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  1. Results of radiation therapy for carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Fifty-nine consecutive patients who were treated with radiation therapy for carcinoma of the uterine cervix between April 1982 and December 1986 were reviewed. Twelve patients were treated with low dose-rate intracavitary irradiation using radium-226, and 46 were treated with high dose-rate irradiation using a remote afterloading system combined with external irradiation, and the other one was treated with external irradiation alone. The 5-year-survival rates for stage Ib, IIa, IIb, IIIb, and IVa were 77.8, 85.7, 87.5, 45.5 and 40.0%, respectively. The 5-year-survival rates for the low and high dose-rates irradiation were 66.7 and 73.9%, respectively. The most common complication of radiation therapy was rectal bleeding, which required conservative treatment (grade 2) in 11 (18.6%). The morbidities for the low and high dose-rates irradiation were similar. The causes of death in 17 patients were local recurrence in 14, metastases in 2 and other specified in one. These findings suggest that high dose-rate intracavitary irradiation is as effective as low dose-rate irradiation for carcinoma of the uterine cervix, and that further efforts for controlling the local tumors with stage IIIb disease without an increased rate of side-effects is required. (author)

  2. Carcinoma of the cervix

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    Purpose: To discuss a variety of technical and clinical issues concerning the management of carcinoma of the uterine cervix. Radiation therapy plays a central role in the management of patients with invasive carcinoma of the uterine cervix. Although survival rates are high for patients with small volume disease, clinicians continue to search for approaches that might improve treatment results for patients who have bulky central disease, evidence of regional dissemination or other factors associated with a high rate of disease recurrence. New technical approaches have contributed to controversy about the best means of optimizing therapeutic ratio. This course will review current approaches to the management of cervical cancer. Technical aspects of intracavitary and external beam treatment will be emphasized. Problems with brachytherapy dose specification will be discussed as will technical factors that may influence the incidence of treatment-related complications. Current understanding of the natural history of disease and of clinical factors that influence the rate of disease recurrence will be reviewed, including the importance of tumor volume, lymph node involvement, and histologic type on natural history and prognosis. The possible role of controversial methods of clinical evaluation such as lymphangiography and surgical staging will be discussed. Some of the more controversial aspects of treatment including the indications of radiation therapy vs. surgical therapy for stage IB disease, the role of extended field therapy, postoperative therapy, adjuvant hysterectomy, and neoadjuvant or concurrent chemotherapy will be discussed. Conclusions from the recent NCI consensus conference on cervical cancer will be reviewed

  3. Carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose: To discuss a variety of technical and clinical issues concerning the management of carcinoma of the uterine cervix. Radiation therapy plays a central role in the management of patients with invasive carcinoma of the uterine cervix. Although survival rates are high for patients with small volume disease, clinicians continue to search for approaches that might improve treatment results for patients who have bulky central disease, evidence of regional dissemination or other factors associated with a high rate of disease recurrence. New technical approaches have contributed to controversy about the best means of optimizing therapeutic ratio. This course will review current approaches to the management of cervical cancer. Technical aspects of intracavitary and external beam treatment will be emphasized. Problems with brachytherapy dose specification will be discussed as will technical factors that may influence the incidence of treatment-related complications. Current understanding of the natural history of disease and of clinical factors that influence the rate of disease recurrence will be reviewed, including the importance of tumor volume, lymph node involvement, and histologic type on natural history and prognosis. The possible role of controversial methods of clinical evaluation such as lymphangiography and surgical staging will be discussed. Some of the more controversial aspects of treatment such as the indications for radiation therapy vs. surgical therapy for stage IB disease, the role of extended field therapy, postoperative therapy, adjuvant hysterectomy and neoadjuvant or concurrent chemotherapy will be reviewed

  4. PREGNANCY WITH CARCINOMA CERVIX

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    Sunita

    2014-05-01

    Full Text Available : Invasive cervical cancer during pregnancy is rare, but is a dilemma for women and their physicians. Pregnancy provides a good opportunity to the obstetrician to screen the patient for cervical neoplasia. We report a case of pregnancy with carcinoma cervix. A 40 years old lady G5P3+1 presented in casualty at 38 weeks 2 days with bleeding per vaginum. On examination she was stage III b Carcinoma Cervix with term pregnancy. She underwent classical cesarean section followed by EBRT and brachytherapy. The main objective of this case report is to highlight the need of doing cervical screening routinely in pregnancy in a low resource setting also to decrease the burden of carcinoma cervix in society

  5. Stage IB carcinoma of the cervix, the Norwegian radium hospital, 1968--1970: results of treatment annd major complications

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    Martimbeau, P.W.; Kjorstad, K.E.; Kolstad, P.

    1978-06-15

    Different methods of treatment have been debated over the years for Stage IB carcinoma of the cervix, especially in view of the results and complications. We have reviewed the experience of the Norwegian Radium Hospital for carcinoma of the cervix, Stage IB, for the years 1968, 1969, and 1970; most of the patients receive preoperative intrauterine and intravaginal radium, followed by radical hysterectomy and pelvic lymphadenectomy; if the nodes are involved, they also receive external pelvic irradiation. During this period, 437 patients had Stage IB; the 5 year survival was 80.2 per cent (not corrected). We focused our attention on lymphedema following such a method of treatment; of 402 patients operated upon, 23.4% developed lymphedema ranging from mild to moderate to severe; 20 patients (5%) had severe lymphedema; factors involved are analyzed.

  6. Carcinoma cervix presenting with clivus metastasis

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    Arpitha S Rao

    2015-01-01

    Full Text Available We present an unusual case of a large metastatic lesion from carcinoma cervix located in the clivus. Patient presented with severe headache and vomiting, mimicking an intracranial pathology. Radiological imaging suggested metastatic origin of the lesion and later on investigations revealed primary in the uterine cervix. The anatomic importance of extradural neural axis component in the process of metastasis of carcinoma cervix to the clivus is highlighted in this case report.

  7. Carcinoma of the cervix: results of a hyperbaric oxygen trial associated with the use of the Cathetron

    International Nuclear Information System (INIS)

    Since 1971, 82 patients with advanced carcinoma of the cervix has been included in a randomised clinical trial in association with the Working Party on Radiotherapy and Hyperbaric Oxygen of the Medical Research Council. External irradiation was given in 10 fractions by an unconventional schedule, either in air or HBO, and combined with three large fractions of intracavitary irradiation using the Cathetron. The results are acceptable overall, with 69% local control, 15% with tumour developing outside the treated volume and 40% survival at five years, but no improvement has been shown with HBO. Symptoms suggestive of some degree of late damage to the small bowel were present in 13% of patients, with higher but not statistically significant, incidence in the HBO group. It is postulated that the schedule of radiotherapy used has allowed reoxygenation during treatment and that no further gain due to the use of HBO may be achieved. After a review of the results from other centres and taking into account the difficulties of treatment in HBO it is concluded that for advanced carcinomas of the cervix the addition of HBO to radiotherapy is not clinically worthwhile. (author)

  8. Substantiation of combined and complex radiotherapy of cervix uteri carcinoma (stage 1) from point of view of delayed results and occupational rehabilitation of patients

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    A clinical evaluation of the results of treatment of 225 patients with cervix uteri carcinoma (stage 1) is presented. 113 patients received complex radiation and 112 patients - combined therapy. A better therapeutic effect was obtained in the complex radiation group. Combined therapy should be recommended only unless full-scale complex radiation treatment can be applied

  9. Palmar cutaneous metastasis from carcinoma cervix

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    Elamurugan T

    2011-01-01

    Full Text Available Carcinoma of the uterine cervix is the most common gynecological malignancy in developing countries. However, its cutaneous metastasis is a rare entity. The reported incidence of cutaneous metastasis ranges from 0.1 to 2%. Frequent sites of cutaneous metastasis in decreasing order are: abdominal wall, vulva and anterior chest wall. To the best of our knowledge, only three cases of cutaneous metastasis to the upper extremity have been reported in the world. We report a case of a 74-year-old postmenopausal lady diagnosed to have carcinoma cervix (stage IIIB who presented with cutaneous metastasis to palm and thigh, 10 months after radical radiotherapy. At presentation, the primary disease had resolved completely. She had a small nodular growth in the left palm and left thigh. Fine needle aspirate cytology and core needle biopsy from both the nodular lesions were positive for squamous cell carcinoma.

  10. Can pure accelerated radiotherapy given as six fractions weekly be an option in locally advanced carcinoma cervix: Results of a prospective randomized phase III trial

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    Mukesh Sharma

    2016-01-01

    Conclusions: Accelerated radiotherapy given as six fractions per week is an effective alternative to concomitant chemoradiation in locally advanced carcinoma cervix and has shown lesser toxicities in our study.

  11. FIGO Stage IIIB squamous cell carcinoma of the uterine cervix: natural history, treatment results, and prognostic factors

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    Purpose: To define patient, tumor, and treatment factors that influence the outcome of patients with FIGO Stage IIIB squamous cell carcinoma of the intact uterine cervix. Materials and Methods: The hospital and radiotherapy records of 1007 consecutive patients treated between 1960 and 1989 for FIGO Stage IIIB squamous cell carcinoma of the intact uterine cervix were reviewed retrospectively. All patients were treated with radiation therapy (RT) either with curative intent (903 patients) or to palliate symptoms (104 patients). Patients who were selected for palliative treatment usually had a combination of adverse characteristics including massive tumor with bilateral pelvic wall fixation, hydronephrosis, bulky adenopathy, pathologic evidence of extrapelvic disease, and poor performance status. 64 (7%) of 903 patients failed to complete planned curative RT either because of progressive disease, complications, or poor compliance. Of 903 patients treated with curative intent, 319 (35%) were treated with external beam radiotherapy (EBRT) alone and 586 (65%) were treated with a combination of EBRT and intracavitary irradiation (ICRT). EBRT was usually delivered using 18-25 MV photons and ICRT was administered with Fletcher-Suit-Delclos applicators. Treatment philosophies evolved during the study period with greater emphasis placed on EBRT between 1966 and 1979 (52% treated with EBRT alone) compared with the other study years (15% treated with EBRT alone). 206 patients received investigational treatments including neutrons (69 pts), hyperbaric oxygen (66 pts), concurrent chemotherapy (29 pts), or neoadjuvant chemotherapy (42 pts). 875 patients have been followed until death. Median follow up for surviving patients is 171 months with only 9 surviving patients followed for 10%, or hgb < 10 gm% before treatment or at any time during radiotherapy. DSS was significantly better for patients whose treatment included ICRT (43% vs 21%; P< 0.0001). Also, patients who received

  12. Value and importance of intracavitary therapy in uterine cervix carcinoma

    International Nuclear Information System (INIS)

    The guiding topic of this report was 'the value and importance of intracavitary therapy in uterine cervix carcinoma'. This implies first of all the task to assess the importance of contact therapy within the scope of all therapeutic measures taken in case of uterine cervix carcinoma. Furthermore it was necessary to compare the importance of the different methods of contact therapy: conventional radium therapy as well as low dose rate and high dose rate afterloading techniques. As to surgical intervention, it is clear that only favorable stages can be taken into consideration for this treatment. It is shown by means of data taken from the Annual Report, Vol. 18, that a considerable number of patients with uterine cervix carcinoma I are irradiated even in hospitals whose field of activity lies preponderantly in surgery, and that by far most of the patients cured from uterine cervix cancer owe their recovery to contact therapy. The consideration of contact therapy methods show clearly that radium should no longer be used in clinical practice. Psychological doubts often hinder the decision if long-term or short-term afterloading therapy is to be applied. It is therefore shown that the very different forms of radium therapy with their chronological and spatial dose distribution were due to the characteristics of radium (e.g. little specific activity) or to other compelling features and that they were not based on radiobiological aspects. The radium dose values obtained by empirical research and the resulting spatial and chronological dose distribution are therefore not imperative. So it is not inevitable to choose the low dose rate afterloading method. On the contrary, the high dose rate technique with an adequate fractionation is very probably the method of choice. To sum up it can be said that contact therapy is still the most important therapeutic method in uterine cervix cancer. (orig.)

  13. Irradiation with or without misonidazole for patients with stages IIIb and IVa carcinoma of the cervix: final results of RTOG 80-05

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    Purpose: The purpose of this study was to evaluate tumor response, progression-free survival, local tumor control, patterns of relapse, and toxicity in patients with Stages IIIb and IVa squamous cell carcinoma of the uterine cervix treated with irradiation or irradiation and misonidazole. This is a report of the final results of the study. Methods: This study was a prospective randomized Phase III trial performed by the Radiation Therapy Oncology Group (RTOG). Between August 1980 and November 1984, 120 patients with Stages IIIb and IVa squamous cell carcinoma of the cervix were randomized to receive either standard irradiation or standard irradiation and misonidazole. Irradiation consisted of 46 Gy to the pelvis plus a 10 Gy parametrial boost followed by intracavitary brachytherapy or external irradiation boost to the primary tumor. Misonidazole was administered at 400 mg/m2 daily, 2-4 h before irradiation. Patients in the 2 treatment groups were evenly distributed by stage, Karnofsky Performance Status, and positive para-aortic lymph nodes. Results: Sixty-one patients were treated with irradiation alone, and 59 patients received irradiation and misonidazole. Complete response in the pelvis occurred in 44 (75%) of those treated with irradiation and in 38 (64%) of those treated with irradiation and misonidazole. The progression-free survivals were 22% at 5 years for the control group, and 29% at 5 years for the misonidazole group. At the time of last follow-up, 18 patients in the control arm were free of disease, and in the experimental arm, 19 were free of disease. The patterns of failure for those treated with irradiation alone were local-only in 9 patients, distant-only in 8 patients, and local and distant in 11 patients. The patterns of failure for those receiving irradiation and misonidazole were local-only in 3 patients, distant-only in 8 patients, and local and distant in 8 patients. The maximum toxicity experienced per patient was grade 3 in 18%, grade 4 in

  14. Adenosquamous cell carcinoma of the cervix — clinical and prognostic characteristics of the disease

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    E. K. Tanriverdieva

    2012-01-01

    Full Text Available Adenosquamous cell carcinoma of the cervix is a rare form of cancer of the cervix. Because of the small number of observations adenosquamous cell carcinoma of the cervix remains poorly understood disease, although the first mention of it dates back to 1956, when A. Glucksmann, and C.D. Cherry first described of mixed carcinoma (adenoacanthoma of the uterine cervix.

  15. 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

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    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

  16. Two-dimensional Electrophoresis Analysis of Differential Protein Expression in Squamous Carcinoma of the Cervix

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    ZHU Xue-qiong; WU Jie-li; YU Li-rong; LIN Yi; L(U) Jie-qiang; ZOU Shuang-wei; HU Yue

    2008-01-01

    Objective:To establish and optimize the two-dimensional gel electrophoresis(2-DE)maps of squamous carcinoma of the cervix and to study the protein difference between squamous carcinoma of the cervix(SCC)and normal cervical tissue.Methods:Using Two-dimensional gel electrophoresis followed by computer-assisted image analysis,the differential proteins between squamous carcinoma of the cervical tissue and normal cervical tissue were compared.Then using matrix-assisted laser desorption/ionization-time of flight mass spectrometry,the differential proteins were identified.Results:The well-resolved and reproducible two-dimensional gel electrophoresis patterns of squamous carcinoma of the cervix tissue and normal cervical tissue were obtained.After silver staining.the average matching ratio of squamous carcinoma of the cervix was 86.1%.There was a good reproducibility of spot position in 2-DE map,with average deviation in IEF direction of 0.95±0.13 mm,while in SDS-PAGE direction it was 1.20±0.18 mm.Ten protein spots were identified by mass spectrometry,some of which were involved in cell proliferation,cell apoptosis,intracellular enzymes,structural proteins,cycle regulation,and tumor occurrence.Conclusion:The differentially expressed proteins provide a fundamental basis for further study of human squamous carcinoma of the cervix and screening of its specific markers.

  17. 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.

  18. Changes in oxygenation during radiotherapy in carcinoma of the cervix

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    Purpose: The aim of this study was to investigate changes in tumor oxygenation, assessed by polarographic needle electrode measurements, following fractionated external beam radiotherapy in carcinoma of the cervix. Methods and Materials: Normal and tumor tissue oxygenation was measured in 19 patients prior to radiotherapy and after 40-45 Gy of external beam radiotherapy delivered in 20 fractions over 4 weeks. All measurements were performed during anesthesia. Results: There was no significant difference in the level of normal tissue oxygenation pre- and post radiotherapy. The individual patient median tumor pO2 values ranged from 0 to 31 mmHg pre-radiotherapy and 1 to 61 mmHg post-radiotherapy. The mean of the 19 median pO2 values increased from 8 (SD ± 10) mmHg to 20 (± 20) mmHg following external beam radiotherapy. The increase was significant by paired Wilcoxon test (p = 0.011). There was also a significant fall in the proportion of values < 5 mmHg (p = 0.040). Although this value remained constant, or fell, in the majority of patients (15/19), it increased in 4 tumors. Tumor size pre- and post-radiotherapy did not correlate with the level of pretreatment oxygenation; neither did the change in tumor size and change in level of oxygenation. Conclusion: The level of tumor oxygenation increased in the majority of patients (15/19) following 40-45 Gy of radiotherapy in carcinoma of the cervix

  19. Metastatic squamous cell carcinoma thyroid from functionally cured cancer cervix

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    The authors report a very unusual occurrence of a metastatic squamous carcinoma to thyroid gland from a treated squamous cell carcinoma cervix 12 years before with no recurrence at the primary site. The case also has an additional complexity of rapid progression of the metastatic thyroid carcinoma to wide spread dissemination to lungs and bones while on concurrent chemo radio therapy confirming the aggressiveness of the entity

  20. ROLE OF PALLIATION IN STAGE IV CARCINOMA CERVIX

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    Smriti

    2013-03-01

    Full Text Available ABSTRACT: BACKGROUND: Palliation reduces the severity of disease symptoms, rather than reversing its progression or providing a cure. Metast atic cancer cervix (Ca Cx is incurable by surgery, radiation or chemotherapy, but these modali ties are useful for palliation. Globally about five to six lakh new cases of carcinoma cervi x are diagnosed every year. Of these, one lakh cases are diagnosed in India of which 25.0% are fro m West Bengal only. OBJECTIVES: Our objective was to study the role of palliation in Sta ge IV Carcinoma Cervix. SETTINGS AND DESIGN: During the study period of five years from January 2 007 to December 2011, consecutive seventy five new cases of stage IV carc inoma cervix diagnosed at Netaji Subhas Chandra Bose Cancer Research Institute, Kolkata, we re included in our study. MATERIALS AND METHODS: Clinical examination with relevant investigations l ike kidney function tests (KFT, biopsy, cystoscopy, CT scan etc were done for diagno sis & staging. Treatment was decided based on woman's age, general health and the locati on & type of the tumour. Treatment options were surgery, radiotherapy (RT, chemotherapy (CT an d simple palliation. In our study, combined CT+RT was done in 18.67% patients most of w ho presented with Stage IV disease. Radiation was given as brachytherapy following telet herapy. Chemotherapy was used as adjunct to RT or for palliation or as neo-adjuvant c hemotherapy (NACT, most commonly using paclitaxel (135mg/square metre, cisplatin (50mg/ squ are metre and 5- fluorouracil (600mg/ square metre. At times, chemotherapy could provide pa in relief only. Vault smear and metastatic workup was done during follow-up visits ev ery 8-12 weeks after treatment completion. RESULTS: Majority of patients belonged to the age group 42-69 years with a median age of 53 years. Bladder involvement was see n in 15(20.0% cases, bowel involvement in 14(19.0% and distant metastasis in 46(61.0% ca ses. Most cases were of Squamous

  1. Sacral plexus injury after radiotherapy for carcinoma of cervix

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    A 42-year-old woman developed lower extremity weakness and sensory loss 1 year after external and intracavitary radiotherapy for Stage IB carcinoma of cervix. She has been followed for 5 years posttreatment, and the neurologic abnormalities have persisted, but no evidence of recurrent carcinoma has been found. We believe this to be a rare case of sacral plexus radiculopathy developing as a late complication after radiotherapy. Suggestions are made for improving the radiotherapy technique to prevent this complication in future cases

  2. Local therapy for small cell carcinoma of the cervix

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    Objective: Small cell carcinoma of the uterine cervix is a rare and aggressive tumor. This tumor is similar to small cell carcinoma of the lung with a tendency to metastasize early. While there has been an increasing interest in the use of chemotherapy regimens similar to those used for small cell carcinoma of the lung, the optimum local therapy for small cell carcinoma of the cervix remains unknown. We reviewed the treatment outcome of patients with small cell carcinoma of the cervix diagnosed in our cancer center with an emphasis on the local/regional disease control. Material and Methods: Between 1983 and 1993, medical records of patients diagnosed with carcinoma of the uterine cervix were reviewed. There were 281 patients with carcinoma of the uterine cervix referred to our department for radiation treatment. Seven patients had pathologic diagnosis of either small cell or neuroendocrine histology. Details of the treatments and follow-up information of these patients were reviewed with a medium follow-up period of three years (range - 1 to 4 years). Results: Five patients had pure small cell histology. Two patients had mixed histology: one with mixed small cell anaplastic neuroendocrine cells and a small foci of adenocarcinoma, the other had mixed small cell and squamous cell histology. Four patients had clinical stage IB disease. The others had IIA, IIB, and IIIB disease, respectively. All patients received either irradiation (XRT) alone or as part of the local therapy. Three patients received XRT alone, one received surgery followed by XRT, one received XRT followed by surgery, and the remaining two had triple modality treatment (chemotherapy, surgery, and XRT). Three patients were alive without evidence of disease recurrence at the last follow-up. Two of these received adjuvant chemotherapy in addition to local therapy. The third patient, whose tumor was smaller than one cm at the time of diagnosis, received XRT alone. Four patients died with disease

  3. Prognostic significance of s-phase fraction detected by antithymidine antibodies in epidermoid cervix carcinomas

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    Purpose: To assess the predictive value of pretreatment proliferative activity of epidermoid cervix carcinoma cells with respect to short- and long-term results of radiotherapy. Methods and Materials: The proliferative activity of 25 epidermoid cervix carcinomas was evaluated as the immunofluorescent labelling index (LI) by rabbit antithymidine antibodies reacting specifically with single-stranded DNA of replication forks in S-phase cells. The short-term clinical outcome was estimated at 3-6 months after treatment by visual and palpatory examination. Three-year follow-up data were obtained through hospital charts and correspondence with referring physicians for only 19 patients. Results: There was no statistically significant association between LI and such conventional prognostic factors as clinical stage. The LI value of cervix carcinomas was significantly associated with complete regression at 3-6 months after radiotherapy and 3-year disease-free survival. Complete regression at 3-6 months was observed in 87.5% patients with fast proliferating tumors (LI > 7.0%), and only in 41.2% patients with slowly proliferating tumors (p = 0.03). Probability of 3-year disease-free survival was 85.7% in patients with fast proliferating tumors and 50.0% in those with slowly proliferating tumors (p = 0.05). Conclusions: The immunofluorescent LI of epidermoid cervix carcinoma is able to provide prognostic information on short-term tumor response to radiotherapy and disease-free survival

  4. Oncologic imaging for carcinoma of the cervix, ovary and endometrium

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    Ninety percent of neoplasms of the cervix are epidermoid carcinomas. Most of the remaining 10% is accounted for by adenocarcinomas; sarcomas of the cervix are rare lesions with a very poor prognosis. Grading of the microscopic specimens obtained from patients with epidermoid carcinomas generally follows the standard three-grade system, viz, well, moderately, and poorly differentiated cellular structure. While the degree of differentiation may have less influence on overall survival than does stage and bulk of the primary lesion, there are studies that indicate that patients with high grade lesions have a poorer prognosis. In Chung's series, for example, the incidence of nodal metastases in patients with stage IB squamous cancers was 0% for grade 1, 18% for grade 2, and 50% for grade 3 lesions. Similarly, the two year survival in the same stage was 100%, 93%, and 77% for grades 1, 2 and 3, respectively

  5. Papillary squamotransitional cell carcinoma of the uterine cervix: A histomorphological and immunohistochemical study of nine cases

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    Mani Anand

    2013-01-01

    Full Text Available Background: Papillary squamotransitional cell carcinoma (PSCC is a distinctive subcategory of squamous cell carcinoma of the uterine cervix. It has a propensity for local recurrence and late metastasis. Histologically, it can be misinterpreted as transitional cell carcinoma, or other papillary lesions of the cervix including squamous papilloma, verrucous carcinoma or cervical intraepithelial neoplasia grade 3 with papillary configuration. Materials and Methods: Nine cases of PSCC of the uterine cervix were diagnosed on a cervical biopsy specimen on routine hematoxylin and eosin (H and E stained sections. Their clinic-morphological features were analyzed. The cases were further evaluated immunohistochemically by cytokeratin 7 (CK7, cytokeratin 20 (CK20, p53 and Ki-67. Results: The patients ranged in age from 35 years to 75 years; with abnormal uterine bleeding being the most common clinical presentation. All the cases showed papillary architecture with fibrovascular cores lined by multilayered atypical epithelium. Three cell types were observed: Clear, intermediate and basaloid. Stromal invasion was seen in five cases, whereas in the remaining four cases, the biopsy specimen was too superficial to definitely assess invasion. Immunohistochemically, eight cases were CK7 + /CK20 - and one case was CK7 - /CK20 - . All nine cases showed nuclear accumulation of mutant p53. Moderate and high proliferative activity was observed in two and seven cases, respectively. Five of patients for whom follow-up information was available underwent radical hysterectomy and two of them were disease free 18 months following treatment. Conclusion: PSCC of the uterine cervix are a clinicomorphologically distinct group of cervical lesions that display a morphologic spectrum. They are potentially aggressive malignant tumors that should be distinguished from transitional cell carcinoma and other papillary lesions of the uterine cervix.

  6. Impact of 3D image-based PDR brachytherapy on outcome of patients treated for cervix carcinoma in France: Results of the French STIC prospective study

    International Nuclear Information System (INIS)

    Purpose: In 2005 a French multicentric non randomized prospective study was initiated to compare two groups of patients treated for cervix carcinoma according to brachytherapy (BT) method: 2D vs 3D dosimetry. The BT dosimetric planning method was chosen for each patient in each center according to the availability of the technique. This study describes the results for 705 out of 801 patients available for analysis. Patients and methods: For the 2D arm, dosimetry was planned on orthogonal X-Rays using low dose rate (LDR) or pulsed dose rate (PDR) BT. For the 3D arm, dosimetry was planned on 3D imaging (mainly CT) and performed with PDR BT. Each center could follow the dosimetric method they were used to, according to the chosen radioelement and applicator. Manual or graphical optimization was allowed. Three treatment regimens were defined: Group 1: BT followed by surgery; 165 patients (2D arm: 76; 3D arm: 89); Group 2: EBRT (+chemotherapy), BT, then surgery; 305 patients (2D arm: 142; 3D arm: 163); Group 3: EBRT (+chemotherapy), then BT; 235 patients, (2D arm: 118; 3D arm: 117). The DVH parameters for CTVs (High Risk CTV and Intermediate Risk CTV) and organs at risk (OARs) were computed as recommended by GYN GEC ESTRO guidelines. Total doses were converted to equivalent doses in 2 Gy fractions (EQD2). Side effects were prospectively assessed using the CTCAEv3.0. Results: The 2D and 3D arms were well balanced with regard to age, FIGO stage, histology, EBRT dose and chemotherapy. For each treatment regimen, BT doses and volumes were comparable between the 2D and 3D arms in terms of dose to point A, isodose 60 Gy volume, dose to ICRU rectal points, and TRAK. Dosimetric data in the 3D arm showed that the dose delivered to 90% of the High Risk CTV (HR CTV D90) was respectively, 81.2 Gyα/β10, 63.2 Gyα/β10 and 73.1 Gyα/β10 for groups 1, 2 and 3. The Intermediate Risk (IR) CTV D90 was respectively, 58.5 Gyα/β10, 57.3 Gyα/β10 and 61.7 Gyα/β10 for groups 1, 2 and

  7. Brachytherapy as sole treatment modality in initial cervix carcinoma

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate brachytherapy as the only treatment modality in inoperable early cervix carcinoma patients (carcinoma in situ, IA and IBocc). In a retrospective analysis 36 patients were treated with intracavitary irradiation between 1984 and 1988 in the Radiotherapy Department of the National Institute of Neoplasmic Diseases. Distribution by stage was; carcinoma in situ: one patient (2,47%), IA: six patients (16,6%), IBooc: twenty-nine patients (80,7%). Histology revealed epidermoid carcinoma in all cases. Mean age 55 years (range: 32-78). Treatment consisted in: two intracavitary applications of Radium, for 120 hours each, with a month interval, in 30 patients (carcinoma in situ: one, IA: four, IBocc: twenty-five patients), two applications of 72 hours each, with 15 days interval in four patients (IA: one, IBocc: 3) and one single intracavitary radium application in two patients (IA and IBocc). Local control was complete in all carcinoma in situ and IA patients. Only 1 of 29 patients with IBocc stage failed to respond, in spite of having received two applications, this shows that local response is independent of the number of insertions. Incidence of complications was low, and resolved with medical treatment. One patient had rectal adenocarcinoma 3 years after treatment -it was considered as radio induced neoplasm, since time of appearance was more than two years and localization was within irradiated area. Two patients died form intercurrent diseases, one (IBocc) from persistent diseases. Two patients were lost to follow-up. Three years survival was: 100% for carcinoma in situ and IA 86,2% for IBocc. Five years survival was 80% for IA and IBocc. Brachytherapy as unique modality of treatment is highly effective in initial cervix carcinoma stages. (author). 41 refs., 14 tabs., 2 figs., 1 ill

  8. HDR neutron brachytherapy for cervix carcinoma in Lithuania

    International Nuclear Information System (INIS)

    Between 1988 and December 1995, a total of 285 patients with stage I-17, with stage II-157, with stage III-104 and stage IV-7 carcinoma of the cervix were treated with a combination of external beam radiation or surgery and HDR brachytherapy. The dose prescription for HDR brachytherapy was point A. The goals of combined radiation therapy were to deliver a total dose of 60.5-68.5 Gy to point A and 53-58 Gy to the pelvic lymph nodes (point B) or 14 Gy-eq to point A in case of preoperative brachytherapy. Dosimetric planning was performed in Gray- equivalents by the use of PC-based computer programme. Relative biological effectiveness of the Cf-252 neutrons was physical gamma and neutron dose rate dependent. Most of the insertions were performed weekly when dose per fraction was 8-10 Gy or 2 insertions were done in one week at lower fractions. The median follow-up for the various stages of disease ranged from 0.5 to 6.5 year. Treatment results, acute and late toxicity will be discussed

  9. MRI findings of small cell neuroendocrime carcinoma of the uterine cervix: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Won, You Sun; Yi, Boem Ha; Lee, Hae Kyung; Lee, Min Hee; Choi, Seo Youn; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2015-10-15

    Small cell neuroendocrine carcinoma of the uterine cervix is a rare primary neoplasm, accounting for less than 5% of all uterine cervical cancers. The tumor is known to have an aggressive behavior and poor prognosis. In this article, we present the MRI findings of 5 cases of pathologically-proven small cell neuroendocrine carcinoma of the uterine cervix, including diffusion-weighted images.

