endothelial growth factor receptor, angiogenesis

  14. Trimodality Therapy for an Advanced Thymic Carcinoma With Both Aorta and Vena Cava Invasion.

    Science.gov (United States)

    Momozane, Tohru; Inoue, Masayoshi; Shintani, Yasushi; Funaki, Soichiro; Kawamura, Tomohiro; Minami, Masato; Shirakawa, Yukitoshi; Kuratani, Toru; Sawa, Yoshiki; Okumura, Meinoshin

    2016-08-01

    A case of locally advanced thymic carcinoma that was successfully resected with the great vessels after chemoradiation therapy is reported. A 57-year-old man with Masaoka stage III thymic carcinoma received two cycles of cisplatin/docetaxel and 60 Gy irradiation. The response was stable disease with 19% size reduction, and a radical resection with the ascending aorta and superior vena cava with the patient under circulatory arrest with the use of cardiopulmonary bypass was performed. The postoperative course was uneventful, and the patient has been free of disease for 28 months. Trimodality therapy with use of a cardiovascular surgical procedure might be a valuable option in locally advanced thymic carcinoma. PMID:27449450

  15. Analysis of Prognosis and Prognostic Factors of Cervical Adenocarcinoma and Adenosqumous Carcinoma of the Cervix

    Institute of Scientific and Technical Information of China (English)

    Guangwen Yuan; Lingying Wu; Xiaoguang Li; Manni Huang

    2009-01-01

    OBJECTIVE To analyze clinical characteristics and treatment methods of the patients with adenocarcinoma of the uterine cervix (AUC) and adenosquamous carcinoma of the cervix (ASCC). To compare the survival time of the patients in 2 groups and analyze the prognostic factors.METHODS Clinical data of both 123 patients with AUC and 32 patients with ASCC treated at the Cancer Hospital, Chinese Academy of Medical Science (CAMS) & Peking Union Medical College (PUMC), were retrospectively analyzed.RESULTS The median age of the AUC patients was 50 years, and that of the ASCC patients was 44, P = 0.019. Poorly-differentiated (grade 3) cases accounted for 59.5% of the total ASCC patients,while only 32.5% of the AUC patients were in grade 3, P = 0.002.In 123 AUC patients, relapse or failure of the treatment occurred in 63 of the patients (51.2%), and the median relapse time was 6 months (0-59 months). In 32 ASCC patients, relapse or failure of the treatment occurred in 8 of these patients (51.2%), with a median relapse time of 4.5 months (0-52 months). The overall 5-year survival rate of the AUC patients was 49.8%, which was significantly lower than that of the ASCC patients (74.1%), P =0.015. The 5-year survival rates of the ASCC patients in Stage Ⅰ-Ⅲ were higher than that of the AUC patients with the same stages.However, statistical significant difference could only be found among the patients in Stage Ⅱ, P = 0.006. The 5-year survival rates of the ASCC patients with various differential grade were higher than those of the AUC patients with the same differential grade,but statistical significant difference could only be found among the patients in the two groups with moderately differentiation,P = 0.039. It was found by Cox regression analysis that only clinical stage (P < 0.001) and histological type (P = 0.046) were the independent prognostic factors.CONCLUSION Clinical stage and histological type were the independent prognostic factors of the AUC and ASCC patients

  16. Neurovascular Invasion and Histological Grade Serve as the Risk Factors of Cervical Lymph Node Metastases in Early Tongue Squamous Cell Carcinoma.

    Science.gov (United States)

    Wu, Kailiu; Yang, Xi; Li, Liwen; Ruan, Min; Liu, Wei; Lu, Wei; Zhang, Chenping; Li, Siyi

    2016-07-01

    The objectives of this study were to analyze the regional characteristics of the cervical lymph node metastasis and to investigate the factors associated with the risk of lymph node involvement. One hundred seventy-one patients suffering from early primary squamous cell carcinoma (SCC) of the tongue (cT1-2N0) were enrolled. Gender, age, growth site, T stage, histological grade, and neurovascular invasion were statistically analyzed by K-M survival analysis and Cox multivariate analysis to evaluate the relationship between the factors and the neck lymph node metastasis. Of the 171 cases divided into the neck dissection group and observation group, 40 ended up with lymph node metastasis, of which 17 were metastasized to level I, 27 to level II, 10 to level III, 2 to level IV, and 1 to level V. Histological grade and neurovascular invasion were significantly associated with lymph node involvement in univariate and multivariate analyses. Age distribution was found to be significantly associated with the lymph node metastasis in multivariate analysis. The metastasis of early tongue SCC has a certain regularity at different sites. Age was not a critical risk factor for cervical lymph node metastasis after surgery. Tumor size was suspected to exert a negative effect on metastasis by influencing tumor invasion. Histological grade and neurovascular invasion were significantly associated with the risk of cervical lymph node metastasis of early tongue SCC. PMID:25911199

  17. Use of serum squamous cell carcinoma antigen for follow-up monitoring of cervical cancer patients who were treated by concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    To investigate the significance of monitoring the levels of the serum squamous cell carcinoma antigen (SCC-Ag) for the detection of recurrent disease in patients with cervical cancer treated by concurrent chemoradiotherapy. The records of 112 patients with cervical cancer were reviewed. Serum SCC-Ag levels were measured at regular follow-up visits. A SCC-Ag level of 2 ng/mL was considered the upper limit of normal. Biochemical failure was defined as two consecutively increasing SCC-Ag values above normal. Recurrent disease was confirmed by histologic and radiographic studies. Eighteen patients (16%) developed recurrent disease. Sixteen patients had initially elevated SCC-Ag, post-treatment normalization of SCC-Ag, and tumor recurrence. The SCC-Ag difference (ΔSCC-Ag), defined as the difference between the last value after two consecutively increases above normal and the value immediately before the elevation, had good clinical performance in predicting cancer recurrence. The cutoff value of ΔSCC-Ag was 0.95 ng/mL. SCC-Ag is a relatively good method for the detection of disease recurrence in patients with cervical cancer who were treated by concurrent chemoradiotherapy

  18. Ossification of the cervical ligamentum flavum and osseous brown tumor: late manifestations of primary hyperparathyroidism misdiagnosed in a case of parathyroid carcinoma

    Science.gov (United States)

    Sampanis, Nikolaos; Gavriilaki, Eleni; Paschou, Eleni; Kalaitzoglou, Asterios; Vasileiou, Sotirios

    2016-01-01

    Summary Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations. Herein we aimed at presenting an unique case of a young patient with late manifestations of parathyroid cancer and reviewing the relevant literature. A 45-year-old male patient presented in the Outpatient Clinic with an episode of nephrolithiasis. His personal medical history includes: recurrent episodes of nephrolithiasis, laminectomy in the cervical spine due to ossification of the cervical ligamentum flavum and surgical resection of a giant cell tumor of the brain. Laboratory testing revealed findings of primary hyperparathyroidism (serum calcium 16,0 mmol/l phosphorus 1,46 mg/dl and parathyroid hormone/PTH 8560 pg/ml). Neck ultrasound and technetium-99 m sestamibi scan were performed showing a parathyroid tumor. Due to the persistently high serum calcium and PTH levels, the high alkaline phosphatase levels (440 IU/L) and the late manifestations of HPT, surgical excision of the tumor was performed. The tumor was identified as parathyroid carcinoma. Immediately after surgery serum calcium and phosphorus levels were normalized. The patient is on a regular follow-up program with no signs of recurrence or metastasis one year after the excision. We describe the coexistence of rare late manifestations of HPT, which had not been adequately investigated at their onset in this young patient. Therefore, increased awareness is needed in order to recognize and further investigate signs or symptoms of HPT. PMID:27252748

  19. E2F-Rb complexes assemble and inhibit cdc25A transcription in cervical carcinoma cells following repression of human papillomavirus oncogene expression

    DEFF Research Database (Denmark)

    Wu, L; Goodwin, E C; Naeger, L K;

    2000-01-01

    Expression of the bovine papillomavirus E2 protein in cervical carcinoma cells represses expression of integrated human papillomavirus (HPV) E6/E7 oncogenes, followed by repression of the cdc25A gene and other cellular genes required for cell cycle progression, resulting in dramatic growth arrest....... To explore the mechanism of repression of cell cycle genes in cervical carcinoma cells following E6/E7 repression, we analyzed regulation of the cdc25A promoter, which contains two consensus E2F binding sites and a consensus E2 binding site. The wild-type E2 protein inhibited expression of a...... in the absence of E2 expression. Expression of the E2 protein also led to posttranscriptional increase in the level of E2F4, p105(Rb), and p130 and induced the formation of nuclear E2F4-p130 and E2F4-p105(Rb) complexes. This resulted in marked rearrangement of the protein complexes that formed at the...

  20. The Proteasome Inhibitor MG-132 Protects Hypoxic SiHa Cervical Carcinoma Cells after Cyclic Hypoxia/Reoxygenation from Ionizing Radiation

    Directory of Open Access Journals (Sweden)

    Frank Pajonk

    2006-12-01

    Full Text Available INTRODUCTION: Transient hypoxia and subsequent reoxygenation are common phenomena in solid tumors that greatly influence the outcome of radiation therapy. This study was designed to determine how varying cycles of hypoxia/reoxygenation affect the response of cervical carcinoma cells irradiated under oxic and hypoxic conditions and whether this could be modulated by proteasome inhibition. MATERIALS AND METHODS: Plateau-phase SiHa cervical carcinoma cells in culture were exposed to varying numbers of 30-minute cycles of hypoxia/reoxygenation directly before irradiation under oxic or hypoxic conditions. 26S Proteasome activity was blocked by addition of MG-132. Clonogenic survival was measured by a colonyforming assay. RESULTS: Under oxic conditions, repeated cycles of hypoxia/reoxygenation decreased the clonogenic survival of SiHa cells. This effect was even more pronounced after the inhibition of 26S proteasome complex. In contrast, under hypoxic conditions, SiHa cells were radioresistant, as expected, but this was increased by proteasome inhibition. CONCLUSIONS: Proteasome inhibition radiosensitizes oxygenated tumor cells but may also protect tumor cells from ionizing radiation under certain hypoxic conditions.

  1. A STUDY OF ENDOSCOPIC TREATMENT OF ADVANCED ESOPHAGEAL AND GASTRIC CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    Zhang Jichang; Zhang Lijian; Wang Yanmeng; Li Wei

    1998-01-01

    Objective: To investigate the effect of endoscopic treatment on advanced esophageal and gastric carcinoma.Methods: Twenty advanced gastric cancer patients and 25advanced esophageal cancer patients, who had recurrence after operation and radiotherapy were managed by endoscopic treatment. Results: 10 cases were treated to stop bleeding only, 35 cases were treated by microwave,dilation and local chemotherapy. The successful rate of hemostasis was about 67%, the remission rate of digestive obstruction was about 100% after dilation, 83% of the recurrence lesions were relieved by endoscopic chemotherapy. Conclusion: Endoscope treatment has certain therapeutic efficiency for the recurrence of advanced esophageal and gastric cancer.

  2. A phase II study of weekly neoadjuvant chemotherapy followed by radical chemoradiation for locally advanced cervical cancer

    OpenAIRE

    McCormack, M; Kadalayil, L; Hackshaw, A; Hall-Craggs, M A; Symonds, R P; Warwick, V; Simonds, H.; Fernando, I.; Hammond, M.; James, L.; Feeney, A.; Ledermann, J. A.

    2013-01-01

    Background: We investigated the feasibility of dose-dense neoadjuvant chemotherapy (NACT) with paclitaxel and carboplatin before radical chemoradiation (CRT) and assessed the response rate to such a regimen. Methods: CxII is a single-arm phase II trial of 46 patients, with locally advanced cervical cancer (stage Ib2-IVa). Patients received dose-dense carboplatin (AUC2) and paclitaxel (80 mg m−2) weekly for six cycles followed by CRT (40 mg m−2 of weekly cisplatin, 50.4 G...

  3. Neoadjuvant intraarterial chemotherapy and embolization in treatment of advanced ovarian epithelial carcinoma

    Institute of Scientific and Technical Information of China (English)

    刘恩令; 糜若然

    2004-01-01

    Background The purpose of the study was to evaluate the role of neoadjuvant chemotherapy and embolization via the anterior branches of the bilateral internal iliac arteries in treating patients with advanced ovarian epithelial carcinoma.Methods Forty-two patients with advanced ovarian epithelial carcinoma (study group) were treated via the anterior branches of the bilateral internal iliac arteries after cytoreductive surgery and 7 courses of adjuvant platinum-based combination chemotherapy. Primary cytoreductive surgery was performed in 43 patients with advanced ovarian epithelial carcinoma (control group), and then followed by 8 courses of adjuvant platinum-based combination chemotherapy. The rate of optimal cytoreductive surgery, survival rate, blood loss during operation and operative time were investigated in the two groups. Statistical significance was asessed using Student's t test, the Chi-squre test and the log-rank test. Results In the study group, the rate of optimum debulking after platinum-based chemotherapy and embolization via the anterior branches of the bilateral internal iliac arteries was 71.43%(30/42) (χ2=10.06, P0.05).Conclusions Neoadjuvant platinum-based combination chemotherapy and embolization via the anterior branches of the bilateral internal iliac arteries is an alternative treatment for patients with advanced ovarian epithelial carcinoma, in whom the chance of optimal cytoreductive surgery is low. The treatment can reduce blood loss, decrease operative time, and increase the rate of optimal cytoreductive surgery; but the median survival can't be improved significantly.

  4. Topotecan Monotherapy in Heavily Pretreated Patients with Progressive Advanced Stage Neuroendocrine Carcinomas

    DEFF Research Database (Denmark)

    Olsen, Ingrid Marie Holst; Knigge, Ulrich; Federspiel, Birgitte;

    2014-01-01

    BACKGROUND: Neuroendocrine carcinomas (WHO grade 3) are highly aggressive tumors with an immense tendency to metastasize and with a poor prognosis. In advanced disease, there is no standard treatment beyond first-line platin/etoposide-based chemotherapy. Topotecan is widely used as second...

  5. Sorafenib and hepatic arterial infusion chemotherapy for unresectable advanced hepatocellular carcinoma: A comparative study

    OpenAIRE

    Hiramine, Yasunari; Uto, Hirofumi; Imamura, Yasushi; Tabu, Kazuaki; BABA, YOSHIROU; HIWAKI, TAKUYA; SHO, YUKIHIKO; TAHARA, KENJI; HIGASHI, HIROFUMI; TAMAI, TUTOMU; Oketani, Makoto; Ido, Akio; Tsubouchi, Hirohito

    2011-01-01

    Sorafenib is a kinase-targeted drug that has high efficacy for advanced hepatocellular carcinoma (HCC). The aim of the present study was to determine whether sorafenib is more effective than hepatic arterial infusion chemotherapy (HAIC) for HCC. Twenty patients treated with sorafenib (sorafenib group) initiated at 800 mg/day and 45 patients treated with HAIC (HAIC group) for unresectable Child-Pugh A advanced HCC were investigated retrospectively. The treatment effect was assessed using the R...

  6. Sorafenib-induced acute interstitial pneumonia in patients with advanced hepatocellular carcinoma: report of three cases

    OpenAIRE

    Takeda, Haruhiko; Nishikawa, Hiroki; Iguchi, Eriko; Matsuda, Fumihiro; Kita, Ryuichi; Kimura, Toru; Osaki, Yukio

    2012-01-01

    Little is known about acute interstitial pneumonia (AIP) induced by sorafenib therapy in patients with advanced hepatocellular carcinoma (HCC). Here, we present three patients with advanced HCC who developed AIP during sorafenib therapy, with fatal complications in two cases. Case 1 was a 76-year-old man who developed dyspnea. Chest CT showed interstitial pneumonia. Sorafenib was discontinued immediately, and prednisolone was started. His pneumonia resolved. A drug-induced lymphocyte stimulat...

  7. Tamoxifen compared to best supportive care in advanced hepatocelluar carcinoma: A retrospective matched-cohort study

    OpenAIRE

    Ahmed Abdelmabood Zeeneldin; Salem Mohamed Eid; Amira Diaa Darweesh; Manar Mohamed Moneer; Mohamed Saadeldin

    2014-01-01

    Background: Hepatocelluar carcinoma (HCC) is a common cancer worldwide as well as in Egypt with hepatitis B and C, alcohol and aflatoxins being the commonest risk factors. Tamoxifen was initially reported to confer a marginal survival benefit in advanced HCC. However, later reports declined any benefit. Objective: To study the impact of tamoxifen on overall survival (OS) compared to best supportive care (BSC) in Egyptian patients with advanced HCC. Methods: This retrospective matched-co...

  8. Concurrent Chemoradiotherapy With Paclitaxel and Nedaplatin Followed by Consolidation Chemotherapy in Locally Advanced Squamous Cell Carcinoma of the Uterine Cervix: Preliminary Results of a Phase II Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy and toxicities of concurrent chemoradiotherapy (CCRT) and consolidation chemotherapy in patients with locally advanced squamous cell cervical carcinoma. Methods and Materials: Patients with LASCC (FIGO Stage IIB-IIIB) were treated with pelvic external beam radiotherapy (45 Gy for Stage IIB and 50 Gy for Stage III) and high-dose-rate intracavitary brachytherapy (50 Gy for Stage IIB and 35 Gy for Stage III). The cumulative dose at point A was 50 Gy for Stage IIB and 65 Gy for Stage III. Concurrent chemotherapy with paclitaxel (35 mg/m2) and nedaplatin (20 mg/m2) was given every week for 6 weeks. Consolidation chemotherapy with paclitaxel (135 mg/m2) and nedaplatin (60 mg/m2) was administered every 3 weeks for 4 cycles. Results: All patients completed CCRT, and 28 of 34 patients completed consolidation chemotherapy. The complete response rate was 88% (95% CI, 73-96%). The most common Grade 3 or higher toxicities were leukopenia/neutropenia (10.9% of the cycles). During a median follow up of 23 months (range, 14-30 months), 5 patients had locoregional failure and 1 patient had distant metastasis. The estimated 2-year progression-free survival and overall survival were 82% (95% CI, 68-95%) and 93% (95% CI, 83-100%), respectively. Grade 3 late complications occurred in 3 patients (9%). Conclusions: CCRT with paclitaxel and nedaplatin followed by consolidation chemotherapy is well tolerated and effective in patients with locally advanced squamous cell cervical carcinoma. Further randomized trials of comparing this regimen with the standard treatment are worth while.

  9. An evidence on G2/M arrest, DNA damage and caspase mediated apoptotic effect of biosynthesized gold nanoparticles on human cervical carcinoma cells (HeLa)

    Energy Technology Data Exchange (ETDEWEB)

    Jeyaraj, M. [Department of Biotechnology and Genetic Engineering, School of Biotechnology, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu (India); Arun, R. [Department of Biomedical Sciences, Bharathidasan University, Tiruchirappalli 620024 (India); Sathishkumar, G. [Department of Biotechnology and Genetic Engineering, School of Biotechnology, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu (India); MubarakAli, D. [Central Inter-Disciplinary Research Facility, Mahatma Gandhi Medical College and Research Institute Campus, Pondicherry 607402 (India); Rajesh, M.; Sivanandhan, G.; Kapildev, G.; Manickavasagam, M. [Department of Biotechnology and Genetic Engineering, School of Biotechnology, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu (India); Thajuddin, N. [Department of Microbiology, Bharathidasan University, Tiruchirappalli 620024 (India); Ganapathi, A., E-mail: aganapathi2007@gmail.com [Department of Biotechnology and Genetic Engineering, School of Biotechnology, Bharathidasan University, Tiruchirappalli 620024, Tamil Nadu (India)

    2014-04-01

    Highlights: • Gold nanoparticles (AuNPs) have been synthesized using Podophyllum hexandrum L. • AuNPs induces the oxidative stress to cell death in human cervical carcinoma cells. • It activates the caspase-cascade to cellular death. • It is actively blocks G2/M phase of cell cycle. - Abstract: Current prospect of nanobiotechnology involves in the greener synthesis of nanostructured materials particularly noble metal nanoparticles for various biomedical applications. In this study, biologically (Podophyllum hexandrum L.) synthesized crystalline gold nanoparticles (AuNPs) with the size range between 5 and 35 nm were screened for its anticancereous potential against human cervical carcinoma cells (HeLa). Stoichiometric proportion of the reaction mixture and conditions were optimized to attain stable nanoparticles with narrow size range. Different high throughput techniques like transmission electron microscope (TEM), X-ray diffraction (XRD) and UV–vis spectroscopy were adopted for the physio-chemical characterization of AuNPs. Additionally, Fourier transform infrared spectroscopy (FTIR) study revealed that the water soluble fractions present in the plant extract solely influences the reduction of AuNPs. Sublimely, synthesized AuNPs exhibits an effective in vitro anticancer activity against HeLa cells via induction of cell cycle arrest and DNA damage. Furthermore, it was evidenced that AuNPs treated cells are undergone apoptosis through the activation of caspase cascade which subsequently leads to mitochondrial dysfunction. Thereby, this study proves that biogenic colloidal AuNPs can be developed as a promising drug candidature for human cervical cancer therapy.