  10. The sexual function following irradiation for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Following irradiation of a carcinoma of the cervix, the vagina is frequently narrowed or sometimes obliterated. This article considers the sexual functioning of women following such treatment. They noticed changes in their emotions and felt alterations in their function as a woman. They were less happy with cohabitation and found it more difficult to experience an orgasm. Their frequency of lovemaking diminished as did the occurrence of sexual dreams. A treatment scheme for helping such women with their sexual problems is outlined. (C.F.)

  11. Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix

    Directory of Open Access Journals (Sweden)

    Senger Jenna-Lynn B

    2010-12-01

    Full Text Available Abstract Introduction Pulmonary metastasis presenting as lymphangitic carcinomatosis arising from squamous cell carcinoma (SCC of the cervix is a rare event. Poorly represented in the literature, this event is associated with a difficulty in accurate diagnosis, b grave prognosis, and the c lack of recognized predisposing risk factors. Case Report A 50 year-old female presented at our practice with a three-month history of a productive cough associated with dyspnoea and shortness of breath. A chest x-ray and computed tomography (CT scan revealed multiple bilateral patchy areas with subsegmental atelectasis in both lungs which was investigated with a bronchoscopy, left thoracoscopy, and a left lung biopsy. Pathological examination of the wedge biopsy of the left upper lobe revealed neoplastic sheets of cell disturbed along the septal vessels, perivascular/peribronchial lymphatics, and the subpleural lymphatics. This lymphangitic carcinomatosis was confirmed to be metastatic from SCC of the cervix that had been diagnosed and treated two years ago. She was treated with systemic Carbo/Taxol chemotherapy and corticosteroids as a palliative measure. Despite temporary improvement, she died 13 months later. Conclusion Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic SCC of the cervix. As clinical presentations including radiographic imaging mimics other pulmonary entities, accurate diagnosis remains a challenge. Increased clinical awareness of such patterns of metastases in cervical cancer supported by accurate pathological diagnosis is imperative to guide appropriate therapy in these patients.

  12. 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

  13. Elevated cyclooxygenase-2 expression correlates with diminished survival in carcinoma of the cervix treated with radiotherapy

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to examine the relationship between overall survival and prognostic factors in carcinoma of the cervix treated with radiation therapy. A clinicopathologic study was performed on 24 patients. Methods and Materials: Formalin-fixed, paraffin-embedded tumor biopsies were stained for Cyclooxygenase-2 (COX-2), Topoisomerase I, Topoisomerase II, and p53. Clinical factors such as stage, grade, tumor size, pre- and post-treatment hemoglobin level, and radiotherapy dose were also evaluated. Results: Median follow-up was 75 months for living patients. The only immunohistochemical or clinical factor that was associated with improved survival was decreased COX-2 distribution staining. High COX-2 distribution staining was associated with decreased overall survival (p=0.021) and decreased disease-free survival (p=0.015) by log-rank comparison of Kaplan-Meier survival curves. The 5-year overall survival rates for tumors with low vs. high COX-2 distribution values were 75% and 35%, respectively. COX-2 staining intensity was found to correlate positively with tumor size (p=0.022). Conclusion: These findings indicate that increased expression of COX-2 portends a diminished survival in patients with invasive carcinoma of the cervix treated with radiotherapy. Because COX-2 is an early-response gene involved in angiogenesis and inducible by different stimuli, these data may indicate opportunity to intervene with specific inhibitors of COX-2 in carcinoma of the cervix

  14. Carcinoma of the vulva and vagina in patients irradiated for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Six patients with carcinoma of the vulva and 3 with carcinoma of the vagina following radiation therapy for cancer of the cervix were analyzed. The interval between irradiation and diagnosis of the second tumor varied from 5 to 23 years. Despite the lack of having detailed information on irradiation factors in all patients, circumstantial evidence from this study suggests that radiation therapy may have contributed to the development of carcinoma of the vulva and vagina in some of the patients. Close follow-up patients treated for squamous carcinoma of the genital tract must emphasize inspection for new lesions. The incidences previously reported in the literature are also reviewed for comparison. (author)

  15. Carcinoma of the vulva and vagina in patients irradiated for carcinoma of the cervix

    Energy Technology Data Exchange (ETDEWEB)

    Tsukiyama, Iwao; Kakehi, Masae; Ono, Ryosuke; Watai, Kiichi; Yanagawa, Shigeo; Kasamatsu, Tatsuhiro

    1984-08-01

    Six patients with carcinoma of the vulva and 3 with carcinoma of the vagina following radiation therapy for cancer of the cervix were analyzed. The interval between irradiation and diagnosis of the second tumor varied from 5 to 23 years. Despite the lack of having detailed information on irradiation factors in all patients, circumstantial evidence from this study suggests that radiation therapy may have contributed to the development of carcinoma of the vulva and vagina in some of the patients. Close follow-up patients treated for squamous carcinoma of the genital tract must emphasize inspection for new lesions. The incidences previously reported in the literature are also reviewed for comparison. (author).

  16. Chemotherapy, brachytherapy and surgery of locally evolved uterine cervix carcinomas: prognosis factors of local control and global survival

    International Nuclear Information System (INIS)

    The protocol used allows an excellent local control of the uterine cervix carcinoma with an acceptable morbidity. To anticipate the presence of a tumor residue can be an evolution in the therapy management after external radiotherapy, particularly in optimized image-guided brachytherapy (MRI and PET)New utero vaginal applicators with parameters implantation allow to realise the dose complement at the distal parameters. These advances make consider an improvement of results in the management of locally evolved uterine cervix carcinomas. (N.C.)

  17. Bone metastases in the patients of carcinoma cervix

    International Nuclear Information System (INIS)

    Seventeen of 620 patients (2.7%) of cancer cervix were diagnosed to have bone metastasis (BM). In three bone metastasis were seen at initial presentation; remaining 14 developed BM in 3 to 36 months after the diagnosis of cancer cervix. Back ache (8), localised pain (8), in thigh/hip/neck paraparesis (1) were main symptoms. The duration of symptoms ranged from 1 to 4 (median 2.5) months. Lumber spine, pelvic bones and long bones were commonest site of involvement. The lesions were single in 12 and at multiple sites in five patients. Radiologically the lesions were osteolytic in all except three where 99mTc bone scan showed increased uptake of radionuclide. Palliative radiotherapy resulted in significant symptomatic relief. (author). 9 refs., 3 figs

  18. Clear cell carcinoma of cervix in a postmenopausal woman: A case report

    OpenAIRE

    Pal, Subrata; Jana, Sritanu; Bose, Kingshuk

    2015-01-01

    Clear cell carcinoma of cervix is a very rare neoplasm accounting only 4% of all cervical adenocarcinomas. Intrauterine exposure to diethylstilbestrol (DES) is supposed to be causative factor for clear cell adenocarcinoma in childhood and young-age patients. We are reporting a case of clear cell carcinoma of cervix in a 49-years-old multiparous post-menopausal woman, who had no exposure to DES (in-utero) or synthetic non-steroidal estrogen.

  19. 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.

  20. Family history as a co-factor for adenocarcinoma and squamous cell carcinoma of the uterine cervix: results from two studies conducted in Costa Rica and the United States.

    Science.gov (United States)

    Zelmanowicz, Alice de M; Schiffman, Mark; Herrero, Rolando; Goldstein, Alisa M; Sherman, Mark E; Burk, Robert D; Gravitt, Patti; Viscidi, Ray; Schwartz, Peter; Barnes, Willard; Mortel, Rodrigue; Silverberg, Steven G; Buckland, Julie; Hildesheim, Allan

    2005-09-10

    Previous work suggests that cervical cancer may aggregate in families. We evaluated the association between a family history of gynecological tumors and risk of squamous cell and adenocarcinomas of the cervix in 2 studies conducted in Costa Rica and the United States. The Costa Rican study consisted of 2,073 women (85 diagnosed with CIN3 or cancer, 55 diagnosed with CIN2 and 1,933 controls) selected from a population-based study of 10,049 women. The U.S. study consisted of 570 women (124 with in situ or invasive adenocarcinomas, 139 with in situ or invasive squamous cell carcinomas of the cervix and 307 community-based controls) recruited as part of a multicentric case-control study in the eastern part of the United States. Information on family history of cervical and other cancers among first-degree relatives was ascertained via questionnaire. Information on other risk factors for cervical cancer was obtained via questionnaire. Human papillomavirus (HPV) exposure was assessed in both studies using broad spectrum HPV L1-based PCR testing of exfoliated cervicovaginal cells and in Costa Rica by additional testing of plasma collected from participants for antibodies against the L1 protein of HPV types 16, 18, 31 and 45 by ELISA. A family history of cervical cancer in a first-degree relative was associated with increased risk of squamous tumors in both studies (odds ration [OR] = 3.2 for CIN3/cancer vs. controls; 95% confidence interval [CI] = 1.1-9.4 in Costa Rica; OR = 2.6 for in situ/invasive squamous cell carcinoma cases vs. controls, 95% CI = 1.1-6.4 in the Eastern United States study). These associations were evident regardless of whether the affected relative was a mother, sister or daughter of the study participant. Furthermore, observed effects were not strongly modified by age. In Costa Rica, the effect persisted in analysis restricted to HPV-exposed individuals (OR = 3.0; 95% CI = 1.0-9.0), whereas in the Eastern United States study there was evidence of

  1. Lymphocyte radiosensitivity is a significant prognostic factor for morbidity in carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose: To study the relationship between pretreatment peripheral blood lymphocyte radiosensitivity and morbidity following radiation therapy. Methods and Materials: A prospective study was carried out in which patients with carcinoma of the cervix underwent radiation therapy. Intrinsic radiosensitivity was measured on pretreatment peripheral blood lymphocytes, using a limiting dilution clonogenic assay. Late morbidity was assessed using the Franco-Italian glossary. Results were correlated in an actuarial analysis. Results: There were no correlations between the measured lymphocyte radiosensitivity (SF2) and colony-forming efficiency, patient age, tumor grade, or disease stage. For 83 patients, lymphocyte SF2 was a significant prognostic factor for the probability of developing both any (p=0.002) and Grade 3 (p=0.026) morbidity. In 174 patients, stage showed borderline significance as a prognostic factor for morbidity (p=0.056). However, the type of treatment (intracavitary alone, intracavitary plus parametrial irradiation, single insertion plus whole-pelvis irradiation) was significantly associated with the probability of developing late complications (p=0.013). There was a weak significant inverse correlation between lymphocyte SF2 and grade of morbidity (r=-0.34, p=0.002). Conclusion: These data highlight the importance of normal cell radiosensitivity as a factor determining radiation therapy response. They also show that peripheral blood lymphocyte SF2 is a highly significant prognostic factor for the probability of developing late radiation morbidity, and that carcinoma of the cervix is a good model for testing radiobiologic principles in the clinic

  2. Relation between simple cytological test and persistence of disease in radiation-treated uterine cervix carcinomas

    International Nuclear Information System (INIS)

    A cytological study was conducted covering 174 epidermoid uterine cervix carcinoma patients who had been given combined radiation therapy. The changes were assessed in the karyopyknotic index (KPI) as related to radiation therapy and the incidence of local relapses. At the limit KPI value of 10, the average reliability of the method for diagnosing persistence in the group under study was 83.0%. Patients showing KPI of more than 10 at six weeks following the termination of radical radiation therapy represent a poor prognosis group whereas those showing KPI values lower than 10 have good prognosis. The results show that no strict hormonal dependence of the KPI value exists in uterine ceervix carcinoma patients; only a different situation exists which is probably due to the tumor-organism interaction or to the metabolism of the tumor itself. (author)

  3. Analysis on the Incidence, Staging and Treatment of Carcinoma Cervix at Delta Medical College and Hospital of Bangladesh

    Directory of Open Access Journals (Sweden)

    Parvin A Banu

    2013-07-01

    Full Text Available Background: Cervical cancer remains the most common cancer among women in this part of the world. Bangladesh has the highest level of incidence and mortality rates due to cervical cancer among women. Cervical cancer is a preventable disease by screening and treatment of pre-invasive condition. Unfortunately, there is no effective screening program in Bangladesh.Objective: The objective was to analyze the clinico-pathologic characteristics and, subsequently the therapy delivered to the patients.Materials and method: This cross sectional study was done from January to December 2011 in oncology division of Delta Medical College and Hospital, Dhaka, Bangladesh. During this period a total of 2264 female carcinoma patients were registered. Out of them 523 patients were with the diagnosis of carcinoma of cervix. Evaluation and characterization of patients with carcinoma cervix were done according to the age group, clinical stages and surgical status. External beam radiotherapy (EBRT and doses, brachytherapy doses and fractions, time interval between EBRT and brachytherapy, neo-adjuvant and concurrent chemotherapy status were the factors taken into consideration for the analysis of treatment of these patients.Results: The study revealed that the incidence of carcinoma cervix was 23% and highest incidence was between 40-50 years of age group, most of the patients were in Stage IIB (34% and IIIB (28% and 31% with unknown stage. About 44% patients were referred postoperatively and most of them with unknown stage. Almost 90% patients received EBRT, 24% patients received concurrent chemo-radiation, 46% of them completed 5 cycles of concurrent chemotherapy and 8.6% patients received neo-adjuvant chemotherapy. About 69% patients received brachytherapy with HDR Co-60 sources and 23% of patients received their brachytherapy treatment after 12 weeks of completion of EBRT.Conclusion: Lack of proper clinical evaluation and documentation, delay in referral and lack

  4. Epidermoid Carcinoma of the Cervix and Pregnancy. A case presentation.

    Directory of Open Access Journals (Sweden)

    Práxedes Rojas Quintana

    2007-12-01

    Full Text Available A 25 year-old female patient with a 12 week pregnancy was presented. She was diagnosed with an ultered Pap test. She was referred to the cervix uterine pathology specialist where an exophytic lesion compatible to cervix uterine cancer in advanced stages. The treatment as well as the conduct followed by the specialist was really hard due to the patient´s pregnant condition.

  5. Contributions of imaging to radiation therapy planning for uterine cervix carcinoma

    International Nuclear Information System (INIS)

    External irradiation and brachytherapy are curative in the treatment of carcinoma of the cervix. The aim of radiotherapy is to optimize the irradiation of the target volume and to optimize the irradiation of the target volume and to reduce the dose to critical organs. The use of imaging (computed tomography and magnetic resonance imaging (computed tomography and magnetic resonance imaging added to clinical findings and standard guidelines) are studied in the treatment planning of external irradiation and brachytherapy in carcinoma of the cervix. Imaging allows an individualized and conformal treatment planning. (author)

  6. Risk factors of distant metastasis in patients with squamous cell carcinoma of the uterine cervix treated with postoperative irradiation

    International Nuclear Information System (INIS)

    This paper reports the results of a study of risk factors for recurrence in non-irradiated sites in patients with squamous cell carcinoma of the uterine cervix who received postoperative irradiation. It also discusses clinical experience with such patients, particularly those with a poor prognosis, based on a review of the literature. The study was conducted at the National Shikoku Cancer Center in 62 patients with squamous cell carcinoma of the uterine cervix (mean age=50.5, range=30-66) who received 10 MeV postoperative irradiation with a Linac between 1981 and 1990. An analysis was performed in terms of sites and times of recurrence, risk factors for distant metastasis, and groups at high risk for distant metastasis. Based on the results of the study as well as the review of the literature, it was concluded that squamous cell carcinoma of the uterine cervix is sensitive to radiation therapy and that the clinical outcome of local treatment is satisfactory. However, systemic chemotherapy should be considered for patients who are suspected of having minute distant metastasis at the time of surgical operation, i.e., those with moderate to severe vascular space invasion, multiple lymph node metastasis, parametrium infiltration, and/or endometrial infiltration. (K.H.)

  7. Pretreatment plasma TGFβ1 levels are prognostic for survival but not morbidity following radiation therapy of carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose: To determine whether pretreatment plasma-transforming growth factor beta 1 (TGFβ1) levels are prognostic for tumor control and late morbidity following radiation therapy in carcinoma of the cervix. Methods and Materials: The study was comprised of 79 patients undergoing radiotherapy with curative intent for Stage I-III carcinoma of the cervix. TGFβ1 levels were analyzed using ELISA. Late morbidity was measured using the Franco-Italian glossary. Data were available for the pretreatment levels of circulating tumor markers that represent disease burden, and for peripheral blood lymphocyte radiosensitivity measured as SF2. Results: Pretreatment TGFβ1 levels were a significant prognostic factor for survival and local control. There were weak significant correlations of TGFβ1 levels with disease stage and the levels of circulating tumor markers (CA125, TPA). There was a weak significant correlation between TGFβ1 levels and normal cell radiosensitivity (lymphocyte SF2). There was no relationship between TGFβ1 levels and grade of morbidity and pretreatment TGFβ1 levels were not a significant prognostic factor for the probability of developing late morbidity. Conclusion: In carcinoma of the cervix, pretreatment TGFβ1 levels reflect tumor burden and are a significant prognostic factor for survival. Despite an underlying weak relationship of TGFβ1 levels with intrinsic normal cell radiosensitivity, pretreatment levels are not prognostic for the probability of developing late complications. This finding does not rule out the possible usefulness of measurements toward the end of treatment once tumor burden has been reduced

  8. Bone metastases in the patients of carcinoma cervix.

    OpenAIRE

    Baid B; Kumar L; Chander S; Rath G; Kumar S; Kriplani A; Batla N

    1992-01-01

    Seventeen of 620 patients (2.7%) of cancer cervix were diagnosed to have bone metastasis (BM). In three bone metastasis were seen at initial presentation; remaining 14 developed BM in 3 to 36 months after the diagnosis of cancer cervix. Backache (8), localised pain (8), in thigh/hip/neck paraparesis (1) were main symptoms. The duration of symptoms ranged from 1 to 4 (median 2.5) months. Lumber spine, pelvic bones and long bones were the commonest site of involvement. The lesions were s...

  9. Long-Term Outcome and Prognostic Factors for Adenocarcinoma/Adenosquamous Carcinoma of Cervix After Definitive Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To study the outcomes of patients with adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix primarily treated with radiotherapy (RT), identify the prognostic factors, and evaluate the efficacy of concurrent chemoradiotherapy (CCRT) or salvage surgery. Methods and Materials: A total of 148 patients with Stage I-IVA AC/ASC of cervix after full-course definitive RT were included. Of the 148 patients, 77% had advanced stage disease. Treatment failure was categorized as either distant or local failure. Local failure was further separated into persistent tumor or local relapse after complete remission. The effectiveness of CCRT with cisplatin and/or paclitaxel was examined, and the surgical salvage rate for local failure was reviewed. Results: The 5-year relapse-free survival rate was 68%, 38%, 49%, 30%, and 0% for those with Stage IB/IIA nonbulky, IB/IIA bulky, IIB, III, and IVA disease, respectively, and appeared inferior to that of those with squamous cell carcinoma of the cervix treated using the same RT protocol. Incomplete tumor regression after RT, a low hemoglobin level, and positive lymph node metastasis were independent poor prognostic factors for relapse-free survival. CCRT with weekly cisplatinum did not improve the outcome for our AC/ASC patients. Salvage surgery rescued 30% of patients with persistent disease. Conclusion: Patients with AC/ASC of the cervix primarily treated with RT had inferior outcomes compared to those with squamous cell carcinoma. Incomplete tumor regression after RT was the most important prognostic factor for local failure. Salvage surgery for patients with persistent tumor should be encouraged for selected patients. Our results did not demonstrate a benefit of CCRT with cisplatin for this disease.

  10. Intracavitary radiotherapy of cervix carcinoma with flexible applicators after vesicovaginal interposition operation of the uterus

    International Nuclear Information System (INIS)

    Advantages of new flexible intracervical applicators treating cervical cancer with high dose rate afterloading brachytherapy are reported: The insertion of the flexible applicator is usually possible without anesthesia and dilatation of the cervix. Therefore the treatment can be performed on an outpatient basis. The risks of perforation and infection are minimal. Dosimetry and documentation of the applicator geometry are possible, if the planning system allows the definition of individual curves of an individual applicator. We now prefer flexible applicators instead of rigid steel applicators treating cervix carcinoma. (orig.)

  11. Adjuvant postoperative radiation therapy for carcinoma of the uterine cervix

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    Lee, Kyung Ja; Moon, Hye Seong; Kim, Seung Cheol; Kim, Chong Il; Ahn, Jung Ja [College of Medicine, Ewha Womans Univ., Seoul (Korea, Republic of)

    2003-09-01

    This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study, The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, Iymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer following simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was 45 - 50 Gy. Vagina cuff irradiation was performed, after completion of the external beam irradiation, al a low-dose rate of CS-137, with the total dose of 4488-4932 chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months (15-108 months), The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were 98%, 95% and 94%, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients (9%) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Our results indicate that postoperative radiation therapy can

  12. Adjuvant postoperative radiation therapy for carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study, The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, Iymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer following simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was 45 - 50 Gy. Vagina cuff irradiation was performed, after completion of the external beam irradiation, al a low-dose rate of CS-137, with the total dose of 4488-4932 chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months (15-108 months), The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were 98%, 95% and 94%, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients (9%) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Our results indicate that postoperative radiation therapy can

  13. Uterine cervix squamous cell carcinoma metastatic to the Ampulla of Vater: a case report with review of the literature

    OpenAIRE

    Dalma Udovčić Gagula; Faruk Skenderi; Srđan Gornjaković; Nermina Ibišević; Adisa Chikha; Semir Vranić; Aleksandra Ðuran

    2013-01-01

    Metastases to gastrointestinal tract are uncommon. In particular, metastases to the ampulla of Vater are very rare and may represent a significant diagnostic challenge. Metastases from the uterine cervix to the ampulla of Vater are exceedingly rare and only one case has been described in the available literature. We describe here a second case of metastatic squamous cell carcinoma of the cervix to the ampulla of Vater in a 45-year-old woman. Poorly differentiated squamous cell carcinoma prese...

  14. Role of surgery in breast metastasis from carcinoma of the cervix

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    Parveen Yadav

    2011-01-01

    Full Text Available Carcinoma of the cervix is the most common malignancy among women in India. Although metastatic disease is common, metastasis to breast is rare. A limited number of case reports are published in the world literature. Most of the previous reports of metastatic cervical carcinoma to breast are either autopsy series or widely disseminated disease where no treatment options were available. A rare case of cervical carcinoma presenting as metastasis in breast is reported here where palliative mastectomy improved the general condition of the patient. A female patient aged 58 years was diagnosed and treated for cervical carcinoma, FIGO stage 2B. Four months after the treatment which included both external beam and intracavitory radiotherapy, the patient presented with breast and lung metastasis. Palliative mastectomy was done which improved the general condition of the patient. Metastatic carcinoma of the cervix can present as a case of breast carcinoma. In an appropriate setting, this possibility should be kept in mind. Palliative mastectomy should be offered for patients of cervical carcinoma with metastasis to breast when needed.

  15. Extended-field radiation therapy for carcinoma of the cervix

    International Nuclear Information System (INIS)

    The survival of cervical carcinoma patients with paraaortic/high common iliac nodal metastases was evaluated by retrospective chart review during a 13-year interval. Thirty-three patients with cervical carcinoma and surgically documented nodal metastases received primary, extended-field radiation therapy. Overall 2-year and 5-year actuarial survival rates after diagnosis were 37% and 31%, respectively. Survival was analyzed in terms of the variables patient age, clinical stage, tumor histologic type, the presence of enlarged paraaortic/high common iliac lymph nodes, the extent of nodal involvement (microscopic versus macroscopic), the presence of intraperitoneal disease, and whether intracavitary brachytherapy was administered. The use of intracavitary radiation therapy was associated with improved local control and survival (P = 0.017). None of the other variables were statistically related to patient survival. Twenty-two of the patients died of cervical cancer and five are surviving without evidence of cancer. Four patients died of intercurrent disease. Two patients developed bowel-related radiation complications; both patients received chemotherapy concurrent with the radiation therapy. One of the two patients died of radiation enteritis. The use of extended-field radiation therapy does benefit a small group of patients and may result in extended patient survival

  16. Chromosomal imbalances in four new uterine cervix carcinoma derived cell lines

    Directory of Open Access Journals (Sweden)

    Vázquez Guelaguetza

    2003-03-01

    Full Text Available Abstract Background Uterine cervix carcinoma is the second most common female malignancy worldwide and a major health problem in Mexico, representing the primary cause of death among the Mexican female population. High risk human papillomavirus (HPV infection is considered to be the most important risk factor for the development of this tumor and cervical carcinoma derived cell lines are very useful models for the study of viral carcinogenesis. Comparative Genomic Hybridization (CGH experiments have detected a specific pattern of chromosomal imbalances during cervical cancer progression, indicating chromosomal regions that might contain genes that are important for cervical transformation. Methods We performed HPV detection and CGH analysis in order to initiate the genomic characterization of four recently established cervical carcinoma derived cell lines from Mexican patients. Results All the cell lines were HPV18 positive. The most prevalent imbalances in the cell lines were gains in chromosomes 1q23-q32, 3q11.2-q13.1, 3q22-q26.1, 5p15.1-p11.2, this alteration present as a high copy number amplification in three of the cell lines, 7p15-p13, 7q21, 7q31, 11q21, and 12q12, and losses in 2q35-qter, 4p16, 6q26-qter, 9q34 and 19q13.2-qter. Conclusions Analysis of our present findings and previously reported data suggest that gains at 1q31-q32 and 7p13-p14, as well as losses at 6q26-q27 are alterations that might be unique for HPV18 positive cases. These chromosomal regions, as well as regions with high copy number amplifications, coincide with known fragile sites and known HPV integration sites. The general pattern of chromosomal imbalances detected in the cells resembled that found in invasive cervical tumors, suggesting that the cells represent good models for the study of cervical carcinoma.

  17. 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

  18. Vulvar lymphangioma circumscriptum: a rare complication of therapy for squamous cell carcinoma of the cervix

    Energy Technology Data Exchange (ETDEWEB)

    LaPolla, J.; Foucar, E.; Leshin, B.; Whitaker, D.; Anderson, B.

    1985-11-01

    The clinical and pathological features of a case of multifocal lymphangioma circumscriptum of the vulva are reported in a patient with chronic lymphedema of a lower extremity. Ten years previously the patient had been treated for squamous cell carcinoma of the cervix. Although lymphangioma circumscriptum is an extremely rare complication of altered lymphatic drainage, the presence of multiple noninflammatory vesicular appearing lesions in this setting should suggest the correct diagnosis.

  19. Multicentric pigmented Bowen's disease of the genitalia associated with carcinoma in situ of the cervix.

    OpenAIRE

    King, C. M.; Yates, V. M.; Dave, V K

    1984-01-01

    A case of multicentric pigmented Bowen's disease in a 45 year old woman with a previous history of carcinoma of the cervix is described. The two conditions may have a common pathogenesis, and a preceding viral infection with herpes simplex or human papillomavirus could be of aetiological relevance. Patients with multicentric pigmented Bowen's disease may be at risk of developing other tumours of the genital tract. Treatment with carbon dioxide laser proved effective.

  20. Insufficiency fracture of the pelvis after the radiotherapy for carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Bone injury after radiotherapy for carcinoma of the uterine cervix has been reported since early days of this century. Recently, the concept of insufficiency fracture has been confirmed. Insufficiency fracture is one of the stress fractures and occurs when the elastic resistance of bone is inadequate to withstand normal or physiological stress. In the American and European studies, radiotherapy is known as a cause of insufficiency fracture. There are no reports on insufficiency fracture in the Japanese literatures. Four cases of carcinomas of the uterine cervix presented pelvic insufficiency fractures following radiotherapy. In the pubic bone, a vertical parasymphyseal fracture with mixed lytic and sclerotic changes of surrounding tissue is characteristic. Sacral insufficiency fracture shows a vertical or horizontal line with lytic and sclerotic appearance. Bone scintigraphy is a sensitive modality for the early detection. H-shaped configuration is diagnostic for sacral insufficiency fracture. CT is an accurate technique demonstrating a vertical fracture and excluding the malignant bony lesion. Although radiological findings of insufficiency fracture are similar to bone malignancy, differential diagnosis from malignant lesions is possible. Bony symptoms of all patients disappeared without specific treatments. In the follow-up study of patients with carcinomas of the uterine cervix after radiotherapy, it is important to have the consideration on insufficiency fracture. (author)

  1. Insufficiency fracture of the pelvis after the radiotherapy for carcinoma of the uterine cervix

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Tetsuo; Shimizu, Teppei; Sugiyama, Akira; Ichinohe, Kenji; Teshima, Takeshi; Takahashi, Motoichiro; Takai, Michikatsu; Kaneko, Masao (Hamamatsu University School of Medicine, Shizuoka (Japan))

    1990-10-01

    Bone injury after radiotherapy for carcinoma of the uterine cervix has been reported since early days of this century. Recently, the concept of insufficiency fracture has been confirmed. Insufficiency fracture is one of the stress fractures and occurs when the elastic resistance of bone is inadequate to withstand normal or physiological stress. In the American and European studies, radiotherapy is known as a cause of insufficiency fracture. There are no reports on insufficiency fracture in the Japanese literatures. Four cases of carcinomas of the uterine cervix presented pelvic insufficiency fractures following radiotherapy. In the pubic bone, a vertical parasymphyseal fracture with mixed lytic and sclerotic changes of surrounding tissue is characteristic. Sacral insufficiency fracture shows a vertical or horizontal line with lytic and sclerotic appearance. Bone scintigraphy is a sensitive modality for the early detection. H-shaped configuration is diagnostic for sacral insufficiency fracture. CT is an accurate technique demonstrating a vertical fracture and excluding the malignant bony lesion. Although radiological findings of insufficiency fracture are similar to bone malignancy, differential diagnosis from malignant lesions is possible. Bony symptoms of all patients disappeared without specific treatments. In the follow-up study of patients with carcinomas of the uterine cervix after radiotherapy, it is important to have the consideration on insufficiency fracture. (author).

  2. Results from phase III clinical trials with radachlorine for photodynamic therapy of pre-cancer and early cancer of cervix

    OpenAIRE

    E. V. Filonenko; L. G. Serova; V. I. Ivanova-Radkevich

    2015-01-01

    The results of clinical study for efficacy of photodynamic therapy (PDT) with radachlorine in patients with pre-cancer and cancer of cervix are represented. The study enrolled 30 patients including 4 patients with cervical erosion, 5 patients with cervical intraepithelial neoplasia II, 13 patients with cervical intraepithelial neoplasia III, 4 patients with carcinoma in situ and 4 patients with cervical cancer stage Ia. Radachlorine was administrated as single 30 minute intravenous injection ...

  3. Progress in Diagnosis and Treatment of Small Cell Carcinoma of the Cervix

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Small cell carcinoma of the cervix (SCCC) belongs to the neuroendocrine carcinomas, and it is a rare gynecological tumor of high-potential malignancy. It has a poorer prognosis compared to cervical squamous cancer or adenocarcinoma, and the therapeutic regimen of the disease differs. Diagnosis is based on pathomorphological characteristics, i.e., the small and round cancer cells (oat cell) which are uniform in shape and size, with the immunohistochemical marker helpful for diagnosis. Combined therapy is first recommended. Postoperative chemotherapy with platinum/etoposide (PE), vincristine/adriamycin/cyclophosphamide (VAC) and taxel/carboplatin (TP) can markedly improve the prognosis of early SCCC patients.

  4. The clinical significance of postoperative irradiation for squamous cell carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose/Objective: To evaluate the efficacy of postoperative irradiation including the paraaortic node irradiation on pelvic control and survival in the squamous cell carcinoma of the cervix. Materials and Methods: Between 1977 and 1991, 179 cases of squamous cell carcinoma of the cervix who received radical hysterectomy and bilateral pelvic lymphadenectomy were deter-mined as pT1b-2N0-1M0 and followed by postoperative pelvic/paraaortic radiation therapy. 112 cases(pT1b 37 cases and pT2 75 cases) with the number of positive pelvic nodes≥2 or parametrial invasion were treated with whole pelvic irradiation(WP-RT,44-45.6Gy/22-24fr.) and 67 cases(pT1b 30 cases and pT2 37 cases) with the number of positive pelvic node≥3(from 1989 ≥4) or positive common iliac node were treated with whole pelvic and paraaortic node irradiation(WP+PAN-RT,44Gy/22fr.). Almost all cases were irradiated with dynamic conformal technique. For pelvic irradiation, two axial dynamic conformal method that is conformed to pelvic lymphatic region and makes the high dose area concave between the axes to reduce bladder and intestinal dose. For the paraaortic area, one axial dynamic conformal method was used. Results: 5-Y pelvic control were pT1b 89.2% and pT2 94.2%. 5-Y overall survival of pT1b WP-RT and WP+PAN-RT cases were 91.6% and 86.2%, pT2 were 90.6% and 61.6%, respectively. 5-Y survival in the cases of positive pelvic nodes≥3, WP-RT vs WP+PAN-RT were 50.0% vs 69.8%. Therefore, paraaortic irradiation seems to improve the survival. In the cases with positive pelvic nodes≥2, paraaortic recurrences were noted in (5(21)) (23.8%) WP-RT and (3(44))(6.8%) WP+PAN-RT. In the cases with positive pelvic node 0-1, no paraaortic recurrences were observed. Moderate or severe late complications occur red in 38 cases(21.2%). Obstructions of small intestine were seen in 10 cases and urinary complications were in 12 cases. The crude incidence of late complications were (23(112))(20.5%) in WP-RT and (15

  5. How can laparoscopic management assist radiation treatment in cervix carcinoma?

    International Nuclear Information System (INIS)

    Purpose: To determine the role of laparoscopic lymphadenectomy (pelvis ± para-aortic nodes) and laparoscopic hysterectomy in cervical cancer compared to 'classic radical surgery' in patients undergoing surgery in comparison with modern imaging in patients treated with radiotherapy alone.Materials and methods: The limitations of modern imaging are presented as well as how complication rates can be increased when classic laparotomy is followed by radiation therapy.Laparoscopic procedures are described with particular emphasis on how to provide information on lymph node metastases with the risk of overlooking microscopic involvement. A number of clinical experiences are cited to illustrate this problem and show how treatment approaches can be adapted.Results: The role of laparoscopy is evaluated according to different clinical situations and treatment protocols emphasizing the possibilities offered by this method to the radiotherapist. Conclusion: When developing laparoscopic techniques for the management of cervical carcinoma, caution must be exercised to ensure that these techniques are not detrimental to the prognosis. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  6. Carcinoma of the cervix. Correlations between MR staging and prognosis

    International Nuclear Information System (INIS)

    In 110 patients with cervical cancer, correlations between pretreatment MR findings and 5-year prognoses were analyzed. MR findings were classified according to clinical staging criteria of the Japan Society of Obstetrics and Gynecology. In 75 patients, staging by MR and that by conventional clinical methods agreed with surgical findings in 51 (68%) cases each, was overestimated in 5 (7%) and 16 (21%), and underestimated in 19 (25%) and 8 (11%), respectively. None of 41 patients without high-intensity areas (HIA) in the cervix on MR developed recurrence, but 26 of 69 (38%) with HIA relapsed. Two of 67 (3%) patients with MR stage IIa or lower developed recurrence, but 24 of 43 (56%) with stage IIb or higher relapsed. Among 26 patients with poor prognoses, 2 of 11 (18%) with stage IIb or lower, versus 9 of 15 (60%) with stage IIIb or higher disease detected by MR had distant metastases. Among 22 patients with MR stage IIb disease, local and distant recurrence occurred in 6 and 2 (50%, 17%) of 12 patients who underwent radical hysterectomy, versus 1 and none (10%, 0%) of 10 who received definitive radiotherapy. Fifteen of 95 (16%) patients without lymph node swelling greater that 1.5 cm on MR developed recurrence, while 11 of 15 (73%) patients with lymphadenopathy relapsed. MR is valuable not only in staging cervical cancer but also in assessing the risk of recurrence. (author)

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

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    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

  8. Dosimetry of intracavitary applications in carcinoma of the cervix: rectal dose analysis

    International Nuclear Information System (INIS)

    The International Commission on Radiation Units and Measurements (ICRU), in its Report-38, has given certain recommendations regarding the specifications of bladder and rectal reference points in the intracavitary treatment of carcinoma of the cervix. Conforming to this report, 182 intracavitary applications performed in stage I and II cervix cases were analyzed. In 113 applications, the maximum rectal dose was found to be in a point on the anteroposterior line drawn through the centre of colpostat sources. However, for our type of applications, the point on the anteroposterior line drawn through the lower end of the uterine tube seldom gets maximum dose. In addition, it was observed that there are other dose points than the ICRU reference point receiving doses close to maximum dose. It was concluded that doses to multiple rectal reference points should be recorded, in addition to the ICRU-defined rectal reference point

  9. Functional changes in the lower urinary tract following to irradiation of the cervix carcinoma

    International Nuclear Information System (INIS)

    104 patients submitted to primary irradiation for cervix carcinoma were examined by means of urodynamic methods of diagnosis in order to investigate the functional changes of the lower urinary tract induced by therapy. 34 patients could be examined prior the therapy, 19 and 12 patients, respectively, were examined six and 18 months on an average after the treatment. Another group of 70 patients had retrospective check-up examinations with average intervals of five and ten years. Hydronephroses occured only as a late result after more than six years in 12% of the irradiated women. The incidence of residual urine, significant bacteriuria, and disturbed sensory function of the bladder was not important. All patients were incontinent two years after the irradiation; 60% of these cases of incontinence were due to the bladder and 40% to the urethra. The increase of urge incontinences is possibly caused by a radiofibrotic reaction of the bladder, as is shown by correspondent cystonometric alterations: The bladder tonicity increased, whereas the bladder capacity decreased. These alterations were only partially reversible. The stress incontinence, however, was found already before the treatment. The maximum urethral closing pressure, which often indicates incontinences due to the urethra, was not modified by the irradiation. An increased stress incontinence, probably caused by advanced age, was found only after six years or later. The problems resulting from functional changes should be taken into consideration in the course of posttherapeutic care, i.e. the patients concerned should be given instructions for a regular bladder training. (orig.)

  10. Clear cell carcinoma of the uterine corpus following irradiation therapy for squamous cell carcinoma of the cervix

    International Nuclear Information System (INIS)

    A case of clear cell carcinoma of the endometrium following squamous cell carcinoma of the cervix is reported. The patient had had a previous cervical biopsy which revealed squamous cell carcinoma (large cell non-keratinizing type), classified clinically as a stage IIb lesion. She was treated with external pelvic irradiation delivering an estimated tumor dose of approximately 7,000 rads and intracavital radium application delivering 4,995 mg.hr.radiation when she was 51 years old. She complained of post-menopausal bleeding at age 66 and was diagnosed by endometrial cytology as having clear cell carcinoma of the endometrium. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed. The clinical stage of the endometrial cancer was Ib. She is alive after 2 years with no evidence of disease. Endometrial cytology revealed several adenocarcinoma cells in small clusters. The shape of the nuclei was somewhat irregular, the chromatin pattern was fine granular, and single or multiple nucleoli were seen. The diameter of these nuclei ranged from 10 to 30 μm. The cytoplasm was pale green or vacuolated. The volume of the cytoplasm varied from scanty to abundant. These findings suggested clear cell carcinoma. Histopathologically, an irregular shaped polypoid tumor, 3 x 1.5 cm in size, was located on the lower anterior wall of the uterine corpus. The tumor was a clear cell carcinoma showing a solid and papillary pattern. A hobnail pattern was not observed. The cytoplasm was clear and abundant, and PAS-positive granules digestible by diastase were seen. These 2 cancers had different pathological features and their immunohistochemical reactivities for CEA and keratin were also different. The patient was regarded as having a rare heterochronous double cancer consisting of squamous cell carcinoma of the cervix and clear cell carcinoma of the endometrium. (author)

  11. COMMUNITY BASED EARLY DETECTION OF CARCINOMA CERVIX BY VARIOUS S CREENING METHODS AND COMPARING THEIR EFFICACY

    Directory of Open Access Journals (Sweden)

    Hari Pavithra Reddy

    2015-08-01

    Full Text Available Background Ca cervix is the most common cancer among women in developing countries. In developed countries , screening is done by Pap smear which is resulting in drastic decrease in ca cervix which is not so in developing countries due to various reasons. So visual inspection of cervix can be cost effective screening procedure if its efficacy is proved in low resource countries. OBJECTIVE : To determine which screening method is efficient in detecting premalignant & malignant lesions of ca cervix in resource poor settings . METHODS : Pap smear was done in all 600 women , along with this VIA in 200 women , VILI in 20 0 women was done. Either pap or VIA or VILI positive cases were selected for colposcopy followed by biopsy if positive findings were there on colposcopy . 10% of either screening negative cases were subjected for biopsy to know false negative rate from each group. Main outcome measures: comparison of all three screening methods (pap smear , VIA , VILI in terms of sensitivity , specificity , PPV , NPV in comparison with gold standard colposcopic guided cervical biopsy . RESULTS: The aided visual inspection has mor e PPV than pap smear , The sensitivity of all three screening methods were comparable. The specificity & NPV of pap smear were high. CONCLUSION: So the aided visual inspection can be used as screening method in detection of premalignant and malignant lesion s of cervix in place of papsmear especially in rural setting.

  12. Study of a new tumor marker, CYFRA 21-1, in squamous cell carcinoma of the cervix, and comparison with squamous cell carcinoma antigen

    International Nuclear Information System (INIS)

    The diagnosis value of a new tumor marker, CYFRA 21-1, was studied in the blood samples collected from 22 controls, and 87 pre-treatment patients with squamous cell carcinoma of the cervix. Sensitivity and specificity of CYFRA 21-1 was was compared with those of squamous cell carcinoma antigen (SCC) measured in the sera of the same patients. Serum CYFRA 21-1 levels were higher in patients with squamous cell carcinoma than in controls (p < 0.05), and correlated with FIGO stage (Stage IIb-IV vs. Stage Ib-IIa, p = 0.0477). Using 2.5 ng/ml as cut-off value, elevated CYFRA 21-1 levels were found in 13.6% of controls, 34.8% of patients with Stage Ib-IIa squamous cell carcinoma of the cervix, and 63.5% of patients with Stage IIb-IV squamous cell carcinoma of the cervix. However, there was less sensitivity and specificity of CYFRA 21-1 than those of SCC in detecting squamous cell carcinoma of the cervix. CYFRA 21-1 may not be a better tumor marker than SCC for squamous cell carcinoma of the cervix. (author)

  13. Nuclear and cytoplasmic oestrogen receptors in squamous carcinoma of the cervix.

    OpenAIRE

    Soutter, W P; Pegoraro, R J; Green-Thompson, R. W.; Naidoo, D. V.; Joubert, S. M.; Philpott, R. H.

    1981-01-01

    Nuclear and cytoplasmic oestrogen receptors (REN and REC) were sought in 5 normal cervices and in 43 specimens of squamous carcinoma of the cervix. All 3 tissues components of the 5 normal cervices contained both REN and REC. Thirty-five (81%) of the tumours contained receptors, but in only 9 (21%) were they found in both subcellular compartments. Twenty-four tumours (56%) had only REC and 2 had only REN. The potential therapeutic significance of these findings is not yet known, but it seems ...

  14. Incidence of invasive cancers following carcinoma in situ of the cervix.

    OpenAIRE

    Levi, F; Randimbison, L.; La Vecchia, C; Franceschi, S.

    1996-01-01

    Women with carcinoma in situ (CIS) of the cervix uteri, notified to the population-based Cancer Registry of the Swiss Canton of Vaud between 1974 and 1993, were actively followed up to 31 December 1993 for the occurrence of subsequent invasive neoplasms. Among 2190 incident cases of CIS, followed for a total of 22,225 person-years, 95 metachronous cancers were observed vs 77.9 expected, corresponding to a significant standardised incidence ratio (SIR) of 1.2. Ten cases of invasive cervical ca...

  15. Rectal complications in carcinoma of the uterine cervix by RALS-therapy

    International Nuclear Information System (INIS)

    Between July 1979 and January, 1980, we treated 24 patients with carcinoma of the uterine cervix with RALS-TRON-20B, using the rapid processing system of pretreatment dose calculation. The incidence of rectal complications (3/24) was the same as that of a historical control group (5/28). According to ROC curve analysis, 5 rectal complications were related to the measured rectal dose, not to the point A dose or mg-hrs. Our findings suggest that hemorrhagic tendency, syphilis and diabetes mellitus influence the rectal complications. (author)

  16. 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

  17. [Cell oncogene expression in normal, metaplastic, dysplastic epithelium and squamous cell carcinoma of the uterine cervix].

    Science.gov (United States)

    Petrov, S V; Mazurenko, N N; Sukhova, N M; Moroz, I P; Katsenel'son, V M; Raĭkhlin, N T; Kiselev, F L

    1994-01-01

    Immunohistochemical analysis of the protein expression c-myc, ets 1, ets 2, TPR-met, c-fos, c-jun, c-ras-pan, p53, yes, src in 79 samples of normal, metaplastic squamous epithelium, intraepithelial and invasive squamous cell carcinoma of uterine cervix was performed using polyclonal rabbit antibodies to the synthetic peptides homologous active areas of corresponding oncoproteins. Higher content of myc, fos, ets2, p53, ras is noted in metaplasia, dysplasia and in tumours as compared to the normal tissues. Protein myc is revealed in the cytoplasm at a grave dysplasia and in the nucleus in the intraepithelial carcinoma: this may serve as a criterion at a differential diagnosis of these conditions. Expression of the oncoproteins fos, ets2, p53, src in the metaplastic squamous cell carcinoma was higher than in the true squamous cell (ectocervical) carcinoma. When compared to the advanced carcinomas, increase of ets2, p53, and at some degree that of myc, the increase is noted in the latter. Invasive carcinoma with a high level of oncoproteins showed a tendency to the synchronization of myc and ras expression. Poor prognosis was associated with a low level (before treatment) of the expression of the majority of the oncoproteins studied. PMID:7848100

  18. Limitations of adjunctive surgery in carcinoma of the cervix

    International Nuclear Information System (INIS)

    This study analyzed 41 patients with bulky/barrel-shaped Stage IIB cervical carcinoma. Twenty patients were treated with radical radiation alone. Twenty one patients had post-radiation surgery; ten underwent total abdominal hysterectomy and lymphadenectomy and eleven underwent extrafascial hysterectomy. Histologic review of the submitted specimens showed complete tumor sterilization in all but two. One of these had a microscopic focus of residual tumor with changes suggesting radiation damage; the other had wide-spread disease. All but one of the submitted nodal specimens were negative. Among patients receiving radiation and surgery, there was a 15% incidence of fistulization. In addition these patients had an unusually high incidence (60%) of prolonged (more than 18 months) unilateral and bilateral obstructive uropathy. Patients managed by radiation alone showed a 5% incidence of fistulization and 30% incidence of obstructive uropathy. This high incidence of ureteral obstruction following radiation alone without concurrent disease has not been reported previously. This study questions the routine use of abdominal hysterectomy with or without lymphadenectomy following radical radiation therapy in the treatment of Stage IIB disease and outlines the criteria for the combination of the modalities

  19. Limitations of adjunctive surgery in carcinoma of the cervix

    Energy Technology Data Exchange (ETDEWEB)

    Rotman, M.; John, M.J.; Moon, S.H.; Choi, K.N.; Stowe, S.M.; Abitbol, A.; Herskovic, T.; Sall, S.

    1979-03-01

    This study analyzed 41 patients with bulky/barrel-shaped Stage IIB cervical carcinoma. Twenty patients were treated with radical radiation alone. Twenty one patients had post-radiation surgery; ten underwent total abdominal hysterectomy and lymphadenectomy and eleven underwent extrafascial hysterectomy. Histologic review of the submitted specimens showed complete tumor sterilization in all but two. One of these had a microscopic focus of residual tumor with changes suggesting radiation damage; the other had wide-spread disease. All but one of the submitted nodal specimens were negative. Among patients receiving radiation and surgery, there was a 15% incidence of fistulization. In addition these patients had an unusually high incidence (60%) of prolonged (more than 18 months) unilateral and bilateral obstructive uropathy. Patients managed by radiation alone showed a 5% incidence of fistulization and 30% incidence of obstructive uropathy. This high incidence of ureteral obstruction following radiation alone without concurrent disease has not been reported previously. This study questions the routine use of abdominal hysterectomy with or without lymphadenectomy following radical radiation therapy in the treatment of Stage IIB disease and outlines the criteria for the combination of the modalities.

  20. Expression of ras oncogene and major histocompatibility complex (MHC) antigen in carcinomas of the uterine cervix

    International Nuclear Information System (INIS)

    Consecutive 50 cases of squamous cell carcinomas of the uterine cervix diagnosed in 1992 were subjected to immunohistochemical study for ras oncogene product (p21) and MHC class II (DR) antigen using a microprobe immunostainer. Activated ras and aberrant DR expression were noted in 26 cases (52%) and 11 cases (22%) of cervical squamous cell carcinomas, respectively, without difference among histologic types. The reaction was mainly intracytoplasmic, with granular staining pattern and diffuse distribution. No direct histologic correlation between ras and DR expression was found. Four cases with HPV 16/18 DNA in superficial koilocytotic cells, revealed by in situ hybridization, showed various expression of ras and DR, and these 3 factors histologically did not seem to be affected one another. (Author)

  1. Effects of radiotherapy on immunity in patients with localized carcinoma of the cervix uteri

    International Nuclear Information System (INIS)

    To assess the effects of radiotherapy on immune status, a wide range of assessments have been performed on patients with localized carcinoma of the cervix uteri undergoing and initially responding clinically to radical pelvic radiotherapy. neutrophil function was essentially unchanged by treatment. Absolute neutrophil and lymphocyte counts fell after treatment and remained depressed 3 and 12 months following treatment. The proportions of T and B cells dropped with treatment but recovered to near-presentation levels during the follow-up period even though absolute counts remained depressed. In vitro tests of cellular immunity were depressed by treatment and remained so 3 and 12 months following treatment whereas skin test responses remained normal throughout the assessments. Inhibitory plasma effects were observed in photohaemagglutinin lymphocyte transformation studies on 4 untreated patients; at follow-up these effects were not evident. A variable response in immune indices has therefore been observed in patients in remission after treatment of localized carcinoma cervix stressing the importance of assessing several aspects of immune function and implying that persistent depression of certain indices does not adversely affect the host tumor response. In two patients relapsing after apparently good initial response, all aspects of immunological assessment (except serum immunoglobulin levels and neutrophil function) deteriorated

  2. Hemoglobin as an important prognostic factor in concurrent chemoradiotherapy for locally advanced carcinoma of the cervix

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    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)

  3. Prediction of radiotherapy outcome using dynamic contrast enhanced MRI of carcinoma of the cervix

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    Purpose: To investigate whether analysis of MRI enhancement data using a pharmacokinetic model improved a previously found correlation between contrast enhancement and tumor oxygenation measured using Po2 histograph. To evaluate the prognostic value of gadolinium enhancement data for radiotherapy outcome, and to study the efficacy of combined enhancement and MRI volume data. Methods and materials: Fifty patients underwent dynamic gadolinium-enhanced MRI as part of their initial staging investigations before treatment. Gadolinium enhancement was analyzed using the Brix pharmacokinetic model to obtain the parameters amplitude and rate of contrast enhancement. Pretreatment tumor oxygen measurements (Eppendorf Po2 histograph) were available for 35 patients. Results: Both standard and pharmacokinetic-derived enhancement data correlated with tumor oxygenation measurements, and poorly enhancing tumors had low tumor oxygen levels. However, only the pharmacokinetic-analyzed data correlated with patient outcome and patients with poorly (amplitude less than median) vs. well-enhancing tumors had significantly worse disease-specific survival (p=0.024). For the 50 patients studied, no relationship was found between enhancement and volume data. Combining MRI volume and enhancement information highlighted large differences in outcome (p = 0.0054). At the time of analysis, only 55% of patients with large, poorly enhanced tumors were alive compared with 92% of patients with small, well-enhanced tumors. Conclusion: These preliminary results suggest that pharmacokinetic modeling of dynamic contrast-enhanced MRI provides data that reflect tumor oxygenation and yields useful prognostic information in patients with locally advanced carcinoma of the cervix. Combining MRI-derived enhancement and volume data delineates large differences in radiotherapy outcome

  4. Uterine cervix squamous cell carcinoma metastatic to the Ampulla of Vater: a case report with review of the literature

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    Dalma Udovčić Gagula

    2013-09-01

    Full Text Available Metastases to gastrointestinal tract are uncommon. In particular, metastases to the ampulla of Vater are very rare and may represent a significant diagnostic challenge. Metastases from the uterine cervix to the ampulla of Vater are exceedingly rare and only one case has been described in the available literature. We describe here a second case of metastatic squamous cell carcinoma of the cervix to the ampulla of Vater in a 45-year-old woman. Poorly differentiated squamous cell carcinoma presented as an isolated metastasis to the ampulla of Vater, two years after the initial diagnosis. While the squamous cell carcinoma could occur as primary ampullary carcinoma, albeit very rare, it is necessary to exclude the possibility of metastatic cancer.

  5. Comparative analysis of 2D and 3D dosimetry with brachytherapy high dose rate cervix carcinoma un operated

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    It has recently been installed in our department based on an SPB CT images, and found that the dose at points H is less than that obtained by calculations based on radiographs. This study aims to analyze this discrepancy in the transition from 2D to 3D calculation in patients with carcinoma of the cervix not operated.

  6. Loss of sequences on the short arm of chromosome 17 is a late event in squamous carcinoma of the cervix

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    Herrington, C S; Worsham, M; Southern, S A; Mackowiak, P; Wolman, S R

    2001-01-01

    Aims—To determine by fluorescence in situ hybridisation (FISH) whether deletion of D17S34, a subtelomeric probe for 17p, occurs in invasive squamous carcinoma of the cervix, and to determine the extent of such loss by analysis of the p53 and HER2/NEU genes.