  10. Influence of chromosomal integration on glucocorticoid-regulated transcription of growth-stimulating papillomavirus genes E6 and E7 in cervical carcinoma cells.

    Science.gov (United States)

    von Knebel Doeberitz, M; Bauknecht, T; Bartsch, D; zur Hausen, H

    1991-01-01

    In most cervical carcinoma cells the E6 and E7 genes of specific human papillomaviruses are transcribed from viral sequences integrated into host cell chromosomes. Glucocorticoids activate the promoter elements of various human papillomaviruses in transient-expression assays. We have analyzed the effect of dexamethasone on the transcription rate of human papillomavirus 18 E6 and E7 genes integrated at different chromosomal sites in four cervical cancer cell lines. Dexamethasone led to an increase in the transcription rate of the integrated E6-E7 sequences in C4-1 and C4-2 cells but led to a decrease in SW 756 cells and did not affect the transcription rate in HeLa cells. However, when the viral promoter elements derived from HeLa or SW 756 cells, in which dexamethasone does not activate transcription of the integrated E6-E7 sequences, were tested in transient-expression assays within the same cell lines, dexamethasone consistently activated the viral promoter. It thus appears that dominant regulatory mechanisms presumably depending on the chromosomal integration site are able to override the response of the viral promoter to steroid hormones. The growth rate of all dexamethasone-treated cell lines correlated consistently with the expression of the papillomavirus E6 and E7 genes, supporting their role in the maintenance of the proliferative phenotype of cervical carcinoma cells. Since human papillomaviruses are integrated into the host cell genome at variable, presumably randomly selected chromosomal loci, regulatory mechanisms that influence viral gene expression, and hence cell growth, may differ among cancers of independent clonal origin. Images PMID:1847520

  11. Diagnostic efficacy of diffusion-weighted MRI for pre-operative assessment of myometrial and cervical invasion and pelvic lymph node metastasis in endometrial carcinoma

    International Nuclear Information System (INIS)

    To determine the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) for the pre-operative assessment of patients with endometrial carcinoma and to assess myometrial and cervical invasion as well as pelvic lymph node metastasis. Fifty-eight women who underwent surgery for histopathologically confirmed endometrial carcinoma were included in the current study. Prior to surgery, patients were evaluated using pelvic DW-MRI and gadolinium-enhanced T1-weighted imaging (Gd-T1WI). Gd-T1WI was evaluated together with T2-weighted images. DW-MR images were obtained in the axial plane using echo-planar spin-echo pulse sequences with different b factors. Endometrial carcinomas were observed as areas of increased intensity on DW-MRI images, and their intensity was compared with the surrounding hypo-intense myometrium. Pre-operative DW-MRI and Gd-T1WI results were compared with post-operative histopathological findings that served as reference standards. The sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and diagnostic accuracy of DW-MRI for differentiation between superficial myometrial invasion and deep myometrial invasion were 85%, 89%, 81%, 92% and 88%, respectively. The sensitivity, specificity and diagnostic accuracy rates were 82%, 91% and 89.6% for cervical invasion and 100%, 96% and 96.5% for pelvic lymph node metastasis, respectively. The sensitivity, specificity, PPV and NPV, and diagnostic accuracy of Gd-T1WI for differentiation between superficial myometrial invasion and deep myometrial invasion were 85%, 81.5%, 71%, 91% and 83%, respectively. The sensitivity, specificity and diagnostic accuracy were 73%, 89% and 86% for cervical invasion, respectively. These findings suggest that DW-MRI may be a good diagnostic tool with high sensitivity and specificity for assessing myometrial invasion and detecting tumour extension. We suggest that DW-MRI should be considered as a routine part of the pre-operative pelvic

  12. BRAIN METASTASES FROM CARCINOMA OF UTERINE CERVIX

    Institute of Scientific and Technical Information of China (English)

    张国楠; 徐世强; 石宇; 樊英; 吴艳丽; 殷红; 余健; 陈毅男

    2002-01-01

    Objective: To study the mechanism, clinical characteristics, therapy regimens, and survival of cervical carcinoma metastases to the brain. Methods: We retrospectively analyzed 11 patients with brain metastases from cervical carcinoma. Results: Two cases were at stage lb, two at IIa, and seven at IIIb, respectively. Histologically, they were squamous cell carcinoma (6 cases), adeno-squamous carcinoma (2 cases), small cell carcinoma (2 cases), or adenocarcinoma (1 cases), poorly differentiated. Eight were accompanied with lung, liver, and bone metastases disease and three had no any other systemic metastases at the time of the brain metastases diagnosis. Two had controlled, and other nine were uncontrolled or progressive primary disease. The median interval from the diagnosis of the primary carcinoma to the detection of brain lesion was 14.6 months. Headache was the most common symptom of brain metastases. Eight of 11 patients developed multiple lesions and other 3 cases had a solitary lesion in brain. The patients were treated by combination of surgery and whole brain radiation therapy (WBRT) (3 cases), stereotactic radiosurgery (SRS) (3 cases), or WBRT (5 cases). The patients had a median survival of 6.6 months. Conclusion: Brain metastases are not always a late complication of cervical carcinoma. The development of the metastases is related to pathological type, poorly differentiation, and advanced stage. Surgery and SRS arc the appropriate therapy regimen for these patients.

  13. Short-course PET based simultaneous integrated boost for locally advanced cervical cancer

    International Nuclear Information System (INIS)

    Patients with large, locally advanced cervical cancers (LACC) are challenging to treat. The purpose of this work is to use 18F-FDG PET as planning basis for a short-course simultaneous integrated boost (SIB) in external beam radiotherapy of LACC in order to increase tumour shrinkage and likelihood of local control. Ten previously treated patients with LACC were included, all with pre-treatment FDG PET/CT images available. The FDG avid tumour volume, MTV50, was dose escalated in silico by intensity modulated radiotherapy from the standard 1.8 Gy to 2.8 Gy per fraction for the 10 first fractions; a short-course SIB. For the 18 remaining external fractions, standard pelvic treatment followed to total PTV and MTV50 doses of 50.4 Gy and 60.4 Gy, respectively. Photon and proton treatment were considered using volumetric modulated arc treatment (VMAT) and intensity-modulated proton therapy (IMPT), respectively. All treatment plans were generated using the Eclipse Treatment Planning System (TPS). The impact of tumour shrinkage on doses to organs at risk (OARs) was simulated in the TPS for the SIB plans. Dose escalation could be implemented using both VMAT and IMPT, with a D98 ≥ 95 % for MTV50 being achieved in all cases. The sum of the 10 fraction short-course SIB and subsequent 18 standard fractions was compared to the standard non-SIB approach by dose volume histogram (DVH) analysis. Only marginal increase of dose to OARs was found for both modalities and a small further increase estimated from tumour shrinkage. Most DVH parameters showed a mean difference below 2 %. IMPT had, compared to VMAT, reduced OAR doses in the low to intermediate dose range, but showed no additional advantage in dose escalation. Planning of dose escalation based on a FDG avid boost volume was here demonstrated feasible. The concept may allow time for enhanced tumour shrinkage before brachytherapy. Thus, this strategy may prove clinically valuable, in particular for patients with large tumours

  14. BCG plus levamisole following irradiation of advanced squamous bronchial carcinoma

    International Nuclear Information System (INIS)

    Fifty patients with inoperable squamous cell carcinoma of the bronchus were treated with radical radiotherapy. Afterwards, 16 patients received levamisole on 2 days per week and bacillus calmette guerin (B.C.G.) skin innoculations every two weeks;another 16 received the same dosage of levamisole but B.C.G. every 4 weeks; 18 patients were controls. Survival was better in the first group of patients only during the first two years of study (P = 0.02) but not later: metastases were fewer. Both B.C.G. and levamisole gave little discomfort when the dose was adjusted for each patient

  15. Renal cell carcinoma: evolving approaches to advanced non-clear cell carcinoma

    OpenAIRE

    Bukowski, Ronald M; Heng, Daniel Y.C.

    2011-01-01

    The treatment of metastatic renal cell carcinoma (RCC) has changed dramatically with the introduction of targeted therapies including sunitinib, sorafenib, and temsirolimus. Because patients with conventional clear cell histology account for 75- 80% of all patients with RCC, there has been little accumulated evidence on the treatment of patients with non-clear cell histologies. Most clinical trials have excluded them from enrolment, except for randomized studies investigating temsirolimus. Ma...

  16. Auto-Penectomy: A Devastating Complication of Advanced, Neglected Penile Carcinoma: Autopenectomy due to penile carcinoma

    OpenAIRE

    Kumar, Arvind; Goel, Apul; Sankhwar, Satya N.

    2013-01-01

    Auto-penectomy is a rare consequence of penile carcinoma (PC). Two men, 65 and 74 years of age, presented with total penile loss secondary to PC. Due to poor hygiene and negligence, the ulcer was infected with maggots. The management was by local debridement and suprapubic cystostomy. No further treatment was done as the patients did not come for follow-up.

  17. [A CASE OF ADVANCED BLADDER NEUROENDOCRINE CARCINOMA (SMALL CELL CARCINOMA) SIGNIFICANTLY IMPROVED BY LOW DOSE OF ORAL TEGAFUR-URACIL].

    Science.gov (United States)

    Nomi, Hayahito; Takahara, Kiyoshi; Minami, Koichiro; Maenosono, Ryoichi; Matsunaga, Tomohisa; Yoshikawa, Yuki; Tsujino, Takuya; Hirano, Hajime; Inamoto, Teruo; Yamamoto, Ikuhisa; Tsuji, Motomu; Kiyama, Satoshi; Azuma, Haruhito

    2015-10-01

    A 81-old-woman underwent a transurethral resection of bladder tumor (TURBT) at a nearby hospital in April 2011. The diagnosis was invasive urothelial carcinoma, G3 with a component of bladder small cell carcinoma, T1 or more. She was recommended to visit our hospital for combined modality therapy of bladder cancer, but she refused the treatment for over one year. In May 2012, she came to our hospital with the chief complaint of pain at urination. Cystoscopy revealed non-papillary sessile tumor in the top of the bladder, and CT scan demonstrated the presence of the right obturator lymph nodes swollen up to 1.2 cm in size. The second TURBT was performed and the diagnosis was bladder small cell carcinoma (pT3N2M0) according to urothelial cancer guidelines of the Japanese Urological Association (JUA). Because she strongly refused hospitalization anymore, we started daily oral intake of low dose Tegafur-Uracil (100 mg) for the treatment. After one month, the serum Neuron-Specific Enolase (NSE; tumor maker of small cell cancer) level was elevated to 27.6 ng/ml and the right obturator lymph node was enlarged up to 1.9 cm. Therefore, the Trgafur-Uracil dose was increased to 200 mg daily. After then, the serum NSE level was decreased to 15.5 ng/ml following reduction in size of the obturator lymph nodes with partial response in December 2013. After two years of follow-up period, her regular urine test showed normal findings, and no apparent recurrence was detected on urinary bladder with MRI and Cystoscopy. This is a case of advanced bladder small cell carcinoma significantly improved by oral administration of Tegafur-Uracil 200 mg/day for over 2 years. PMID:26717786

  18. Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

    Directory of Open Access Journals (Sweden)

    Christian Steinberg

    2013-01-01

    Full Text Available Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

  19. Neoadjuvant chemotherapy versus primary surgery in advanced ovarian carcinoma

    OpenAIRE

    Elshamy Maged R; Setit Ahmed E; Elshafei Mohamed A; Hegazi Refaat AF; Hegazy Mohamed AF; Eltatoongy Mohamed; Halim Amal AF

    2005-01-01

    Abstract Background Patients with advanced ovarian cancer should be treated by radical debulking surgery aiming at complete tumor resection. Unfortunately about 70% of the patients present with advanced disease, when optimal debulking can not be obtained, and therefore these patients gain little benefit from surgery. Neoadjuvant chemotherapy (NACT) has been proposed as a novel therapeutic approach in such cases. In this study, we report our results with primary surgery or neoadjuvant chemothe...

  20. Neo-adjuvant chemotherapy in advanced hypopharyngeal carcinoma

    OpenAIRE

    Joshi, P.; V Patil; Joshi, A; V Norohna; Chaturvedi, P.; Chaukar, D.; P Pai; D Nair; Juvekar, S; Agarwal, J. P.; A K D′cruz; Prabhash, K

    2013-01-01

    Objective: The aim of this retrospective study was to find out the role of neo-adjuvant chemotherapy (NACT) in changing the management and outcome of advanced hypopharyngeal cancer patients. Materials and Methods: This is a retrospective analysis of 59 treatment naïve, advanced hypopharyngeal cancer patients presenting to our tertiary care center from April 2010 to October 2011. NACT was given as two (platinum with taxane) or three drug with (platinum, taxane with 5-flurouracil [5 FU]) as 3 w...

  1. Persistent human papillomavirus infection in the etiology of cervical carcinoma: The role of immunological, genetic, viral and cellular factors

    OpenAIRE

    Živadinović Radomir; Petrić Aleksandra; Lilić Goran; Lilić Vekoslav; Đorđević Biljana

    2014-01-01

    The aim of this paper was to present the role of human papillomavirus (HPV) in cervical carcinogenesis from several aspects. By explaining the HPV virus lifecycle and structure, its effect on cervical cell cycle and subversion of immune response can be better understood. Early E region of the viral genome encodes proteins that are directly involved in carcinogenesis. The E6 protein binds to p53 protein (product of tumor-suppressor gene) blocking and degradi...

  2. 宫颈癌前病变及宫颈癌与高危型HPV16,18 DNA关系的探讨%Role of high-risk HPV16,18 DNA in early cervical dysplasia and cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    张巧红; 陈黎亚; 万汝根

    2013-01-01

    Objective:To explore the relationship beteen HPV16,18 and early dysplasia as well as cervical carcinoma by examining the infection with human HPV16,18 in early cervical dysplasia and cervical carcinoma. Methods; All specimens were detected for HPV16,18 DNA using techniques of fluorescence quantitative polymerase chain reaction (FQ -PCR). The pathological changes were graded based on CIN criteria. CIN Ⅱ - Ⅲ were the early cervical dysplasia of cervical cancer. Results; The cervical tissue HPV16,18 infection rate of CIN Ⅱ - Ⅲ patients was 67. 6% . The detection rate of HPV16,18 in cervicl cancer patients was 91. 8% . The detection rate of HPV16,18 in chronic cervicitis patients was 28.6%. Conclusion; The development of cervical carcinoma and early cervical dysplasia were associated with an increased risk of HPV16,18 infection. The detection of high - risk HPV16,18 DNA provides application value for the forcast and theraphy of cervical carcinoma.%目的:通过检测宫颈癌前病变及宫颈癌患者宫颈分泌物HPV16,18的感染情况,探讨其与宫颈癌前病变及宫颈癌的相关性.方法:应用荧光定量PCR(FQ-PCR)技术对宫颈分泌物进行HPV16,18DNA定性检测.以光镜下病理学诊断作为CIN分级标准.CINⅡ及Ⅲ级是宫颈癌的癌前病变.结果:CINⅡ-Ⅲ级患者宫颈分泌物HPV16.18的检出率为67.7%.宫颈癌患者HPV16.18的检出率为91.8%.慢性宫颈炎患者的HPV16,18的检出率为28.6%.结论:HPV16,18感染与宫颈癌及宫颈癌前病变的发生发展密切相关.高危型HPV16,18 DNA的检测对预防宫颈癌及宫颈癌的治疗有重要的指导作用.

  3. Leukemia Inhibitory Factor Downregulates Human Papillomavirus-16 Oncogene Expression and Inhibits the Proliferation of Cervical Carcinoma Cells

    Directory of Open Access Journals (Sweden)

    Joseph M. Bay

    2011-01-01

    Full Text Available The constitutive proliferation and resistance to differentiation and apoptosis of neoplastic cervical cells depend on sustained expression of human papillomavirus oncogenes. Inhibition of these oncogenes is a goal for the prevention of progression of HPV-induced neoplasias to cervical cancer. SiHa cervical cancer cells were transfected with an HPV-16 promoter reporter construct and treated with leukemia inhibitory factor (LIF, a human cytokine of the interleukin 6 superfamily. SiHa and CaSki cervical cancer cells were also assessed for proliferation by MTT precipitation, programmed cell death by flow cytometry, and HPV E6 and E7 expression by real-time PCR. LIF-treated cervical cancer cells showed significantly reduced HPV LCR activation, reduced levels of E6 and E7 mRNA, and reduced proliferation. We report the novel use of LIF to inhibit viral oncogene expression in cervical cancer cells, with concomitant reduction in proliferation suggesting re-engagement of cell-cycle regulation.

  4. Recent advances in the prevention of hepatocellular carcinoma recurrence.

    Science.gov (United States)

    Lu, Li-Chun; Cheng, Ann-Lii; Poon, Ronnie T P

    2014-11-01

    Hepatocellular carcinoma (HCC) is one of the most lethal malignancies worldwide. Early-stage HCC can be curatively treated, but the recurrence rate remains high. To date, adjuvant treatments have not proven effective in preventing HCC recurrence after curative treatment. Although early studies explored the potential of vitamin K2, retinoid, chemotherapy, and recently, sorafenib, none of the studies reported successful outcomes. Several new lines of evidence have emerged to support the use of novel antiviral agents for preventing the recurrence of virus-related HCC after curative treatment. In this review, the authors provide a thorough overview of the various adjuvant treatments that have been attempted or are being considered for trial. PMID:25369304

  5. Virilizing adrenocortical carcinoma advancing to central precocious puberty after surgery.

    Science.gov (United States)

    Kim, Min Sun; Yang, Eu Jeen; Cho, Dong Hyu; Hwang, Pyung Han; Lee, Dae-Yeol

    2015-05-01

    Adrenocortical carcinoma (ACC) in pediatric and adolescent patients is rare, and it is associated with various clinical symptoms. We introduce the case of an 8-year-old boy with ACC who presented with peripheral precocious puberty at his first visit. He displayed penis enlargement with pubic hair and facial acne. His serum adrenal androgen levels were elevated, and abdominal computed tomography revealed a right suprarenal mass. After complete surgical resection, the histological diagnosis was ACC. Two months after surgical removal of the mass, he subsequently developed central precocious puberty. He was treated with a gonadotropin-releasing hormone agonist to delay further pubertal progression. In patients with functioning ACC and surgical removal, clinical follow-up and hormonal marker examination for the secondary effects of excessive hormone secretion may be a useful option at least every 2 or 3 months after surgery. PMID:26019766

  6. Effects of Tatariside G Isolated from Fagopyrum tataricum Roots on Apoptosis in Human Cervical Cancer HeLa Cells

    OpenAIRE

    Yuan Li; Su-Juan Wang; Wei Xia; Khalid Rahman; Yan Zhang; Hao Peng; Hong Zhang; Lu-Ping Qin

    2014-01-01

    Cervical cancer is the second most common female carcinoma. Current therapies are often unsatisfactory, especially for advanced stage patients. The aim of this study was to explore the effects of tatariside G (TG) on apoptosis in human cervical cancer HeLa cells and the possible mechanism of action involved. An MTT assay was employed to evaluate cell viability. Hoechst 33258 staining and flow cytometry (FCM) assays were used to detect cell apoptosis. The protein expression of phosphorylated J...

  7. Chemoradiotherapy using retrograde superselective intra-arterial infusion for advanced oral cancer. Therapeutic effect for T3 and T4 squamous cell carcinoma of the upper gingiva

    International Nuclear Information System (INIS)

    Concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion demonstrates good local control and overall survival rates due to the advantage of simultaneous infusion of anticancer agent with the synergistic effects of chemotherapy and radiotherapy. This study was conducted to evaluate the therapeutic results of 17 patients with locally advanced squamous cell carcinoma of the upper gingiva (T3, T4) treated with definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m2: cisplatin, total 150 mg/m2) and daily concurrent radiotherapy (total 60 Gy) for 6 weeks. Patients underwent biopsy of the primary lesion and radiological examinations 4 weeks after the completion of all treatments. Complete response (CR) of the primary site was achieved in 14 (82.4%) patients. Among them, 1 patient showed local recurrence and 1 patient showed cervical and pulmonary metastases. Four patients died, 1 of pulmonary metastases, 1 of cervical metastases, and 2 of uncontrolled local lesion during follow-up. Two-year cumulative local control and overall survival rates by the Kaplan-Meier method were 76.5% and 81.4%, respectively. (author)

  8. A Phase II Study of Docetaxel, Cisplatin and 5- Fluorouracil (TPF) In Patients with Locally Advanced Head and Neck Carcinomas

    OpenAIRE

    Ansari, M.; Omidvari, S; Mosalaei, A.; Ahmadloo, N; Mosleh-Shirazi, M. A.; Mohammadianpanah, M.

    2011-01-01

    Background The combination of cisplatin and 5-fluorouracil (PF) is currently considered a standard and effective regimen for the treatment of advanced head and neck carcinomas. The aim of this study was to evaluate the efficacy and safety of docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with unresectable head and neck carcinomas. Methods Forty-six patients with previously untreated non-metastatic stage IV head and neck carcinomas were enrolled. All patients received three cycles o...