  7. Long-term survival of hypoxia radiotherapy for carcinoma of uterine cervix

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    Objective: To evaluate the relationship between long-term survival rate and protection to marrow and lymphoid tissues in the pelvis with hypoxia radiotherapy for uterine cervical carcinoma. Methods: 113 patients, confirmed as having carcinoma of uterine cervix by pathology, were randomly divided by the envelope method into two groups: hypoxia radiotherapy group (HRG, 57 patients) and conventional radiotherapy group (CRG, 56 patients). HRG was given by sustained inhaling hypoxia gas (oxygen physical volume = 0.105) for two minutes before the start of radiotherapy till the end of radiotherapy of each field and then repeated for the other field in the same way. The duration of irradiation to each field was less than five minutes. CRG was given with conventional radiotherapy. The irradiation dose in the midpelvical plane was 20-50 Gy depending on the different stages of cervical carcinomatous lesion. The dose of four-divided-field in the parametria was 15-34 Gy. The dose at point A of intracavitary therapy was 15-35 Gy. Results: The decreased value of peripheral blood white cells after treatment was (1.36 ± 1.27) x 109/L in HRG and (2.97±1.19) x 109/L in CRG(P<0.05). E flower ring test (EFRT) increased by (6.00 ± 2.39)% and lymphocyte transformation rate(LTR) increased by (3.78±1.83)% in HRG, but decreased by (3.97±1.88)% and (4.47±1.73)% in CGR(P<0.01). The 5-year survival rate was 65% in HRG and 57% in CRG(P<0.05). The incidence of complications such as radiation proctitis and radiocystitis was also of statistically significant (P< 0.01, 0.05). Conclusions: Hematopoisis and columnar immunity can be protected by hypoxia radiotherapy for uterine cervical cancer. As a result, both long-term survival rate and life quality of patients are expected to be improved. (authors)

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

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    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.

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

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    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.

  10. Perioperative and postoperative complications of intracavitary radiation for FIGO stage I-III carcinoma of the cervix

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    Purpose: To evaluate perioperative and postoperative complications of low-dose-rate (LDR) intracavitary radiation therapy in patients with FIGO Stage I-III carcinoma of the uterine cervix. Methods and Materials: We retrospectively reviewed the medical and radiotherapy records of all patients treated with radiation between 1960 and 1992 at The University of Texas M. D. Anderson Cancer Center for FIGO I-III carcinomas of the cervix. Patients who had had initial hysterectomy or whose treatment did not include intracavitary irradiation were excluded. The final study included 4043 patients who had undergone 7662 intracavitary procedures. Results: Eleven (0.3%) patients had documented or suspected cases of thromboembolism resulting in 4 deaths. Of these 11 patients, 8 had clinical or radiographic evidence of tumor involving pelvic nodes or fixed pelvic wall. The risk of postoperative thromboembolism did not decrease significantly with the routine use of mini-dose heparin prophylaxis (p = 0.3). Other life-threatening perioperative complications included myocardial infarction (1 death in 5 patients), cerebrovascular accident (2 patients), congestive heart failure or atrial fibrillation (3 patients), and halothane liver toxicity (2 deaths in 2 patients). Intraoperative complications included uterine perforation (2.8%) and vaginal laceration (0.3%), which occurred more frequently in patients ≥ 60 years old (p < 0.01). Fourteen percent of patients had a temperature ≥ 101 deg. F during at least one hospital stay. The only correlation between minor intraoperative complications and disease-specific survival was found in patients who had Stage III disease and uterine perforation; survival was significantly (p = 0.01) decreased in these patients. Conclusions: Fatal or life-threatening complications of intracavitary treatment were very rare. Deep venous thrombosis (DVT) and pulmonary embolism (PE) did not occur in otherwise healthy patients with early disease and were rare even

  11. Association between occupational history of exposure to tobacco dust and risk of carcinoma cervix: A case-control study

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    N Joseph

    2016-01-01

    Full Text Available Context: Cervical cancer is the second most common malignancy among women in India. There is thus a need to identify unexplored risk factors such as occupational exposure to tobacco dust to justify its increasing trend so as to recommend suitable preventive measures. Aims: The aim was to study the association between occupational exposure to tobacco dust with development of carcinoma cervix. Settings and Design: Case-control study done in two tertiary care hospitals in Mangalore. Methodology: 239 histologically confirmed new cases of cervical cancer and the equivalent number of age-matched controls from 2011 to 2012 were interviewed about occupational history of beedi rolling and related factors. Statistical Analysis: Chi-square test, unpaired t-test, logistic regression. Results: Exposure rate to tobacco dust following beedi rolling was 63 (26.4% among cases and 38 (15.9% among controls (P = 0.005, odds ratio [OR] =1.893. The latent period from occupational exposure of tobacco dust subsequent to beedi rolling and development of cervical cancer was found to be 26.5 ± 8.5 years. Adjusted OR of beedi rolling with development of cervical cancer was found to be 1.913 (P = 0.005 after controlling the confounding effect of tobacco usage and was 1.618 (P = 0.225 after controlling the effects of all confounders. Three-quarters of beedi rollers were working in conditions of inadequate ventilation and hardy anybody used face mask during work. About a quarter of participants underwent voluntary screening for cervical cancer. Conclusion: Occupational exposure to tobacco dust was found to be associated with risk of developing cervical cancer. Measures to promote awareness, timely screening of this disease along with the improvement in working conditions is required for improving the health status of beedi rollers and to minimize the incidence of carcinoma cervix in the community.

  12. Pre-operative radiotherapy treatment in uterine cervix voluminous carcinoma clinic phase IB

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    Forty four patients with voluminous tumor of the uterine cervix were selected and submitted to preoperative radiation with radical dosages in pelvis and to radiation therapy alone. Results as to survival in both of the treatments were similar. Complication rates in both of the treatments were not higher than the acceptable levels. Hospitalization periods were not longer than the usual for Wertheim-Meigs surgery. (author)

  13. Effects of radiotherapy on immunity in patients with cured localized carcinoma of the cervix uteri

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    The effects of radiotherapy on immune status in patients with localized carcinoma of the cervix have been assessed serially up to 5 years remission by a wide range of methods. Neutrophil function and serum immunoglobulins were essentially normal throughout. Peripheral blood neutrophil and lymphocyte counts and the proportions of T and B-cells fell with treatment but were all normal at 5 years, with the exception of B-cell proportions which remained significantly low. Marked deterioration was seen in in vivo cellular immune responses and this persisted even at 5 years remission. Reduced in vitro immunoreactivity is not therefore a reliable marker of disease recurrence and persisting defects in cellular immunity after radiotherapy do not seem to adversely affect the host tumor response. However, in three of the six patients who subsequently relapsed after therapy, subnormal PHA lymphocyte transformation responses were observed at presentation; all patients achieving sustained remission had normal pretreatment responses

  14. Rectal complication after remote afterloading intracavitary therapy for carcinoma of the uterine cervix

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    Teshima, T.; Chatani, M.; Hata, K.; Inoue, Ta.; Inoue, To.; Suzuki, T.

    1985-06-01

    From August 1978 through December 1980, 119 patients of previously untreated carcinoma of the uterine cervix were treated using RALS, remote afterloading high dose rate intracavitary therapy at our department. The data from 92 out of 119 patients were available for analysis of rectal complication. The incidence of major rectal complications was only 2% (2/92). Uni- and multivariate analyses were used based on the external criterion variable of rectal complication which included even minor injuries. By using these methods, it was clearly indicated that these factors such as TDF of rectum, Z-coordinate of weighted geometric center (WGC-Z), the dose of whole pelvic irradiation, history of chemotherapy and Treponema pallidum hemoagglutination test (TPHA) were important for occurrence of rectal complication. According to discriminant score, 71 out of 92 cases (77%) could be correctly discriminated.

  15. Rectal complication after remote afterloading intracavitary therapy for carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    From August 1978 through December 1980, 119 patients of previously untreated carcinoma of the uterine cervix were treated using RALS, remote afterloading high dose rate intracavitary therapy at our department. The data from 92 out of 119 patients were available for analysis of rectal complication. The incidence of major rectal complications was only 2% (2/92). Uni- and multivariate analyses were used based on the external criterion variable of rectal complication which included even minor injuries. By using these methods, it was clearly indicated that these factors such as TDF of rectum, Z-coordinate of weighted geometric center (WGC-Z), the dose of whole pelvic irradiation, history of chemotherapy and Treponema pallidum hemoagglutination test (TPHA) were important for occurrence of rectal complication. According to discriminant score, 71 out of 92 cases (77%) could be correctly discriminated. (orig.)

  16. Carcinomas of endometrium and cervix: magnetic resonance assessment of changes following radiotherapy

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    To present the changes induced at the tissue level in patients subjected to external radiotherapy and brachytherapy to treat carcinomas of endometrium and cervix, as disclosed by magnetic resonance (MR). The MR study dealt with 26 patients 14 with endometrial carcinoma and 12 with cervical carcinoma who were treated with external radiotherapy and brachytherapy. The features assessed retrospectively were bone marrow of the lumbar and sacral spine, pelvic fat, abdominal wall, uterine, junction and size, rectal and bladder wall and pelvic musculature. The most common changes observed after radiotherapy according to our study were changes in signal intensity in the bone marrow of the pelvic bones (88%), followed by changes in the pelvic fat (65.3%). Other radiotherapy-related findings in order of frequency were cervical fibrosis, colitis and cystitis. Radiotherapy induces changes in the tissue of the pelvic structures, and the knowledge of these changes is important in the evaluation of the follow-up studies of these patients. (Author) 12 refs

  17. 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

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    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

  18. Dose rate correction in medium dose rate brachytherapy for carcinoma cervix

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    Purpose: To establish the magnitude of brachytherapy dose reduction required for stage IIB and III carcinoma cervix patients treated by external radiation and medium dose rate (MDR) brachytherapy at a dose rate of 220±10 cGy/h at point A.Materials and methods: In study-I, at the time of MDR brachytherapy application at a dose rate of 220±10 cGy/h at point A, patients received either 3060 cGy, a 12.5% dose reduction (MDR-12.5), or 2450 cGy, a 30% dose reduction (MDR-30), to point A and they were compared to a group of previously treated LDR patients who received 3500 cGy to point A at a dose rate of 55-65 cGy/h. Study-II was a prospective randomized trial and patients received either 2450 cGy, a 30% dose reduction (MDR-II (30)) or 2800 cGy, a 20% dose reduction (MDR-II (20)), at point A. Patients were evaluated for local control of disease and morbidity. Results: In study-I the 5-year actuarial local control rate in the MDR-30 and MDR-12.5 groups was 71.7±10% and 70.5±10%, respectively, compared to 63.4±10% in the LDR group. However, the actuarial morbidity (all grades) in the MDR-12.5 group was 58.5±14% as against 34.9±9% in the LDR group (P3 developed complication as against 62.5% of those receiving a rectal BED of (1403 (χ2=46.43; P<0.001). Conclusion: We suggest that at a dose rate of 220±10 cGy/h at point A the brachytherapy dose reduction factor should be around 30%, as suggested by radiobiological data, to keep the morbidity as low as possible without compromising the local control rates. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  19. Bladder–Rectum Spacer Balloon in High-Dose-Rate Brachytherapy in Cervix Carcinoma

    International Nuclear Information System (INIS)

    Purpose: To compare bladder and rectum doses with the use of a bladder–rectum spacer balloon (BRSB) versus standard gauze packing in the same patient receiving 2 high-dose-rate intracavitary brachytherapy fractions. Methods and Materials: This was a randomized study to compare the reduction in bladder and rectum doses with the use of a BRSB compared with standard gauze packing in patients with carcinoma of the cervix being treated with high-dose-rate intracavitary brachytherapy. The patients were randomized between 2 arms. In arm A, vaginal packing was done with standard gauze packing in the first application, and BRSB was used in the second application. Arm B was the reverse of arm A. The International Commission for Radiation Units and Measurement (ICRU) point doses and doses to 0.1-cm3, 1-cm3, 2-cm3, 5-cm3, and 10-cm3 volumes of bladder and rectum were compared. The patients were also subjectively assessed for the ease of application and the time taken for application. Statistical analysis was done using the paired t test. Results: A total of 43 patients were enrolled; however, 3 patients had to be excluded because the BRSB could not be inserted owing to unfavorable local anatomy. Thus 40 patients (80 plans) were evaluated. The application was difficult in 3 patients with BRSB, and in 2 patients with BRSB the application time was prolonged. There was no significant difference in bladder doses to 0.1 cm3, 1 cm3, 2 cm3, 5 cm3, and 10 cm3 and ICRU bladder point. Statistically significant dose reductions to 0.1-cm3, 1-cm3, and 2-cm3 volumes for rectum were observed with the BRSB. No significant differences in 5-cm3 and 10-cm3 volumes and ICRU rectum point were observed. Conclusion: A statistically significant dose reduction was observed for small high-dose volumes in rectum with the BRSB. The doses to bladder were comparable for BRSB and gauze packing. Transparent balloons of variable sizes are recommended for patients with a less spacious vaginal cavity

  20. Bladder–Rectum Spacer Balloon in High-Dose-Rate Brachytherapy in Cervix Carcinoma

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    Rai, Bhavana [Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh (India); Patel, Firuza D., E-mail: firuzapatel@gmail.com [Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh (India); Chakraborty, Santam; Sharma, Suresh C.; Kapoor, Rakesh [Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh (India); Aprem, Abi Santhosh [Corporate R and D Division, HLL Lifecare Limited, Karamana, Trivandrum (India)

    2013-04-01

    Purpose: To compare bladder and rectum doses with the use of a bladder–rectum spacer balloon (BRSB) versus standard gauze packing in the same patient receiving 2 high-dose-rate intracavitary brachytherapy fractions. Methods and Materials: This was a randomized study to compare the reduction in bladder and rectum doses with the use of a BRSB compared with standard gauze packing in patients with carcinoma of the cervix being treated with high-dose-rate intracavitary brachytherapy. The patients were randomized between 2 arms. In arm A, vaginal packing was done with standard gauze packing in the first application, and BRSB was used in the second application. Arm B was the reverse of arm A. The International Commission for Radiation Units and Measurement (ICRU) point doses and doses to 0.1-cm{sup 3}, 1-cm{sup 3}, 2-cm{sup 3}, 5-cm{sup 3}, and 10-cm{sup 3} volumes of bladder and rectum were compared. The patients were also subjectively assessed for the ease of application and the time taken for application. Statistical analysis was done using the paired t test. Results: A total of 43 patients were enrolled; however, 3 patients had to be excluded because the BRSB could not be inserted owing to unfavorable local anatomy. Thus 40 patients (80 plans) were evaluated. The application was difficult in 3 patients with BRSB, and in 2 patients with BRSB the application time was prolonged. There was no significant difference in bladder doses to 0.1 cm{sup 3}, 1 cm{sup 3}, 2 cm{sup 3}, 5 cm{sup 3}, and 10 cm{sup 3} and ICRU bladder point. Statistically significant dose reductions to 0.1-cm{sup 3}, 1-cm{sup 3}, and 2-cm{sup 3} volumes for rectum were observed with the BRSB. No significant differences in 5-cm{sup 3} and 10-cm{sup 3} volumes and ICRU rectum point were observed. Conclusion: A statistically significant dose reduction was observed for small high-dose volumes in rectum with the BRSB. The doses to bladder were comparable for BRSB and gauze packing. Transparent balloons of

  1. X-ray computed tomography in the post treatment evaluation of carcinoma of the cervix

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    Kobayashi, Hiroshi

    1988-12-01

    The diagnostic value of X-ray computed tomography scan for early detection of recurrence and/or metastasis were analyzed as an index of a sensitivity, a specificity, a positive predictive value, a negative predictive value and an accuracy among one hundred and thirty-one patients with carcinoma of the cervix as part of post-treatment evaluation during a period from 1980 to 1987. The diagnostic points of CT scan was the following criteria which including (1) parametrial involvement, (2) enlargement of uterine cervix, (3) invasion to vaginal wall, (4) bladder and/or rectal invasion, (5) pyometra, (6) enlargement of pelvic and/or paraaortic lymph nodes, (7) laterality of pelvic muscle, (8) intrapelvic abnormal shadow or ascites retension, (9) hydronephrosis, and (10) distant metastasis. (1) Among the patients treated with surgery, accuracy of each diagnostic point for early detection of recurrence was as follows: (8) 73%, (6) 60%, (9) 47%, (10) 47%, (3) 40%, (1) 33%, (4) 27%, (7) 27%, respectively. (2) Among the patients reated with radiotherapy, accuracy of each diagnostic point for early detection of recurrence was as follws: (1) 65%, (8) 64%, (5) 63%, (4) 61%, (10) 58%, (6) 55%, (9) 53%, (2) 42%, (3) 41%, (7) 41%, respectively. (3) Among the patients treated with surgery and radiotherapy, accuracy of each diagnostic point for early detection of recurrence was as follows: (8) 76%, (10) 76%, (9) 57%, (6) 52%, (1) 48%, (4) 43%, (7) 33%, (3) 19%, respectively. In conclusion, CT findings such as paraaortic lymphadenopathy and invasion to vaginal wall including distant metastasis were most important for early detection of recurrence during the follow-up study.

  2. A comparative study of external radiotherapy alone versus external radiotherapy + brachytherapy in carcinoma cervix stage III B

    International Nuclear Information System (INIS)

    Carcinoma of the cervix is the commonest cancer seen in women at Sardar Patel Medical College, Bikaner (Rajasthan). In the present study external radio-therapy and brachytherapy are used in carcinoma cervix stage III B. After 4000 to 4500 rads to pelvis by external radio-therapy, patient was assessed for intra cavitary application. Total given dose to point A was 7500 rads, to point B was 5000 rads. If patient was not suitable a split course was given where patient was asked to come after 3 weeks for intracavitary application. A comparative study of both methods was done. There was significant improvement in the control of central disease by applying intracavitary source. Radiation reactions were comparable. (author). 4 tables, 10 refs

  3. Preoperative external beam radiotherapy and reduced dose brachytherapy for carcinoma of the cervix: survival and pathological response

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    To evaluate the pathologic response of cervical carcinoma to external beam radiotherapy (EBRT) and high dose rate brachytherapy (HDRB) and outcome. Between 1992 and 2001, 67 patients with cervical carcinoma were submitted to preoperative radiotherapy. Sixty-five patients were stage IIb. Preoperative treatment included 45 Gy EBRT and 12 Gy HDRB. Patients were submitted to surgery after a mean time of 82 days. Lymphadenectomy was performed in 81% of patients. Eleven patients with residual cervix residual disease on pathological specimen were submitted to 2 additional insertions of HDRB. median follow up was 72 months. Five-year cause specific survival was 75%, overall survival 65%, local control 95%. Complete pelvic pathological response was seen in 40%. Surgery performed later than 80 days was associated with pathological response. Pelvic nodal involvement was found in 12%. Complete pelvic pathological response and negative lymphnodes were associated with better outcome (p = .03 and p = .005). Late grade 3 and 4 urinary and intestinal adverse effects were seen in 12 and 2% of patients. Time allowed between RT and surgery correlated with pathological response. Pelvic pathological response was associated with improved outcome. Postoperative additional HDRB did not improve therapeutic results. Treatment was well tolerated

  4. Risk-factors and strategies for control of carcinoma cervix in India: Hospital based cytological screening experience of 35 years

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    J S Misra

    2009-01-01

    Full Text Available Purpose: Role of risk factors in cervical carcinogenesis and strategies for control of the disease have been assessed from the accumulated cytological data, derived from 35 years of hospital-based screening in Lucknow, North India. Materials and Methods: A total of 36,484 women have been cytologically screened during a span of 35 years (April 1971 - June 2005 in the Gynaecology out patient department (OPD of Queen Mary′s Hospital. Results: The frequency of Squamous Intraepithelial Lesion (SIL and carcinoma was found to be 7.2% and 0.6%, respectively, in the present study. The study revealed high age and parity as a predominant factor in cervical carcinogenesis, while viral sexually transmitted disease (STDs -human papilloma virus (HPV and Herpes simplex virus (HSV were also largely associated with SIL cases. The study emphasized great value of clinically downstaging the cervical cancer by detecting cervical cancer in the early stage. The study also revealed a significant difference in the frequency of SIL in symptomatic and asymptomatic women. Conclusion: Based on the analyzed data, it was felt that single lifetime screening, which appears to be the most feasible and affordable mode for control of carcinoma cervix in developing countries like India, should be carried out in all women of high parity irrespective of age (with three or more children and in older women above the age of 40 years irrespective of parity.

  5. Pre-operative Concomitant Radio-chemotherapy in Bulky Carcinoma of the Cervix: A Single Institution Study

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    Anne de la Rochefordiere

    2008-01-01

    Full Text Available Objective: To evaluate the treatment results of patients (pts with FIGO stage IB2, IIA, IIB cervical carcinoma (CC treated with pre-operative radio-chemotherapy, followed by extended radical hysterectomy.Methods: Retrospective study of 148 women treated to the Institut Curie for operable FIGO Stage IB2 to IIB, biopsy proved CC. Among them, 70 pts, median age 46 years, were treated using the same regimen associating primary radio-cisplatinum based chemotherapy, intracavitary LDR brachytherapy, followed by extended radical hysterectomy. Kaplan-Meier estimates were used to draw survival curves. Comparisons of survival distribution were assessed by the log-rank test. Results: Complete histological local-regional response was obtained in 56% of the pts (n = 39. Residual macroscopic or microscopic disease in the cervix was observed in 28 pts (40%. All but one had in-situ microscopic residual CC. Lateral residual disease in the parametria was also present in 9 pts, all with residual CC. Pelvic lymph nodes were free from microscopic disease in 56 pts (80%. Eight of 55 (11% radiological N0 patients had microscopic nodal involvement, as compared to 6/15 (40% radiological N1 (p = 0.03. Seventeen pts (25% had residual cervix disease but negative nodes. After median follow-up of 40 months (range, 8–141, 38/70 patients (54.1% are still alive and free of disease, 6 (8.6% alive with disease, and 11 (15.8% patients were lost for follow-up but free of disease.In conclusion: The treatment of locally advanced CC needs a new multidisciplinary diagnostic and treatment approach using new therapeutic arms to improve the survival and treatment tolerance among women presenting this disease.

  6. Carcinoma of the cervix: patterns of care studies: review of 1978, 1983, and 1988-1989 surveys

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    Purpose: A review of the Patterns of Care Studies Process Survey data on carcinoma of the cervix conducted on patients in 1978, 1983, and 1988-89 was carried out to identify changes or trends in the demographics, evaluation, and treatment that might have occurred over this time period. Methods and Materials: Patterns of Care Studies conducted surveys on patients treated by radiation therapy for cervical carcinoma in 1978, 1983, and 1988-89. These surveys have compiled demographic and treatment data on a total of 993 patients. There is outcome data for the 1978 and 1983 surveys, but not for the 1988-89 survey because follow-up has not been collected yet. The demographic and treatment delivery data on all three surveys has been reviewed and analyzed and is the subject of this study. Results: There was no difference in the age distribution at the time of diagnosis of the patients in these surveys. The percentage of black patients remained constant in the three surveys, 19%, 17%, and 21%, respectively. The percentage of white patients was 76%, 78%, and 67%, but that of nonwhite/nonblack patients was 3%, 4%, and 12% (p 60Co units decreased from 35 to 2% from the first to the third survey [6 to 0% for short source-surface distance (SSD) 60Co units]. Point dose calculations for the intracavitary therapy increased from 78% in the 1978 survey to 95% in the third survey. As determined by the total dose delivered to the paracentral points, more patients (75.1%) were treated according to the Patterns of Care recommended guidelines in the 1988-89 survey than in the 1983 survey (63.6%). Chemotherapy was given to 12% of the patients undergoing radiation therapy during the period of the third survey, but these data are not available for the first and second surveys. Conclusion: Review of the Carcinoma of the Cervix Patterns of Care studies discloses significant changes in the demographics, patient evaluation, and radiation therapy techniques during the period of the studies. The

  7. Cervix carcinoma is associated with an up-regulation and nuclear localization of the dual-specificity protein phosphatase VHR

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    The 21-kDa Vaccinia virus VH1-related (VHR) dual-specific protein phosphatase (encoded by the DUSP3 gene) plays a critical role in cell cycle progression and is itself regulated during the cell cycle. We have previously demonstrated using RNA interference that cells lacking VHR arrest in the G1 and G2 phases of the cell cycle and show signs of beginning of cell senescence. In this report, we evaluated successfully the expression levels of VHR protein in 62 hysterectomy or conization specimens showing the various (pre) neoplastic cervical epithelial lesions and 35 additional cases of hysterectomy performed for non-cervical pathologies, from patients under 50 years of age. We used a tissue microarray and IHC technique to evaluate the expression of the VHR phosphatase. Immunofluorescence staining under confocal microscopy, Western blotting and RT-PCR methods were used to investigate the localization and expression levels of VHR. We report that VHR is upregulated in (pre) neoplastic lesions (squamous intraepithelial lesions; SILs) of the uterine cervix mainly in high grade SIL (H-SIL) compared to normal exocervix. In the invasive cancer, VHR is also highly expressed with nuclear localization in the majority of cells compared to normal tissue where VHR is always in the cytoplasm. We also report that this phosphatase is highly expressed in several cervix cancer cell lines such as HeLa, SiHa, CaSki, C33 and HT3 compared to primary keratinocytes. The immunofluorescence technique under confocal microscopy shows that VHR has a cytoplasmic localization in primary keratinocytes, while it localizes in both cytoplasm and nucleus of the cancer cell lines investigated. We report that the up-regulation of this phosphatase is mainly due to its post-translational stabilization in the cancer cell lines compared to primary keratinocytes rather than increases in the transcription of DUSP3 locus. These results together suggest that VHR can be considered as a new marker for cancer

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

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    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

  9. A prospective randomized controlled trial to study the role of sulfasalazine in prevention of acute gastrointestinal toxicity associated with concurrent chemoradiation in carcinoma cervix

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    Santanu Pal

    2013-01-01

    Full Text Available Background: The primary aim of the study was to evaluate the effectiveness of sulfasalazine in reducing the incidence of acute radiation-induced enteritis in carcinoma cervix patients receiving pelvic external beam radiotherapy along with concurrent cisplatin-based chemotherapy. Materials and Methods: Between November 2011 and July 2012 a total of 98 patients of locoregionally advanced carcinoma of cervix (49 each in study and control arms were enrolled in this study. Patients in both the arms were treated with whole pelvis external beam radiotherapy with total dose of 50 Gy in conventional fractionation. Along with this inj. cisplatin was given concurrently at the dose of 40 mg/m 2 of body surface area every week during radiation for 5 weeks. Concurrent chemoradiation was followed by brachytherapy after a gap of 2 weeks. Patients in the study arm also received tablet sulfasalazine 1,000 mg orally twice daily from the day of starting of radiotherapy to 1 week after completion of treatment. Weekly follow-up of all patients to assess acute toxicities was done using common toxicity criteria version 4.0 (CTC v4.0 toxicity scores. Data analysis was carried out by SPSS version 20.0 software. Results: Incidence of grade II or higher grade, lower gastrointestinal toxicity was 19.14% (09/47 in study arm and 41.66% (20/48 in control arm which was statistically significant (P = 0.017. Conclusion: The study shows that sulfasalazine can significantly reduce the acute radiation-induced diarrhea (ARID in patients undergoing whole pelvis external beam radiotherapy for carcinoma cervix. The drug is safe, cheap, and readily available.

  10. Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated by Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy

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    Huang, Yi-Ting; Wang, Chun-Chieh; Tsai, Chien-Sheng [Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan (China); Lai, Chyong-Huey; Chang, Ting-Chang; Chou, Hung-Hsueh [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Lee, Steve P. [Department of Radiation Oncology, University of California, Los Angeles School of Medicine, Los Angeles, CA (United States); Hong, Ji-Hong, E-mail: jihong@adm.cgmh.org.tw [Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan (China)

    2012-10-01

    Purpose: To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods and Materials: A total of 318 Stage IB-IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated. Results: The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients. Conclusions: Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients.

  11. Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated by Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy

    International Nuclear Information System (INIS)

    Purpose: To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods and Materials: A total of 318 Stage IB–IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated. Results: The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients. Conclusions: Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients.

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

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    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.