  9. Combination of radiotherapy with chemotherapy using cisplatin of advanced esophageal carcinoma

    International Nuclear Information System (INIS)

    Of 38 patients with esophageal carcinoma who were treated at the Department of Radiology, Tokushima University Hospital between 1983 and 1987, 13 (34 %) received a combination of radiation and chemotherapy of cisplatin-based combination regimens. Twelve patients with squamous cell carcinoma and one with adenocarcinoma were treated by a 6 MV linear accelerater. They received a cummulative dose ranging from 18 to 68 Gy (average dose : 50.5 Gy), in 2 Gy fractions. The response rate was 62 % (CR 1, PR 7). Two of the six patients with Stage III survived more than three years. Median survival time was 11.4 months for patients with Stage III and 4.7 months for Stage IV. Chemotherapy improved median survival duration for patients with advanced esophageal carcinoma but did not produce a significant improvement in survival, as reported in other recent series. (author)

  10. Invasive Stratified Mucin-producing Carcinoma and Stratified Mucin-producing Intraepithelial Lesion (SMILE): 15 Cases Presenting a Spectrum of Cervical Neoplasia With Description of a Distinctive Variant of Invasive Adenocarcinoma.

    Science.gov (United States)

    Lastra, Ricardo R; Park, Kay J; Schoolmeester, J Kenneth

    2016-02-01

    Stratified mucin-producing intraepithelial lesion (SMILE) is a cervical intraepithelial lesion, distinct from conventional squamous or glandular counterparts, believed to arise from embryonic cells at the transformation zone by transdifferentiation during high-risk HPV-associated carcinogenesis. It is characterized by stratified, immature epithelial cells displaying varying quantities of intracytoplasmic mucin throughout the majority of the lesional epithelium. We identified a distinct form of invasive cervical carcinoma with morphologic features identical to those in SMILE, which we have termed "invasive stratified mucin-producing carcinoma." Fifteen cases from 15 patients (mean 36 y; range, 22 to 64 y) were retrieved from the pathology archives of multiple institutions with a diagnosis of either SMILE or invasive cervical carcinoma with a description or comment about the invasive tumor's resemblance to SMILE. Seven cases had solely intraepithelial disease with a component of SMILE (mean 29 y; range, 22 to 40 y). The 8 other cases had invasive stratified mucin-producing carcinoma (mean 44; range, 34 to 64 y) in which SMILE was identified in 7. All cases of invasive stratified mucin-producing carcinoma demonstrated stratified, immature nuclei with intracytoplasmic mucin, which morphologically varied between cases from "mucin-rich" to "mucin-poor" in a similar manner to SMILE. All cases had mitotic figures and apoptotic debris, and an intralesional neutrophilic infiltrate was seen in the majority of cases. In cases of invasive carcinoma, the depth of invasion ranged from growth patterns. Given that SMILE is well rooted as a distinct intraepithelial lesion, we propose "invasive stratified mucin-producing carcinoma" to describe its corresponding form of invasive carcinoma. PMID:26523540

  11. A dosimetric comparison of three plans in simultaneous integrated boost intensity-modulated radiotherapy in cervical esophageal carcinoma undergoing prophylactic lymphatic irradiation

    International Nuclear Information System (INIS)

    Objective: To evaluate the optimized simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) plans in cervical esophageal carcinoma underwent prophylactic lymphatic irradiation. Methods: Six patients with cervical esophageal carcinoma were studied.The gross tumor volume (GTV) and clinical target volume (CTV) (including bilateral mid-lower neck and supraclavicular lymph drainage regions, upper mediastinal lymph drainage regions) were delineated on sim-CT images, GTV and CTV were uniformly expanded by 5 mm to create PGTV and PTV. Five fields (5F), 7F and 9F SIB-IMRT plans were designed. The prescribed doses to PGTV and PTV were 66 Gy and 60 Gy in 30 fractions respectively. The parameters of dose-volume histograms in three groups planning were compared. Results: The values of conformity index (CI) of PGTV were 0.56, 0.62 and 0.69 (F =6.22, P<0.01), the V66 with 88.24%, 95.03% and 94.91% (F=4.39, P<0.05) and D95 with 6539.67, 6601.83 and 6602.00 cGy (F=4.46, P<0.05) in 5F, 7F and 9F SIB-IMRT plans. The values of CI, V66 and D95 of PTV were 0.80, 0.85 and 0.87 (F=11.29, P<0.01), with 91.64%, 94.05% and 95.06% (F=4.10, P<0.05) and with 5934.00, 5987.17 and 6006.33 cGy (F=4.01, P<0.05). The values of maximal dose of spinal cord were 4707.17, 4497.83 and 4357.00 cGy (F=11.26, P<0.011) in 5F, 7F and 9F SIB-IMRT plans. The values of all dosimetric parameters about PGTV and PTV were same in 7F and 9F SIB-IMRT plans (all P>0.05). Conclusion: 7F-SIB-IMRT plan is best one scheme for cervical esophageal carcinoma underwent prophylactic lymphatic irradiation. (authors)

  12. Response analysis of the results of radiotherapy for cervical lymph node metastasis in squamous cell carcinoma of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Kita, Midori; Okawa, Tomohiko; Ikeda, Michio (Tokyo Women' s Medical Coll. (Japan))

    1989-06-01

    Seventy-three patients with squamous cell carcinoma of the head and neck were treated with radiotherapy from 1968 until 1985. The 135 metastatic cervical lymph nodes were given radiation doses exceeding TDF 65 (40 Gy/20 fr/4 weeks). The data was analyzed retrospectively to evaluate the factors affecting radiation response and control. At 1 month following radiotherapy, the complete response (CR) rate was 102/135, partial response (PR) was 23/135,while 6/135 registered no change (NC), and 4/135 exhibited progressive disease (PD). The CR rate for nodes near the primary site was 65/68 for nasopharynx, 12/15 oropharynx 13/21, for hypopharynx, 0/7 for tongue, 8/17 for larynx, and 4/7 for maxillary sinus, respectively. The CR rate was 81/98 for lymph nodes up to 3 cm compared to 21/37 for larger nodes. In nasopharyngeal carcinoma, the CR rate for nodes up to 3 cm was 30/30 at dose levels over TDF 65; however, for larger nodes, it was 4/7 at TDF 65-99 and 10/10 at TDF 100 or above. In other carcinomas, the CR rate for nodes up to 3 cm was 13/23 at 65-99 and 17/24 at TDF 100 or above; however, for larger nodes, it was 0/2 at TDF 65-99 and 7/18 at TDF 100 or above. In moderately and well differentiated carcinomas, the CR rate was related to TDF. In follow-up studies, 8 of 102 CR nodes recurred and were accompanied by primary and/or distant disease; 5 out of 23 PR nodes changed to CR 2-12 months after treatment. The 2-year CR rate for nasopharyngeal carcinoma nodes was 19/28 and 15/42 in the other nodes. The data suggests that, for patients with metastatic lymph nodes from squamous cell carcinoma of the head and neck, radiotherapy was effective and useful in curing nodes up to 3 cm, irrespective of the primary site or histological grade. However, with the excretion of nasopharyngeal carcinoma, multimodal treatment should be considered for nodes larger than 3 cm.

  13. The accuracy of ultrasonography in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma: A meta-analysis

    International Nuclear Information System (INIS)

    Background: Ultrasonography has been proposed to enhance preoperative assessment of cervical lymph node status in patients with papillary thyroid carcinoma (PTC). Management is most controversial for patients with a clinically negative (cN0) neck. We aimed to evaluate the diagnostic properties of ultrasonography in the detection of cervical lymph node metastasis in patients with PTC. Materials and methods: Studies evaluating the diagnostic accuracy of Ultrasonography in the diagnosis of cervical lymph node metastasis in patients with PTC were systematically searched for in the MEDLINE, EMBASE, Cancerlit and Cochrane Library and other database from January 1995 to November 2010. Two reviewers independently abstracted data including research design, sample size, imaging technique and technical characteristics, method of image interpretation. By patient-based and region- or node-based data analyses, we determined pooled sensitivities and specificities across studies, and constructed summary receiver operating characteristic curves, and area under summary receiver operating characteristic curves were calculated. Results: The pooled patient-based sensitivity for ultrasonography was 0.72 (95% CI, 0.46–0.88), specificity was 0.98 (95% CI, 0.84–1.00), and the area under the curve (AUC) was 0.94 (95% CI, 0.92–0.0.96). The pooled region- or node-based sensitivity for ultrasonography was 0.63 (95% CI, 0.47–0.76), specificity was 0.93 (95% CI, 0.73–0.99), and the AUC was 0.81 (95% CI, 0.77–0.84). For lesion-based analysis, the subgroup of lateral compartment lymph node involvement was found to have the highest sensitivity (0.72, 95% CI 0.68–0.75) and specificity (0.97, 95% CI 0.93–0.99) among the studies (p 2 = 0.0196, p = 0.7915; region- or node-based: R2 = 0.3835, p = 0.1381). Conclusions: We conclude that preoperative ultrasonography is a good technique for the preoperative lymph node staging of PTC and is helpful for detecting metastatic cervical lymph

  14. Perfusion CT in patients with advanced bronchial carcinomas: a novel chance for characterization and treatment monitoring?

    International Nuclear Information System (INIS)

    Advanced bronchial carcinomas by means of perfusion and peak enhancement using dynamic contrast-enhanced multislice CT are characterized. Twenty-four patients with advanced bronchial carcinoma were examined. During breathhold, after injection of a contrast-medium (CM), 25 scans were performed (1 scan/s) at a fixed table position. Density-time curves were evaluated from regions of interest of the whole tumor and high- and low-enhancing tumor areas. Perfusion and peak enhancement were calculated using the maximum-slope method of Miles and compared with size, localization (central or peripheral) and histology. Perfusion of large tumors (>50 cm3) averaged over both the whole tumor (P=0.001) and the highest enhancing area (P=0.003) was significantly lower than that of smaller ones. Independent of size, central carcinomas had a significantly (P=0.04) lower perfusion (mean 27.9 ml/min/100 g) than peripheral ones (mean 66.5 ml/min/100 g). In contrast, peak enhancement of central and peripheral carcinomas was not significantly different. Between non-small-cell lung cancers and small-cell lung cancers, no significant differences were observed in both parameters. In seven tumors, density increase after CM administration started earlier than in the aorta, indicating considerable blood supply from pulmonary vessels. Tumor perfusion was dependent on tumor size and localization, but not on histology. Furthermore, perfusion CT disclosed blood supply from both pulmonary and/or bronchial vessels in some tumors. (orig.)

  15. Treatment methods of neoadjuvant chemotherapy for locally advanced cervical adenocarcinoma%局部晚期宫颈腺癌新辅助化疗方式探讨

    Institute of Scientific and Technical Information of China (English)

    李桑; 谢榕; 林玉珍

    2011-01-01

    目的:探讨不同用药途径的新辅助化疗对局部晚期宫颈腺癌的疗效,寻找更安全、有效的化疗方法.方法:回顾性分析我院2006 年1月-2009年12月期间收治的58例经手术治疗的局部晚期宫颈腺癌,根据新辅助化疗方式不同分为新辅助动脉化疗(neoadjuvant intra-arterial chemotherapy,NAIC)28例和新辅助化疗(neoadjuvant chemotherapy,NACT)30例.NAIC组采用紫杉醇脂质体、博来霉素、顺铂方案,NACT组采用紫杉醇脂质体、顺铂方案化疗,两组均1-2个疗程后行手术,对比两组化疗后肿瘤退缩及术后病理情况.结果:两组化疗有效率差异无显著性(P>0.05),NAIC组组织学痊愈率明显高于NACT组(P0.05).两组术后均无阴道切缘阳性病例.两组化疗不良反应差异无显著性(P>0.05).结论:新辅助动脉化疗对局部晚期宫颈腺癌产生的组织学痊愈率明显高于静脉化疗,可以减少宫旁浸润和脉管癌栓的发生率,是值得推广的新辅助化疗方式.%Objective:To compare the effect of neoadjuvant intra - arterial chemotherapy and neoadjuvant chemotherapy, to search more effective chemotherapy methods. Methods: Retrospectievely analyzed 58 patients with locally advanced cervical ade no carcinoma in our hospital from January 2006 to December 2009, all patients were divided into two groups, 28 patients in NAIC group were treated by neoadjuvant intra - arterial chemotherapy with paclitaxel liposome.bleomycin plus cisplatin for 2 cycles followed by radical hysterectomy and lymphadenectomy, 30 patients in NACT group were treated by neoadjuvant chemotherapy with paclitaxel liposome and cisplatin for 2 cycles followed by the same operation. To compare the regress rate of tumor, pathologic change of two groups. Results: There was no significant difference in the effective rate of NAIC group and NACT group ( P>0.05 ). The rate of histologic healed in NAIC group was more than that of in NACT group( P 0. 05 ). There was no

  16. Advanced Urothelial Carcinoma: Overcoming treatment resistance through novel treatment approaches

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    RichardMBambury

    2013-02-01

    Full Text Available The current standard of care for metastatic urothelial carcinoma (UC is cisplatin-based chemotherapy but treatment is generally not curative. Mechanisms of resistance to conventional cytotoxic regimens include tumor cell drug efflux pumps, intracellular anti-oxidants and enhanced anti-apoptotic signaling. Blockade of signaling pathways with small molecule tyrosine kinase inhibitors has produced dramatic responses in subsets of other cancers. Multiple potential signaling pathway targets are altered in UC. Blockade of the PI3K/Akt/mTOR pathway may prove efficacious because 21% have activating PI3K mutations and another 30% have PTEN inactivation (which leads to activation of this pathway. The fibroblast growth factor receptor 3 protein may be overactive in 50-60% and agents which block this pathway are under active development. Blockade of multiple other pathways including HER2 and aurora kinase also have potential efficacy. Anti-angiogenic and immunotherapy strategies are also under development in UC and are discussed in this review. Novel therapeutic approaches are needed in UC. We review the various strategies under development in this disease and discuss how best to evaluate and optimize their efficacy.

  17. Advanced Gastric Neuroendocrine Carcinoma with an Adenocarcinoma Component

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    Masashi Miguchi

    2012-01-01

    Full Text Available In the present study, we observed that the adenocarcinoma component in the mucosa was continuous with neuroendocrine carcinoma (NEC in the deeper layers; this suggests the normal course of NEC carcinogenesis at the histological level. A 72-year-old man was admitted to our hospital with a chief complaint of tarry stools. Endoscopic examination of the upper gastrointestinal tract revealed a 2-cm tumor, with a deep central depression, surrounded by a smooth elevated area, in the middle of the stomach body. A biopsy showed that the tumor was a moderately differentiated gastric adenocarcinoma. The patient underwent total gastrectomy and standard lymph node dissection. The resected tumor was a 3.5 × 2.5 cm type 2 lesion. It comprised two elements at the histological level: (i a moderately differentiated adenocarcinoma in the superficial portion of the mucous membrane layer, and (ii NEC-like cells with dark, round nuclei and scant cytoplasm, presenting a solid and trabecular pattern, in the submucosal and muscularis propria layers. Immunohistochemical findings showed that the NEC-like cells were diffusely positive for chromogranin A, synaptophysin, neural cell adhesion molecule, and neuron-specific enolase, but were negative for carcinoembryonic antigen. The Ki-67 labeling index was 95%. The final pathological diagnosis was gastric NEC with an adenocarcinoma component and a high cellular proliferative potential.

  18. Effects of concurrent chemoradiotherapy on cervical lymph node metastases

    International Nuclear Information System (INIS)

    We report an investigation into the effects of concurrent chemoradiotherapy (CCRT) on cervical lymph node metastases in cases of head and neck squamous cell carcinoma occurring with cervical lymph node metastasis. The subjects were 32 patients receiving CCRT simultaneously for both the primary tumor and cervical lymph node metastases over a five-year period, from January 2005 to December 2009. A complete response (CR) was observed in 71.9% of cases, increasing to 87.5% when cases with no residual viable tumor cells in excised specimens of radical neck dissection were included. Although no relationship existed between primary tumor location, N classification, and the therapeutic effect on cervical lymph node, the actual ratio of CR for cervical lymph node metastases tended to decrease with advanced stages of T classification. Considering that positive results are obtained without planned neck dissection, recurrence occurs only in a few cases, and there are no serious complications of radical neck dissection after CCRT, we believe that a planned neck dissection procedure is not necessarily required in all cases. However, evaluation is difficult with regard to cervical lymph nodes subsequent to CCRT, and therefore, future studies are needed to investigate a test method or a combination of test methods that provide a definite assessment of the presence or absence of residual cervical lymph node metastasis. (author)

  19. Renal cell carcinoma: evolving approaches to advanced non-clear cell carcinoma

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    Daniel Y.C. Heng

    2011-12-01

    Full Text Available The treatment of metastatic renal cell carcinoma (RCC has changed dramatically with the introduction of targeted therapies including sunitinib, sorafenib, and temsirolimus. Because patients with conventional clear cell histology account for 75- 80% of all patients with RCC, there has been little accumulated evidence on the treatment of patients with non-clear cell histologies. Most clinical trials have excluded them from enrolment, except for randomized studies investigating temsirolimus. Many retrospective studies on the use of all three of these targeted therapies in patients with non-clear cell histology have demonstrated response rates ranging from 3.7%–16%. Although response rates may not be as high compared to patients with clear cell histologies, targeted therapy does provide a clinically meaningful response.

  20. Neoadjuvant treatment in advanced renal cell carcinoma: current situation and future perspectives.

    Science.gov (United States)

    Timsit, Marc-Olivier; Albiges, Laurence; Méjean, Arnaud; Escudier, Bernard

    2012-12-01

    Neoadjuvant approaches in renal cell carcinoma are currently under investigation, following the demonstration of targeted therapy efficacy in the metastatic setting. It raises the issues of downsizing locally advanced or nonresectable tumor and offering organ-sparing surgery, safety and its potential role in early micrometastatic disease. Relevant studies of the neoadjuvant setting in renal cell carcinoma with targeted therapies were identified from the literature, clinical trial databases and conference abstracts. To date, a neoadjuvant approach appears feasible in terms of safety. Currently available drugs do not achieve major tumor downsizing with primary tumor diameters response rate of 10%. Neoadjuvants should only be considered in clinical trials or as a litmus test in locally advanced patients. PMID:23253222

  1. The observation and nursing for advanced hepatocellular carcinoma patients treated with Sorafenib

    International Nuclear Information System (INIS)

    Objective: To summarize the author's experience which was obtained in observing and nursing the adverse reactions of advanced hepatocellular carcinoma patients who were treated with Sorafenib. Methods: The adverse reactions and their severity observed in 34 patients with advanced hepatocellular carcinoma who were treated with Sorafenib were retrospectively analyzed. Results: Side effects or toxic reaction were observed in all the patients, which included neutropenia, foot-hand syndrome (FHS), fatigue, diarrhea, hypertention, rash, etc. Five patients had to cut down the dose of Sorafenib in order to relieve the symptom, among them one patient had grade 4 FHS, 3 patients had grade 3 FHS and one patient had grade 3 neutropenia. Conclusion: Being familiar with sorafenib's adverse reaction, closely observing the patients condition and affording appropriate nursing measures, all the above items can definitely improve the therapeutic results and patient's living quality. (authors)

  2. Effective multimodality treatment for advanced epidermoid carcinoma of the female genital tract

    Energy Technology Data Exchange (ETDEWEB)

    Kalra, J.; Cortes, E.; Chen, S.; Krumholz, B.; Rovinsky, J.J.; Molho, L.; Seltzer, V.; Papantoniou, P.; Lee, J.Y.

    1985-07-01

    Fifteen patients with advanced or recurrent squamous-cell carcinoma of the cervix, vulva, vagina, and urethra were treated with simultaneous combination chemotherapy (5-fluorouracil infusion and mitomycin C) and radiotherapy (3,000 rad for a period of three weeks). Three to four weeks after completion of radiotherapy, 13 of 15 patients achieved partial or complete tumor shrinkage. Nine of 15 patients are alive, eight of whom (at a median follow-up time of 24 months) have no evidence of disease. The longest survival time was 45 + months. There was minimal toxicity associated with this therapy. The results of this pilot study suggest that the simultaneous administration of radiation and chemotherapy is an effective method of treatment of advanced female genital tract carcinoma.

  3. Selective arterial embolization for control of haematuria secondary to advanced or recurrent transitional cell carcinoma of the bladder.

    LENUS (Irish Health Repository)

    Halpenny, D

    2014-05-02

    Haematuria is a common symptom in patients with advanced transitional cell carcinoma of the bladder. We report our experience of selective pelvic embolization using gelfoam as an embolic agent to treat intractable haematuria in these patients.

  4. A meta-analysis of neoadjuvant chemotherapy plus radiation in the treatment of locally advanced nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Xun He

    2015-01-01

    Conclusion: Neoadjuvant chemotherapy followed by radiation can decrease the risk of recurrence and metastasis but not improve the 5 years overall survival and 5 years disease free survival compared to radiotherapy alone in the patients with locally advanced nasopharyngeal carcinoma.

  5. The Role of Sorafenib in the Treatment of Advanced Hepatocellular Carcinoma: An Update

    OpenAIRE

    Gauthier, Angela; Ho, Mitchell

    2012-01-01

    Sorafenib is the first and only orally administered drug currently approved to treat advanced hepatocellular carcinoma (HCC). However, concerns have been raised about sorafenib therapy, including acquired drug resistance. This review provides an overview of sorafenib in the treatment of HCC on the basis of data obtained in the laboratory and in clinical studies. Three underlying mechanisms have been found to support sorafenib therapy. First, sorafenib blocks HCC cell proliferation by inhibiti...

  6. Cost-effectiveness of sorafenib versus SBRT for unresectable advanced hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Stereotactic body radiotherapy (SBRT) has been shown to improve overall survival in patients with advanced hepatocellular carcinoma. This study aimed to assess the cost-effectiveness of SBRT compared to sorafenib which is the only drug for advanced hepatocellular carcinoma. A Markov decision-analytic model was performed to compare the cost-effectiveness of SBRT and sorafenib for unresectable advanced hepatocellular carcinoma. Patients transitioned between three health states: stable disease, progression disease and death. We calculated the data on cost from the perspective of our National Health Insurance Bureau. Sensitivity analyses were conducted to determine the impact of several variables. The incremental cost effectiveness ratio (ICER) for sorafenib compared to SBRT was NT$3,788,238 per quality-adjusted life year gained (cost/QALY), which was higher than the willingness to pay threshold of Taiwan according to WHO’s guideline. One-way sensitivity analysis revealed that the utility of progression disease for the sorafenib treatment, utility of progression free survival for SBRT, utility of progression free survival for sorafenib, utility of PFS to progression disease for SBRT and transition probability of progression disease to dead for SBRT were the most sensitive parameters in all cost scenarios. The Monte-Carlo simulation demonstrated that the probability of cost-effectiveness at a willingness to pay threshold of NT$ 2,213,145 per QALY was 100 % and 0 % chance for SBRT and sorafenib. This study indicated that SBRT for advanced hepatocellular carcinoma is cost-effective at a willingness to pay threshold as defined by WHO guideline in Taiwan

  7. Chemotherapy with enteric-coated tegafur/uracil for advanced hepatocellular carcinoma

    OpenAIRE

    ISHIKAWA, TORU

    2008-01-01

    Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, including Japan. Although the development of imaging modalities has made the early diagnosis of HCC possible, surgically resectable cases are relatively uncommon because of hepatic function reserve and/or an advanced stage at presentation. Several modalities, such as transcatheter arterial chemoembolization, percutaneous ethanol injection, microwave coagulation therapy and radiofrequency ablation are reportedly u...

  8. Research progress of cervical carcinoma risk factors%宫颈癌致病危险因素的研究进展

    Institute of Scientific and Technical Information of China (English)

    顾红媛(综述); 樊立华(审校)

    2014-01-01

    Cervical carcinoma is a serious threat to the health of women around the world ,and its inci-dence ranks at the second position after breast cancer in female reproductive system .In addition to oncogene acti-vation and inactivation of tumor suppressor gene ,endogenous and exogenous factors also affect the development of cervical cancer .%宫颈癌是发病率仅次于乳腺癌的女性生殖系统恶性肿瘤,它严重威胁全球女性的健康。宫颈癌的致病机制较为复杂,目前人乳头瘤样病毒( HPV )被认为是宫颈癌最主要的致病因素。此外,相关的癌基因激活及抑癌基因失活、内源性因素和外源性因素等也会影响宫颈癌的发生。

  9. Assessment of radiation doses to the para-aortic, pelvic, and inguinal lymph nodes delivered by image-guided adaptive brachytherapy in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Mohamed, Sandy M I; Aagaard, Torben; Fokdal, Lars U; Pedersen, Erik Morre; Lindegaard, Jacob C; Tanderup, Kari

    2015-01-01

    PURPOSE: This study evaluated the dose delivered to lymph nodes (LNs) by brachytherapy (BT) and the effect of BT image-guided optimization on the LN dose. METHODS AND MATERIALS: Twenty-five patients with locally advanced cervical cancer were retrospectively analyzed, 16 patients of them had LN...

  10. Dose escalation study of carbon ion radiotherapy for locally advanced carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Purpose: To evaluate the toxicity and efficacy of carbon ion radiotherapy (CIRT) for locally advanced cervical cancer by two phase I/II clinical trials. Methods and Materials: Between June 1995 and January 2000, 44 patients were treated with CIRT. Thirty patients had Stage IIIB disease, and 14 patients had Stage IVA disease. Median tumor size was 6.5 cm (range, 4.2-11.0 cm). The treatment consisted of 16 fractions of whole pelvic irradiation and 8 fractions of local boost. In the first study, the total dose ranged from 52.8 to 72.0 gray equivalents (GyE) (2.2-3.0 GyE per fraction). In the second study, the whole pelvic dose was fixed at 44.8 GyE, and an additional 24.0 or 28.0 GyE was given to the cervical tumor (total dose, 68.8 or 72.8 GyE). Results: No patient developed severe acute toxicity. In contrast, 8 patients developed major late gastrointestinal complications. The doses resulting in major complications were ≥60 GyE. All patients with major complications were surgically salvaged. The 5-year local control rate for patients in the first and second studies was 45% and 79%, respectively. When treated with ≥62.4 GyE, the local control was favorable even for the patients with stage IVA disease (69%) or for those with tumors ≥6.0 cm (64%). Conclusions: In CIRT for advanced cervical cancer, the dose to the intestines should be limited to <60 GyE to avoid major complications. Although the number of patients in this study was small, the results support continued investigation to confirm therapeutic efficacy

  11. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  12. Phase 1 Study of Erlotinib Plus Radiation Therapy in Patients With Advanced Cutaneous Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Heath, C. Hope; Deep, Nicholas L.; Nabell, Lisle; Carroll, William R.; Desmond, Renee; Clemons, Lisa; Spencer, Sharon; Magnuson, J. Scott [Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (United States); Rosenthal, Eben L., E-mail: oto@uab.edu [Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (United States)

    2013-04-01

    Purpose: To assess the toxicity profile of erlotinib therapy combined with postoperative adjuvant radiation therapy in patients with advanced cutaneous squamous cell carcinoma. Methods and Materials: This was a single-arm, prospective, phase 1 open-label study of erlotinib with radiation therapy to treat 15 patients with advanced cutaneous head-and-neck squamous cell carcinoma. Toxicity data were summarized, and survival was analyzed with the Kaplan-Meier method. Results: The majority of patients were male (87%) and presented with T4 disease (93%). The most common toxicity attributed to erlotinib was a grade 2-3 dermatologic reaction occurring in 100% of the patients, followed by mucositis (87%). Diarrhea occurred in 20% of the patients. The 2-year recurrence rate was 26.7%, and mean time to cancer recurrence was 10.5 months. Two-year overall survival was 65%, and disease-free survival was 60%. Conclusions: Erlotinib and radiation therapy had an acceptable toxicity profile in patients with advanced cutaneous squamous cell carcinoma. The disease-free survival in this cohort was comparable to that in historical controls.

  13. Photodynamic therapy (PDT) in advanced inoperable bronchial carcinoma

    Science.gov (United States)

    Moghissi, Keyvan; Dixon, Kate; Stringer, Mark R.; Brown, Stanley B.

    1996-12-01

    Objective: To assess the efficacy of PDT to: Palliate symptoms, control disease and extend survival in patients with advanced inoperable cancer. Subject and Method: 55 Males and 23 females aged between 45-81 years (mean 66 years) with inoperable and advanced lung cancer with > 5O. obstructive lesions of the main, lobar or segmental bronchi. Patients had pre-treatment routine clinical radiological, functional and endoscopic assessment with proven histological diagnosis. Protocol of PDT was; Intravenous injection of 2 mg/Kg bodyweight Polyhaematoporphyrin (equivalent to Photofrin) or Photofrin followed 24-72 hours later by illumination of tumour using 630 nm light (Oxford Laser) delivered via an optical fibre with end diffuser. Treatments were carried out under general anaesthesia as a day case procedure. Patients were rebronchoscoped for debridement/retreatment 4-7 days later. Results: There was no treatment related mortality. Two patients developed mild photosensitivity reaction. All patients showed symptomatic improvement with good initial functional and radiological amelioration. Every patient responded to treatment. Seven patients had complete response and negative histology for 3-12 months. After the first treatment average Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1) improvement was 0.5 litres and 0.4 litres respectively. Twenty five percent of patients (nr 19) survived more than 2 years, 10'. (nr=8) between 1-2 years and the remaining 51 patients less than a year. Conclusion: PDT should be considered as a therapeutic modality for all stages of lung cancer and is an excellent treatment modality for palliation in advanced bronchial malignancies.

  14. A CLINICAL STUDY OF LOCALLY ADVANCED CARCINOMA OF BREAST

    Directory of Open Access Journals (Sweden)

    Mrinalini

    2015-06-01

    Full Text Available BACKGROUND : In India it is observed that most of the patients of breast cancer clinically present in late stage due to their ignorance of disease despite so much advancement in its detection and management. Locally advanced breast cancer (LABC accounts for 30 - 35% of all cases of breast cancers in India. This study aims to evaluate C linical features, Investigations, various Treatment modalities and the Clinico - pathological correlation & outcome of various treatment modalities of LABC, with special emphasis on Neo - adjuvant chemotherapy (NACT in Indian setting. MATERIAL AND METHOD : This was a non - randomised prospective observational study. We analyzed 57 patients of LABC Stage IIIB & IIIC presenting at Government Medical College, Nagpur, Maharashtra, a tertiary care C entre from September 2012 to November 2014. RESULTS : Stage IIIB comprised 84.21% patients while remaining 15.79% were having Stage IIIC disease. Skin involvement was observed in 91.23% patients. 15.79% showed supraclavicular lymph node involvement. 32 patients received NACT (2 to 6 cycles. Out of these 32, complete clinical response (cCR was 12.5%, partial response (cPR was 68.75% and pathological CR (pCR was 6.25% with Total Objective response (cCR+cPR 81.25%. Feasibility of Breast Conserving Surgery (BCS was observed in 12.5% patients. 25 patients underwent primary surgery followed by adjuvant chemotherapy. Modified Radical Mastectomy was performed in 89.48% patients. CONCLUSIONS : With overall clinical response of 81.25%, n eoadjuvant chemotherapy is the best treatment option for patients with Locally Advanced Breast Cancer with added advantage of in vivo testing the sensitivity of chemotherapeutic agents, early management of micrometastasis and down staging the primary tumour with feasibility of BCS. Patients presenting LABC constitute a diverse group for whic h a variety of treatment modalities should be instituted with co o rdinated treatment planning among surgeons

  15. Renal cell carcinoma in long-term survivors of advanced stage neuroblastoma in early childhood

    International Nuclear Information System (INIS)

    Renal cell carcinoma (RCC) is rare in children and comprises only 1-3% of all pediatric primary renal tumors. Recently, several case reports have described RCC developing in patients previously treated for advanced stage neuroblastoma (NB). Our experience with four patients treated for advanced stage NB during early childhood who developed RCC later in life are added to 14 others in the literature. These patients and our review of the literature suggest an association between RCC and NB that warrants further study. (orig.)

  16. Pretreatment serum lactate dehydrogenase is an independent prognostic factor for patients receiving neoadjuvant chemotherapy for locally advanced cervical cancer.

    Science.gov (United States)

    Li, Jing; Wu, Miao-Fang; Lu, Huai-Wu; Chen, Qing; Lin, Zhong-Qiu; Wang, Li-Juan

    2016-08-01

    For locally advanced cervical cancer (LACC), hypoxia is a characteristic property. This study aimed to investigate whether baseline lactic dehydrogenase (LDH) level, which is a marker of hypoxia, had clinical value in determining neoadjuvant chemotherapy (NACT) response and prognosis for LACC patients. The study cohort included 418 patients with a median follow-up of 37.5 months. Cox proportional hazards models were used to assess the prognostic value of baseline LDH levels. Multivariate logistic regression analysis was performed to identify independent predictors of complete response after NACT. Backward stepwise selection with the Akaike information criterion was used to identify factors that could be entered into the multivariate regression model. Compared with patients with LDH levels NACT (adjusted odds ratio [OR], 0.29; 95% CI, 0.15-0.58; P NACT. PMID:27350066

  17. Intensity-modulated radiation therapy with concurrent chemotherapy for locally advanced cervical and upper thoracic esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Shu-Lian Wang; Zhongxing Liao; Helen Liu; Jaffer Ajani; Stephen Swisher; James D Cox; Ritsuko Komaki

    2006-01-01

    AIM: To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer.METHODS: A retrospective study was performed on 7 patients who were definitively treated with IMRT and concurrent chemotherapy. Patients who did not receive IMRT radiation and concurrent chemotherapy were not included in this analysis. IMRT plans were evaluated to assess the tumor coverage and normal tissue avoidance. Treatment response was evaluated and toxicities were assessed.RESULTS: Five- to nine-beam IMRT were used to deliver a total dose of 59.4-66 Gy (median: 64.8 Gy) to the primary tumor with 6-MV photons. The minimum dose received by the planning tumor volume (PTV) of the gross tumor volume boost was 91.2%-98.2% of the prescription dose (standard deviation [SD]: 3.7%-5.7%).tumor volume was 93.8%-104.8% (SD: 4.3%-11.1%)of the prescribed dose. With a median follow-up of 15 mo (range: 3-21 mo), all 6 evaluable patients achieved complete response. Of them, 2 developed local recurrences and 2 had distant metastases, 3 survived with no evidence of disease. After treatment, 2 patients developed esophageal stricture requiring frequent dilation and 1 patient developed tracheal-esophageal fistula.CONCLUSION: Concurrent IMRT and chemotherapy resulted in an excellent early response in patients with locally advanced cervical and upper thoracic esophageal cancer. However, local and distant recurrence and toxicity remain to be a problem. Innovative approaches are needed to improve the outcome.

  18. Neo-adjuvant chemotherapy in advanced hypopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    P Joshi

    2013-01-01

    Full Text Available Objective: The aim of this retrospective study was to find out the role of neo-adjuvant chemotherapy (NACT in changing the management and outcome of advanced hypopharyngeal cancer patients. Materials and Methods: This is a retrospective analysis of 59 treatment naïve, advanced hypopharyngeal cancer patients presenting to our tertiary care center from April 2010 to October 2011. NACT was given as two (platinum with taxane or three drug with (platinum, taxane with 5-flurouracil [5 FU] as 3 weekly regimen with cisplatin and docetaxel as 75 mg/m 2 each, 5-FU as 1000 mg/m 2 . NACT was either given with the intent of achieving: (1 surgical resection (extensive soft tissue disease, oropharyngeal involvement, extensive disease with cartilage erosion or (2 organ preservation (Bulky disease with inner cartilage erosion, exolaryngeal disease without cartilage erosion, large N3 nodes. Results: The mean age of this population was 55 years. Most (83% of the patients had pyriform sinus (PFS involvement. 69% patients had Stage IVa disease, 21% Stage IVb and 10% Stage III. The overall response rate was 66%, including 06% complete responses and 60% partial responses. Following NACT, resectability was achieved in 30% (10/33 and organ preservation protocol was planned after NACT in 73% (19/26 patients. The main toxicities were neutropenia (grade 3, 4, 04%; febrile neutropenia, 4%, mucositis 5%, diarrhea 5%. The median progression free survival was 20 months. Conclusions: NACT can be useful in patients with oropharyngeal involvement to achieve surgical resection and larynx preservation in patients with bulky T3 disease.

  19. Could tumor characteristics identified by colonoscopy predict the locally advanced rectal carcinoma?

    Institute of Scientific and Technical Information of China (English)

    WANG Hao; CAO Fu-ao; GONG Hai-feng; ZHENG Jian-ming; FU Chuan-gang

    2010-01-01

    Background Neoadjuvant chemoradiation is now considered the standard care for locally advanced rectal carcinoma (T3-4 or/and N1-2 lesions), but the accuracy of staging examinations including endorectal ultrasonography (ERUS) and MRI is far from excellent. In addition, the above staging equipment or professionals who perform the examinations may not be available in some hospitals, while preoperative colonoscopy and biopsy are usually obtainable in most hospitals.The objective of the present study was to investigate the clinical and pathological characteristics of locally advanced rectal carcinoma and identify candidates for neoadjuvant chemoradiation.Methods This was a retrospective study. Patients who were treated for rectal cancer at Changhai Hospital from January 1999 to July 2008 were identified from our prospectively collected database. Statistical analysis was performed using SPSS Software System (version 15.0). The Mann-Whitney test, chi-square test and multivariate Logistic regression analysis were performed,Results A total of 1005 cases were included in this research, of which 761 cases were identified as locally advanced rectal carcinoma depending on postoperative TNM staging. The results of multivariate Logistic regression analysis indicated seven independent risk factors that could be used to predict a locally advanced rectal carcinoma independently: a high grade (including poor differentiation and undifferentiation) (OR: 3.856; 95% CI: 2.064 to 7.204;P=0.000); large tumor size (OR: 2.455; 95% CI: 1.755 to 3.436; P=0.000); elevated preoperative serum CEA level (OR:1.823; 95% CI: 1.309 to 2.537; P=0.000); non-polypoid tumor type (OR: 1.758; 95% CI: 1.273 to 2.427; P=0.001); the absence of synchronous polyps (OR: 1.602; 95% CI: 1.103 to 2.327; P=0.013); the absence of blood in stool (OR: 1.659;95% CI: 1.049 to 2.624; P=0.030); and a greater circumferential tumor extent (OR: 1.813; 95% CI: 1.055 to 3,113;P=0.031). Based on these findings, a Logistic

  20. Patient, Physician, and Nurse Factors Associated With Entry Onto Clinical Trials and Finishing Treatment in Patients With Primary or Recurrent Uterine, Endometrial, or Cervical Cancer

    Science.gov (United States)

    2016-02-09

    Recurrent Cervical Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Uterine Corpus Cancer; Stage I Uterine Sarcoma; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Uterine Sarcoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Uterine Sarcoma; Stage IV Uterine Corpus Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  1. The predictive value of serum squamous cell carcinoma antigen in patients with cervical cancer who receive neoadjuvant chemotherapy followed by radical surgery: a single-institute study.

    Directory of Open Access Journals (Sweden)

    Xiong Li

    Full Text Available Neoadjuvant chemotherapy (NACT could affect the levels of squamous cell carcinoma antigen (SCC-Ag. This study evaluates the predictive value of pre- and posttreatment SCC-Ag levels in patients with cervical cancer who were treated with NACT followed by radical surgery.A total of 286 patients with Stage IB1-IIIB squamous cell carcinoma of the uterine cervix who were treated with NACT followed by radical hysterectomy were analyzed retrospectively. The relationship between SCC-Ag levels, the clinicopathologic parameters, the response to NACT and the three-year survival rate was investigated.The levels of SCC-Ag were elevated (>3.5 ng/mL in 43.8% of patients before NACT, and 13.0% of patients after NACT. Pre- and posttreatment levels of SCC-Ag correlated with the response to NACT (P = 0.010, and P3.5 ng/mL (P3.5 ng/mL indicated a poor response to NACT and a higher risk of lymph node metastases. Elevated posttreatment levels of SCC-Ag were correlated with poor DFS and OS.