  13. Carcinoma of the cervix: analysis of complications after primary external beam radiation and Ir-192 HDR brachytherapy

    International Nuclear Information System (INIS)

    Background and purpose: There is still a concern that the use of HDR brachytherapy might result in an increase of late tissue damage. This retrospective study evaluates the incidence and severity of late complications in patients with carcinoma of the cervix who underwent combined external beam radiation (EBR) and Ir-192 HDR brachytherapy and attempts to identify pretreatment and treatment parameters correlating with late complications. Material and methods: Between 1985 and 1992, 161 patients with carcinoma of the cervix (FIGO stages IB-IVB) received EBR to the pelvis (ave. max. dose 48.8 Gy) followed by 1-6 Ir-192 HDR placements (median 2). Doses to point A ranged from 8.5 to 38.7 Gy (median 17 Gy). Parameters examined included age, diabetes, obesity, history of inflammatory bowel disease or diverticulitis, prior surgery, hemoglobin level, FIGO stage, EBR dose, technique and daily dose fraction, number of HDR treatments and total dose to point A, maximum doses to bladder and rectum delivered by brachytherapy and cumulative dose to point A. Median follow-up for all patients was 37 months. Complications were rated using an in-house scoring system and according to the French-Italian Glossary (FIG). Results: Actuarial 5-year survival was 93%, 57%, 46%, and 0% for stages IB, II, IIIB, and IV, respectively. Of 161 patients, 11% developed moderate and 3.7% severe sequelae (FIG: 2.5%, 3.7%). Since some patients experienced more than one complication, the overall incidence was 13.6% and 4.9% (FIG: 3.1%, 4.9%) with respective 5-year actuarial rates of 14% and 5% for moderate, and 2% and 8% for severe bowel and genitourinary tract complications (FIG: 3.5%, 0, and 2%, 8%). All severe bowel complications occurred within 1.5 years whereas urinary tract sequelae continued to develop throughout the follow-up period. FIGO stage was associated with a significant increase in late sequelae (P=0.015). Analysis of the remaining pretreatment and treatment parameters failed to reveal

  14. Clinicopathological Significance of Vimentin and Cytokeratin Protein in the Genesis of Squamous Cell Carcinoma of Cervix

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    Husain, Nazik Elmalaika O. S.; Babiker, Ali Yousif; Albutti, Aqel S.; Alsahli, Mohammed A.; Aly, Salah M.; Rahmani, Arshad H.

    2016-01-01

    Cervical cancer is one of the commonest types of cancers worldwide especially in developing countries. Intermediate filaments protein family has shown a role in the diagnosis of various cancers, but a few studies are available about the vimentin and cytokeratin roles in the cervical cancer. This case control study aimed to interpret the expression of vimentin and cytokeratin proteins in the development and progression of cervical cancer and its correlation with clinicopathological features. The cytoplasmic expression of vimentin was observed in 40% of cases, but not in inflammatory lesions of cervix. It was noticed that vimentin expression was increasing significantly with high grade of the tumour. Cytokeratin expression was observed in 48.33% and it was noticed that the expression was 62.5% in well differentiated (G1), 45% in moderately differentiated (G2), and 41.66% in poorly differentiated carcinoma, yet statistically insignificant. The expression of vimentin and cytokeratin proteins was not significantly associated with age groups. The current findings concluded a possible role of vimentin in the development and progression of cervical cancer and vimentin marker will be useful in the diagnosis and grading of cervical cancer.

  15. Clinical and experimental investigation on small intestinal injury following radiation therapy for carcinoma of uterine cervix

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    Radiation injury of the small bowel was observed in 6 of 460 patients with carcinoma of uterine cervix who were treated by radiation between April 1966 and December 1973 at Tokyo Women's Medical College, Department of Radiology. Three of these 6 patients were treated conservatively and the other 3 others underwent surgery but died subsequently. Clinically and surgically these 6 patients showed marked adhesions of intestinal loops, which may be accounted for by the radiation injury of the small bowel. Clinical experience has shown that it is necessary to use a small radiation field to decrease small bowel injury from radiation. An experiment using abdominal radiation in mice confirmed that LD sub(50/30) is larger with a center split, maintaining equal integral doses. In adult dogs, severe small bowel obstruction was observed with over 4000 rad irradiation. Small bowel injury was milder in case with center split, intracavitary irradiation, and small radiation field. It was concluded that center split is one of the methods of preventing radiation injury of the small bowel. (Evans, J.)

  16. Combined radiotherapy and surgery : Local control and complications in early carcinoma of the uterine cervix

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    From January 1975 to December 1984, 41 patients were treated by combined radiotherapy and surgery at Institut Gustave Roussy for Stage IB (288) and II (proximal) (103) carcinoma of uterine cervix. Standard treatment consisted of pre-operative utero-vaginal brachytherapy (60 Gy) using a mould technique followed by colpho-hysterectomy and external iliac lymphadenectomy. Overall 5 year actuarial survival for whole population was 87% and disease-free survival 85%. Locoregional relapse occurred in 23 patients (5%). Of these, 12 where central pelvic failures, 8 regional failures and 3 combined central and regional failures. Of 36 systemic relapses (8%), 12 relapsed concurrently in pelvis. Five year actuarial pelvic disease-free, disease-free and overall survival was 87, 85 and 87%, resp., for the whole population. 340 patients developed one or more complications [Grade 1: 198/441 (44%), Grade 2: 121/441 (27%) and Grade 3 or 4: 21/441 (4.7%)]. Five year actuarial survival for the whole population was poorer for histologically node positive than for node negative (89 vs. 55%, p<0.0001). Pre-operative brachytherapy by surgery can provide good local control with acceptable morbidity in early cervical cancer. (author). 39 refs.; 4 figs.; 4 tabs

  17. Analysis of Pretreatment Prognostic Factors in Locally Advanced Carcinoma of the Uterine Cervix

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    Oh, Do Hoon; Ha, Sung Whan; Lee, Moo Song [Seoul Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1992-06-15

    To identify pretreatment prognostic factors in locally advanced carcinoma of the uterine cervix, retrospective analysis was undertaken of 154 patients treated with curative radiation therapy at Seoul National University Hospital, from March 1979 through December 1980. According to FIGO classification, eight patients were stage IIIA, 134 were stage IIIB, and 12 were stage IVA. Five year locoregional control rate was 58%, 51%, and 27% in stage IIIA, IIIB, and IVA, respectively. Five year disease free survival was 57%, 40%, and 25% for each stage respectively. Five year overall survival was 67%, 51%, and 33% in stage IIIA, IIIB, and IVA, respectively. In univariate analysis, fewer than or equal to four of pregnancies, initial hemoglobin of lower than 10 g%, and pelvic sidewall invasion on CT were associated with poor locoregional control. Number of pregnancies, initial hemoglobin level, obstructive uropathy on intavenous pyelography(IVP), pelvic lymph node(LN) status on CT, and pelvic sidewall Invasion on CT were significant factors in disease free survival. In terms of overall survival, pelvic sidewall invasion on CT and bladder invasion on CT were prognostically significant. In multivariate analysis, no factor was found to affect locoregional control and pelvic LN status was a sole significant factor affecting disease free survival. In terms of overall survival, the size of primary tumor was a significant prognosticator.

  18. Patient-derived xenograft models of squamous cell carcinoma of the uterine cervix.

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    Rofstad, Einar K; Simonsen, Trude G; Huang, Ruixia; Andersen, Lise Mari K; Galappathi, Kanthi; Ellingsen, Christine; Wegner, Catherine S; Hauge, Anette; Gaustad, Jon-Vidar

    2016-04-10

    Patient-derived xenograft (PDX) models of cancer are considered to reflect the biology and treatment response of human tumors to a larger extent than xenograft models initiated from established cell lines. The characterization of a panel of four novel PDX models of cervical carcinoma of the uterine cervix is described in this communication. The outcome of treatment differed substantially among the donor patients, and the PDX models were found to mirror the histology, aggressiveness, and metastatic propensity of the donor patients' tumors. Two of the models (BK-12 and LA-19) were highly metastatic, one model (ED-15) was poorly metastatic, and one model (HL-16) was non-metastatic. The primary tumors of the two highly metastatic models showed high density of intratumoral lymphatics, whereas the other two models did not develop intratumoral lymphatics. The potential of the models to metastasize to lymph nodes was associated with high expression of both angiogenesis-related genes and cancer stem cell-related genes. The models may be highly valuable for studying mechanisms linking lymph node metastasis to lymphangiogenesis, hemangiogenesis, and the presence of cancer stem cells. PMID:26828134

  19. Radiation therapy for carcinoma of the uterine cervix. Comparison of two brachytherapy schedules

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    We compared the survival rates and late effects for two groups of cervical cancer patients treated with almost the same external radiotherapy but different remote afterloading systems (RALS) for high-dose-rate intracavitary radiation therapy regimens. A total of 218 patients with carcinoma of the uterine cervix were treated. For 98 patients, intracavitary brachytherapy was delivered with 6-7.5 Gy/fraction to Point A (Group A), and for 120, 5 Gy/fraction with a modified source step size (Group B). The 3-year cause-specific survival rates by stage and treatment schedule were Group A: 91% and Group B: 96% in Stage I, 89% and 92% in Stage II, 64% and 75% in Stage III, 44% and 69% in Stage IV. The survival curves did not reveal any statistically significant differences at any stage. The 3-year cumulative local failure rates were 14% in Group A and 7% in Group B (P = 0.1202), while the actuarial rates of developing rectal complication (Grade 2 or more) at 3 years were 25% in Group A and 4% in Group B (P < 0.0001). This retrospective analysis suggests that a low dose per fraction with modified source step size is advantageous because of yielding almost the same local control but with fewer rectal complications. (author)

  20. Hydroxyurea: a radiation potentiator in carcinoma of the uterine cervix. A randomized double-blind study

    International Nuclear Information System (INIS)

    From June, 1972, to December, 1976, 40 patients with FIGO (International Federation of Gynaecology and Obstetrics) Stage IIB carcinoma of the uterine cervix were entered into a prospective, double-blind, randomized study to evaluate the possible radiation-potentiating properties (i.e., improved survival) of the S-phase cell cycle-specific inhibitor of DNA synthesis, hydroxyurea. All patients were documented to be without aortic lymph node metastasis by pretherapy staging para-aortic lymphadenectomy. All 40 patients were followed up for longer than 5 years (5.2 to 9.2 years) or until death. The double-blind code was not broken until all patients had been followed up for a minimum of 2 to 5 years. Leukopenia (white blood cell count less than 2,500 mm3) was significantly increased in the patients given hydroxyurea as compared to those given placebo (P less than 0.0001). There was no statistically significant difference relative to anemia, thrombocytopenia, radiation-induced skin reaction, and radiation-induced intestinal reaction between the patients given placebo or those given hydroxyurea. Life-table survival for the patients given hydroxyurea was 94% as compared to 53% for the patients given placebo (P . 0.006). Only one (5%) patient given hydroxyurea died of cervical cancer. Of the other patients who died in the group given hydroxyurea, all were confirmed by postmortem examination to have been without recurrent cervical cancer. In contrast, 45% (nine) of the patients given placebo died of cervical cancer

  1. Change in interstitial fluid pressure measurements in carcinoma of the uterine cervix as an early predictor of radioresponsiveness

    International Nuclear Information System (INIS)

    Purpose/Objective: Interstitial fluid pressure (IFP) has been found to be elevated in cervical carcinomas. This study sought to evaluate IFP as a potential early measure of tumor response to radiation therapy. Identification of poor responders early in the course of treatment may allow the clinician to modify the treatment strategy early in the course of therapy. Materials and Methods: IFP was measured using the wick-in-needle technique in 42 patients undergoing definitive radiotherapy for carcinoma of the cervix. Measurements were taken before and after external beam radiation treatment (EBRT) in 25, after intracavitary treatment (ICT) in 7, and after both EBRT and ICT in 10 patients. An additional 10 patients had weekly measurements during radiotherapy. Tumor stage, size, hemoglobin, and clinical response were assessed and correlated with IFP readings. Results: All initial IFP readings were elevated. The extent of elevation did not correlate with outcome (p=0.76) or stage (p=0.6). Smaller tumors had a higher initial IFP (p=0.02). Tumor response correlated with change in IFP readings (p=0.01), tumor size (0.04), hemoglobin (p=0.01), and stage (0.04). On multivariate analysis, change in IFP remained an independent predictor of response. The IFP change from pretreatment to post-EBRT was - 13±3 in complete responders versus 4±11 and 18±10 in the partial and nonresponders respectively (p=0.01). In those with post-ICT readings, the change was -18±4 in complete responders versus 54±18 in the partial responders (p=0.01). In 10 patients undergoing weekly measurement, 8 complete responders had decreasing IFP measurements. An average fall of 51.6% was seen in five patients at < 1620cGy despite little or no change in tumor size, and by 2700cGy (average decrease 31%) in the remaining 3 complete responders. Nonresponders had either no change or an increase in IFP throughout EBRT. Conclusion: IFP is elevated in tumors of the uterine cervix. Decreasing IFP measurement

  2. Status of carcinoma cervix and high risk HPV 16 DNA in women with postmenopausal uterine bleeding (PMB

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    Veena Kashyap

    2014-09-01

    Full Text Available Postmenopausal bleeding (PMB is a discharge that occurs following the firm diagnosis of menopause, which is at least six months from the end of women’s menstrual cycle but not to be confused with infrequent or irregular periods occurring around the time of menopause. It is a common problem representing 5% of all gynecology outpatient attendances which are to eliminate endometrial cancer as the cause of bleed and PMB should be reported urgently to the gynecologist. Uterine bleeding in postmenopausal women is highly indicative clinically of malignancy originating from cervix or endometrium and Human papilloma virus (HPV is one of the causative agent for carcinoma cervix. Incidence of carcinoma cervix increases with the age in mature women, however, incidence of human papillomavirus (HPV infection reduces as menopause sets in. The presence of the virus could be used as an early indication of disease potential. Because the Pap test can only detect clinical evidence of cervical disease, molecular-based diagnostic tools are being used more frequently to detect the virus before abnormal cell growth can be observed. This study was aimed to determine the status of cervical cancer and HPV 16 DNA positivity in relation to postmenopausal bleeding.

  3. Clear cell carcinoma of the uterine cervix: clinical characteristics and feasibility of fertility-preserving treatment

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    Jiang X

    2014-01-01

    bleeding. Radiotherapy appears to be effective for local control but to have no effect on distant recurrences. In our study, the prognosis of patients with early-stage CCA, including those who had undergone fertility-preserving treatment, was not inferior to that of patients with other types of cervical adenocarcinoma. Keywords: clear cell carcinoma, cervix, diagnosis, prognosis, fertility-preserving

  4. A retrospective study of the effects of pelvic irradiation for carcinoma of the cervix on gastrointestinal function

    International Nuclear Information System (INIS)

    The purpose of the study was to evaluate the prevalence of disordered gastrointestinal function following therapeutic irradiation. Gastrointestinal function was evaluated in 30 randomly selected patients who had received pelvic irradiation for treatment of carcinoma of the cervix between 1 and 6 years previously. Each patient underwent evaluations of (a) gastrointestinal symptoms (b) absorption of bile acid, vitamin B12, lactose and fat (c) gastrointestinal transit: gastric emptying, small intestinal transit and whole gut transit and (d) intestinal permeability. Results were compared with those obtained in 18 normal volunteers. Stool frequency was above the control range in five patients and had increased (p < 0.001) since radiotherapy treatment. Bile acid (p<0.001) vitamin B12(p<0.01) and lactose (p<0.01) absorption were less in the patients when compared with the control subjects. Bile acid adsorption was below the control range in 14 of the 30 patients. Dietary calcium intake was lower (p<0.05) in those patients with lactose malabsorption. Gastric emptying (p<0.01) and small intestinal transit (p<0.01) were more rapid in the patients. Both small intestinal (r=-0.39, p<0.05) and whole gut (r=-0.45) transit were inversely related to stool frequency. Either bowel frequency, bile acid adsorption, vitamin B12 absorption was outside the control range in 19 of the 30 patients. Abnormal gastrointestinal function is essentially an inevitable long-term sequel of pelvic irradiation. 41 refs., 4 figs., 3 tabs

  5. 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.

  6. Carcinoma of uterine cervix with isolated metastasis to fibula and its unusual behavior: Report of a case and review of literature

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    Pasricha Rajesh

    2006-01-01

    Full Text Available Bone metastasis from carcinoma cervix is uncommon, especially in the distal appendicular skeleton. A 36 year old lady presented with carcinoma of uterine cervix, FIGO, stage IIb. She was treated with radical radiotherapy. Nine months later, she developed an isolated lytic lesion in right fibula, which turned out to be a metastatic lesion. The patient is doing well, 3 years after the surgical excision of metastasis. This is one of the few documented cases of metastasis to fibula, arising from carcinoma of uterine cervix and probably the first with isolated metastasis of this site. Unlike the dismal outcome commonly seen in patients with bone secondaries, she continues to be disease free and alive at 39 months of follow up, after the development of skeletal metastasis.

  7. Evaluation of carcinoma cervix using magnetic resonance imaging: correlation with clinical FIGO staging and impact on management

    International Nuclear Information System (INIS)

    To evaluate carcinoma of the cervix using magnetic resonance imaging (MRI), correlate with clinical approach of International Federation of Gynecology and Obstetrics (FIGO) staging system and to study the impact of MRI findings on patient management. Pathologically confirmed, 75 cases of carcinoma cervix referred to our institute from April 2007 to March 2008 were prospectively studied. Clinical FIGO stage was assigned to each patient by gynaecologists blinded to MRI findings. MRI stage (based on FIGO and TNM) was allotted by radiologists blinded to clinicopathological details. For patients who were operated, histopathological stage was taken as gold standard. For patients who were not operated, gynaecologists decided on a gold standard stage based on all available clinical and imaging data. MR staging was correlated with FIGO staging, with focus on significant alterations in treatment strategy caused due to MRI findings. MRI staging had an accuracy of 89.3% (67/75), while clinical FIGO staging had 61.3% (46/75) accuracy. MRI staging and FIGO staging concurred in 65.6% of the patients and differed in 34.4% of the patients. In about 30.6% (23/75) of the patients, there were relevant additional MRI findings not suspected clinically. The common significant MRI findings were detection of pelvic lymphadenopathy and clinically unsuspected bowel/bladder invasion. The management protocol was significantly altered in 86.9% (20/23) of the patients with additional MRI findings constituting 26.6% (20/75) of the total population. MRI is highly accurate in evaluating carcinoma of the cervix. MRI findings significantly altered therapeutic decisions in 26.6% of the patients. MRI should be considered prior to treatment planning in every patient.

  8. Persisting cyclical uterine bleeding in patients treated with radical radiation therapy and hormonal replacement for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Radical radiation therapy used for carcinoma of the cervix will ablate ovarian function. Since January 1986, our policy has been to administer oral combination oestrogen-progesterone replacement hormonal therapy to all premenopausal patients undergoing radical radiation with or without synchronous chemotherapy, for invasive cervix cancer. Five out of 22 (23%) such patients unexpectedly experienced between one and four episodes of cyclical per vaginal bleeding after the completion of radiation therapy. Bleeding episodes occurred in the absence of persistent tumor or radiation reaction, and suggest persisting endometrial response to exogenous hormonal stimulation. Uterine activity was temporarily retained in these five patients despite a minimal endometrial surface dose of between 4800 and 6490 cGy. The limited number of cycles before bleeding spontaneously ceased may represent the slow death of endometrial cells subsequent to radiation or radiochemotherapy treatment, and has not previously been described. In view of the paucity of data on the radiosensitivity of normal endometrium, we have carefully examined these patients who appear to have retained endometrial sensitivity to hormonal stimuli after radical radiation-chemotherapy for uterine cervix cancer

  9. DNA level and stereologic estimates of nuclear volume in squamous cell carcinomas of the uterine cervix. A comparative study with analysis of prognostic impact

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Bichel, P; Jakobsen, A

    1992-01-01

    Grading of malignancy in squamous cell carcinomas of the uterine cervix is based on qualitative, morphologic examination and suffers from poor reproducibility. Using modern stereology, unbiased estimates of the three-dimensional, volume-weighted mean nuclear volume (nuclear vv), were obtained in...... pretreatment biopsies from 51 patients treated for cervical cancer in clinical Stages I through III (mean age of 56 years, follow-up period greater than 5 years). In addition, conventional, two-dimensional morphometric estimates of nuclear and mitotic features were obtained. DNA indices (DI) were estimated by...... carcinoma of the uterine cervix....

  10. Late Rectal Complication in Patients Treated with High Dose Rate Brachytherapy for Stage IIB Carcinoma of the Cervix

    International Nuclear Information System (INIS)

    Purpose : This paper reports a dosimetric study of 88 patients treated with a combination of external radiotherapy and high dose rate ICR for FIGO stage IIB carcinoma of the cervix. The purpose is to investigate the correlation between the radiation doses to the rectum. external radiation dose to the whole pelvis. ICR reference volume. TDF, BED and the incidence of late rectal complications, retrospectively. Methods and Materials : From November 1989 through December 1992, 88 patients with stage IIB cervical carcinoma received radical radiotherapy at Department or Radiation Oncology in Yonsei University Hospital. Radiotherapy consisted of 44-54 Gy(median 49 Gy) external beam irradiation plus high dose rate intracavitary brachy therapy with 5 Gy per fraction twice a week to a total dose of 30 Gy on point A. The maximum dose to the rectum by contrast(r,R) and reference rectal dose by ICRU 38(dr, DR) were calculated. The ICR reference volume was calculated by Gamma Dot 3.11 HDR planning system, retrospectively. The time-dose factor(TDF) and the biologically effective dose (BED) were calculated. Results : Twenty seven(30.7%) of the 88 patients developed late rectal complications : 12 patients(13.6%) for grade 1, 12 patients(13.6%) for grade 2 and 3 patients(3.4%) for grade 3. We found a significant correlation between the external whole pelvis irradiation dose and grade 2, 3 rectal complication. The mean dose to the whole pelvis for the group of patients with grade 2, 3 complication was higher, 4093.3±453.1 cGy, than that for the patients without complication 3873.8±415.6 (0.05< p<0.1). This investigation has revealed a significant correlation between the dose calculated at the rectal dose by ICRU 38(DR) or the most anterior rectal dose by contrast(R), dose to the whole pelvis and the incidence of grade 2, 3 late rectal complications in patients with stage IIB cervical cancer undergoing external beam radiotherapy and HDR ICR. Thus these rectal reference points doses

  11. Are recommendations from carcinoma of the cervix Patterns of Care studies (PCS) in the United States of America (USA) applicable to centers in developing countries?

    International Nuclear Information System (INIS)

    Purpose: To compare patient demographics, treatment resources, practice patterns, and outcome results for squamous cell carcinoma of the uterine cervix (SCC) between the 1978 and 1983 Patterns of Care studies (PCS) in the United States of America (USA) and a nonacademic center within a developing country. Methods and Materials: Patient details (race, age, stage, and number per year), treatment used, and treatment outcome were retrieved from the charts of the 1160 cases registered at this center with SCC of the cervix between 1976 and 1985. Demographic variables and Kaplan-Meier survival estimates were calculated and compared with results from published PCS reviews. Results: There is a significant difference in the racial group presentation of cervix cancer at this center compared with the PCS reviews (p < 0.005), and median ages are significantly lower at this center (t = p < 0.001). The proportion of patients with Stage III or more was significantly higher at this center than the PCS centers (24 vs. 47%, p < 0.001). There were also vast differences in facility resources. Fewer cases at this center underwent intracavitary insertions than at PCS centers. Mean Point A doses were significantly reduced for this center compared with the PCS reviews. Kaplan-Meier estimates were similar for Stage I and II in PCS centers and this center, but were inferior for this center in Stage III patients (p < 0.05 for OS and p < 0.01 for LC). Late morbidity rates were similar for both PCS centers and this center. Conclusion: PCS recommendations may be applicable to nonacademic centers within developing countries, if the latter use staging techniques that are consistent with the PCS staging guidelines

  12. Routine clinical estimation of rectal, rectosigmoidal, and bladder doses from intracavitary brachytherapy in the treatment of carcinoma of the cervix

    International Nuclear Information System (INIS)

    An evaluation of rectal, rectosigmoidal, and bladder doses from intracavitary brachytherapy in carcinoma of the cervix has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Contrast radiography on a radiotherapy simulator is used to image the rectum and bladder, and dose rates are determined at predesignated reference points with the aid of computer calculated dose distributions. Forty-three patients have been reviewed in order to ascertain the correlation between radiation injury and dose at reference points in the rectum and bladder. In a related study involving 77 patients, the doses at points A and B and the prescription in mghr were analyzed in relation to radiation injury. There was no apparent association between the incidence of radiation injury in either the mghr prescription or the doses at points A or B. Computer calculations were supplemented with in vivo and in vitro thermoluminescent dosimeter (TLD) measurements. We conclude that routine contrast radiography of the rectum and the bladder with dose calculations at selected reference points provides important information for optimizing radiotherapy in carcinoma of the cervix without a significant increase in treatment planning effort or patient discomfort

  13. Injuries of the sigmoid colon following radiation therapy for carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Grade 2 or 3 injuries of the sigmoid colon were observed in 4 of 42 patients with carcinoma of the uterine cervix who were treated by radiation therapy. The irradiation was planned as the combination of the external irradiation (whole pelvic 30 Gy and 20 Gy with central shielding by 25 fractions, 5 weeks) and the intracavitary irradiation (RALS, 19 Gy at point A by 3 fractions). To analyze the causes of the radiation sigmoiditis, we have investigated the following factors: age, dose at point A, dose at point C, grade of tandem dislocation, uterine angle, obesity score, evidence of previous surgery to the pelvic cavity and hypertension. The dose at point C and the grade of tandem dislocation were determined from the confirming X-Ps at RALS therapy and external irradiation. The superimposition of these films was performed with corrections for the angle between the projection direction of the X-Ps and the vertical magnification factor of the central shielding area. Point C was defined as a point 2 cm anterior to the intersection of the tandem axis and a curvilinear line 1 cm outside from the margin of central shield on the X-Ps. Grades of tandem disclocation were decided as the number of tandem tips outside of the central shielding area on X-Ps. The doses at point C showed very high statistical significance (p<0.001) with the evidence of radiation sigmoiditis. All the cases with radiation sigmoiditis received over 1290 cGy at point C. Age had also some significance (p<0.05) with radiation sigmoiditis. Other factors showed no significant relationship. Among the patients receiving more than 1280 cGy at point C, injury free cases had over 30% obesity score except for one case. This exceptional patient had 12% obesity score and was in special condition of hydrometra. In conclusion, the dose at point C will be an index of injuries of the sigmoid colon following radiation therapy, and obesity score and condition of the uterus seem to be additional factors. (J.P.N.)

  14. NQO1 overexpression is associated with poor prognosis in squamous cell carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    NQO1 (NAD(P)H: quinone oxidoreductase-1), located on chromosome 16q22, functions primarily to protect normal cells from oxidant stress and electrophilic attack. Recent studies have revealed that NQO1 is expressed at a high level in most human solid tumors including those of the colon, breast, pancreas, ovaries and thyroid, and it has also been detected following the induction of cell cycle progression and proliferation of melanoma cells. In this study, we aimed to investigate the clinicopathological significance of upregulated NQO1 protein expression in squamous cell carcinomas (SCCs) of the uterine cervix. The localization of the NQO1 protein was determined in the SiHa cervical squamous cancer cell line using immunofluorescence (IF) staining, and immunohistochemical (IHC) staining performed on paraffin-embedded cervical SCC specimens from 177 patients. For comparison, 94 cervical intraepithelial neoplasia (CIN) and 25 normal cervical epithelia samples were also included. QRT-PCR was performed on RNA from fresh tissues to detect NQO1 mRNA expression levels, and HPV infection status was genotyped using oligonucleotide microarray. Disease-free survival (DFS) and 5-year overall survival (OS) rates for all cervical SCC patients were calculated using the Kaplan–Meier method, and univariate and multivariate analysis was performed using the Cox proportional hazards regression model. The NQO1 protein showed a mainly cytoplasmic staining pattern in cervical cancer cells, and only three cases of cervical SCC showed a nuclear staining pattern. The strongly positive rate of NQO1 protein expression was significantly higher in cervical SCCs and CINs than in normal cervical epithelia. High-level NQO1 expression was closely associated with poor differentiation, late-stage, lymph node metastasis and high-risk for HPV infection. Additionally, high-level NQO1 expression was associated with lower DFS and 5-year OS rates, particularly for patients with early-stage cervical SCCs

  15. Continuous or split-course combined external and intracavitary radiotherapy of locally advanced carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    From 1974 to 1984, 442 consecutive patients with carcinoma of the uterine cervix (FIGO IIB: 139, IIIA: 10, IIIB: 221, IVA: 72) were referred for combined intracavitary (IRT) and external radiotherapy (ERT). To improve local control and reduce late rectosigmoid morbidity the treatment strategy was changed from continuous (CRT) to split-course radiotherapy (SCRT) in 1978. Stage by stage the 5-year actuarial estimates of survival, local control, and late morbidity did not differ in relation to strategy. In the patients with tumours larger than 8 cm, the SCRT involved an increased dose in point B, a reduced dose in point A from the IRT, a lower total dose in point A, and a 34 day's prolongation of the total treatment time (TTT). The resulting 5-year actuarial local control rates were significantly lower compared with those after CRT. No difference of late severe morbidity was found except in IVA patients. In the patients with tumours between 4 and 8 cm, the SCRT involved a reduced dose in point A from the IRT, an increased total dose in point A and B, and a 50 day's prolongation of the TTT. In patients with stage IIB, the 5-year actuarial central local control rate was lower (p=0.06), and the 5-year estimate of late severe morbidity significantly higher after SCRT compared with CRT. It is concluded that the increase of the dose in point B in the SCRT was insufficient to prevent the deleterious effect on local tumour control of either the lower dose from IRT in point A, or the prolonged TTT. The increase of the total dose in the SCRT may explain why the late morbidity was not reduced, and may suggest that the TTT is of no significant importance for the risk of late normal tissue damage. (orig.)