  2. HPV-16在宫颈癌和宫颈上皮内瘤变组织中的表达%Evaluation of the Gene Expression of HPV-16 in Cervical Intraepithelial Neoplasia and Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    秦莉; 王桂芳

    2015-01-01

    Objective To study cervical intraepithelial neoplasia and cervical HPV-16 tissue expression and clinical signiifcance.Methods 200 cases of high-risk HPV treated in the gynecology clinic in our hospital between July 2011and June 2013, gene capture technology (HC2)was performed to detect the human papilloma virus (HPV-DNA), and analyzed HPV infection and expression of the relationship between cervical lesions. Results The detection of HPV infection in 16 cases, including 28 cases of HPV-16 type, HPV-18 type 2 cases, 31 cases of others. Pathologically conifrmed 19 cases of cervical squamous cell carcinoma, CIN Ⅰ grade 20 cases, Ⅱ grade 19 cases, Ⅲ grade 3 cases. CC group of HPV-16 was signiifcantly higher than the normal group and CINⅠ, CIN Ⅱ, HPV-18 positive rate was signiifcantly higher than CIN group and the normal group,P0.05). Conclusion HPV-16 cervical tissue overexpression of cervical intraepithelial neoplasia and cervical squamous cell carcinoma is closely related to the development, testing HPV-16 help to elucidate the etiology and pathogenesis of cervical cancer, early screening and predicting cervical intraepithelial neoplasia become of great signiifcance.%目的:研究宫颈癌以及宫颈上皮内瘤变组织中HPV-16的表达及其临床意义。方法随机选择2011年7月至2013年6月期间,我院妇科门诊收治的HPV高危病例200例,以基因捕获技术(HC2)对人乳头病毒(HPV-DNA)进行检测,并分析HPV感染及表达与宫颈病变之间的关系。结果本组共检出HPV感染61例,其中HPV-16型28例,HPV-18型2例,31例其他。经病理证实宫颈鳞癌19例, CINⅠ级20例,Ⅱ级19例,Ⅲ级3例。CC组的HPV-16显著高于正常组及CINⅠ、CINⅡ,HPV-18的阳性率显著高于CIN组及正常组, P0.05

  3. Phase Ib Study of BKM120 With Cisplatin and XRT in High Risk Locally Advanced Squamous Cell Cancer of Head and Neck

    Science.gov (United States)

    2015-12-08

    Carcinoma, Squamous Cell of Head and Neck; HPV Positive Oropharyngeal Squamous Cell Carcinoma; Hypopharyngeal Cancer; Early Invasive Cervical Squamous Cell Carcinoma; Carcinoma of Larynx; Cancer of Nasopharynx

  4. Combined bleomycin and irradiation in preoperative treatment of advanced squamous cell carcinoma of the vulva

    Energy Technology Data Exchange (ETDEWEB)

    Scheistroeen, M. (Norwegian Radium Hospital, Oslo (Norway)); Trope, C. (Norwegian Radium Hospital, Oslo (Norway))

    1993-01-01

    Forty-two patients with advanced squamous cell carcinoma of the vulva were treated with a combination regimen of bleomycin 180 mg and external irradiation 30-45 Gy. Twenty patients had primary lesions, and 22 patients had recurrent disease. Fifteen (75%) of the patients with primary disease showed objective response (five complete and ten partial response). Four underwent surgery. Of these, one is alive after 60 months with no evidence of disease. Two have died of unrelated causes without signs of recurrence. Seventeen relapsed and died of carcinoma of the vulva. Median survival for patients treated for primary disease was 8.0 months. Thirteen (59%) of 22 patients treated for recurrence showed objective response (two complete and eleven partial responses). None underwent surgery. All these patients died of carcinoma of the vulva. Median survival was 6.4 months. Toxicity was acceptable, and there were no treatment-related deaths. Even taking into account that our patients had very advanced disease, the results are disappointing. An increase of the radiation dose beyond the maximum of 45 Gy given, and more aggressive surgery, might have improved the results. (orig.).

  5. Combined bleomycin and irradiation in preoperative treatment of advanced squamous cell carcinoma of the vulva

    International Nuclear Information System (INIS)

    Forty-two patients with advanced squamous cell carcinoma of the vulva were treated with a combination regimen of bleomycin 180 mg and external irradiation 30-45 Gy. Twenty patients had primary lesions, and 22 patients had recurrent disease. Fifteen (75%) of the patients with primary disease showed objective response (five complete and ten partial response). Four underwent surgery. Of these, one is alive after 60 months with no evidence of disease. Two have died of unrelated causes without signs of recurrence. Seventeen relapsed and died of carcinoma of the vulva. Median survival for patients treated for primary disease was 8.0 months. Thirteen (59%) of 22 patients treated for recurrence showed objective response (two complete and eleven partial responses). None underwent surgery. All these patients died of carcinoma of the vulva. Median survival was 6.4 months. Toxicity was acceptable, and there were no treatment-related deaths. Even taking into account that our patients had very advanced disease, the results are disappointing. An increase of the radiation dose beyond the maximum of 45 Gy given, and more aggressive surgery, might have improved the results. (orig.)

  6. Induction Chemotherapy in Technically Unresectable Locally Advanced Carcinoma of Maxillary Sinus

    Directory of Open Access Journals (Sweden)

    Vanita Noronha

    2014-01-01

    Full Text Available Background. Locally advanced carcinoma of maxillary sinus has been historically reported to have poor prognosis. We evaluated the role of NACT in improving the outcome in these patients. Methods. 41 patients with locally advanced technically unresectable (stage IVa or unresectable maxillary carcinoma (stage IVb were treated with induction chemotherapy between 2008 and 2011. The demographic profile, response and toxicity of chemotherapy, definitive treatment received, progression free survival (PFS, and overall survival (OS were analyzed. Univariate and multivariate analysis were performed to determine factors associated with PFS and OS. Results. The chemotherapy included two drugs (platinum and taxane in 34 patients (82.9% and three drugs (platinum, taxane, and 5 FU in 7 (17.1%. There was no complete response seen in any of the patients, stable disease in 18 (43.9%, partial response in 16 (39%, and progression in 7 (17.1% patients. After induction, the treatment planned included surgery in 12 (29.3%, CT-RT in 24 (58.5%, radical RT in 1 (2.4%, palliative RT in 1 (2.4%, and palliative chemotherapy in 3 (7.3% patients. Overall, the median PFS was 10.0 months. The OS at 24 months and 36 months was 41% and 35%, respectively. Conclusion. In unresectable maxillary carcinoma, induction chemotherapy has clinically significant benefit with acceptable toxicity.

  7. Usefulness of C-arm CT during superselective infusion chemotherapy for advanced head and neck carcinoma

    International Nuclear Information System (INIS)

    To evaluate the usefulness of C-arm computed tomography (CT) during superselective intra-arterial infusion chemotherapy for advanced head and neck carcinoma. C-arm CT was performed during superselective intra-arterial infusion chemotherapy for 11 patients with advanced head and neck carcinoma located in the hypopharynx (n = 3), maxillary sinus (n = 3), oropharynx (n = 1), larynx (n = 1), extra-auditory canal (n = 1), tonsil (n = 1) and tongue (n = 1). The usefulness of C-arm CT during superselective catheterisation was evaluated. On arteriography, nine tumours showed tumour stains and two in the oropharynx or tonsil showed no obvious tumour stains. C-arm CT was performed one to four times (mean ± standard deviation, 2.5 ± 0.8) in each patient during a single procedure. C-arm CT clearly showed not only the vascular territory of the selected branch but also the tumour itself in all patients. Intra-arterial infusion chemotherapy was performed through one to three branches (mean, 1.7 ± 0.9) according to C-arm CT findings without any complications. C-arm CT during superselective intra-arterial infusion chemotherapy was useful to determine the arterial supply of head and neck carcinoma. C-arm CT may replace conventional CT during superselective arteriography in this procedure.

  8. Emerging new therapeutic applications of capecitabine as a first-line chemotherapeutic agent in the management of advanced carcinomas other than colorectal carcinoma

    Directory of Open Access Journals (Sweden)

    Kapoor S

    2012-05-01

    Full Text Available Shailendra KapoorRichmond, VA, USAI read with great interest the recent article by Hameed et al in a recent issue of your journal.1 The article is very interesting. Interestingly, the past few years have seen the emergence of capecitabine as a highly potent first-line chemotherapeutic agent against advanced systemic carcinomas other than colorectal carcinoma. For instance, capecitabine has recently been used successfully as a first-line monotherapeutic agent for HER-2-negative metastatic breast cancer.2 Cotherapy with agents such as sorafenib and paclitaxel for HER-2-negative metastatic breast cancer has also been recently used first-line, and significantly improves progressionfree survival, in addition to being very safe.3,4 Similarly, in patients with advanced gastric carcinoma, capecitabine has been used successfully as first-line therapy in combination with agents such as cisplatin.5 The XELOX regimen comprising capecitabine in conjunction with oxaliplatin is another recent highly effective alternative for gastric carcinoma.6 The modified XELIRI regimen compromising capecitabine and irinotecan is a further option for advanced and unresectable gastric carcinoma.7View original paper by Hameed and colleagues.

  9. Long-term outcomes of patients with advanced hepatocellular carcinoma who achieved complete remission after sorafenib therapy

    OpenAIRE

    Park, Jung Gil

    2015-01-01

    Background/Aims Sorafenib is currently the sole molecular targeted agent that improves overall survival in advanced hepatocellular carcinoma (HCC). Despite the efficacy of sorafenib, the response rate varies in patients with advanced HCC. We retrospectively analyzed a series of Korean patients with advanced HCC with complete remission (CR) after sorafenib therapy. Methods In total, 523 patients with advanced HCC were treated with sorafenib in 3 large tertiary referral hospitals in Korea. A su...

  10. Rationale for targeted therapies and potential role of pazopanib in advanced renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Peter E Clark

    2010-06-01

    Full Text Available Peter E ClarkVanderbilt University Medical Center, Nashville, Tennessee, USAAbstract: Advanced renal cell carcinoma (RCC remains a challenging, major health problem. Recent advances in understanding the fundamental biology underlying one form of RCC, ie, clear cell (or conventional RCC, have opened the door to a series of targeted agents, such as the tyrosine kinase inhibitors (TKIs, which have become the standard of care in managing advanced clear cell RCC. Among the newest of these agents to receive Food and Drug Administration approval in this disease is pazopanib. This review will summarize what is known about the fundamental biology that underlies clear cell RCC, the data surrounding the previously approved targeted agents for this disease, including not only the TKIs but also the mTOR inhibitors and the vascular endothelial growth factor-specific agent, bevacizumab, and the newest TKI, pazopanib. It will also explore the potential role for pazopanib relative to the other available agents and where it may fit into the armamentarium for treatment of advanced/metastatic RCC.Keywords: pazopanib, targeted therapy, tyrosine kinase inhibitor, clear cell renal cell carcinoma

  11. Intracellular delivery of NF-κB small interfering RNA for modulating therapeutic activities of classical anti-cancer drugs in human cervical cancer cells

    OpenAIRE

    Anthony Stanislaus; Anil Philip Kunnath; Snigdha Tiash; Tahereh Fatemian; Nur Izyani Kamaruzman; Athirah Bakhtiar; Sayyad Mustak; Sharif Hossain; Toshihiro Akaike; Ezharul Hoque Chowdhury

    2013-01-01

    Cervical cancer is the second most common cancer and fourth leading cause of cancer-related deaths among women. Advanced stage of the disease is treated with radiation therapy and chemotherapy with poor therapeutic outcome and adverse side effects. NFκB, a well-known transcription factor in the control of immunity and inflammation, has recently emerged as a key regulator of cell survival through induction of antiapoptotic genes. Many human cancers, including cervical carcinoma, constitutively...

  12. National Cancer Data Base Analysis of Radiation Therapy Consolidation Modality for Cervical Cancer: The Impact of New Technological Advancements

    International Nuclear Information System (INIS)

    locally advanced cervical cancer; however, there has been declining utilization of brachytherapy. Increased use of IMRT and SBRT boost coupled with increased mortality risk should raise concerns about utilizing these approaches over brachytherapy

  13. National Cancer Data Base Analysis of Radiation Therapy Consolidation Modality for Cervical Cancer: The Impact of New Technological Advancements

    Energy Technology Data Exchange (ETDEWEB)

    Gill, Beant S. [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Lin, Jeff F. [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Krivak, Thomas C. [Department of Gynecologic Oncology, Western Pennsylvania Hospital, Pittsburgh, Pennsylvania (United States); Sukumvanich, Paniti; Laskey, Robin A.; Ross, Malcolm S.; Lesnock, Jamie L. [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

    2014-12-01

    locally advanced cervical cancer; however, there has been declining utilization of brachytherapy. Increased use of IMRT and SBRT boost coupled with increased mortality risk should raise concerns about utilizing these approaches over brachytherapy.

  14. A papillomavirus DNA from a cervical carcinoma and its prevalence in cancer biopsy samples from different geographic regions.

    Science.gov (United States)

    Dürst, M; Gissmann, L; Ikenberg, H; zur Hausen, H

    1983-01-01

    DNA from one biopsy sample of invasive cancer of the cervix contained sequences hybridizing with human papillomavirus (HPV) type 11 DNA only under nonstringent conditions. This DNA was molecularly cloned in lambda phage. Under stringent conditions of hybridization it cross-hybridized to a minor extent (less than 0.1%) with HPV types 10, 14, and 15 and showed no homology with DNA of other human HPV types. We therefore propose to designate it tentatively as HPV 16. HPV 16 DNA was used as a probe to test additional cancer biopsy samples from cervical, vulval, and penile cancer, as well as benign genital warts (condylomata acuminata) and cervical dysplasias for the presence of homologous sequences. In 61.1% (11/18) of cervical cancer samples from German patients sequences were found hybridizing with HPV 16 DNA under conditions of high stringency. In contrast, only 34.8% (8/23) of cancer biopsy samples from Kenya and Brazil revealed this DNA. Vulval and penile cancer biopsy samples hybridized to 28.6% (2/7) or 25% (1/4), respectively. Only 2 out of 33 condylomata acuminata contained HPV 16 DNA. Both positive tumors harbored in addition HPV 6 or HPV 11 DNA. The data thus indicate that HPV 16 DNA prevails in malignant tumors, rendering an accidental contamination with papillomavirus DNA from adjacent papillomas rather unlikely. The rare presence in benign genital papillomas in addition to common genital papillomaviruses suggests a dependence of HPV 16 replication on helper virus. Images PMID:6304740

  15. Chemotherapy with enteric-coated tegafur/uracil for advanced hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Toru Ishikawa

    2008-05-01

    Full Text Available Hepatocellular carcinoma (HCC is one of the most common malignancies worldwide, including Japan. Although the development of imaging modalities has made the early diagnosis of HCC possible, surgically resectable cases are relatively uncommon because of hepatic function reserve and/or an advanced stage at presentation. Several modalities, such as transcatheter arterial chemoembolization, percutaneous ethanol injection, microwave coagulation therapy and radiofrequency ablation are reportedly useful in treating patients with non-resectable disease. However, unfortunately, many HCC patients have tumor recurrence. The overall prognosis of patients with HCC is very poor, and treatment of the advanced form is still problematic. In this article, we review the clinical efficacy and toxicity of enteric-coated tegafur/uracil in the treatment of patients with advanced non-resectable HCC.

  16. Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3)

    DEFF Research Database (Denmark)

    Sorbye, H; Welin, S; Langer, S W;

    2013-01-01

    Background As studies on gastrointestinal neuroendocrine carcinoma (WHO G3) (GI-NEC) are limited, we reviewed clinical data to identify predictive and prognostic markers for advanced GI-NEC patients. Patients and methods Data from advanced GI-NEC patients diagnosed 2000-2009 were retrospectively...

  17. Induction chemotherapy and radiotherapy in loco-regionally advanced epidermoid carcinoma of the anal canal

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of induction chemotherapy in combination with radiotherapy for treatment of loco-regionally advanced epidermoid anal carcinoma. Methods and Materials: Thirty-one patients diagnosed during the period 1989-1994 with loco-regionally advanced cancer of the anal canal (PHITmax ≥ 4 cm or T4 or N+) were treated with induction chemotherapy consisting of one to three courses of carboplatin (300-375 mg/m2 i.v.) and 5-fluorouracil [5,000 mg/(m2 x 120 h) i.v.] followed by external beam irradiation ± surgery. Results: The toxicity of the chemotherapy was low. Twenty-nine patients were tumor free after the primary therapy. Kaplan-Meier analyses were made for overall survival, tumor-specific survival, freedom from recurrence, preservation of sphincter, and event-free survival. For these end points the 5-year data were 67, 85, 80, 69, and 51%, respectively. Conclusion: The results are promising but a well-designed randomized trial is needed to further elucidate the role of induction chemotherapy in the treatment of loco-regionally advanced anal carcinoma

  18. Prognostic factors in the treatment of locally advanced hepatocellular carcinoma with radiotherapy and arterial infusion

    International Nuclear Information System (INIS)

    Prognostic factors in the treatment of local advanced hepatocellular carcinoma with radiotherapy, transcatheter arterial embolization and arterial infusion. The treatment effects of radiotherapy and combination modality therapy for the local advanced hepatocellular carcinoma (HCC) were retrospectively reviewed. Three hundred and fifty-six patients of HCC (187 recurrent cases after surgical resection) were treated by: radiotherapy only ; bi-therapeutic method: hepatic artery ligation (HAL) and/or hepatic artery embolization (HAE) plus radiotherapy; and tri-therapeutic method (bi-therapeutic method plus hepatic artery infusion) from 1975 to 1996. Kaplan-Meier method has been used to evaluate the survival rates. There were no significant differences among these three treatment groups in the symptom relied rate, but the mean relief time period was much shorter in radiotherapy alone group (2.5 vs 44 months, P 0.05). There were evident differences in five-year survivals among these three treatment groups: 0 % for radiotherapy alone, 22.8 % for bi-therapeutic method and 38.8 % for tri-therapeutic method (P < 0.01). The prognosis was influenced by Okuda classification. Non-resectable local advanced HCC can be treated by the combination modality therapy, including radiotherapy, with a quite high cure rate. Radiotherapy alone can relief the symptoms. (authors)

  19. Results of three-dimensional conformal radiotherapy and thalidomide for advanced hepatocellular carcinoma

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the effectiveness of three-dimensional conformal radiotherapy and thalidomide in the treatment of advanced hepatocellular carcinoma. Between 1999 and 2003, 121 patients (mean age, 54.4±12.4 years; range, 20-81 years) with advanced hepatocellular carcinoma received three-dimensional conformal radiotherapy and thalidomide. Radiation was delivered in 1.5 Gy fractions twice daily for 5 days a week, for a total dose of 45-75 Gy. Mean treatment volume was 429.52±408.50 cm3 (range, 26.89-2284.82 cm3). Thalidomide was given concomitantly: 200 mg/day in 109 patients, 300 mg/day in 8 patients and 400 mg/day in 4 patients. Treatment responses, survival rates and factors affecting survival were analyzed. Treatment responses were observed in 61% of the patients. Liver cirrhosis (P=0.001) and tumor size (P=0.001) significantly affected the tumor responses. Overall survival at 6, 12 and 24 months was 84.8, 60.0 and 44.6%, respectively. On univariate analysis, liver cirrhosis (P=0.003), Karnofsky performance status (P=0.007), tumor size (P<0.001), portal vein tumor thrombosis (P<0.001) and alpha-fetoprotein level (P=0.003) were shown to significantly affect survival. On multivariate analysis, only thrombosis (P=0.039) and alpha-fetoprotein level (P=0.006) were shown to be factors affecting survival. Three-dimensional conformal radiotherapy with thalidomide seems to be effective in the treatment of advanced hepatocellular carcinoma. (author)

  20. Chronic thyroiditis in patients with advanced breast carcinoma: metabolic and morphologic changes on PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Tateishi, Ukihide [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan); University of Texas MD Anderson Cancer Center, Division of Diagnostic Imaging, Houston, TX (United States); Gamez, Cristina; Yeung, Henry W.D.; Macapinlac, Homer A. [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Dawood, Shaheenah; Cristofanilli, Massimo [University of Texas, MD Anderson Cancer Center, Division of Breast Medical Oncology, Houston, TX (United States); Inoue, Tomio [Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan)

    2009-06-15

    To investigate clinical implications of FDG uptake in the thyroid glands in patients with advanced breast carcinoma by comparing metabolic and morphologic patterns on positron emission tomography (PET)/computed tomography (CT). The institutional review board waived the requirement for informed consent. A retrospective analysis was performed in 146 women (mean age 54 years) with advanced breast carcinoma who received systemic treatment. All patients underwent PET-CT before and after treatment. All PET-CT studies were reviewed in consensus by two reviewers. Morphologic changes including volume and mean parenchymal density of the thyroid glands were evaluated. Maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG) were determined to evaluate metabolic changes. These parameters were compared between patients with chronic thyroiditis who received thyroid hormone replacement therapy and those who did not. Of the 146 patients, 29 (20%) showed bilaterally diffuse uptake in the thyroid glands on the baseline PET-CT scan. The SUVmax showed a linear relationship with volume (r = 0.428, p = 0.021) and the mean parenchymal density (r = -0.385, p = 0.039) of the thyroid glands. In 21 of the 29 patients (72%) with hypothyroidism who received thyroid hormone replacement therapy, the volume, mean parenchymal density, SUVmax, and TLG of the thyroid glands showed no significant changes. In contrast, 8 of the 29 patients (28%) who did not receive thyroid hormone replacement therapy showed marked decreases in SUVmax and TLG. Diffuse thyroid uptake on PET-CT represents active inflammation caused by chronic thyroiditis in patients with advanced breast carcinoma. Diffuse thyroid uptake may also address the concern about subclinical hypothyroidism which develops into overt disease during follow-up. (orig.)

  1. Neoadjuvant chemotherapy and radiation therapy compared with radiation therapy alone in advanced nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Purpose: To analyze the impact of neoadjuvant chemotherapy on the treatment of locoregionally advanced nasopharyngeal carcinoma and to assess the outcomes of patients receiving such treatment. Methods and Materials: We analyzed 137 previously untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with either radiation therapy only or combined radiation therapy and chemotherapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows: AJCC Stage III-21, Stage IV-61 in the radiation therapy group (RT group); AJCC Stage III-1, Stage IV-54 in neoadjuvant chemotherapy and radiation therapy group (CT/RT group). The median follow-up for surviving patients was 48 months. Results: The 5-year overall survival (OS) rates were 71% for the CT/RT group and 59% for the RT group (p = 0.04). The 5-year actuarial disease-free survival (DFS) rates were 63% for the CT/RT group and 52% for the RT group (p = 0.04). Distant metastasis (DM) incidence was significantly lower in the CT/RT group. The 5-year freedom from distant metastasis rates were 84% for the CT/RT group and 66% for the RT group (p 0.01). The incidence of locoregional failures was also lower in the CT/RT group, although this difference did not reach statistical significance (69% vs. 56%, p = 0.09) Conclusion: While not providing conclusive evidence, historical evidence from this institution suggests that neoadjuvant chemotherapy significantly improves both overall and the disease-free survival of patients with advanced stage nasopharyngeal carcinoma

  2. A comparison of androgen deprivation therapy versus surgical castration for patients with advanced prostatic carcinoma

    Institute of Scientific and Technical Information of China (English)

    Yu-hsiang LIN; Chien-lun CHEN; Chen-pang HOU; Phei-lang CHANG; Ke-hung TSUI

    2011-01-01

    Airn:To examine the outcomes of patients with advanced prostate carcinoma who underwent medical or surgical castration.Methods:A hundred twenty one consecutive cases of patients with advanced prostate carcinoma who underwent medicaI or surgical castration between 2001 and 2006 were retrospectively reviewed.Associations between clinicaI outcomes and prognostic scoring factors were determined based on the Reijke study.In the surgical and medical castration groups.the impact on the prostate-specific antigen(PSA)normalization rate,the rebound rate and the disease-free survivaI rate were evaluated.The mean foIlow-up was 36.1months.Results:In the initial 12 months.there were no statisticaI differences in the PSA normalization rate and the PSA rebound rate between the two groups.However,the PSA rebound rate after the 12th month(20.90%vs 40.74%.P=-0.0175)and the 18th month PSA normalization rate(59.70%vs 37.04%.P=0.0217)differed significantly between the two groups,and these differences were maintained to the end of the study.When comparing patients grouped according to Reijke prognosis scores.there was no difference between medical and surgical castration for the good prognosis group.However, among the patients given a poor prognosis,surgical castration was superior in terms of the PSA normalization rate,the PSA rebound rate.the tumor progression-free survival rate(P<0.001)and the overalI survivaI rate (P<0.001).Conclusion:Advanced prostate carcinoma patients with poor pretreatment prognosis scores should undergo surgical castration rather than medical castration for better PSA rebound rates and overaII survival.

  3. Sorafenib Prevents Escape from Host Immunity in Liver Cirrhosis Patients with Advanced Hepatocellular Carcinoma

    OpenAIRE

    Yasukiyo Sumino; Takanori Mukozu; Hidenari Nagai; Yoshinori Igarashi; Koji Ishii; Kouichi Momiyama; Mie Shinohara; Noritaka Wakui; Masahiro Kanayama; Takenori Kanekawa; Kazunari Iida; Daigo Matsui

    2012-01-01

    Purpose. It has been reported that Th2 cytokines downregulate antitumor immunity, while activation of type T cells promotes antitumor immunity. The aim of this paper was to evaluate host immunity in liver cirrhosis (LC) patients with advanced hepatocellular carcinoma (aHCC) receiving sorafenib therapy. Methods. Forty-five adult Japanese LC patients received sorafenib for aHCC between 2009 and 2011 at our hospital. Sorafenib was administered at a dose of 200–800 mg/day for 4 weeks. Blood sampl...

  4. Sorafenib induced tumor lysis syndrome in an advanced hepatocellular carcinoma patient

    Institute of Scientific and Technical Information of China (English)

    Wu-Shiung Huang; Chang-Hsu Yang

    2009-01-01

    A 55-year-old male patient with hepatitis B-related liver cirrhosis was found to have advanced hepatocellular carcinoma. His AFP was initially 9828 mg/L and rapidly dropped to 5597 mg/L in ten days after oral sorafenib treatment. However, he developed acute renal failure, hyperkalemia, and hyperuricemia 30 d after receiving the sorafenib treatment. Tumor lysis syndrome was suspected and intensive hemodialysis was performed. Despite intensive hemodialysis and other supportive therapy, he developed multiple organ failure (liver, renal, and respiratory failure) and metabolic acidosis. The patient expired 13 d after admission.

  5. Intraarterial chemotherapy with gemcitabine and cisplatin in locally advanced or recurrent penile squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Jian-Ye Liu; Yong-Hong Li; Zhuo-Wei Liu; Zhi-Ling Zhang; Yun-Lin Ye; Kai Yao; Hui Han; Zi-Ke Qin; Fang-Jian Zhou

    2013-01-01

    The prognosis of locally advanced or recurrent squamous cell carcinoma (SCC) of the penis after conventional treatment is dismal. This study aimed to evaluate the therapeutic effects of intraarterial chemotherapy with gemcitabine and cisplatin on local y advanced or recurrent SCC of the penis. Between April 1999 and May 2011, we treated 5 patients with locally advanced penile SCC and 7 patients with recurrent disease with intraarterial chemotherapy. The response rate and toxicity data were analyzed, and survival rates were calculated. After 2 to 6 cycles of intraarterial chemotherapy with gemcitabine and cisplatin, 1 patients with locoregional y advanced disease achieved a complete response, and 4 achieved partial response. Of the 7 patients with recurrent disease, 2 achieved complete response, 3 achieved partial response, 3 had stable disease, and 1 developed progressive disease. An objective tumor response was therefore achieved in 10 of the 12 patients. The median overal survival for the patients was 24 months (range, 10-50 months). Three out of 10 patients who responded were long-term survivors after intraarterial chemotherapy. Intraarterial chemotherapy with gemcitabine and cisplatin may be effective and potential y curative in locoregional y advanced or recurrent penile SCC. The contribution of this therapy in the primary management of advanced or recurrent penile SCC should be prospectively investigated.

  6. Experimental studies of metastases of esophageal carcinoma to lymph nodes

    International Nuclear Information System (INIS)

    Marked progress has been made in surgery for esophageal carcinoma, however, when compared to results of surgery for other carcinomas of the digestive tract, much research remains to be done. The author transplanted VX2 carcinoma, a transplantable tumor of the rabbit, to the esophagus in attempt to determine the mode of metastases of esophageal carcinoma to lymph nodes and also to observe the effect of chemotherapy (Bleomycin) and radiotherapy (Betatron). Carcinoma of the cervical esophagus metastasized to the cervical lymph nodes and then to the paratracheal lymph nodes. Carcinoma of the upper thoracic esophagus metastasized to the paratracheal lymph nodes and then to the cervical lymph nodes. Carcinoma of the mid-thoracic esophagus metastasized to the intrathoracic lymph nodes and then to the intraperitoneal lymph nodes. Carcinoma of the abdominal esophagus metastasized to the intraperitoneal lymph nodes and then to the intrathoracic lymph nodes. Skipping metastasis was rarely observed. Carcinoma of the thoracic esophagus with metastases of lymph nodes in the cervical or abdominal portion was considerably advanced, therefore it is considered that cleaning of the intrathoracic lymph nodes and simultaneous chemotherapy are required when such cases are encountered clinically. Irradiation resulted in regression in the size of the tumor and metastases to lymph nodes and there was a decrease in metastases to the distant lymph nodes. Effects of irradiation were similar on tumors and lymph nodes with positive metastases located within the field of irradiation. Bleomycin medication resulted in regression in the size of tumor and metastases to lymph nodes. Effects of Bleomycin medication were similar on tumors and lymph nodes with positive metastases. (auth.)

  7. Radiation therapy for the treatment of feline advanced cutaneous squamous cell carcinoma

    International Nuclear Information System (INIS)

    The efficacy of radiation therapy for feline advanced cutaneous squamous cell carcinoma was evaluated. A full course radiation therapy protocol was applied to six cats showing single or multiple facial squamous cell carcinomas, in a total of seven histologically confirmed neoplastic lesions. Of the lesions, one was staged as T1, and six as T4 according to WHO staging system of epidermal tumors. The animals were submitted to twelve radiation fractions of 4 Gy each, on a Monday-Wednesday-Friday schedule, and the equipment used was an orthovoltage unit. Energy used was 120 kV, 15 mA and 2 mm aluminum filter. The cats were evaluated during the treatment and 30 and 60 days after the end of the radiation therapy. In this study, 87% of the lesions had complete remission and 13% partial remission to the treatment. Side effects were considered mild according to Veterinary Radiation Therapy Oncology Group Toxicity criteria, and included erythema, epilation and rhinitis. Radiation Therapy was considered safe for feline cutaneous squamous cell carcinoma, leading to mild side effects and can represent a good therapeutic option. (author)

  8. Transforming Growth Factor β1 Could Influence Thyroid Nodule Elasticity and Also Improve Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Li, Yi; Wang, Yan; Wu, Qiong; Hu, Bing

    2015-11-01

    Ultrasound elastography has been a very useful tool in predicting the risk of malignant thyroid tumor for several years. The objective of this study was to determine if there is a correlation between strain ratio (SR), collagen deposition and transforming growth factor β1 (TGF-β1) expression in different types of thyroid nodules and if TGF-β1 is related to cervical lymph node metastasis. 102 nodules from 81 patients who underwent thyroid resection surgery in our hospital were retrospectively studied. All of these patients had undergone ultrasound elastography scanning before surgery. Masson staining and immunohistochemical staining were used to evaluate the ratio of expression of collagen deposition and TGF-β1. There was a significant difference between benign and malignant thyroid nodules in SR (8.913 ± 11.021 vs. 1.732 ± 0.727, p = 0.000), collagen content (0.371 ± 0.125 vs. 0.208 ± 0.057, p = 0.000) and TGF-β1 expression (0.336 ± 0.093 vs. 0.178 ± 0.071, p = 0.000). A cutoff of 2.99 for SR measurement was selected for the highest Youden index for predicting malignant thyroid nodules, which yielded 87.88% sensitivity, 100% specificity, 100% positive predictive value, 83.72% negative predictive value and 92.15% accuracy. Expression of collagen and TGF-β1 was positively correlated with SR measurements (coefficient = 0.839 for collagen and 0.855 for TGF-β1, p = 0.000). Among 61 nodules with papillary thyroid carcinoma, the average SR for the metastasis group was higher than that for the non-metastasis group (10.955 ± 13.805 and 7.852 ± 7.931, respectively), but without statistical significance (p = 0.287). Collagen deposition was significantly higher in the metastasis group than in the non-metastasis group (0.421 ± 0.091 vs. 0.353 ± 0.118, p = 0.011). TGF-β1 expression was also significantly higher in the metastasis group than in the non-metastasis group (0.378 ± 0.0.69 vs. 0.328 ± 0.091, p = 0.016). To conclude, TGF-β1 may contribute to thyroid

  9. Synergic effect of human IL-21 gene transfer combined with γ-ray irradiation on the growth of cervical carcinoma HeLa cells

    International Nuclear Information System (INIS)

    Objective: To study the combined effect of interleukin-21 gene transfer and ionizing radiation on the growth of cervical carcinoma HeLa cells. Methods: Previously constructed Ad-IL-21 gene was amplified by infecting 293A cells and the titer was measured by TCID50 method. HeLa cells were transfected with Ad-IL-21 and then irradiated with 6 Gy 137Cs γ-rays. The cells were divided into 5 groups, including blank control, Ad-LacZ group, Ad-IL-21 group,radiation group and Ad-IL-21 combined with radiation group (combination group). The cell growth, cell cycle, apoptosis, and the expressions of IL-21 gene and protein in HeLa cells were detected. Results: Ad-IL-21 was successfully amplified and the titer of Ad-11.-21 was 9 × 1010 pfu/ml. Compared with Ad-IL-21 group and radiation group,the cell growth of combination group was significantly inhibited at 96 h after transfection (F=85.26, 72.98, P<0.05). The cells in combination group were arrested in G1 phase and decreased at S phase (F=36.69, 34.83, P<0.05), while the cellular apoptosis increased markedly (F=28.23, 25.57, Pcervical carcinoma cell growth. (authors)

  10. Incidence of cervical lymph node metastasis and its association with outcomes in patients with adenoid cystic carcinoma

    DEFF Research Database (Denmark)

    Amit, Moran; Binenbaum, Yoav; Sharma, Kanika; Ramer, Naomi; Ramer, Ilana; Agbetoba, Abib; Glick, Joelle; Yang, Xinjie; Lei, Delin; Bjørndal, Kristine; Godballe, Christian; Mücke, Thomas; Wolff, Klaus-Dietrich; Fliss, Dan; Eckardt, André M; Copelli, Chiara; Sesenna, Enrico; Palmer, Frank; Ganly, Ian; Patel, Snehal; Gil, Ziv

    2015-01-01

    BACKGROUND: The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established. METHODS: We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection. RESULTS: The incidence...

  11. Cixutumumab, Everolimus, and Octreotide Acetate in Treating Patients With Advanced Low to Intermediate Grade Neuroendocrine Carcinoma

    Science.gov (United States)

    2016-07-14

    Gastrin-Producing Neuroendocrine Tumor; Lung Carcinoid Tumor; Metastatic Digestive System Neuroendocrine Tumor G1; Pancreatic Glucagonoma; Pancreatic Insulinoma; Pancreatic Polypeptide Tumor; Paraganglioma; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Merkel Cell Carcinoma; Recurrent Pancreatic Neuroendocrine Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Somatostatin-Producing Neuroendocrine Tumor; Stage III Merkel Cell Carcinoma; Stage IV Merkel Cell Carcinoma; Thyroid Gland Medullary Carcinoma

  12. FDG PET imaging of locally advanced gastric carcinomas: correlation with endoscopic and histopathological findings

    International Nuclear Information System (INIS)

    Gastric cancer carries a poor prognosis and is the second most frequent cause of cancer-related death worldwide. In spite of the clinical importance of this tumour entity, only a few fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) studies have been published on gastric carcinomas. The aim of this study was to characterise the FDG uptake of gastric carcinomas by relating it to the histopathological properties of the tumours. Within this context, we focussed particularly on the microscopic growth type according to Lauren since our preliminary observations indicated low FDG accumulation in the non-intestinal growth type compared with the intestinal type. Forty patients with locally advanced gastric carcinomas and ten control subjects were studied by FDG PET (300 MBq i.v., emission scan: 40 min p.i., one bed position, measured transmission, filtered back-projection). Detectability of the tumours was qualitatively assessed by two independent observers. For quantitative analysis the regional tumour uptake was measured by standardised uptake values (SUV normalised to the body surface area) using a region of interest technique. Qualitative and quantitative analyses were performed with respect to the microscopic growth type according to Lauren (intestinal type vs non-intestinal type). Other histopathological characteristics were also assessed: mucus content, grading, tumour extension and tumour location. In 36 patients the survival rates were compared for detectable vs non-detectable tumours and for tumour FDG uptake above and below the median. Only 24 of the 40 locally advanced gastric carcinomas (60%) were detected by FDG PET. The detection rate for tumours of the intestinal type was significantly higher than that for tumours of the non-intestinal type (83% vs 41%, P=0.01). Only 2/18 intestinal type tumours contained extracellular or intracellular mucus whereas 17/22 non-intestinal tumours did so (P<0.01). The mean SUV was significantly different

  13. Pelvic insufficiency fractures in postmenopausal woman with advanced cervical cancer treated by radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To assess the predisposing factors and clinical characteristics of pelvic insufficiency fractures (PIF) in postmenopausal women with pelvic irradiation. Material and methods: A total 335 postmenopausal patients with cervical cancer of the intact uterus treated with radiation therapy between 1983 and 1998 were reviewed. Total external dose was delivered between 45 and 50.4 Gy with parallel opposed anteroposterior portals. Total brachytherapy dose at point A was delivered between 10 and 36 Gy. PIF were diagnosed by bone scintigraphy and confirmed by computed tomography. The cumulative incidence of symptomatic PIF was estimated by actuarial methods. Potential risk factors (age, weight, type II diabetes, delivery, menopause, total external dose, total brachytherapy dose) were assessed. Results: Fifty-seven (17.0%) of 335 patients were diagnosed as having PIF. Forty-seven patients were symptomatic and ten were asymptomatic. Parameters carrying a significant association with PIF were body weight 49 kg or below (P=0.044) in stepwise logistic regression analysis. The cumulative incidence of symptomatic PIF at 5 years was 17.9% calculated by the Kaplan-Meier method. A body weight of 49 kg or below and more than three deliveries were identified as having a significant effect on symptomatic PIF in univariate analysis (P=0.021, P=0.003, log-rank test) and Cox life table regression analysis (P=0.038, P=0.013). Five patients required narcotic agents and eight patients required hospital admission. Conclusions: We should consider reducing the dose contribution to the sacrum and sacroilac joints, without underdosing the tumor, especially in postmenopausal women with many deliveries or low body weight

  14. Incorporating biologic measurements (SF2, CFE) into a tumor control probability model increases their prognostic significance: a study in cervical carcinoma treated with radiation therapy

    International Nuclear Information System (INIS)

    Purpose: To assess whether incorporation of measurements of surviving fraction at 2 Gy (SF2) and colony-forming efficiency (CFE) into a tumor control probability (tcp) model increases their prognostic significance. Methods and Materials: Measurements of SF2 and CFE were available from a study on carcinoma of the cervix treated with radiation alone. These measurements, as well as tumor volume, dose, and treatment time, were incorporated into a Poisson tcp model (tcpα,ρ). Regression analysis was performed to assess the prognostic power of tcpα,ρ vs. the use of either tcp models with biologic parameters fixed to best-fit estimates (but incorporating individual dose, volume, and treatment time) or the use of SF2 and CFE measurements alone. Results: In a univariate regression analysis of 44 patients, tcpα,ρ was a better prognostic factor for both local control and survival (p2 alone (p=0.009 for local control, p=0.29 for survival) or CFE alone (p=0.015 for local control, p=0.38 for survival). In multivariate analysis, tcpα,ρ emerged as the most important prognostic factor for local control (pα,ρ, CFE was still a significant independent prognostic factor for local control, whereas SF2 was not. The sensitivities of tcpα,ρ and SF2 as predictive tests for local control were 87% and 65%, respectively. Specificities were 70% and 77%, respectively. Conclusions: A Poisson tcp model incorporating individual SF2, CFE, dose, tumor volume, and treatment time was found to be the best independent prognostic factor for local control and survival in cervical carcinoma patients

  15. Electrochemotherapy as a new therapeutic strategy in advanced Merkel cell carcinoma of head and neck region

    International Nuclear Information System (INIS)

    Merkel Cell Carcinoma (MCC) is a rare and aggressive tumour, arising from a cutaneous mechanoceptor cell located in the basal layer of epidermis, with poor prognosis. The treatment of choice for the initial stage of the disease is surgery and/or radiotherapy. The treatment of recurrent or advanced disease is still controversial. We report a case of 84 years old woman with a recurrent MCC of the chin treated with electrochemotherapy (ECT). During the period of 20 months, four sessions of ECT were employed, which resulted in an objective response of the tumour and good quality of residual life. Our case shows the effectiveness of ECT in the treatment of locally advanced MCC of the head and neck region in a patient not suitable for standard therapeutic options

  16. Percutaneous irreversible electroporation of locally advanced pancreatic carcinoma using the dorsal approach: a case report.

    Science.gov (United States)

    Scheffer, Hester J; Melenhorst, Marleen C A M; Vogel, Jantien A; van Tilborg, Aukje A J M; Nielsen, Karin; Kazemier, Geert; Meijerink, Martijn R

    2015-06-01

    Irreversible electroporation (IRE) is a novel image-guided ablation technique that is increasingly used to treat locally advanced pancreatic carcinoma (LAPC). We describe a 67-year-old male patient with a 5 cm stage III pancreatic tumor who was referred for IRE. Because the ventral approach for electrode placement was considered dangerous due to vicinity of the tumor to collateral vessels and duodenum, the dorsal approach was chosen. Under CT-guidance, six electrodes were advanced in the tumor, approaching paravertebrally alongside the aorta and inferior vena cava. Ablation was performed without complications. This case describes that when ventral electrode placement for pancreatic IRE is impaired, the dorsal approach could be considered alternatively. PMID:25288173

  17. Percutaneous Irreversible Electroporation of Locally Advanced Pancreatic Carcinoma Using the Dorsal Approach: A Case Report

    International Nuclear Information System (INIS)

    Irreversible electroporation (IRE) is a novel image-guided ablation technique that is increasingly used to treat locally advanced pancreatic carcinoma (LAPC). We describe a 67-year-old male patient with a 5 cm stage III pancreatic tumor who was referred for IRE. Because the ventral approach for electrode placement was considered dangerous due to vicinity of the tumor to collateral vessels and duodenum, the dorsal approach was chosen. Under CT-guidance, six electrodes were advanced in the tumor, approaching paravertebrally alongside the aorta and inferior vena cava. Ablation was performed without complications. This case describes that when ventral electrode placement for pancreatic IRE is impaired, the dorsal approach could be considered alternatively

  18. Percutaneous Irreversible Electroporation of Locally Advanced Pancreatic Carcinoma Using the Dorsal Approach: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Scheffer, Hester J., E-mail: hj.scheffer@vumc.nl; Melenhorst, Marleen C. A. M., E-mail: m.melenhorst@vumc.nl [VU University Medical Center, Department of Radiology and Nuclear Medicine (Netherlands); Vogel, Jantien A., E-mail: j.a.vogel@amc.uva.nl [Academic Medical Center, Department of Surgery (Netherlands); Tilborg, Aukje A. J. M. van, E-mail: a.vantilborg@vumc.nl [VU University Medical Center, Department of Radiology and Nuclear Medicine (Netherlands); Nielsen, Karin, E-mail: k.nielsen@vumc.nl; Kazemier, Geert, E-mail: g.kazemier@vumc.nl [VU University Medical Center, Department of Surgery (Netherlands); Meijerink, Martijn R., E-mail: mr.meijerink@vumc.nl [VU University Medical Center, Department of Radiology and Nuclear Medicine (Netherlands)

    2015-06-15

    Irreversible electroporation (IRE) is a novel image-guided ablation technique that is increasingly used to treat locally advanced pancreatic carcinoma (LAPC). We describe a 67-year-old male patient with a 5 cm stage III pancreatic tumor who was referred for IRE. Because the ventral approach for electrode placement was considered dangerous due to vicinity of the tumor to collateral vessels and duodenum, the dorsal approach was chosen. Under CT-guidance, six electrodes were advanced in the tumor, approaching paravertebrally alongside the aorta and inferior vena cava. Ablation was performed without complications. This case describes that when ventral electrode placement for pancreatic IRE is impaired, the dorsal approach could be considered alternatively.