  16. Irradiation alone or in combination with surgery in stage IB and IIA carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    This is a report of a nonrandomized comparison of treatment results of 244 patients with stage IB carcinoma of the uterine cervix treated by radiation alone and 92 treated with preoperative radiation and surgery and 77 patients with stage IIA treated by radiation alone and 24 treated with a combination of radiation and surgery. The techniques or irradiation and types of operation are described in detail. The five-year tumor free actuarial survival for the patients with stage IB treated either with irradiation alone or combined with surgery was approximately 85% and the ten-year survival, 78%. Of the 24 patients treated with irradiation and surgery, there were two parametrial recurrences combined with distant metastasis (8.2%). There was no significant difference in the survival or recurrence rate of the patients treated with either method. In the group treated with combined therapy, patients with stage IB who showed evidence of microscopic residual tumor after irradiation had a failure rate of approximately 42% (8/18) in contrast to only 8.6% (6/70) in those with negative specimens. In stage IIA there were three failures in eight patients with residual tumor in the specimen in contrast to only two of 16 with negative specimens (12.5%). Major complications were comparable in both groups (radiation alone approximately 8.7% and irradiation combined with surgery approximately 14%); the difference is not statistically significant. The most frequent minor complication in patients treated with radiation alone was vaginal fibrosis (30 patients--9%) or vaginal vault necrosis

  17. High-dose rate intracavitary irradiation using linear source arrangement for squamous cell carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Purpose: To evaluate the results of fractionated high-dose-rate (HDR) intracavitary irradiation using a linear source arrangement (LSA) without vaginal ovoids for patients with squamous cell carcinoma of the uterine cervix. Methods and Materials: From 1980 to 1990, 236 patients with squamous cell carcinoma received external beam therapy (EBT) followed by fractionated HDR intracavitary irradiation using LSA (HDR-LSA). The initial FIGO stage was I, II, and III for 19, 71, and 146 patients respectively. Forty Gy in 20 fractions (40 Gy/20 Fr) were delivered to the whole pelvis and additional 10 Gy/5 Fr to the center shielding field with parallel opposed ports. The HDR-LSA dose was 30 Gy/6 Fr or 35 Gy/7 Fr at Manchester's point A giving two fractions per week. During the intracavitary irradiation, patients were treated in the out-patient clinic. A vaginal plastic applicator was inserted with lubricating gel without spinal or general anesthesia and gauze packing. Results: Pelvic failure rate was 10.5% for stage I, 12.7% for stage II, and 35.6% for stage III. Cause-specific 5-year survival rates were 69.1% for stage I, 77.1 % for stage II, and 50.1 % for stage III, respectively. The low survival for stage I disease was suggested to be due to selection bias. In multivariant analyses, stage (stage I+II vs. III, p=0.0003), pre-treatment serum hemoglobin level (p=0.0021), pre-treatment serum total protein level (p=0.0028), and total treatment time (p=0.0035) were significantly associated with cause-specific survival. The rate of late severe complications was 2.1% for rectum, 1.2% for small intestine, and 1.3 % for bladder. Conclusions: The LSA-HDR method following EBT is a safe and effective technique for the majority of patients. Reproducibility of dose distribution and the easiness of the insertion for the patients are suitable for multi-fractionated schedule required in HDR treatment. The benefit of the LSA, compared to the arrangement using a tandem and ovoids, should be

  18. Significance of ovoid separation, with different applications of high dose rate intracavitary radio therapy in carcinoma of the uterine cervix: a study from rural centre of Maharashtra, India

    International Nuclear Information System (INIS)

    To analyze the difference in the dose distribution with ovoid separation in different applications by the different radiotherapists in the same patient of the carcinoma of the uterine cervix treated by multiple fractions of high-dose-rate (HDR) intracavitary radio therapy (ICRT)

  19. Osteoclastic Giant Cell Rich Squamous Cell Carcinoma of the Uterine Cervix: A Case Report and Review of the Literature

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    Lucía Alemán-Meza

    2014-01-01

    Full Text Available Cervical carcinoma is the most common malignancy of the female genital tract and represents the second most common malignancy in women worldwide. Histologically 85 to 90% of cervical cancers are squamous cell carcinoma. Osteoclastic giant cell rich squamous cell carcinoma is an unusual histological variant of which only 4 cases have been reported. We present the case of a 49-year-old woman with a 6-month history of irregular vaginal bleeding. Examination revealed a 2.7 cm polypoid mass in the anterior lip of the uterine cervix. The patient underwent hysterectomy with bilateral salpingo-oophorectomy. Microscopically the tumor was composed of infiltrative nests of poorly differentiated nonkeratinizing squamous cell carcinoma. Interspersed in between these tumor cells were numerous osteoclastic giant cells with abundant eosinophilic cytoplasm devoid of nuclear atypia, hyperchromatism, or mitotic activity. Immunohistochemistry was performed; CK and P63 were strongly positive in the squamous component and negative in the osteoclastic giant cells, while CD68 and Vimentin were strongly positive in the giant cell population and negative in the squamous component. The patient received chemo- and radiotherapy for recurrent disease identified 3 months later on a follow-up CT scan; 7 months after the surgical procedure the patient is clinically and radiologically disease-free.

  20. Analysis of 30 patients with persistent or recurrent squamous cell carcinoma of the cervix within one year after concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    To investigate the recurrence sites, risk factors, and prognosis of patients with persistent or recurrent squamous cell carcinoma (SCC) of the cervix within one year after undergoing concurrent chemoradiotherapy (CCRT). Clinical data of 30 patients with persistent or recurrent SCC of the cervix within one year after CCRT between July 2006 and July 2011 were analyzed retrospectively. These data were compared with those of 35 SCC cases with no signs of recurrence after complete remission. These 35 patients were treated during the same period (between 2006 and 2011) and selected randomly. Among these 30 patients, 25 exhibited distant metastases of which 14 were observed within 6 months after CCRT. Univariate analysis showed higher incidence of pelvic or para-aortic lymphadenectasis and SCC-ag >10 ng/mL in the group with persistent or recurrent disease before treatment (P<0.01). Multivariate analysis by logistic regression revealed that the pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag >10 ng/mL were the independent risk factors. Palliative chemotherapy was the main treatment option for patients with persistent or recurrent disease. The 2-year survival rate was 21.7%, and the median survival time was 17 months. Patients with persistent or recurrent SCC of the cervix after CCRT exhibited a high rate of distant metastasis with poor prognosis. The pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag >10 ng/mL were identified as the independent risk factors for persistent or recurrent SCC within 1 year after CCRT

  1. RESULTS OF 192IR CONTACT RADIATION THERAPY FOR CERVIX UTERI CANCER

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    O. A. Kravets

    2014-09-01

    Full Text Available The paper presents the results of treatment for locally advanced cervix uteri cancer, by applying a 192Ir radioactive source for contact radiation. Three- and five-year overall and relapse-free survival rates have been obtained for stages: 82.5 and 82.5%; 78.4 and 78.4% for Stage IIb; 57 and 52.3%; 41.6 and 41.6 for IIIb; 53.3 and 47.3%; 42.4 and 37.7% for IVb, respectively.

  2. Radical radiotherapy treatment (EBRT + HDR-ICRT of carcinoma of the uterine cervix: Outcome in patients treated at a rural center in India

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    Jain Vandana

    2007-01-01

    Full Text Available Aim: To report the outcome of carcinoma of the uterine cervix patients treated radically by external beam radiotherapy (EBRT and high-dose-rate (HDR intracavitary radiotherapy (ICRT. Materials and Methods: Between January 1997 to December 2001, a total of 550 newly diagnosed cases of carcinoma of the uterine cervix were reported in the department. All cases were staged according to the International Federation of Gynecologists and Oncologists (FIGO staging system, but for analytical convenience, the staging was limited to stages I, II, III, and IV. Out of the 550 cases, 214 completed radical radiotherapy (EBRT + HDR-ICRT and were retrospectively analyzed for presence of local residual disease, local recurrence, distant metastases, radiation reactions, and disease-free survival. Results: There were 7 (3.27%, 88 (41.1%, 101 (47.1%, and 18 (8.4% patients in stage I, II, III, and IV, respectively. The median follow-up time for all patients was 43 months (range: 3-93 months and for patients who were disease free till the last follow-up it was 59 months (range: 24-93 months. The overall treatment time (OTT ranged from 52 to 73 days (median 61 days. The 5-year disease-free mean survival rate was 58%, 44%, 33%, and 15%, with 95% confidence interval of 48 to 68, 37 to 51, 24 to 35, and 6 to 24 for stages I, II, III, and IV, respectively. There were 62 (28.97% cases with local residual disease, 35 (16.3% developed local recurrence/distant metastases, 17 (7.9% developed distant metastases, and 9 (4.2% had local recurrence as well. Discussion and Conclusion: The overall outcome was poor in advanced stage disease, but might be improved by increasing the total dose, decreasing overall duration of treatment, and by adding chemotherapy in patients with disease limited to the pelvis.

  3. Radiation dose delivery verification in the treatment of carcinoma-cervix

    Science.gov (United States)

    Shrotriya, D.; Kumar, S.; Srivastava, R. N. L.

    2015-06-01

    The accurate dose delivery to the clinical target volume in radiotherapy can be affected by various pelvic tissues heterogeneities. An in-house heterogeneous woman pelvic phantom was designed and used to verify the consistency and computational capability of treatment planning system of radiation dose delivery in the treatment of cancer cervix. Oncentra 3D-TPS with collapsed cone convolution (CCC) dose calculation algorithm was used to generate AP/PA and box field technique plan. the radiation dose was delivered by Primus Linac (Siemens make) employing high energy 15 MV photon beam by isocenter technique. A PTW make, 0.125cc ionization chamber was used for direct measurements at various reference points in cervix, bladder and rectum. The study revealed that maximum variation between computed and measured dose at cervix reference point was 1% in both the techniques and 3% and 4% variation in AP/PA field and 5% and 4.5% in box technique at bladder and rectum points respectively.

  4. Radiation dose delivery verification in the treatment of carcinoma-cervix

    Energy Technology Data Exchange (ETDEWEB)

    Shrotriya, D., E-mail: shrotriya2007@gmail.com; Srivastava, R. N. L. [Department of Radiotherapy, J.K. Cancer Institute Kanpur-208019 (India); Kumar, S. [Department of Physics, Christ Church College, Kanpur-208001 (India)

    2015-06-24

    The accurate dose delivery to the clinical target volume in radiotherapy can be affected by various pelvic tissues heterogeneities. An in-house heterogeneous woman pelvic phantom was designed and used to verify the consistency and computational capability of treatment planning system of radiation dose delivery in the treatment of cancer cervix. Oncentra 3D-TPS with collapsed cone convolution (CCC) dose calculation algorithm was used to generate AP/PA and box field technique plan. the radiation dose was delivered by Primus Linac (Siemens make) employing high energy 15 MV photon beam by isocenter technique. A PTW make, 0.125cc ionization chamber was used for direct measurements at various reference points in cervix, bladder and rectum. The study revealed that maximum variation between computed and measured dose at cervix reference point was 1% in both the techniques and 3% and 4% variation in AP/PA field and 5% and 4.5% in box technique at bladder and rectum points respectively.

  5. Cancer cervix?: a retrospective study

    International Nuclear Information System (INIS)

    Anemia is very commonly seen in most of the malignancies including cancer cervix. Anemia has long been reported to adversely affect the efficacy of radiation treatment in cervical cancer. At our center, carcinoma cervix accounts for approximately 8-10% of all malignancies. The objective of this study is to see the impact of anemia in the treatment of cancer cervix. In the present study, we collected data of treatment results of FIGO stage II and III cancer cervix patients retrospectively treated in years of 2009-10. We have tried to assess the outcome of results in patients whom haemoglobin (Hb) level < 10 gm/dl and e''10 gm/dl. Out of 200 patients of disease with baseline Hb less than 10 gm/dl, 80(40%) patients had residual disease after 4 weeks of completion of treatment. Out of 168 patients with baseline Hb more than 10 gm/dl, 42(25%) had residual disease (p-0.0012 i.e highly significant). Our study shows that there is a good disease control at local site in patients with higher pretreatment Hb level. Effect of pretreatment Hb on treatment outcome in terms of overall survival, disease free survival, and local relapse free survival along with effect on corrective measures should be studied in detail. (author)

  6. Comparative analysis of cisplatin-induced nephrotoxicity in head and neck cancer and carcinoma cervix during concurrent chemoradiotherapy

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    Puneet Kumar Bagri

    2014-01-01

    Full Text Available Background: Cisplatin is widely used as radio sensitizer in head and neck cancer (HNC and carcinoma cervix (CaCx. This study aims to see comparative nephrotoxicity of cisplatin in HNC and in CaCx without obstructive uropathy treated by concurrent chemoradiotherapy (CCRT. Materials and Methods: Fifty patients of HNC and 50 patients of CaCx stage II/III without obstructive uropathy were included in this study. Cisplatin 50 mg intravenous weekly was given before EBRT with adequate hydration and premedication in both groups. Before chemotherapy; blood urea, serum creatinine, and glomerular filtration rate (GFR were measured. GFR was measured using 99m Tc diethylene triamine pentacaetic acid (DTPA renogram study. Results: At the end of 4 th week, blood urea level 41-45 mg% was in 40 and 4% in HNC and CaCx, respectively (P = 0.018. At the end of 3 rd and 4 th week, blood urea level >45 mg% was 10 and 6% in HNC cases, respectively. At the end of 4 th week, serum creatinine level 1.1-1.5 mg% was 50 and 8% in HNC and CaCx, respectively (P = 0.047. Serum creatinine level >1.5 mg% was 6, 8, and 22% in HNC at the end of 2 nd , 3 rd , and 4 th week, respectively. GFR <80 ml/min at the end of 4 th week was 14% in HNC and only 2% in CaCx. GFR <100ml/min was significant at the end of 4 th week (P = 0.04. Univariate analysis showed significant relation between reduced oral fluid intake and reduced GFR (P < 0.001. Conclusion: In HNC, during concurrent chemoradiation, as the 3 rd -4 th week is reached, oral mucosal reactions increase and affect oral intake which further add to the cisplatin-induced nephrotoxicity. In CaCx without obstructive uropathy, renal function impairment is less severe as oral intake of water and liquid is not much impaired.

  7. Carcinoma adenoescamoso do colo uterino mimetizando carcinoma adenóide basal: relato de um caso e revisão da literatura Adenosquamous carcinoma of the cervix mimicking adenoid basal carcinoma: case report and review of the literature

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    Álvaro Piazzeta Pinto

    2007-02-01

    Full Text Available O carcinoma adenoescamoso do colo uterino é definido como um tumor que contém uma mistura de células malignas com diferenciação escamosa e glandular. A literatura salienta a importância de se fazer esse diagnóstico, uma vez que, quando os componentes não são bem diferenciados ou não se encontram evidentes na amostra analisada, esse tumor pode ser erroneamente interpretado como carcinoma escamoso ou adenocarcinoma. O presente trabalho descreve a apresentação pouco comum de um carcinoma adenoescamoso. Após sucessivos diagnósticos citológicos não concordantes e complicados por uma história de sangramento uterino anormal ocasionado por endometriose cervical, a paciente de 47 anos foi submetida a histerectomia total, obtendo diagnóstico definitivo. Esse particular tumor aqui relatado foi diagnosticado como carcinoma adenoescamoso, mas em muitos aspectos apresentou-se semelhante ao carcinoma adenóide basal. Elementos característicos do carcinoma adenóide basal, como presença de lesão intra-epitelial escamosa na superfície, diferenciação escamosa e glandular no centro dos blocos neoplásicos e células basalóides na profundidade da lesão, foram observados em nosso caso. Em contrapartida, os seguintes elementos normalmente não observados no carcinoma adenóide basal estavam presentes: atipias e figuras de mitose nas células indiferenciadas da profundidade do tumor e lesão intra-epitelial escamomucinosa (SMILE na superfície. Fatores epidemiológicos e clínicos, como idade (47, raça (branca e forma de apresentação clínica (massa visível na inspeção cervical, também colaboraram para afastar esse diagnóstico diferencial. Outros diagnósticos diferenciais do carcinoma adenoescamoso do colo uterino incluem o carcinoma puramente escamoso ou glandular, o tumor de colisão e o adenocarcinoma de endométrio com diferenciação escamosa invadindo o colo uterino.Adenosquamous carcinoma of the uterine cervix is defined as a

  8. Cervix cancer

    International Nuclear Information System (INIS)

    A retrospective and descriptive study was conducted to characterize the behavior of cervix cancer in a sample of 162 patients with this diagnosis during 2003-2009 in the Isla de la Juventud municipality. From the review of case reports from the National Unit of Cancer the individual medical records of Teaching General Hospital of this municipality and from the National Institute of Oncology and Radiology, as well as the deceased persons, it was possible to note that the 63% of cases were women aged 34-57 and that the 20% was in ages outside the screening program. The NIC and/or infection by HPV and smoking were the more frequent risk factors. There was predominance of large cells epidermoid non-keratinized carcinoma and the O stage or in situ. Most of patients were operated on is initial therapy. The great mortality was between fifth and sixth decades of life with a acceptable survival at 5 years

  9. Microarray comparative genomic hybridization detection of chromosomal imbalances in uterine cervix carcinoma

    International Nuclear Information System (INIS)

    Chromosomal Comparative Genomic Hybridization (CGH) has been applied to all stages of cervical carcinoma progression, defining a specific pattern of chromosomal imbalances in this tumor. However, given its limited spatial resolution, chromosomal CGH has offered only general information regarding the possible genetic targets of DNA copy number changes. In order to further define specific DNA copy number changes in cervical cancer, we analyzed 20 cervical samples (3 pre-malignant lesions, 10 invasive tumors, and 7 cell lines), using the GenoSensor microarray CGH system to define particular genetic targets that suffer copy number changes. The most common DNA gains detected by array CGH in the invasive samples were located at the RBP1-RBP2 (3q21-q22) genes, the sub-telomeric clone C84C11/T3 (5ptel), D5S23 (5p15.2) and the DAB2 gene (5p13) in 58.8% of the samples. The most common losses were found at the FHIT gene (3p14.2) in 47% of the samples, followed by deletions at D8S504 (8p23.3), CTDP1-SHGC- 145820 (18qtel), KIT (4q11-q12), D1S427-FAF1 (1p32.3), D9S325 (9qtel), EIF4E (eukaryotic translation initiation factor 4E, 4q24), RB1 (13q14), and DXS7132 (Xq12) present in 5/17 (29.4%) of the samples. Our results confirm the presence of a specific pattern of chromosomal imbalances in cervical carcinoma and define specific targets that are suffering DNA copy number changes in this neoplasm

  10. Analysis of complications of cervix carcinoma treated by radiotherapy using the Franco-Italian glossary

    International Nuclear Information System (INIS)

    We analysed the complications of 215 patients with uterine cervix cancer, treated by radiotherapy (RT) alone. It was done according to the rules of the Franco-Italian glossary, presented at the 7th ESTRO meeting, held in The Hague on September 1988. They were ranked by organ sites and by degrees of gravity. The analysis was done on the total number of complications and they were scored at the highest reached grade of gravity. Seventy one complications were found in 55 patients; they were studied by patient, degree of severity, time of onset, organ system and grade, time of onset and grade, time of onset and organ sites, stage and RT doses and brachytherapy volumes. The importance of the study of complications is stressed, particularly when treatment combines external RT and brachytherapy; some guidelines are given to avoid severe complications. (author) tabs. figs

  11. Carcinoma of the Uterine Cervix Involving the Genitourinary Tract: A Potential Diagnostic Dilemma.

    Science.gov (United States)

    Schwartz, Lauren E; Khani, Francesca; Bishop, Justin A; Vang, Russell; Epstein, Jonathan I

    2016-01-01

    Uterine cervical carcinoma secondarily involving the genitourinary tract is rarely documented histologically. These tumors present a unique diagnostic challenge as they can appear morphologically similar to urothelial carcinoma as well as primary squamous cell carcinoma and primary adenocarcinoma of the bladder. Genitourinary consult cases at the Johns Hopkins Hospital from 1984 to the present were searched for cases in which the differential diagnosis was primary bladder carcinoma versus secondary involvement by cervical carcinoma. We identified 10 cases that met these criteria and evaluated them by immunohistochemistry for p16 and GATA3 and in situ hybridization for human papillomavirus (HPV). Six cases were received with a gynecologic history. Four cases had been misdiagnosed as urothelial carcinoma, and 1 case was favored to be cystitis cystica et glandularis by the submitting institutions. Morphologically, the majority of cases showed basaloid nests of tumor cells infiltrating muscle bundles, with several having foci that mimicked urothelial carcinoma in situ. Six tumors were found to be diffusely positive with p16, 1 tumor was patchy, 1 was weak, and 2 were negative. GATA3 staining was negative in 6 cases, and 4 showed weak to strong positivity. Eight cases were positive for high-risk HPV (6 were positive for HPV 16, and 1 was positive for HPV 18). In the 2 cases that were negative for HPV by in situ hybridization, characteristic morphologic features of HPV-unrelated type of endocervical adenocarcinoma were present. On the basis of our findings we advocate a multifaceted approach, combining morphologic evaluation with ancillary studies including immunohistochemistry and in situ hybridization in the evaluation of genitourinary specimens for secondary involvement by cervical carcinoma. Furthermore, gynecologic clinical history is absolutely critical and most important to the evaluation and diagnosis of these specimens, as these ancillary studies are not

  12. The American Brachytherapy Society recommendations for low-dose-rate brachytherapy for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose: This report presents guidelines for using low-dose-rate (LDR) brachytherapy in the management of patients with cervical cancer. Methods: Members of the American Brachytherapy Society (ABS) with expertise in LDR brachytherapy for cervical cancer performed a literature review, supplemented by their clinical experience, to formulate guidelines for LDR brachytherapy of cervical cancer. Results: The ABS strongly recommends that radiation treatment for cervical carcinoma (with or without chemotherapy) should include brachytherapy as a component. Precise applicator placement is essential for improved local control and reduced morbidity. The outcome of brachytherapy depends, in part, on the skill of the brachytherapist. Doses given by external beam radiotherapy and brachytherapy depend upon the initial volume of disease, the ability to displace the bladder and rectum, the degree of tumor regression during pelvic irradiation, and institutional practice. The ABS recognizes that intracavitary brachytherapy is the standard technique for brachytherapy for cervical carcinoma. Interstitial brachytherapy should be considered for patients with disease that cannot be optimally encompassed by intracavitary brachytherapy. The ABS recommends completion of treatment within 8 weeks, when possible. Prolonging total treatment duration can adversely affect local control and survival. Recommendations are made for definitive and postoperative therapy after hysterectomy. Although recognizing that many efficacious LDR dose schedules exist, the ABS presents suggested dose and fractionation schemes for combining external beam radiotherapy with LDR brachytherapy for each stage of disease. The dose prescription point (point A) is defined for intracavitary insertions. Dose rates of 0.50 to 0.65 Gy/h are suggested for intracavitary brachytherapy. Dose rates of 0.50 to 0.70 Gy/h to the periphery of the implant are suggested for interstitial implant. Use of differential source activity or

  13. Comparison of absorbed dose in the cervix carcinoma therapy by brachytherapy of high dose rate using the conventional planning and Monte Carlo simulation

    International Nuclear Information System (INIS)

    This study aims to compare the doses received for patients submitted to brachytherapy High Dose Rate (HDR) brachytherapy, a method of treatment of the cervix carcinoma, performed in the planning system PLATO BPS with the doses obtained by Monte Carlo simulation using the radiation transport code MCNP 5 and one female anthropomorphic phantom based on voxel, the FAX. The implementation of HDR brachytherapy treatment for the cervix carcinoma consists of the insertion of an intrauterine probe and an intravaginal probe (ring or ovoid) and then two radiographs are obtained, anteroposterior (AP) and lateral (LAT) to confirm the position of the applicators in the patient and to allow the treatment planning and the determination of the absorbed dose at points of interest: rectum, bladder, sigmoid and point A, which corresponds anatomically to the crossings of the uterine arteries with ureters The absorbed doses obtained with the code MCNP 5, with the exception of the absorbed dose in the rectum and sigmoid for the simulation considering a point source of 192Ir, are lower than the absorbed doses from PLATO BPS calculations because the MCNP 5 considers the chemical compositions and densities of FAX body, not considering the medium as water. When considering the Monte Carlo simulation for a source with dimensions equal to that used in the brachytherapy irradiator used in this study, the values of calculated absorbed dose to the bladder, to the rectum, to the right point A and to the left point A were respectively lower than those determined by the treatment planning system in 33.29, 5.01, 22.93 and 19.04%. These values are almost all larger than the maximum acceptable deviation between patient planned and administered doses (5 %). With regard to the rectum and bladder, which are organs that must be protected, the present results are in favor of the radiological protection of patients. The point A, that is on the isodose of 100%, used to tumor treatment, the results indicate an

  14. A dosimetric analysis of 6 MV versus 15 MV photon energy plans for intensity modulated radiation therapy (IMRT) of carcinoma of cervix

    Science.gov (United States)

    Tyagi, Atul; Supe, Sanjay S.; Sandeep; Singh, Man P.

    2010-01-01

    Background Intensity modulated radiotherapy (IMRT) is being used to treat carcinoma of cervix (Ca Cx). Integral dose to normal tissue and increased leakage are the concern about IMRT. 6 MV photon beam is a good choice of energy for Ca Cx IMRT treatment. Aim The objective of this study was to compare intensity modulated radiotherapy (IMRT) plans generated by 6 MV and 15 MV photon energies for carcinoma of cervix (Ca Cx) with regards to dosimetric parameters of planning target volume (PTV) and organs at risk (OAR), homogeneity index (HI), conformity index at 98% level (CI 98%), integral dose to normal tissue (NTID) and total number of monitor units (MUs). Material and methods A cohort of 16 patients was selected for this study. All patients were to receive a dose of 50 Gy in 25 fractions. IMRT plans were generated for both energies using same dose–volume constraints. Results Our results show a comparable coverage of planning target volume (PTV) for both energies. Volume of PTV receiving a prescription dose is 97.8 ± 0.5% and 98.8 ± 0.4% for the 6 MV and the 15 MV plans. Volume of PTV receiving a dose of 107% is 4.4 ± 7.8% and 16.1 ± 22.2%. Bladder and rectum mean doses for the 6 MV and the 15 MV photon plans were 39.8 ± 3.0 Gy and 40.0 ± 3.2 Gy, and 35.8 ± 3.1 Gy and 36.0 ± 3.1 Gy, respectively. Homogeneity index (HI) for both energies was 1.04. The conformity indices at 98% isodose (CI 98%) were 1.3 ± 0.1 and 1.4 ± 0.1 for 6 MV and 15 MV photon plans, respectively. Conclusions We conclude that a 6 MV photon is a good choice for Ca Cx IMRT as it produces a highly conformal, homogeneous plan with superior target coverage and better OAR sparing. PMID:24376938

  15. The dose time relationship in the radiotherapy of carcinoma of the cervix: application of CRE formalism

    International Nuclear Information System (INIS)

    A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were either treated with 45 Gy in 20 fractions by five fractions per week to with 42 Gy in 14 fractions by three fractions per week or with 42 Gy in 14 fractions by three fraction per week schedule by external radiotherapy. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Complication were correlated with total CRE values for point A (CREsub(TA)) and for rectum CREsub(TR). Correlations of CREsub(TA) with overall complication rate (p value 0.1) as well as rectal complication rate (p value >0.1). In order to limit Grade II and III rectal and bladder complications to acceptable level, in combined external and intracavitary treatments, CREsub(TA) value of less than 2500 reu is suggested. (author). 49 refs., 4 tabs., 4 figs., 1 appendix

  16. Radiotherapy and hyperthermia for treatment of primary locally advanced cervix cancer: results in 378 patients.

    NARCIS (Netherlands)

    Franckena, M.; Lutgens, L.C.; Koper, P.C.; Kleynen, C.E.; Steen-Banasik, E.M. van der; Jobsen, J.J.; Leer, J.W.H.; Creutzberg, C.L.; Dielwart, M.F.; Norden, Y. Van; Canters, R.A.; Rhoon, G.C. van; Zee, J. van der

    2009-01-01

    PURPOSE: To report response rate, pelvic tumor control, survival, and late toxicity after treatment with combined radiotherapy and hyperthermia (RHT) for patients with locally advanced cervical carcinoma (LACC) and compare the results with other published series. METHODS AND MATERIALS: From 1996 to

  17. Characterization of human papillomavirus type 66 from an invasive carcinoma of the uterine cervix.

    OpenAIRE

    Tawheed, A R; Beaudenon, S; Favre, M; Orth, G

    1991-01-01

    Human papillomavirus (HPV) DNA sequences coexisting with HPV16 and HPV45 were cloned from an invasive cervical carcinoma. The cloned HPV was shown to be a novel type, named HPV66, and is related to HPV56 (an HPV detected in cervical cancer). After screening 160 anogenital biopsies, four specimens exhibited histological features of intraepithelial neoplasia and contained HPV66 sequences. Of these, three were found to be associated with another HPV type.