  19. Survival among patients with advanced renal cell carcinoma in the pretargeted versus targeted therapy eras.

    Science.gov (United States)

    Li, Pengxiang; Wong, Yu-Ning; Armstrong, Katrina; Haas, Naomi; Subedi, Prasun; Davis-Cerone, Margaret; Doshi, Jalpa A

    2016-02-01

    Between December 2005 and October 2009, FDA approved six targeted therapies shown to significantly extend survival for advanced renal cell carcinoma (RCC) patients in clinical trials. This study aimed to examine changes in survival between the pretargeted and targeted therapy periods in advanced RCC patients in a real-world setting. Utilizing the 2000-2010 SEER Research files, a pre-post study design with a contemporaneous comparison group was employed to examine differences in survival outcomes for patients diagnosed with advanced RCC (study group) or advanced prostate cancer (comparison group, for whom no significant treatment innovations happened during this period) across the pretargeted therapy era (2000-2005) and the targeted therapy era (2006-2010). RCC patients diagnosed in the targeted therapy era (N = 6439) showed improved survival compared to those diagnosed in the pretargeted therapy era (N = 7231, hazard ratio (HR) for all-cause death: 0.86, P < 0.01), while the change between the pre-post periods was not significant for advanced prostate cancer patients (HR: 0.97, P = 0.08). Advanced RCC patients had significantly larger improvements in overall survival compared to advanced prostate cancer patients (z = 4.31; P < 0.01). More detailed year-to-year analysis revealed greater survival improvements for RCC in the later years of the posttargeted period. Similar results were seen for cause-specific survival. Subgroup analyses by nephrectomy status, age, and gender showed consistent findings. Patients diagnosed with advanced RCC during the targeted therapy era had better survival outcomes than those diagnosed during the pretargeted therapy era. Future studies should examine the real-world survival improvements directly associated with targeted therapies. PMID:26645975

  20. Apolipoprotein C-II Is a Potential Serum Biomarker as a Prognostic Factor of Locally Advanced Cervical Cancer After Chemoradiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To determine pretreatment serum protein levels for generally applicable measurement to predict chemoradiation treatment outcomes in patients with locally advanced squamous cell cervical carcinoma (CC). Methods and Materials: In a screening study, measurements were conducted twice. At first, 6 serum samples from CC patients (3 with no evidence of disease [NED] and 3 with cancer-caused death [CD]) and 2 from healthy controls were tested. Next, 12 serum samples from different CC patients (8 NED, 4 CD) and 4 from healthy controls were examined. Subsequently, 28 different CC patients (18 NED, 10 CD) and 9 controls were analyzed in the validation study. Protein chips were treated with the sample sera, and the serum protein pattern was detected by surface-enhanced laser desorption and ionization–time-of-flight mass spectrometry (SELDI-TOF MS). Then, single MS-based peptide mass fingerprinting (PMF) and tandem MS (MS/MS)-based peptide/protein identification methods, were used to identify protein corresponding to the detected peak. And then, turbidimetric assay was used to measure the levels of a protein that indicated the best match with this peptide peak. Results: The same peak 8918 m/z was identified in both screening studies. Neither the screening study nor the validation study had significant differences in the appearance of this peak in the controls and NED. However, the intensity of the peak in CD was significantly lower than that of controls and NED in both pilot studies (P=.02, P=.04) and validation study (P=.01, P=.001). The protein indicated the best match with this peptide peak at 8918 m/z was identified as apolipoprotein C-II (ApoC-II) using PMF and MS/MS methods. Turbidimetric assay showed that the mean serum levels of ApoC-II tended to decrease in CD group when compared with NED group (P=.078). Conclusion: ApoC-II could be used as a biomarker for detection in predicting and estimating the radiation treatment outcome of patients with CC

  1. [A Case of Successful Curative Resection Following Downsizing Chemotherapy in Initially Unresectable Locally Advanced Gallbladder Carcinoma].

    Science.gov (United States)

    Shinmura, Kazuyasu; Kaiho, Takashi; Yanagisawa, Shinji; Okamoto, Ryo; Nishimura, Masaki; Kobayashi, Soichi; Okaniwa, Akira; Mun, Yangi; Tsuchiya, Shunichi; Chiba, Ryoji

    2015-11-01

    A 58-year-old woman was referred to our hospital with high fever and right upper abdominal pain. Abdominal computed tomography (CT) revealed a bulky tumor of the gallbladder with liver invasion, metastases to para-aortic lymph nodes, and extensive infiltration to Glisson's sheath. The tumor was initially considered to be unresectable locally advanced gallbladder carcinoma with inflammation, and she received 6 courses of chemotherapy with gemcitabine plus cisplatin. Subsequently, the inflammation was extinguished, and CT showed the main tumor shrunk and the Glisson's sheath infiltration disappeared; however, a liver metastasis existed in segment 5. Thus, S4a plus S5 hepatic segmentectomy with extrahepatic bile duct resection and regional and para-aortic lymphadenectomy was performed. The pathological diagnosis was pT3a, pN1, pM1 (Hep, LYM), fStage ⅣB. Curative resection was then performed. If selected according to their response to downsizing chemotherapy, conversion therapy might therefore be an effective multidisciplinary treatment for patients with initially unresectable locally advanced gallbladder carcinoma. PMID:26805152

  2. Cryotherapy combined with chemoembolization for the treatment of advanced hepatic carcinoma: a clinical study

    International Nuclear Information System (INIS)

    Objective: To discuss the technique, efficacy and clinical significance of cryoablation combined with transcatheter arterial chemoembolization(TACE) for the treatment of advanced hepatic carcinoma. Methods: One hundred and ninety-two patients, who accorded with the selected criterion, were divided into TACE group (n=100) and combination group (cryotherapy combined with TACE, n=92). Pre-and post-treatment AFP level, recurrence rate and life span between two groups were compared. Results: The complete necrosis rate of the tumor and the recurrence rate in TACE group were 29% and 42%, which were 88.04% and 24% in combination group, respectively. The serum AFP level was significantly decreased after treatment in both groups (P<0.05), and the reduction in AFP level was significantly greater in combination group than that in TACE group (P<0.05). During a follow-up of 30 months the survival rate at each evaluation period of combination group was higher than that of TACE group without exception. Conclusion: As an effective and safe technique, cryoablation combined with chemoembolization is far superior to simple TACE in treating advanced hepatic carcinoma. (authors)

  3. Preoperative radiotherapy followed by radical vulvectomy with inguinal lymphadenectomy for advanced vulvar carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Rotmensch, J.; Rubin, S.J.; Sutton, H.G.; Javaheri, G.; Halpern, H.J.; Schwartz, J.L.; Stewart, M.; Weichselbaum, R.R.; Herbst, A.L. (Univ. of Chicago, IL (USA))

    1990-02-01

    A therapeutic alternative to exenteration for large locally advanced vulvar carcinoma involving the rectum, anus, or vagina is the use of preoperative radiation followed by radical surgery. Between 1980 and 1988, 13 patients with Stage III and 3 with Stage IV vulvar carcinoma involving the rectum/anus, urethra, or vagina were treated with 4000 rad to the vulva and 4500 rad to the inguinal and pelvic nodes followed by a radical vulvectomy and inguinal lymphadenectomy 4 weeks later. The overall 5 year cumulative survival was 45%. Twelve tumors regressed after radiation with 62.5% of the patients having visceral preservation while in 4 patients there was no major response to radiation and urinary or fecal diversion was required. Of the 6 recurrences 4 were central and 2 distant. Three patients with central recurrences had tumor within 1 cm of the vulvectomy margin. Complications included wet desquamation, inguinal wound separation, lymphedema, and urethral strictures. There were no operative deaths. It is concluded that the use of preoperative radiation followed by radical vulvectomy may be an alternative to pelvic exenteration in selected patients with advanced vulvar lesions.

  4. Hemoglobin as an important prognostic factor in concurrent chemoradiotherapy for locally advanced carcinoma of the cervix

    International Nuclear Information System (INIS)

    The objective of this study was to examine a possible association of hemoglobin with clinical outcome in patients with locally advanced squamous cell carcinoma of the cervix who were treated with concurrent chemoradiotherapy (CCRT). Seventy-five patients with Stage IB to IVA disease who were treated with CCRT were reviewed retrospectively. The mean age was 49.8 years. In the treatment, standard radiotherapy was performed accompanied by concomitant chemotherapy using cisplatin. Pre-treatment hemoglobin was defined as the earliest hemoglobin level prior to the initiation of treatment. Weekly nadir hemoglobin levels throughout treatment were averaged and used as average weekly nadir hemoglobin during treatment (AWNHg). The mean follow-up time was 28.6 months. The mean pre-treatment hemoglobin of 11.6 g/dL was significantly reduced to the mean AWNHg of 9.9 g/dL. The levels of pre-treatment hemoglobin and AWNHg were significantly associated with tumor response to treatment. The 5-year cumulative disease-free survival and overall survival rates for all 75 patients were 67.8% and 75.3%, respectively. Multivariate statistical analysis revealed that AWNHg (≥9.0 versus <9.0 g/dL) was an independent prognostic factor for overall survival (p=0.038), but pre-treatment hemoglobin was not a significant factor. AWNHg was one of the most powerful independent predictors of overall survival in patients undergoing CCRT for locally advanced squamous cell carcinoma of the cervix. (author)

  5. Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors

    Directory of Open Access Journals (Sweden)

    Fecher LA

    2015-11-01

    Full Text Available Leslie A Fecher,1,3 William H Sharfman2 1Department of Internal Medicine and Dermatology, Indiana University Health Simon Cancer Center, Indianapolis, IN, USA; 2The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA, 3Department of Internal Medicine and Dermatology, University of Michigan, MI, USA Abstract: Cutaneous basal cell carcinoma (BCC is the most common human cancer and its incidence is rising worldwide. Ultraviolet radiation exposure, including tanning bed use, as well as host factors play a role in its development. The majority of cases are treated and cured with local therapies including surgery. Yet, the health care costs of diagnosis and treatment of BCCs in the US is substantial. In the United States, the cost of nonmelanoma skin cancer care in the Medicare population is estimated to be US$426 million per year. While rare, locally advanced BCCs that can no longer be controlled with surgery and/or radiation, and metastatic BCCs do occur and can be associated with significant morbidity and mortality. Vismodegib (GDC-0449, a smoothened inhibitor targeted at the hedgehog pathway, is the first US Food and Drug Association (FDA-approved agent in the treatment of locally advanced, unresectable, and metastatic BCCs. This class of agents appears to be changing the survival rates in advanced BCC patients, but appropriate patient selection and monitoring are important. Multidisciplinary assessments are essential for the optimal care and management of these patients. For some patients with locally advanced BCC, treatment with a hedgehog inhibitor may eliminate the need for an excessively disfiguring or morbid surgery. Keywords: basal cell carcinoma, hedgehog, smoothened, vismodegib, Gorlin, basal cell nevus syndrome

  6. A phase II trial of gemcitabine plus carboplatin in advanced transitional cell carcinoma of the urothelium

    Directory of Open Access Journals (Sweden)

    Qian Jiong

    2007-06-01

    Full Text Available Abstract Background Recent studies have demonstrated the effectiveness of cisplatin-based combinations in patients with advanced transitional cell carcinoma(TCC of the urothelium. Concern over cisplatin toxicity instigated a search for alternative regimens. The aim of the study was to evaluate the activity and tolerability of gemcitabine plus carboplatin combination as first-line treatment in patients with advanced transitional cell carcinoma of the urothelium. Methods Patients with advanced TCC were treated with gemcitabine 1200 mg/m2 on days 1 and 8 and carboplatin area under the concentration-time curve(AUC 5 on day 1 every 21 days. Results Out of 41 patients, thirty-nine were evaluable for efficacy and 41 for toxicity. A median of 5 cycles (range 1–6 was administered. Overall response rate was 46.2% (95% confidence interval: 32–65% including 10.3% complete responses and 35.9% partial responses. The median time to progression and median overall survival were 7.5 months (95% confidence interval: 6.6–8.4 months and 13.6 months (95% confidence interval: 10.2–17.0 months, respectively. Grade 3/4 neutropenia, anemia and thrombocytopenia were observed in 36.6%, 26.8, and 24.4% of patients, respectively. Non-hematological toxicity was generally mild. Grade 3 vomiting occurred in 1 (2.4% patients. Conclusion The gemcitabine plus carboplatin combination is active in advanced TCC with acceptable toxicity and needs to be evaluated further and compared with other non-cisplatin-containing regimens. Trial registration ISRCTN88259320

  7. A phase II trial of gemcitabine plus carboplatin in advanced transitional cell carcinoma of the urothelium

    International Nuclear Information System (INIS)

    Recent studies have demonstrated the effectiveness of cisplatin-based combinations in patients with advanced transitional cell carcinoma(TCC) of the urothelium. Concern over cisplatin toxicity instigated a search for alternative regimens. The aim of the study was to evaluate the activity and tolerability of gemcitabine plus carboplatin combination as first-line treatment in patients with advanced transitional cell carcinoma of the urothelium. Patients with advanced TCC were treated with gemcitabine 1200 mg/m2 on days 1 and 8 and carboplatin area under the concentration-time curve(AUC) 5 on day 1 every 21 days. Out of 41 patients, thirty-nine were evaluable for efficacy and 41 for toxicity. A median of 5 cycles (range 1–6) was administered. Overall response rate was 46.2% (95% confidence interval: 32–65%) including 10.3% complete responses and 35.9% partial responses. The median time to progression and median overall survival were 7.5 months (95% confidence interval: 6.6–8.4 months) and 13.6 months (95% confidence interval: 10.2–17.0 months), respectively. Grade 3/4 neutropenia, anemia and thrombocytopenia were observed in 36.6%, 26.8, and 24.4% of patients, respectively. Non-hematological toxicity was generally mild. Grade 3 vomiting occurred in 1 (2.4%) patients. The gemcitabine plus carboplatin combination is active in advanced TCC with acceptable toxicity and needs to be evaluated further and compared with other non-cisplatin-containing regimens. ISRCTN88259320

  8. Daily concurrent preoperative chemoradiotherapy using superselective intra-arterial infusion via superficial temporal artery for advanced oral cancer. Histological evaluation of metastatic cervical lymph nodes

    International Nuclear Information System (INIS)

    Superselective intra-arterial chemotherapy via a superficial temporal artery has become feasible for daily concurrent radiotherapy and chemotherapy in patients with oral cancer. In this study, histopathological effects on metastatic cervical lymph nodes in cases of advanced oral cancer using superselective intra-arterial chemoradiotherapy were evaluated. Thirty-seven oral cancer patients with cervical lymph node metastasis were treated with preoperative chemoradiotherapy using superselective intra-arterial infusion via the superficial temporal artery. The treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m2; cisplatin, total 100-150 mg/m2) and concurrent radiotherapy (total 40-60 Gy) for 4-6 weeks, followed by surgery. In cases in which the catheter was inserted into the facial artery, grade III or IV (Oboshi-Shimosato classification) in the cervical lymph node metastasis was obtained in 20 (83.3%) of 24 patients. And, forty-six (88.5%) of 52 metastatic lymph nodes showed grade III or IV. This method was an effective regimen for oral cancer with cervical lymph node metastasis. (author)

  9. Langerhans Cell Histiocytosis of the Thyroid with Multiple Cervical Lymph Node Involvement Accompanying Metastatic Thyroid Papillary Carcinoma

    OpenAIRE

    A. Bahar Ceyran; Serkan Şenol; Barış Bayraktar; Şeyma Özkanlı; Z. Leyla Cinel; Abdullah Aydın

    2014-01-01

    A 37-year-old male case was admitted with goiter. Ultrasonography of thyroid showed a 5 cm cystic nodule in the left lobe with a 1.5 cm solid component. Fine needle aspiration biopsy revealed atypia of undetermined significance or follicular lesion. The patient was operated on. The pathological diagnosis was reported as papillary thyroid carcinoma. The immunohistochemical examination showed multiple foci of Langerhans cell histiocytosis involving both lobes. The patient died due to cardiac ar...

  10. Establishment of cervical lymph node metastasis model of squamous cell carcinoma in the oral cavity in mice

    Institute of Scientific and Technical Information of China (English)

    SUN Rui; ZHANG Jian-gang; GUO Chuan-bin

    2008-01-01

    Background Oral squamous cell carcinoma (OSCC) is the most prevalent malignant tumor in the head and neck region,comprising more than 90% of all oral malignancies. A feasible approach for an animal model to study OSCC lymph node metastasis was established and biological behaviors of three oral squamous cell carcinoma cell lines were compared.Methods After implanting three kinds of call lines (GDC185, Tca8113, Tca83) into three different anatomical sites in nude mice, namely the tongue, floor of the mouth, and axillary fossa, we observed the tumorigenicity and the metastatic capacity, which was confirmed by histopathology under a surgical microscope.Results The animal model injected with GDC185 cells into the floor of the mouth had the highest rate of neck lymph node metastasis (55.6%) and the call lines had significantly different biological behaviors.Conclusions Nude mice injected with GDC185 cells into the floor of the mouth could be used as a feasible animal model to study neck metastasis of oral squamous cell carcinoma.

  11. Dioscin Induces Apoptosis in Human Cervical Carcinoma HeLa and SiHa Cells through ROS-Mediated DNA Damage and the Mitochondrial Signaling Pathway

    Directory of Open Access Journals (Sweden)

    Xinwei Zhao

    2016-06-01

    Full Text Available Dioscin, a natural product, has activity against glioblastoma multiforme, lung cancer and colon cancer. In this study, the effects of dioscin against human cervical carcinoma HeLa and SiHa cells were further confirmed, and the possible mechanism(s were investigated. A transmission electron microscopy (TEM assay and DAPI staining were used to detect the cellular morphology. Flow cytometry was used to assay cell apoptosis, ROS and Ca2+ levels. Single cell gel electrophoresis and immunofluorescence assays were used to test DNA damage and cytochrome C release. The results showed that dioscin significantly inhibited cell proliferation and caused DNA damage in HeLa and SiHa cells. The mechanistic investigation showed that dioscin caused the release of cytochrome C from mitochondria into the cytosol. In addition, dioscin significantly up-regulated the protein levels of Bak, Bax, Bid, p53, caspase-3, caspase-9, and down-regulated the protein levels of Bcl-2 and Bcl-xl. Our work thus demonstrated that dioscin notably induces apoptosis in HeLa and SiHa cells through adjusting ROS-mediated DNA damage and the mitochondrial signaling pathway.

  12. Dioscin Induces Apoptosis in Human Cervical Carcinoma HeLa and SiHa Cells through ROS-Mediated DNA Damage and the Mitochondrial Signaling Pathway.

    Science.gov (United States)

    Zhao, Xinwei; Tao, Xufeng; Xu, Lina; Yin, Lianhong; Qi, Yan; Xu, Youwei; Han, Xu; Peng, Jinyong

    2016-01-01

    Dioscin, a natural product, has activity against glioblastoma multiforme, lung cancer and colon cancer. In this study, the effects of dioscin against human cervical carcinoma HeLa and SiHa cells were further confirmed, and the possible mechanism(s) were investigated. A transmission electron microscopy (TEM) assay and DAPI staining were used to detect the cellular morphology. Flow cytometry was used to assay cell apoptosis, ROS and Ca(2+) levels. Single cell gel electrophoresis and immunofluorescence assays were used to test DNA damage and cytochrome C release. The results showed that dioscin significantly inhibited cell proliferation and caused DNA damage in HeLa and SiHa cells. The mechanistic investigation showed that dioscin caused the release of cytochrome C from mitochondria into the cytosol. In addition, dioscin significantly up-regulated the protein levels of Bak, Bax, Bid, p53, caspase-3, caspase-9, and down-regulated the protein levels of Bcl-2 and Bcl-xl. Our work thus demonstrated that dioscin notably induces apoptosis in HeLa and SiHa cells through adjusting ROS-mediated DNA damage and the mitochondrial signaling pathway. PMID:27271587

  13. Extinction of the HPV18 upstream regulatory region in cervical carcinoma cells after fusion with non-tumorigenic human keratinocytes under non-selective conditions.