  18. Time course and incidence of late complications in patients treated with radiation therapy for FIGO Stage IB carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Purpose: To determine the time course and incidence of late complications from radiation therapy in patients treated with radiation for FIGO Stage IB carcinoma of the uterine cervix, and to evaluate patient and tumor factors associated with an increased probability of treatment complications. Methods and Materials: The medical records of 1784 patients with FIGO Stage IB cervical carcinoma who were treated with initial radiation therapy between 1960 and 1989 were retrospectively reviewed. Follow-up was obtained from clinic visits and correspondence with patients and their physicians. Treatment complications were graded retrospectively. Complication rates were calculated actuarially; patients who died of disease or intercurrent illness without experiencing a major complication were censored at the time of death. There were 1241, 924, 548, and 274 patients followed for more than 5, 10, 15, and 20 years, respectively. Results: Of patients treated for Stage IB cervical carcinoma, 7.7% and 9.3% had experienced major (≥Grade 3) complications at 3 and 5 years, respectively. After 5 years, there was a small but continuous risk of approximately 0.34% per year, resulting in an overall actuarial risk of having had major complications of 14.4% at 20 years. The risk of developing major urinary tract complications was approximately 0.7% per year for the first 3 years of follow-up, decreasing to about 0.25% per year for at least 25 years. In contrast, the risk of developing rectal complications was about 1% per year during the first 2 years, with a subsequent sharp decline to about 0.06% per year between Years 2 and 25. The risk of fistula formation was approximately doubled in the 234 patients who underwent adjuvant extrafascial hysterectomy (5.3 vs. 2.6% at 20 years; p = 0.04) and in the 111 patients who had pretreatment laparotomy (5.2 vs. 2.9%; p = 0.007). The risk of developing small bowel obstruction was increased in patients who underwent pretreatment laparotomy (14.5 vs

  19. Development of uterine neoplasms following radiotherapy for carcinoma of uterine cervix: a clinical evaluation of 47 patients

    International Nuclear Information System (INIS)

    Objective: To analysis the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods: The clinical data of 47 patients of uterine neoplasm developed following radiotherapy for uterine cervical carcinoma were retrospectively reviewed. Results: The median age on diagnosis of uterine neoplasms was 62 years (range 38-77), and the median latency from the initial therapy to the development of uterine neoplasm was 14 years (range 5-35). Thirty of 47 patients had endometrial carcinoma, of which 3 were uterine papillary serous carcinoma(UPSC). Seventeen of 47 patients had uterine sarcoma, all of which were carcinosarcoma. The distribution by stage, grade, and histology of 30 patients with endometrial carcinoma was: stage Ib, 1 patient; stage Ic, 2 patients; stage II, 6; stage III a, 4; stage III b, 2; stage III c, 11; stage IV, 4; grade 1, 2 patients; grade 2, 9; grade 3 (include 3 UPSC patients), 17; unknown grade, 2; endometriod, 27; UPSC, 3. Seven of 30 patients with en- dometrial carcinoma deleloped recurrence, at median time of 24 months. Their median survival time was 26 m. The overall 3- and 5-year survival rate was 60% and 38%, respectively. Of the 17 patients with uterine sarcoma, the median survival was 10 months. Six patients developed recurrence, at a median time of 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rate was 12% and 0, respectively. Conclnsions: The main uterine neoplasm developed after radiotherapy for uterine cervical carcinoma is endometrial carcinoma, of which there is a preponderance of high-risk histological subtype and poor prognosis. Most of the uterine sarcoma which occur following radiation therapy for uterine cervical carcinoma is carcinosarcoma and its prognosis is very poor. (authors)

  20. Dual Tracer PET Imaging with FDG and FLT Differentiates Tuberculous Lymphadenopathy from Metastases in a Case of Carcinoma Cervix

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Prathamesh; Lele, Vikram; Aland, Parag; Gemawat, Shilpa [Jaslok Hospital and Research Centre, Woril (India)

    2013-09-15

    A forty-year-old woman with a known case of carcinoma cervix underwent 18-fluorodeoxyglucose positron emission tomography.computed tomography (18-FDG PET/CT) for evaluation of abdominal lymphadenopathy. Her treatment history included radical hysterectomy and radiotherapy 6 months ago. She complained of weight loss of 7 kg over last 5 months. The maximum intensity projection (MIP) image (Fig. 1a, arrows) revealed multiple areas of intense FDG uptake, which on CT and fused PET/CT images were localized to multiple lymph nodes in bilateral cervical region, right axilla, mediastinum and abdomen. The SUVmax of right axillary lymph nodes (most FDG avid of all lymph node groups) was 15.3. There was no evidence of metabolically active disease or CT demonstrable abnormality in rest of the body. Presence of metabolically active disease in extensive supradiaphramatic lymphadenopathy was unusual for a case of carcinoma cervix. This finding, along with history of significant weight loss and absence of extranodal disease, was suspicious for unrelated pathology like lymphoproliferative disorder or granulomatous disease. Mixed malignant and benign lymphadenopathy was also considered a possibility. To solve the conundrum, 18-fluoro-L-thymidine (FLT) PET/CT was performed on the next day. This scan was performed to assess the proliferation rate in various above-mentioned lymph nodes, and to plan the optimum site of biopsy. The FLT PET scan (Fig. 1b) showed physiological distribution of the tracer in bone marrow, liver, gall bladder and urinary bladder. There was minimal FLT uptake in the enlarged, FDG avid lymph nodes (Fig. 1c and d). SUVmax of FLT uptake in right axillary lymph nodes was 1.4 (SUVmax of FDG uptake = 15.8). The SUVmax of FLT uptake in cervical, mediastinal and abdominal lymph nodes were 1.3, 1.4 and 1.0 respectively. (SUVmax of FDG uptake 12.1, 12.7 and 11.9, respectively). Considering avidity for FDG and non-avidity of proliferation marker tracer (FLT), possibility of

  1. Dual Tracer PET Imaging with FDG and FLT Differentiates Tuberculous Lymphadenopathy from Metastases in a Case of Carcinoma Cervix

    International Nuclear Information System (INIS)

    A forty-year-old woman with a known case of carcinoma cervix underwent 18-fluorodeoxyglucose positron emission tomography.computed tomography (18-FDG PET/CT) for evaluation of abdominal lymphadenopathy. Her treatment history included radical hysterectomy and radiotherapy 6 months ago. She complained of weight loss of 7 kg over last 5 months. The maximum intensity projection (MIP) image (Fig. 1a, arrows) revealed multiple areas of intense FDG uptake, which on CT and fused PET/CT images were localized to multiple lymph nodes in bilateral cervical region, right axilla, mediastinum and abdomen. The SUVmax of right axillary lymph nodes (most FDG avid of all lymph node groups) was 15.3. There was no evidence of metabolically active disease or CT demonstrable abnormality in rest of the body. Presence of metabolically active disease in extensive supradiaphramatic lymphadenopathy was unusual for a case of carcinoma cervix. This finding, along with history of significant weight loss and absence of extranodal disease, was suspicious for unrelated pathology like lymphoproliferative disorder or granulomatous disease. Mixed malignant and benign lymphadenopathy was also considered a possibility. To solve the conundrum, 18-fluoro-L-thymidine (FLT) PET/CT was performed on the next day. This scan was performed to assess the proliferation rate in various above-mentioned lymph nodes, and to plan the optimum site of biopsy. The FLT PET scan (Fig. 1b) showed physiological distribution of the tracer in bone marrow, liver, gall bladder and urinary bladder. There was minimal FLT uptake in the enlarged, FDG avid lymph nodes (Fig. 1c and d). SUVmax of FLT uptake in right axillary lymph nodes was 1.4 (SUVmax of FDG uptake = 15.8). The SUVmax of FLT uptake in cervical, mediastinal and abdominal lymph nodes were 1.3, 1.4 and 1.0 respectively. (SUVmax of FDG uptake 12.1, 12.7 and 11.9, respectively). Considering avidity for FDG and non-avidity of proliferation marker tracer (FLT), possibility of

  2. Radiation injuries of the pelvis and proximal parts of the femur after irradiation of carcinoma of the cervix uteri

    International Nuclear Information System (INIS)

    Data relating to 244 patients with carcinoma of the cervix uteri treated by intensive radiotherapy are given. Radiation injury of bone was diagnosed in 12 cases (4.9 +/- 1.4 percent). After x-ray therapy alone they were found in five of 59 patients treated (8.5 +/- 3.6 percent), and after γ-ray therapy in one of 171 cases (0.6 +/- 0.6 percent). The minimal focal dose of x-ray therapy causing radiation injury to bone was 5,000 rads. With an increase in dose, the frequency of injuries also increased. Radiation injury was found after γ-ray therapy with an absorbed dose of 7,000 rads. The radiological features of radiation injury of bones after irradiation of malignant tumors of the pelvis are increasing osteoporosis and the appearance of foci of sclerosis and osteolysis. Necrotic areas of various sizes may be formed. A fracture of the neck of the femur may be prevented in some cases by taking precautionary measures. Healing of an injured part depends on the size of the dose given. Large doses completely suppressed the reparative powers of the bone. Unlike changes that are traumatic in nature, radiation fractures of the pelvic bones and the proximal part of the femur have a mild clinical course; sometimes the patients continue to use the lower limb, simply complaining of pain that may vary in severity. Metastasization of tumors of the uterus to the pelvic bones is possible but infrequent. Metastases are usually associated with increasing pain

  3. Risk of late rectal complications following definitive external radiotherapy and high dose rate intracavitary irradiation for FIGO stage IIB carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Purpose: To correlate several dosimetric parameters with late rectal complications in patients treated with a combination of external radiotherapy and high dose rate(HDR) intracavitary irradiation(ICR) for FIGO stage IIB carcinoma of the cervix, retrospectively. Materials and Methods: Between 1990 and 1992, 88 patients with stage IIB cervical carcinoma underwent treatment with definitive radiotherapy alone and had a minimum of 2 years of follow up at the Department of Radiation Oncology in Yonsei Cancer Center. The median patient age was 57 years. Radiotherapy consisted of 44-54 Gy(median 49 Gy) external beam followed by a high dose rate intracavitary irradiation 5 Gy per fraction given twice a week, to a total dose of 30 Gy on point A. Parametrial boosting was administered to several patients with lateral parametrial diseases. The median dose to point A was 79.2 Gy. Late rectal complications were scored according to the Kottmeier's grading system. Rectal complications were analyzed as a function of various dosimetric factors (external whole pelvis doses, ICR rectal doses;r and dr, total rectal doses;R and DR, TDF, BED and ICR reference volumes). The maximum rectal doses to the anterior rectal mucosa by contrast media(r, R) and reference rectal point doses by ICRU 38(dr, DR) were calculated. The ICR reference volumes were calculated by the HDR planning system. The TDF (time dose fractionation factor) and BED(biologically effective dose) were also calculated. Complication probabilities were then plotted as a function of the above factors. Regression analysis and the Student's T-test were performed in order to fit data to determine an analytical relationship between complication probability and mean doses with grade 2 or 3 major rectal complications and those without them. Results: There were a total of 27(30.7%) rectal(12 grade 1, 12 grade 2, 3 grade 3) complications. We found a significant correlation between the external whole pelvis doses(midline shielding start

  4. Radiotherapy results of uterine cervix cancer stape IIB : overall survival, prognostic facters, patterns of failure and late complications

    International Nuclear Information System (INIS)

    Treatment of choice for uterine cervix cancer stage IIB is radiotherapy. We analyzed survivals, prognostic factors, patterns of failure and complications. This is a retrospective analysis of 167 patients with stage IIB carcinoma of uterine cervix treated with curative external pelvic and high dose rate intracavitary radiotherapy at the Department of Therapeutic Radiology, Soonchunhyang University Hospital from August 1985 to August 1994. All the patients followed up from 3 to 141 months(mean 60 months) and age of patients ranged from 31 to 78 years at presentation(mean : 55 years). Overall complete response rate was 84%. The response rate for squamous cell carcimoma and adenocarcinoma were 86% and 60%, respectively. Overall 5-years survival rate and disease free survival rate was 62 and 59%, respectively. Mass size and treatment response were significant prognostic factors for survival. Pathologic type and parametrial involvement were marginally significants prognostic factors. Local failure was 43 cases, distant metastasis was 14 cases and local failure plus distant metastasis was 3 cases, and most of local failures occurred within 24 months, distant metastasis within 12 months after treatment. Twenty eight(16.8%) patients developed late rectal and urinary complications There were tendency to increasing severity and frequency according to increased fractional dose and total(rectal and bladder) dose. Survival rate was significantly related to tumor size and radiotherapy response. Tumor size should be considered in the clinical staging. To increased survival and local control, clinical trials such as decreasing duration of radiotherapy or addition of chemotherapy is needed. To detect early recurrence, regular follow up after RT is important. Because total rectal and bladder dose affected late complications, meticulous vaginal packing is needed to optimize dose of normal tissues and to decrease late complications

  5. The role of squamous cell carcinoma antigen as a prognostic and predictive factor in carcinoma of uterine cervix

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Bae Kwon; Choi, Doo Ho; Huh, Seung Jae; Park, Won; Bae, Duk Soo; Kim, Byoung Gie [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    Although the role of squamous cell carcinoma antigen (SCC-Ag) as a predictive and prognostic factor for uterine cervical cancer has been identified ed in previous studies, 1) the effective patient group of screening for recurrence with SCC-Ag, 2) the relationship between SCC-Ag and recurrence site, and 3) the relationship between the change of SCC-Ag and treatment outcome or recurrence have not been described. The study included 506 patients with histologically proven uterine cervical cancer between January 1994 and December 2010. We determining the serum SCC-Ag level before treatment and after treatment, and conducted a retrospective review of the patients' records. We evaluated the sensitivity and specificity of SCC-Ag for the detection of tumor recurrence by comparing biochemical recurrence with clinical recurrence. The pretreatment SCC-Ag level and the proportion of patients over 1.5 ng/mL were higher in poor prognostic patient group. In the univariate and multivariate analysis, pretreatment SCC-Ag showed a statistically significant correlation with tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology. In patients with biochemical recurrence vs. those without, 5-year DFS and OS were 27.6 vs. 92.7% (p{<=}0.001) and 53.7 vs. 92.5% (p{<=}0.001), respectively. Our study reconfirmed the known function of pretreatment SCC-Ag, but could not confirm the function of biochemical response as a predictive factor for treatment and as a prognostic factor. There was no statistically significant relationship between SCC-Ag level and recurrence site. We confirmed the role of SCC-Ag as a follow-up tool for recurrence of disease and which patient groups SCC-Ag was more useful for.

  6. Treatment Outcome of Medium-Dose-Rate Intracavitary Brachytherapy for Carcinoma of the Uterine Cervix: Comparison With Low-Dose-Rate Intracavitary Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kaneyasu, Yuko, E-mail: kaneyasu@hiroshima-u.ac.jp [Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan); Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Kita, Midori [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Department of Clinical Radiology, Tokyo Metropolitan Tama Medical Center, Tokyo (Japan); Okawa, Tomohiko [Evaluation and Promotion Center, Utsunomiya Memorial Hospital, Tochigi (Japan); Maebayashi, Katsuya [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Kohno, Mari [Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women' s Medical University Hospital, Tokyo (Japan); Sonoda, Tatsuo; Hirabayashi, Hisae [Department of Radiology, Tokyo Women' s Medical University Hospital, Tokyo (Japan); Nagata, Yasushi [Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan); Mitsuhashi, Norio [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan)

    2012-09-01

    Purpose: To evaluate and compare the efficacy of medium-dose-rate (MDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for uterine cervical cancer. Methods and Materials: We evaluated 419 patients with squamous cell carcinoma of the cervix who were treated by radical radiotherapy with curative intent at Tokyo Women's Medical University from 1969 to 1999. LDR was used from 1969 to 1986, and MDR has been used since July 1987. When compared with LDR, fraction dose was decreased and fraction size was increased (1 or 2 fractions) for MDR to make the total dose of MDR equal to that of LDR. In general, the patients received a total dose of 60 to 70 Gy at Point A with external beam radiotherapy combined with brachytherapy according to the International Federation of Gynecology and Obstetrics stage. In the LDR group, 32 patients had Stage I disease, 81 had Stage II, 182 had Stage III, and 29 had Stage IVA; in the MDR group, 9 patients had Stage I disease, 19 had Stage II, 55 had Stage III, and 12 had Stage IVA. Results: The 5-year overall survival rates for Stages I, II, III, and IVA in the LDR group were 78%, 72%, 55%, and 34%, respectively. In the MDR group, the 5-year overall survival rates were 100%, 68%, 52%, and 42%, respectively. No significant statistical differences were seen between the two groups. The actuarial rates of late complications Grade 2 or greater at 5 years for the rectum, bladder, and small intestine in the LDR group were 11.1%, 5.8%, and 2.0%, respectively. The rates for the MDR group were 11.7%, 4.2%, and 2.6%, respectively, all of which were without statistical differences. Conclusion: These data suggest that MDR ICBT is effective, useful, and equally as good as LDR ICBT in daytime (about 5 hours) treatments of patients with cervical cancer.

  7. Treatment Outcome of Medium-Dose-Rate Intracavitary Brachytherapy for Carcinoma of the Uterine Cervix: Comparison With Low-Dose-Rate Intracavitary Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate and compare the efficacy of medium-dose-rate (MDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for uterine cervical cancer. Methods and Materials: We evaluated 419 patients with squamous cell carcinoma of the cervix who were treated by radical radiotherapy with curative intent at Tokyo Women’s Medical University from 1969 to 1999. LDR was used from 1969 to 1986, and MDR has been used since July 1987. When compared with LDR, fraction dose was decreased and fraction size was increased (1 or 2 fractions) for MDR to make the total dose of MDR equal to that of LDR. In general, the patients received a total dose of 60 to 70 Gy at Point A with external beam radiotherapy combined with brachytherapy according to the International Federation of Gynecology and Obstetrics stage. In the LDR group, 32 patients had Stage I disease, 81 had Stage II, 182 had Stage III, and 29 had Stage IVA; in the MDR group, 9 patients had Stage I disease, 19 had Stage II, 55 had Stage III, and 12 had Stage IVA. Results: The 5-year overall survival rates for Stages I, II, III, and IVA in the LDR group were 78%, 72%, 55%, and 34%, respectively. In the MDR group, the 5-year overall survival rates were 100%, 68%, 52%, and 42%, respectively. No significant statistical differences were seen between the two groups. The actuarial rates of late complications Grade 2 or greater at 5 years for the rectum, bladder, and small intestine in the LDR group were 11.1%, 5.8%, and 2.0%, respectively. The rates for the MDR group were 11.7%, 4.2%, and 2.6%, respectively, all of which were without statistical differences. Conclusion: These data suggest that MDR ICBT is effective, useful, and equally as good as LDR ICBT in daytime (about 5 hours) treatments of patients with cervical cancer.

  8. A prospective dosimetric and clinical comparison of acute hematological toxicities in three-dimensional conformal radiation therapy and intensity modulated radiation therapy with concurrent chemotherapy in carcinoma cervix

    Directory of Open Access Journals (Sweden)

    H U Avinash

    2015-01-01

    Full Text Available Background and Objectives: Acute hematological toxicities are an important cause of morbidity in patients receiving concurrent chemoradiation to pelvis in carcinoma cervix. The objective of this study was to evaluate the role of intensity-modulated radiotherapy (IMRT in reducing the dose to the bone marrow as compared with three-dimensional conformal radiotherapy (3DCRT and hence its impact on reducing the acute hematological toxicities. Materials and Methods: Eleven consecutive patients treated with IMRT and 12 patients treated with 3DCRT to the whole pelvis along with concurrent chemotherapy were selected. Bone marrow was delineated. V10 Gy, V20 Gy, V95%, and Dmean of bone marrow were recorded. Weekly blood counts were recorded and graded as per Common Terminology Criteria version 4.0 for all the patients. Results: The dose to the bone marrow V20 Gy was 206.78 ± 57.10 cc (75% and 251.70 ± 40.45 cc (91% for IMRT and 3DCRT, respectively (P = 0.04 and V95% was 23.30 ± 8.34% and 46.76 ± 6.71% for IMRT and 3DCRT, respectively (P = 0.001. The grade of toxicities during each week did not show the difference in either arm. However, the total count and Neutrophil counts during the 2nd week showed statistical significance between IMRT and 3DCRT. Conclusion: IMRT significantly reduces the dose to the bone marrow as compared to 3DCRT. The reduction of the dose did not translate into a decrease in acute hematological toxicities. Concurrent platinum-based chemotherapy is the probable cause for the hematological toxicities.

  9. Comparative analysis of 2D and 3D dosimetry with brachytherapy high dose rate cervix carcinoma un operated; Analisis comparativo de dosimetria 2D y 3D con braquiterapia de alta tasa de dosis

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Castejon, M. A.; Penedo Cobos, J. M.; Rincon Perez, M.; Gomez Alonso, S.; Luna Tirado, J.; Perez Casas, A. M.

    2011-07-01

    It has recently been installed in our department based on an SPB CT images, and found that the dose at points H is less than that obtained by calculations based on radiographs. This study aims to analyze this discrepancy in the transition from 2D to 3D calculation in patients with carcinoma of the cervix not operated.

  10. Coexpression of cyclooxygenase-2 and thymidine phosphorylase as a prognostic indicator in patients with FIGO stage IIB squamous cell carcinoma of uterine cervix treated with radiotherapy and concurrent chemotherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate the prognostic significance of thymidine phosphorylase (TP) and coexpression of cyclooxygenase-2 (COX-2)/TP, and to investigate the relationship between COX-2 and TP expression in squamous cell carcinoma of the uterine cervix. Methods and Materials: Cancer specimens from 75 patients with International Federation of Gynecology and Obstetrics Stage IIB squamous cell carcinoma of the uterine cervix who had undergone radiotherapy and concurrent chemotherapy were immunohistochemically stained with COX-2 and TP antibodies and scored. The prognostic significance of their expression status, and the relationship between COX-2 and TP was investigated. Results: TP predominantly stained cytoplasm and the cell membrane of the tumor cells mainly in a diffuse and intense manner. TP was negative (50%) in 57% of patients. TP overexpression was related to a marginal prognostic significance of a poor 5-year overall survival (p = 0.082, log-rank test) and a high locoregional recurrence rate (p < 0.1, chi-square test). COX-2 and TP coexpression was observed in 24% of patients and was significantly related to poor 5-year disease-free and overall survival rates (p = 0.0083 and p 0.025, respectively), a high pelvic lymph node involvement rate, a poor response to treatment, and a greater incidence of locoregional recurrence (p < 0.05). By multivariate analyses, only COX-2, TP, and coexpression of COX-2/TP were significant independent prognostic indicators of patient survival. All tumors showed 1+ or 2+ TP expression when COX-2 was positive, and no tumor expressed COX-2 when TP was negative (p = 0.03). In contrast, 77% of tumors expressed 1+ or 2+ TP without the synchronous expression of COX-2. Conclusions: Thymidine phosphorylase expression or COX-2/TP coexpression may be used as a molecular prognostic marker for squamous cell carcinoma of the uterine cervix. TP appears to be an important downstream molecule of COX-2 during angiogenesis and may be a new target for the

  11. 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

  12. Severe radiation morbidity in carcinoma of the cervix: impact of pretherapy surgical staging and previous surgery

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study is to delineate the factors which (a) contribute to an increase in the severe, radiation induced complication rate and (b) have a significant effect on survival in patients with International Federation of Gynecologists and Obstetricians (FIGO) Stage I-IVA cervical cancer undergoing pretherapy surgical staging. Methods and Materials: From 1971-1991, 189 patients underwent pretherapy surgical staging via a retroperitoneal approach (67) or transperitoneal approach (122). Seventy-nine patients had previously experienced a laparotomy. Patients subsequently received a median of 85 Gy to point A. In patients receiving paraaortic radiation, a median of 45 Gy was administered. One hundred and thirty-two (69.8%) patients received hydroxyurea as a radiation sensitizer. Results: Pretherapy surgical evaluation revealed that 21 of 89 (23.6%) Stage II patients and 32 of 85 (37.6%) Stage III patients had paraaortic lymph node metastases. Multivariate logistic regression analysis detailed the significant factors favorably influencing the radiation-induced complication rate to be a retroperitoneal approach of pretherapy surgical staging and no previous laparotomy. Survival was significantly prolonged in patients receiving hydroxyurea, evaluated via a retroperitoneal incision, with negative paraaortic lymph nodes, and with an early stage of disease. Conclusion: A retroperitoneal approach to pretherapy surgical staging and absence of previous surgery reduced the incidence of subsequent radiation-induced complications. Despite improvements in the detection of occult disease, prolonged survival is impaired when the therapeutic measures currently available are used

  13. Second cancers after squamous cell carcinoma and adenocarcinoma of the cervix

    DEFF Research Database (Denmark)

    Chaturvedi, Anil K; Kleinerman, Ruth A; Hildesheim, Allan;

    2008-01-01

    METHODS: We assessed second cancer risk among 85,109 cervical SCC and 10,280 AC survivors reported to population-based cancer registries in Denmark, Finland, Norway, Sweden, and the United States. Risks compared to the general population were assessed using standardized incidence ratios (SIR). RESULTS......: Overall cancer risk was significantly increased among both cervical SCC survivors (n = 10,559 second cancers; SIR, 1.31; 95% CI, 1.29 to 1.34) and AC survivors (n = 920 second cancers; SIR, 1.29; 95% CI, 1.22 to 1.38). Risks of HPV-related and radiation-related cancers were increased to a similar extent...... among cervical SCC and AC survivors. Although significantly increased in both groups when compared with the general population, risk of smoking-related cancers was significantly higher among cervical SCC than AC survivors (P = .015; SIR for cervical SCC = 2.07 v AC = 1.78). This difference was limited...

  14. Prognostic value of vascular endothelial growth factor in Stage IB carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Purpose: To clarify the role of vascular endothelial growth factor (VEGF) expression as an independent prognostic factor in Stage IB cervical cancer. Methods and Materials: A total of 117 patients with Stage IB cervical cancer who had undergone radical hysterectomy and pelvic lymph node dissection with complete histopathologic examination were included. Eighty-eight (75.2%) patients received postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry. Results: Of 117 patients, 35 (29.9%) showed high-intensity VEGF expression and 69 (59%) had a high score for area of VEGF expression. Strong correlations were found between high VEGF intensity and both deep stromal invasion (p=0.01) and positive pelvic lymph nodes (p=0.03). The area of VEGF expression was significantly associated with tumor size (p=0.02). In a multivariate analysis, high VEGF intensity (p=0.009) and tumor size (p=0.01) were significant prognostic factors for overall survival and disease-free survival (p=0.001 and p=0.003, respectively). However, the area of VEGF expression was not a prognostic factor for overall survival or disease-free survival. Conclusion: Our findings on the correlation between VEGF expression and prognosis were conflicting. Functional and quantitative tools to assess tumor angiogenesis in addition to the expression of VEGF need to be developed and would be helpful to support the finding that tumor angiogenesis correlates significantly with prognosis in early-stage cervical cancer

  15. Magnetic resonance imaging in carcinoma cervix- Does it have a prognostic relevance

    Directory of Open Access Journals (Sweden)

    Sethi Tejinder

    2005-01-01

    Full Text Available PURPOSE: To evaluate the prognostic relevance of tumor size as determined on Magnetic Resonance Imaging (MRI in cervical cancer. METHODS AND MATERIALS: A total of 70 consecutive patients were included in the study. 15 patients underwent surgery alone (Group A, 27 patients underwent surgery followed by adjuvant radiation (Group B, 14 patients underwent concomitant chemo radiation (Group C, and 14 patients underwent radical radiation alone (Group D. External radiation was delivered followed by intra cavitary brachytherapy. Serial MRI scans were performed in all patients before and after completion of treatment on a 1.0 Tesla MRI scanner. Patients were divided into three groups based upon MR volumes < 40 cc, 40-99 cc and > 100 cc. A correlation between MR volume, FIGO stage, disease free survival (DFS and overall survival (OS was done. Disease free and overall survivals were calculated using Kaplan Meier survival curves according to stage, MR volume and treatment protocol. RESULTS: In group I (MR volume < 40 cc, 44% of patients had stage I disease, 47% of patients with stage II and 9% patients had stage III disease. In group II (MR volume 40-99 cc, 35% patients had stage I, 45% had stage II disease and 10% had stage III and IV disease each. In group III (MR volume > 100 cc, 57% patients had stage II, 14% had stage III and 29% patients had stage IV disease. The DFS and OS did not achieve a level of statistical significance when evaluated as per protocol [DFS at p = 0.0685 and OS p = 0.3242], however a statistical significance was seen when DFS and OS were evaluated according to MR volumes [DFS, p = 0.0015 and OS, p = 0.0001]. CONCLUSION: In cervical cancer, the volume of disease as assessed on MRI may be a better prognostic indicator than FIGO staging and needs further evaluation.