    Science.gov (United States)

    Rösl, F; Achtstätter, T; Bauknecht, T; Hutter, K J; Futterman, G; zur Hausen, H

    1991-01-01

    'Universal fuser' clones of a human papillomavirus type 16 positive cervical carcinoma cell line (SiHa) were established to study the effect of a non-tumorigenic fusion partner on the regulation of a stably integrated chloramphenicol acetyltransferase (CAT) gene controlled by the HPV18 upstream regulatory region under non-selective conditions. The CAT expressing cells were fused with both non-tumorigenic, spontaneously immortalized human keratinocytes (HaCaT) and non-modified SiHa cells. The resulting hybrids were characterized by restriction enzyme fragment length polymorphism analysis and flow cytometry. While the non-selectable, HPV18-driven indicator gene is constitutively expressed in SiHa cells, the CAT activity is extinguished in SiHa x HaCaT cells, but still present in SiHa x SiHa hybrids. Examination of the cytokeratin expression pattern reveals that the keratinocyte phenotype seems not only to be dominant in terms of the extinction of the HPV18 regulatory region but also by the conservation of most of the differentiation markers of the non-tumorigenic fusion partner. Cycloheximide treatment and intracellular competition experiments using the transient COS7 fusion-amplification technique are accompanied by the reactivation of the marker gene in previously CAT- SiHa x HaCaT hybrids. These data strongly suggest that trans-acting negative regulatory factors derived from the non-malignant human keratinocytes are responsible for the extinction phenomenon. Images PMID:1709093

  14. Mapping the extent of disease by multislice computed tomography, magnetic resonance imaging and sentinel node evaluation in stage I and II cervical carcinoma

    Directory of Open Access Journals (Sweden)

    Rajaram S

    2010-01-01

    Full Text Available Aims: (1 To map the extent of disease in women with stage I and II carcinoma cervix by multislice spiral computed tomography (CT, magnetic resonance imaging (MRI and sentinel nodes. (2 To assess accuracy of each modality individually and in conjunction with FIGO clinical staging. Design and Setting: Prospective, single-blind study. Departments of Obstetrics and Gynaecology, Radiodiagnosis, and Pathology, UCMS and GTBH and Division of Radiological Imaging and Bioinformatics, INMAS, Delhi. Material and Method: The study was conducted on 25 women with cervical cancer FIGO stage I and II. Each woman underwent clinical staging, multislice spiral CT and MRI which was compared to the gold-standard histopathology/cytology. The overall accuracy of each modality and improvement of clinical staging by CT/MRI were noted. Sentinel nodes were evaluated by intracervical Patent Blue V dye injection. Statistical Analysis: Sensitivity, specificity, positive and negative predictive values were calculated by 2Χ2 contingency tables. Results: The accuracy of staging by FIGO, CT and MRI was 68%, 52% and 80%, respectively. MRI and CT improved the overall accuracy of FIGO staging to 96% and 80%, respectively. Sentinel nodes were identified in 89% of patients with 91% accuracy. Conclusion: MRI emerges as the most valuable stand-alone modality improving accuracy of FIGO staging to 96%. Sentinel lymph-node evaluation appears promising in evaluating spread beyond cervix.

  15. Apparent diffusion coefficients in GEC ESTRO target volumes for image guided adaptive brachytherapy of locally advanced cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Haack, Soeren (Dept. of Clinical Engineering, Aarhus Univ. Hospital (Denmark)), E-mail: Soeren.haack@stab.rm.dk; Morre Pedersen, Erik (Dept. of Radiology, Aarhus Sygehus, Aarhus Univ. Hospital (Denmark)); Jespersen, Sune N. (Center of Functionally Integrative Neuroscience, Aarhus Univ. Hospital (Denmark)); Kallehauge, Jesper F. (Dept. of Medical Physics, Aarhus Univ. Hospital (Denmark)); Lindegaard, Jacob Christian; Tanderup, Kari (Dept. of Oncology Aarhus Univ. Hospital (Denmark))

    2010-10-15

    Background and purpose. T2 weighted MRI is recommended for image guided adaptive brachytherapy (IGABT) in cervical cancer. Diffusion weighted imaging (DWI) and the derived apparent diffusion coefficient (ADC) may add additional biological information on tumour cell density. The purpose of this study was to evaluate the distribution of the ADC within target volumes as recommended by GEC-ESTRO: Gross Tumour Volume at BT (GTVBT), High-Risk Clinical Tumour Volume (HR-CTV) and Intermediate-Risk Clinical Target Volume (IR-CTV) and to evaluate the change of diffusion between fractions of IGABT. Material and methods. Fifteen patients with locally advanced cervical cancer were examined by MRI before their first (BT1) and second (BT2) fraction of IGABT, resulting in a total of 30 MR examinations including both T2 weighted and DWI sequences. The Apparent Diffusion Coefficient (ADC) was calculated by use of three levels of b-values (0, 600, 1000 s/mm2). ADC maps were constructed and fused with the GEC ESTRO target contours. The mean ADC value within each target volume was calculated. Furthermore, volumes of low diffusion (ADClow) were defined based on an ADC threshold of 1.2 x 10-3 mm2/s, and overlap with target volumes was evaluated. Change of ADC level in target volumes and change of ADClow volume from BT1 to BT2 was also evaluated. Results. The mean ADC was significantly lower in GTVBT than in HR-CTV (p<0.001) which again was significantly lower than in IR-CTV (p<0.001). There was no significant change of the ADClow volume or ADC level within each target structure between BT1 and BT2 (p=0.242). All three GEC-ESTRO volumes contained volumes with low diffusion. The GTVBT contained 37.2% volume of low diffusion, HR-CTV 20.3% and IR-CTV 10.8%. Conclusion. With DWI we were able to find a significant difference in ADC-values for the three different GEC ESTRO targets. This supports the assumption that the target volumes used for dose prescription in IGABT contain tissues with

  16. Application of the ICRU Report 38 reference volume concept to the radiotherapeutic management of recurrent endometrial and cervical carcinoma

    International Nuclear Information System (INIS)

    Radiation therapy was given to 25 patients presenting with pelvic recurrence of endometrial (14) and cervical (11) cancer. Of these patients, all but one had undergone hysterectomy following their original diagnosis. Two endometrial patients received post operative intracavitary irradiation. The recurrence-free interval ranged from 5 to 71 months (mean = 21 months). External beam radiation therapy for pelvic recurrence ranged from 3000 to 5000 cGy. Additional central radiation was given to 18 patients with either external beam, intracavitary, interstitial, or transvaginal technique. Dose and dose rates from brachytherapy was documented with maximum values, along with the location of these dose points. Such specification is essential in obtaining a more accurate impression of the total dose delivered to the patient, especially when different techniques are employed to increase the dose to the center of the pelvis

  17. Expression of human papillomavirus-18 E6, E2 and cellular bromodomain protein Brd4 in cervical intraepithelial neoplasia and cervical carcinoma%HPV-18病毒E2、E6与Brd4在宫颈癌及癌前病变的表达与意义

    Institute of Scientific and Technical Information of China (English)

    黄卓敏; 江曼茹; 古衍; 姚吉龙; 谢建生

    2012-01-01

    [Objective] To investigate the expression of human papillomavirus-18 E2, £6 and cellular bromodomain protein Brd4 in cervical lesions and the role of which in cervical carcinogenesis and its potential clinical significance. [Methods] The expression of E2 and E6 mRNA in the tissues of 15 cases of cervicitis, 19 cases of CIN I , 17 cases of CIN Ⅱ, 20 cases of CIN Ⅲ and 24 cases of invasion cervical carcinoma with HPV-18 infection was detected by reverse transcription polymerase chain reaction, meanwhile westernblot was applied to detect E2 protein and Brd4 in such cervical lesions. [Results] No significant differences of E2 and E6 mRNA expression were found between groups of cervicitis and CIN Ⅰ (P >0.05). However, the expression of E2 mRNA decreased dramatically corresponding with pathological upgrading, meanwhile the expression of E6 mRNA increased inversely from groups of CIN to invasion cervical carcinoma (P 0.05), whereas the expression of E2 protein and Brd4 decreased significantly cor-responding with pathological upgrading from groups of CIN to invasion cervical carcinoma (P <0.05). [Conclusion] Deletion of HPV-18 E2 and over expression of E6 induced by degradation of Brd4-E2 complex has been proved to be a key step in the malignant transformation of cervical cells inducted by HPV, which may play an important role in cervical carcinogenesis. Therefore, detection of the levels of HPV-18 E2,E6 and Brd4 expression might be clinically valuable for the prediction of cervical carcinogenesis and the evaluation of prognosis in CIN.%目的 探讨HPV-18病毒E2、E6与宿主蛋白Brd4在CIN和宫颈癌中的表达与临床意义.方法 RT-PCR检测HPV-18阳性的宫颈炎15例、CIN I 19例、CINⅡ17例、CINⅢ20例、宫颈浸润癌24例的标本中E2和E6 mRNA的表达,Westemblot检测E2蛋白和Brd4的表达,比较上述指标在各组中的表达差异.结果 HPV-18 E2和E6 mRNA在宫颈炎和CINI的表达差异无显著性(P>0.05);

  18. Poor Prognosis Associated With Human Papillomavirus α7 Genotypes in Cervical Carcinoma Cannot Be Explained by Intrinsic Radiosensitivity

    International Nuclear Information System (INIS)

    Purpose: To investigate the relationship between human papillomavirus (HPV) genotype and outcome after radiation therapy and intrinsic radiosensitivity. Methods and Materials: HPV genotyping was performed on cervix biopsies by polymerase chain reaction using SPF-10 broad-spectrum primers, followed by deoxyribonucleic acid enzyme immunoassay and genotyping by reverse hybridization line probe assay (LiPA25) (version 1) (n=202). PapilloCheck and quantitative reverse transcription-polymerase chain reaction were used to genotype cervix cancer cell lines (n=16). Local progression-free survival after radiation therapy alone was assessed using log-rank and Cox proportionate hazard analyses. Intrinsic radiosensitivity was measured as surviving fraction at 2 Gy (SF2) using clonogenic assays. Results: Of the 202 tumors, 107 (53.0%) were positive for HPV16, 29 (14.4%) for HPV18, 9 (4.5%) for HPV45, 23 (11.4%) for other HPV genotypes, and 22 (10.9%) were negative; 11 (5.5%) contained multiple genotypes, and 1 tumor was HPV X (0.5%). In 148 patients with outcome data, those with HPVα9-positive tumors had better local progression-free survival compared with α7 patients in univariate (P<.004) and multivariate (hazard ratio 1.54, 95% confidence interval 1.11-1.76, P=.021) analyses. There was no difference in the median SF2 of α9 and α7 cervical tumors (n=63). In the cell lines, 9 were α7 and 4 α9 positive and 3 negative. There was no difference in SF2 between α9 and α7 cell lines (n=14). Conclusion: The reduced radioresponsiveness of α7 cervical tumors is not related to intrinsic radiosensitivity

  19. Poor Prognosis Associated With Human Papillomavirus α7 Genotypes in Cervical Carcinoma Cannot Be Explained by Intrinsic Radiosensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Hall, John S.; Iype, Rohan; Armenoult, Lucile S.C. [Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester (United Kingdom); Taylor, Janet [Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester (United Kingdom); Applied Computational Biology and Bioinformatics Group, Paterson Institute for Cancer Research, Manchester (United Kingdom); Miller, Crispin J. [Applied Computational Biology and Bioinformatics Group, Paterson Institute for Cancer Research, Manchester (United Kingdom); Davidson, Susan [Christie National Health Service Foundation Trust, Manchester (United Kingdom); Sanjose, Silvia de; Bosch, Xavier [Cancer Epidemiology Research Program, Catalan Institute of Oncology, L' Hospitalet de Llobregat (Spain); Stern, Peter L. [Immunology Group, Paterson Institute for Cancer Research, Manchester (United Kingdom); West, Catharine M.L., E-mail: Catharine.West@manchester.ac.uk [Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester (United Kingdom)

    2013-04-01

    Purpose: To investigate the relationship between human papillomavirus (HPV) genotype and outcome after radiation therapy and intrinsic radiosensitivity. Methods and Materials: HPV genotyping was performed on cervix biopsies by polymerase chain reaction using SPF-10 broad-spectrum primers, followed by deoxyribonucleic acid enzyme immunoassay and genotyping by reverse hybridization line probe assay (LiPA{sub 25}) (version 1) (n=202). PapilloCheck and quantitative reverse transcription-polymerase chain reaction were used to genotype cervix cancer cell lines (n=16). Local progression-free survival after radiation therapy alone was assessed using log-rank and Cox proportionate hazard analyses. Intrinsic radiosensitivity was measured as surviving fraction at 2 Gy (SF2) using clonogenic assays. Results: Of the 202 tumors, 107 (53.0%) were positive for HPV16, 29 (14.4%) for HPV18, 9 (4.5%) for HPV45, 23 (11.4%) for other HPV genotypes, and 22 (10.9%) were negative; 11 (5.5%) contained multiple genotypes, and 1 tumor was HPV X (0.5%). In 148 patients with outcome data, those with HPVα9-positive tumors had better local progression-free survival compared with α7 patients in univariate (P<.004) and multivariate (hazard ratio 1.54, 95% confidence interval 1.11-1.76, P=.021) analyses. There was no difference in the median SF2 of α9 and α7 cervical tumors (n=63). In the cell lines, 9 were α7 and 4 α9 positive and 3 negative. There was no difference in SF2 between α9 and α7 cell lines (n=14). Conclusion: The reduced radioresponsiveness of α7 cervical tumors is not related to intrinsic radiosensitivity.

  20. [Transarterial infusion chemotherapy using fine-powder cisplatin in patients with advanced hepatocellular carcinoma].

    Science.gov (United States)

    Hatanaka, Takeshi; Kakizaki, Satoru; Ueno, Takashi; Takeuchi, Suguru; Takizawa, Daichi; Katakai, Kenji

    2014-02-01

    We investigated the therapeutic effects and safety of fine powder cisplatin for patients with advanced hepatocellular carcinoma( HCC). From January 2006 to March 2012, 123 patients with advanced HCC were treated by transarterial infusion chemotherapy(TAI)with fine-powder cisplatin(IA-call®, Nippon Kayaku Co. Ltd., Tokyo, Japan). The drug was infused into the liver through the feeding artery at a dose of 65 mg/m2. The treatment was repeated every 4 to 8 weeks until evidence of either tumor progression or unacceptable toxicity appeared. Treatment responses were classified as complete response(CR), partial response(PR), stable disease(SD), and progressive disease(PD)in 3.2%, 12.0%, 32.2%, and 52.4% of patients, respectively. The median survival durations were as follows: overall, 12.2 months; CR/PR patients, 23.8 months; and SD/PD patients, 10.6 months. The cumulative survival rates of CR/PR patients were significantly higher than those of SD/PD patients (pPIVKA- II )were predictive factors of survival duration. Problematic adverse events were not observed in any of the patients. Our results suggest that TAI using fine-powder cisplatin can be safely administered for advanced HCC and can improve the prognosis of patients with advanced disease. PMID:24743198

  1. Concomitant chemobrachyradiotherapy with ifosfamide and cisplatin followed by consolidation chemotherapy in locally advanced squamous cell carcinoma of the uterine cervix: Results of a phase II study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy and toxicity of ifosfamide and cisplatin administered concomitantly with low-dose-rate brachytherapy followed by consolidation chemotherapy in the treatment of locally advanced squamous cell cervical carcinoma (LASCC). Methods and materials: Forty-four patients with biopsy-proven LASCC were enrolled. FIGO Stages IB2 bulky to IVA were entered into this study. Patients were assigned to receive external radiotherapy (50 Gy in 25 fractions); then ifosfamide 2 g/m2 plus cisplatin 75 mg/m2 was applied during two low-dose-rate brachytherapy applications, and 4 cycles of consolidation chemotherapy with the same drug combination were given after completion of radiotherapy. The planned dose to point A was 85 Gy. Results: All patients received both courses of concomitant chemobrachytherapy and at least 1 cycle of consolidation chemotherapy. The average duration of radiation was 45.1 days. The clinical complete response rate was 100%. Grade 3 and 4 leukopenia occurred in 25% and 11% of the cycles, respectively. After a median follow-up of 34 months (range, 20-54 months), the recurrence-free and the overall survival rates were 84% and 91%, respectively. Major delayed local complications occurred in 7 cases (16%). Conclusions: These results indicate that concomitant chemobrachyradiotherapy with ifosfamide and cisplatin is a feasible combination for patients with LASCC of the cervix uteri. A randomized trial is planned

  2. Repeat CT-scan assessment of lymph node motion in locally advanced cervical cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Bondar, Luiza; Velema, Laura; Mens, Jan Willem; Heijmen, Ben; Hoogeman, Mischa [Erasmus Medical Center Cancer Institute, Department of Radiation Oncology, 3008 AE, Rotterdam (Netherlands); Zwijnenburg, Ellen [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands)

    2014-12-15

    In cervical cancer patients the nodal clinical target volume (CTV, defined using the major pelvic blood vessels and enlarged lymph nodes) is assumed to move synchronously with the bony anatomy. The aim of this study was to verify this assumption by investigating the motion of the major pelvic blood vessels and enlarged lymph nodes visible in CT scans. For 13 patients treated in prone position, four variable bladder-filling CT scans per patient, acquired at planning and after 40 Gy, were selected from an available dataset of 9-10 CT scans. The bladder, rectum, and the nodal-vessels structure containing the iliac vessels and all visible enlarged nodes were delineated in each selected CT scan. Two online patient setup correction protocols were simulated. The first corrected bony anatomy translations and the second corrected translations and rotations. The efficacy of each correction was calculated as the overlap between the nodal-vessels structure in the reference and repeat CT scans. The motion magnitude between delineated structures was quantified using nonrigid registration. Translational corrections resulted in an average overlap of 58 ± 13% and in a range of motion between 9.9 and 27.3 mm. Translational and rotational corrections significantly improved the overlap (64 ± 13%, p value = 0.007) and moderately reduced the range of motion to 7.6-23.8 mm (p value = 0.03). Bladder filling changes significantly correlated with the nodal-vessels motion (p < 0.001). The motion of the nodal-vessels was large, nonrigid, patient-specific, and only moderately synchronous with the bony anatomy. This study highlights the need for caution when reducing the CTV-to-PTV (PTV planning target volume) margin of the nodal CTV for highly conformal radiation techniques. (orig.) [German] Bei Zervixkarzinompatientinnen wird davon ausgegangen, dass das nodale klinische Zielvolumen (CTV, definiert anhand der grossen Blutgefaesse des Beckens und vergroesserter Lymphknoten) sich synchron mit

  3. PCNA和SCCA对宫颈鳞癌NACT敏感性和疗效的预测价值%Values of PCNA and SCCA for predicting the sensitivity and curative effect of NACT for cervical squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    黄梦婷; 姚军; 李曼; 莫训群

    2013-01-01

    目的:探讨增殖细胞核抗原(PCNA)及鳞状细胞癌抗原(SCCA)作为评价宫颈鳞癌新辅助化疗(NACT)敏感性及疗效指标的可行性.方法:收集2006年4月~2012年4月桂林医学院附属医院56例IB2 ~ ⅡB期宫颈鳞癌NACT前后组织标本及其中的2011年4月~2012年4月16例宫颈鳞癌NACT前后血清标本,采用免疫组化法测定癌组织中PCNA的表达,EUSA检测血清中SCCA的表达.结果:56例宫颈鳞癌经NACT治疗2~3周后评价临床疗效,临床总有效率为67.9% (38/56).有效组NACT前组织PCNA指数及血清SCCA水平均高于无效组(P<0.01),有效组PCNA指数及血清SCCA水平化疗后明显下降(P<0.01).NACT后组织PCNA降幅和血清SCCA降幅与肿瘤缩小比例之间有显著相关性(r=0.808,P<0.01;r=0.708,P<0.05).结论:联合检测组织增殖细胞核抗原及血清鳞状细胞癌抗原可作为评价宫颈鳞癌新辅助化疗敏感性和疗效的有效指标之一.%Objective: To explore the feasibilities of proliferating cell nuclear antigen (PCNA) and squamous cell carcinoma antigen (SCCA) as markers for predicting the sensitivity and curative effect of neoadjuvant chemotherapy (NACT) for cervical squamous cell carcinoma. Methods: The 56 samples of cervical squamous cell carcinoma of Ⅰ B2 - Ⅱ B before and after NACT from the hospital from A-pril 2006 to April 2012 were collected, and the ser