  16. Breast cancer and ductal carcinoma in situ among women with prior squamous or glandular precancer in the cervix: a register-based study

    OpenAIRE

    B. T. Hansen; Nygård, M.; Falk, R S; Hofvind, S

    2012-01-01

    Background: Human papillomavirus and hormonal contraceptives may be risk factors for cervical precancer and malignant breast tumours. Methods: Standardised incidence ratios (SIRs) of malignant breast tumours during 1970–2008 were estimated separately for women with prior squamous and glandular cervical precancer. Results: Women with squamous precancer and women with glandular precancer in the cervix had a significantly higher risk of malignant breast tumours than the general female population...

  17. Implementation of a High-Dose-Rate Brachytherapy Program for Carcinoma of the Cervix in Senegal: A Pragmatic Model for the Developing World

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    Einck, John P., E-mail: jeinck@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California (United States); Hudson, Alana [Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada); Shulman, Adam C. [Overlook Medical Center, Summit, New Jersey (United States); Yashar, Catheryn M. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California (United States); Dieng, Mamadou M.; Diagne, Magatte; Gueye, Latifatou; Gningue, Fama; Gaye, Pape M. [Départemént de Radiothérapie, Institut Joliot-Curie, Hôpital Aristide Le Dantec, Dakar (Senegal); Fisher, Brandon J. [GammaWest Cancer Services, Salt Lake City, Utah (United States); Mundt, Arno J. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California (United States); Brown, Derek W. [Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada)

    2014-07-01

    West Africa has one of the highest incidence rates of carcinoma of the cervix in the world. The vast majority of women do not have access to screening or disease treatment, leading to presentation at advanced stages and to high mortality rates. Compounding this problem is the lack of radiation treatment facilities in Senegal and many other parts of the African continent. Senegal, a country of 13 million people, had a single {sup 60}Co teletherapy unit before our involvement and no brachytherapy capabilities. Radiating Hope, a nonprofit organization whose mission is to provide radiation therapy equipment to countries in the developing world, provided a high-dose-rate afterloading unit to the cancer center for curative cervical cancer treatment. Here we describe the implementation of high-dose-rate brachytherapy in Senegal requiring a nonstandard fractionation schedule and a novel treatment planning approach as a possible blueprint to providing this technology to other developing countries.

  18. Implementation of a High-Dose-Rate Brachytherapy Program for Carcinoma of the Cervix in Senegal: A Pragmatic Model for the Developing World

    International Nuclear Information System (INIS)

    West Africa has one of the highest incidence rates of carcinoma of the cervix in the world. The vast majority of women do not have access to screening or disease treatment, leading to presentation at advanced stages and to high mortality rates. Compounding this problem is the lack of radiation treatment facilities in Senegal and many other parts of the African continent. Senegal, a country of 13 million people, had a single 60Co teletherapy unit before our involvement and no brachytherapy capabilities. Radiating Hope, a nonprofit organization whose mission is to provide radiation therapy equipment to countries in the developing world, provided a high-dose-rate afterloading unit to the cancer center for curative cervical cancer treatment. Here we describe the implementation of high-dose-rate brachytherapy in Senegal requiring a nonstandard fractionation schedule and a novel treatment planning approach as a possible blueprint to providing this technology to other developing countries

  19. Prognostic Value of Pretreatment Carcinoembryonic Antigen After Definitive Radiotherapy With or Without Concurrent Chemotherapy for Squamous Cell Carcinoma of the Uterine Cervix

    International Nuclear Information System (INIS)

    Purpose: To evaluate whether pretreatment carcinoembryonic antigen (CEA) levels have a prognostic role in patients after definitive radiotherapy for squamous cell carcinoma (SCC) of the uterine cervix. Methods and Materials: A retrospective study of 550 patients was performed. The SCC antigen (SCC-Ag) and CEA levels were regarded as elevated when they were ≥2 and ≥5 ng/mL, respectively. A total of 208 patients underwent concurrent chemoradiotherapy (CCRT). The Kaplan-Meier method was used to calculate the distant metastasis (DM), local failure (LF), disease-free survival (DFS), and overall survival (OS) rates. Multivariate analysis was performed using the Cox proportional hazards model. The hazard ratio (HR) with 95% confidence interval (CI) was evaluated for the risk of a poor prognosis. Results: Compared with the patients with normal CEA/SCC-Ag levels, CEA levels ≥10 ng/mL but without elevated SCC-Ag levels was an independent factor for LF (HR, 51.81; 95% CI, 11.51–233.23; p < .001), DM (HR, 6.04; 95% CI, 1.58–23.01; p = .008), DFS (HR, 10.17; 95% CI, 3.18–32.56; p < .001), and OS (HR, 5.75; 95% CI, 1.82–18.18; p = .003) after RT alone. However, no significant role for CEA was noted in patients with SCC-Ag levels ≥2 ng/mL. In patients undergoing CCRT, a CEA level ≥10 ng/mL was an independent factor for LF (HR, 2.50; 95% CI, 1.01–6.21; p = .047), DM (HR, 3.41; 95% CI, 1.56–7.46; p = .002), DFS (HR, 2.73; 95% CI, 1.39–5.36; p = .003), and OS (HR, 3.93; 95% CI 1.99–7.75; p < .001). A SCC-Ag level of ≥40 ng/mL was another prognostic factor for DM, DFS, and OS in patients undergoing not only CCRT, but also RT alone. The 5-year OS rate for CCRT patients with CEA <10 ng/mL and ≥10 ng/mL was 75.3% and 35.8%, respectively (p < .001). CCRT was an independent factor for better OS (HR, 0.69; 95% CI, 0.50–0.97; p = .034). Conclusion: Pretreatment CEA levels in patients with SCC of the uterine cervix provide complementary information for

  20. Trans-abdominal ultrasound (US) and magnetic resonance imaging (MRI) correlation for conformal intracavitary brachytherapy in carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Purpose: Trans-abdominal ultrasonography (US) is capable of determining size, shape, thickness, and diameter of uterus, cervix and disease at cervix or parametria. To assess the potential value of US for image-guided cervical cancer brachytherapy, we compared US-findings relevant for brachytherapy to the corresponding findings obtained from MR imaging. Materials and methods: Twenty patients with biopsy proven cervical cancer undergoing definitive radiotherapy with/without concomitant Cisplatin chemotherapy and suitable for brachytherapy were invited to participate in this study. US and MR were performed in a similar reproducible patient positioning after intracavitary application. US mid-sagittal and axial image at the level of external cervical os was acquired. Reference points D1 to D9 and distances were identified with respect to central tandem and flange, to delineate cervix, central disease, and external surface of the uterus. Results: Thirty-two applications using CT/MR compatible applicators were evaluable. The D1 and D3 reference distances which represent anterior surface had a strong correlation with R = 0.92 and 0.94 (p < 0.01). The D2 and D4 reference distances in contrast, which represent the posterior surface had a moderate (D2) and a strong (D4) correlation with R = 0.63 and 0.82 (p < 0.01). Of all, D2 reference distance showed the least correlation of MR and US. The D5 reference distance representing the fundal thickness from tandem tip had a correlation of 0.98. The reference distances for D6, D7, D8, and D9 had a correlation of 0.94, 0.82, 0.96, and 0.93, respectively. Conclusions: Our study evaluating the use of US, suggests a reasonably strong correlation with MR in delineating uterus, cervix, and central disease for 3D conformal intracavitary brachytherapy planning.

  1. Carcinoma of the intact uterine cervix treated with radiotherapy alone: a French cooperative study: update and multivariate analysis of prognostics factors

    International Nuclear Information System (INIS)

    Purpose: To determine independent prognostic factors in a group of 1875 patients with invasive carcinoma of the intact uterine cervix treated with radiotherapy alone in a French cooperative study from 1970 to 1993. Materials and Methods: Patients were staged according to the UICC-FIGO and MDAH sub staging. The distribution per FIGO stage was Ia-Ib: 25.5%; IIa: 12%; IIb: 29%; IIIa: 5%; IIIb: 25%, and IV: 3.5%. Ninety-two percent had squamous cell carcinoma. The maximum diameter of the clinically detectable cervical disease was less than 3 cm in 24.5% of Stages I-II and in 10% of Stages III-IV, more than 5 cm in 13.5% of Stages I-II, and in 16% of Stages III-IV. Nodal involvement was shown on lymphangiogram in 16% of Stages I-II and in 32.5% of Stages III-IV. Results: 1) Univariate analysis of Stages I and II: stage, cervical disease diameter, and nodal involvement are significant prognostic factors. Five-year specific survival rate (5ySS) is 83.5% in Stage Ib, 81% in IIa and 71% in IIb. Five-year disease-free survival rate (5yDFS) is 86% in tumors less of 3 cm, 76% in tumors of 3 to 5 cm, and 61.5% in tumor larger than 5 cm. Lymph angiogram strongly influences the 5-year pelvic disease-free survival rate (5yPDFS): respectively, 90% in non positive lymph angiogram vs. 65% when positive. A significant drop in specific and disease-free survival is observed (10 and 14%, respectively (p = 0.04) when comparing adenocarcinoma and squamous cell carcinoma. Age is a significant prognostic factor for specific survival because patients aged less than 30 years old have 91% vs. about 75% for patients over 30 years (p = 0.03). 2) Univariate analysis of Stages III-IV: Stage and positive lymph angiogram are predictive factors for relapse and death. The MDAH sub staging is more reliable to predict the probability of pelvic disease-free survival in Stage III. At 5 years, the FIGO Stages IIIa and IIIb have a rather similar PDFS (65% vs. 59%). Conversely, the difference of survival

  2. Trends in the use of radiation and chemotherapy in the initial management of patients with carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Purpose: The Commission on Cancer of the American College of Surgeons conducts Patient Care Evaluation studies to describe practice patterns and trends in disease management. This report surveys changing strategies in the initial treatment of patients with invasive cancer of the uterine cervix. Methods and Materials: Using a standard data collection form designed by a multidisciplinary committee of specialists, cancer registrars at 703 hospitals submitted anonymous data on 11,721 total cervical cancer patients diagnosed in 1984 and 1990. Results: Between the two study years, the use of radiation as all, or a component, of the initial course of therapy declined from 70 to 60.3%, coincident with a 32.3% increase in the use of hysterectomy alone and a 33.7% reduction in the use of radiation alone. The percentage of all patients receiving combined hysterectomy and radiation (preoperative or postoperative) remained virtually unchanged--10.2% in 1984, and 9.3% in 1990. However, women who were treated by hysterectomy in 1990 were less likely to receive radiation as part of their treatment than patients treated by hysterectomy in 1984. Among patients treated by radiation without hysterectomy, the use of intracavitary brachytherapy techniques substantially exceeded interstitial brachytherapy techniques in both study years. Among patients treated by local radiation without hysterectomy, the frequency of adjunctive chemotherapy use increased from 6.9% in 1984 to 24.8% in 1990, with chemotherapy and radiation increasingly administered concurrently rather than sequentially. Although differences based on age, histology, race/ethnicity, and insurance status were observed, these general management trends were seen in all groups. Conclusions: Changes in the utilization of radiation and surgery may reflect the increasing surgical involvement of gynecologic oncologists in the management of early stage cervical cancer, rather than significant alterations in the demographics of the

  3. Early Clinical Outcomes and Toxicity of Intensity Modulated Versus Conventional Pelvic Radiation Therapy for Locally Advanced Cervix Carcinoma: A Prospective Randomized Study

    Energy Technology Data Exchange (ETDEWEB)

    Gandhi, Ajeet Kumar, E-mail: ajeetgandhi23@gmail.com [Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi (India); Sharma, Daya Nand; Rath, Goura Kisor; Julka, Pramod Kumar; Subramani, Vellaiyan; Sharma, Seema; Manigandan, Durai; Laviraj, M.A. [Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi (India); Kumar, Sunesh [Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi (India); Thulkar, Sanjay [Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi (India)

    2013-11-01

    Purpose: To evaluate the toxicity and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with whole pelvic conventional radiation therapy (WP-CRT) versus intensity modulated radiation therapy (WP-IMRT). Methods and Materials: Between January 2010 and January 2012, 44 patients with International Federation of Gynecology and Obstetrics (FIGO 2009) stage IIB-IIIB squamous cell carcinoma of the cervix were randomized to receive 50.4 Gy in 28 fractions delivered via either WP-CRT or WP-IMRT with concurrent weekly cisplatin 40 mg/m{sup 2}. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events, version 3.0, and late toxicity was graded according to the Radiation Therapy Oncology Group system. The primary and secondary endpoints were acute gastrointestinal toxicity and disease-free survival, respectively. Results: Of 44 patients, 22 patients received WP-CRT and 22 received WP-IMRT. In the WP-CRT arm, 13 patients had stage IIB disease and 9 had stage IIIB disease; in the IMRT arm, 12 patients had stage IIB disease and 10 had stage IIIB disease. The median follow-up time in the WP-CRT arm was 21.7 months (range, 10.7-37.4 months), and in the WP-IMRT arm it was 21.6 months (range, 7.7-34.4 months). At 27 months, disease-free survival was 79.4% in the WP-CRT group versus 60% in the WP-IMRT group (P=.651), and overall survival was 76% in the WP-CRT group versus 85.7% in the WP-IMRT group (P=.645). Patients in the WP-IMRT arm experienced significantly fewer grade ≥2 acute gastrointestinal toxicities (31.8% vs 63.6%, P=.034) and grade ≥3 gastrointestinal toxicities (4.5% vs 27.3%, P=.047) than did patients receiving WP-CRT and had less chronic gastrointestinal toxicity (13.6% vs 50%, P=.011). Conclusion: WP-IMRT is associated with significantly less toxicity compared with WP-CRT and has a comparable clinical outcome. Further studies with larger sample sizes and longer follow-up times are warranted to justify

  4. Early Clinical Outcomes and Toxicity of Intensity Modulated Versus Conventional Pelvic Radiation Therapy for Locally Advanced Cervix Carcinoma: A Prospective Randomized Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the toxicity and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with whole pelvic conventional radiation therapy (WP-CRT) versus intensity modulated radiation therapy (WP-IMRT). Methods and Materials: Between January 2010 and January 2012, 44 patients with International Federation of Gynecology and Obstetrics (FIGO 2009) stage IIB-IIIB squamous cell carcinoma of the cervix were randomized to receive 50.4 Gy in 28 fractions delivered via either WP-CRT or WP-IMRT with concurrent weekly cisplatin 40 mg/m2. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events, version 3.0, and late toxicity was graded according to the Radiation Therapy Oncology Group system. The primary and secondary endpoints were acute gastrointestinal toxicity and disease-free survival, respectively. Results: Of 44 patients, 22 patients received WP-CRT and 22 received WP-IMRT. In the WP-CRT arm, 13 patients had stage IIB disease and 9 had stage IIIB disease; in the IMRT arm, 12 patients had stage IIB disease and 10 had stage IIIB disease. The median follow-up time in the WP-CRT arm was 21.7 months (range, 10.7-37.4 months), and in the WP-IMRT arm it was 21.6 months (range, 7.7-34.4 months). At 27 months, disease-free survival was 79.4% in the WP-CRT group versus 60% in the WP-IMRT group (P=.651), and overall survival was 76% in the WP-CRT group versus 85.7% in the WP-IMRT group (P=.645). Patients in the WP-IMRT arm experienced significantly fewer grade ≥2 acute gastrointestinal toxicities (31.8% vs 63.6%, P=.034) and grade ≥3 gastrointestinal toxicities (4.5% vs 27.3%, P=.047) than did patients receiving WP-CRT and had less chronic gastrointestinal toxicity (13.6% vs 50%, P=.011). Conclusion: WP-IMRT is associated with significantly less toxicity compared with WP-CRT and has a comparable clinical outcome. Further studies with larger sample sizes and longer follow-up times are warranted to justify its use

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

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    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

  6. Pretreatment prognostic factors in carcinoma of the uterine cervix: a multivariable analysis of the effect of age, stage, histology and blood counts on survival

    International Nuclear Information System (INIS)

    From January, 1953 thorugh December, 1977, 910 previously untreated patients with invasive carcinoma of the uterine cervix (Stages IB-IVB) were seen at Yale-New Haven Medical Center and affiliated hospitals. An extensive retrospective analysis was undertaken in an attempt to identify prognostically significant pretreatment factors. The patients studied were uniformly staged according to the current FIGO recommendations and the majority of patients had been treated under standardized protocols combining external beam radiation therapy and intracavity radium. Pretreatment parameters - including prior medical illnesses, gross tumor characteristics, histology, and blood parameters - were studied, employing stepwise Cox regression analyses to identify the possible effects of all factors and all two-way interactions among factors on survival, disease-free survival and freedom from local-regional failure, controlling for stage of disease. FIGO stage patients age at diagnosis, pretreatment neutrophil count and hematocrit, uterine position, prior subtotal hysterectomy, histology, history of diabetes mellitus and number of pregnancies were all found to have prognostic significance. When other factors including stage of disease were controlled for, increased tumor size was associated with decreased disease-free survival and local-regional control rates

  7. Subsequent malignancies associated with carcinoma of the uterine cervix: including an analysis of the effect of patient and treatment parameters on incidence and sites of metachronous malignancies

    International Nuclear Information System (INIS)

    The incidence and sites of metachronous malignancies were retrospectively determined from the records of 763 patients seen at Yale University Medical Center and affiliated hospitals with previously untreated, invasive carcinoma of the uterine cervix from 1953-1972. These patients were treated predominantly with radiation therapy; follow-up status was known for periods of 5-25 years or until time of death in over 96% of the patients. Forty-four patients had second malignancies noted at least 6 months after the initial cervical cancer was diagnosed. The expected incidence of second malignancies was determined from the Connecticut State Tumor Registry data controlling for year of diagnosis of the cervical cancer, patient age, sex, and time at risk (person-years exposure). To correct for any error in estimation of second malignancies introduced by the existence of a latency period for the development of a second cancer, the expected incidence of malignancies was also computed for 5-year time intervals following the cervical cancer. No significant increase in second malignancies was found (observed/expected-44/36) for the entire follow-up period nor for any individual 5-year interval. However, a statistically significant increase in lung cancer and vulva-vaginal cancer was noted and a significant decrease in breast cancer was observed. Cox regression analyses were performed to study the effect of total radium exposure and total external beam treatment, adjusting for other factors. No statistically significant increased risks were found

  8. Subsequent malignancies associated with carcinoma of the uterine cervix: including an analysis of the effect of patient and treatment parameters on incidence and sites of metachronous malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kapp, D.S.; Fischer, D.; Grady, K.J.; Schwartz, P.E.

    1982-02-01

    The incidence and sites of metachronous malignancies were retrospectively determined from the records of 763 patients seen at Yale University Medical Center and affiliated hospitals with previously untreated, invasive carcinoma of the uterine cervix from 1953-1972. These patients were treated predominantly with radiation therapy; follow-up status was known for periods of 5-25 years or until time of death in over 96% of the patients. Forty-four patients had second malignancies noted at least 6 months after the initial cervical cancer was diagnosed. The expected incidence of second malignancies was determined from the Connecticut State Tumor Registry data controlling for year of diagnosis of the cervical cancer, patient age, sex, and time at risk (person-years exposure). To correct for any error in estimation of second malignancies introduced by the existence of a latency period for the development of a second cancer, the expected incidence of malignancies was also computed for 5-year time intervals following the cervical cancer. No significant increase in second malignancies was found (observed/expected-44/36) for the entire follow-up period nor for any individual 5-year interval. However, a statistically significant increase in lung cancer and vulva-vaginal cancer was noted and a significant decrease in breast cancer was observed. Cox regression analyses were performed to study the effect of total radium exposure and total external beam treatment, adjusting for other factors. No statistically significant increased risks were found.

  9. Effects of radiation therapy alone and in combination with Sizofiran on immunologic and nutritional changes in patients with carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    A total of 31 patients with carcinoma of the uterine cervix were treated with radiation therapy alone (the R group, n=16) or in combination with Sizofiran (the R+S group, n=15). A dose of 40-50 Gy was delivered to the whole pelvis. Intracavitary irradiation of 15-25 Gy was given with a remote controlled after-loading system in some of the patients. Sizofiran was intramuscularly administered at a dose of 40 mg/week. The number of peripheral white blood cells and lymphocytes was significantly decreased in the R group; however, this was not marked in the R+S group. There was no significant change in monocytes or immunosuppressive acidic protein in either group. An examination of peripheral blood lymphocyte subsets revealed a gradual decrease in CD3 in the R+S group and individually different changes in CD4 and CD8. The CD4/CD8 ratio decreased in the R group; however, it had a tendency for increase in the R+S group. The serum level of albumin, as determined as a nutritional indicator, was significantly decreased in the R group. Other nutritional indicators showed aggravation in the R group. There was, however, no change in these nutritional indicators in the R+S group. Antitumor effects were more markedly improved in the R+S group than the R group. Only half of the patients in the R group had an improvement of performance status, compared with many of the patients in the R+S group. In view of antitumor efficacy and performance status, Sizofiran is a useful adjuvant chemotherapy for radiation in the treatment of cervical carcinoma. (N.K.)

  10. Epidermoid Carcinoma of the Cervix and Pregnancy. A case presentation. Carcinoma epidermoide de cuello uterino y embarazo. Presentación de un caso.

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    Doris González Díaz

    Full Text Available

    A 25 year-old female patient with a 12 week pregnancy was presented. She was diagnosed with an ultered Pap test. She was referred to the cervix uterine pathology specialist where an exophytic lesion compatible to cervix uterine cancer in advanced stages. The treatment as well as the conduct followed by the specialist was really hard due to the patient´s pregnant condition.

    Se presenta el caso de una paciente de 25 años, con un embarazo de 12 semanas a la que se le diagnosticó una citología alterada, y que al remitirse a la consulta de patología de cuello uterino se observó una lesión exofítica compatible con un cáncer de cuello en estadio avanzado. El tratamiento y la conducta seguida fueron difíciles debido al embarazo.

     

  11. Results of surgical therapy for lung carcinoma.

    Science.gov (United States)

    Paris, F; Padilla, J; Tarazona, V; Blasco, E; Canto, A; Pastor, J; Zarza, A G

    1979-01-01

    A series of 300 pulmonary resections in patients with lung carcinoma is presented. Total survival rate of the series since the operation, including surgical mortality, was 33% at 3 years and 24% at 5 years. The survival rate and surgical criteria were correlated, having better results when standard surgery was performed. The authors emphasize that the surgical figures of the series are of great value as the surgical indications were large and nonselective, with 85% of resectability in the thoracotomies. PMID:229985

  12. Tissue and serum fluorescence spectroscopy as a marker to monitor radiation therapy in cancer of human uterine cervix

    International Nuclear Information System (INIS)

    During the development of neoplasia epithelial tissues undergo biochemical and structural changes that can manifest in tissue auto-fluorescence. Several research groups have reported the tissue fluorescence spectroscopy for the discrimination of carcinoma or human uterine cervix. And also there have been several reports on using different biomarkers for the detection of cervical cancer. It is attempted to make use of fluorescence spectroscopy technique to monitor the radiation therapy in patients with squamous cell carcinoma of cervix. The clinical samples from 10 patients with stage II and stage III B cervical cancer were analysed. The results showed significant changes in spectral characteristics in tissue fluorescence before and after radiation

  13. Early and late radiotherapeutic morbidity in 442 consecutive patients with locally advanced carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the early and late radiotherapeutic morbidity after combined external and intracavitary radiotherapy to the uterine cervix. Early morbidity was most frequently seen in the rectosigmoideum (61%) and urinary bladder (27%). Medication for early morbidity was required 68% and hospitalization in 10% of the patients. The frequencies of each late morbidity grade did not differ in relation to FIGO State while the actuarial estimates increased significantly with increasing stage. This reflects the poor prognosis in the more advanced stages, where few patients survived to develop late morbidity, and also points to the importance of latency in reporting late radiotherapeutic morbidity. In Stage IVA patients, the ratios between the actuarial estimate and the frequency of late severe rectosigmoid and urinary bladder morbidity were as high as 2.5 and 3, respectively. The highest 5-year risk (± 1 SE of the estimate) of late severe morbidity were found for the rectosignoideum (28% ± 3), small intestine (13% ± 2) and urinary bladder (10% ± 2). Rectosigmoid and urinary bladder complications constituted the most important part of the combined organ morbidity. Almost half of the patients developing late moderate rectosigmoid and one-third of those developing late moderate bladder complications, did so within one year after radiotherapy. Almost all complications were developed within 3 to 4 years after radiotherapy. The probability of surviving without recurrence and/or severe combined rectosigmoid and urinary bladder morbidity was low (23% ± 2). Actuarial estimates rather than frequencies should be reported to avoid underestimation of the risk of late radiotherapeutic morbidity in long-term survivors. 29 refs., 5 figs. 7 tabs

  14. Continuous and split-course radiotherapy in locally advanced carcinoma of the uterine cervix. Analyses of local control, distant metastases, crude survival, early and late morbidity and prognostic factors

    International Nuclear Information System (INIS)

    From 1974 to 1984, 442 consecutive patients with carcinoma of the uterine cervix were referred for combined intracavitary (IRT) and external radiotherapy (ERT). Dose prescriptions were performed based on the points A and B of the Manchester system. From 1978 the treatment strategy was changed from continuous (CRT) to split course radiotherapy (SCRT) with a higher total dose to point B, a lower dose to point A from the IRT, and a longer total treatment time (TTT). The purpose of the present thesis is: To evaluate local tumour control, distant metastases, survival and complications in the rectosigmoid and bladder in relation to treatment strategy (continuous and split course radiotherapy). To evaluate prognostic factors and importance of treatment strategy for local control, distant metastases, and survival by uni- and multivariate analyses. To develop a classification system (AADK, Aarhus, Denmark) for the recording of early and late radiation complications allowing and estimation of the importance of latency when reporting late radiotherapeutic morbidity and a rescoring of complication grade, and to compare results from AADK with those from the French-Italian glossary recording the maximal damage. To evaluate early and late radiotherapeutic morbidity and the importance of latency by comparing frequencies and actuarial estimates of late complications, to estimate the combined late organ morbidity and the probability of being alive, cured and without serious complications. (EG) (61 refs.)

  15. Recurrence in skeletal muscle from squamous cell carcinoma of the uterine cervix: a case report and review of the literature

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    Zannoni Gian

    2006-06-01

    Full Text Available Abstract Background The occurrence of skeletal muscle metastases is a very rare event. Only two cases of late skeletal muscle recurrence from cervical cancer have been documented until now. Case presentation A 38-year old patient, submitted to radical hysterectomy and pelvic lymphadenectomy for a squamous FIGO stage IB1 cervical carcinoma, presented after 76 months with a palpable, and painless swelling on the left hemithorax. MRI showed a nodule located in the context of the intercostal muscles. Pathology revealed the presence of metastasis of squamous cell carcinoma of similar morphology as the primary. On the basis of FDG-PET findings, which excluded other sites of disease, surgical excision of the lesion was performed. The patient was triaged to chemotherapy plus external radiotherapy. Conclusion A case of skeletal muscle recurrence from cervical cancer after a very long interval from primary diagnosis is reported. Muscular pain or weakness, or just a palpable mass in a patient with a history of cancer has always to raise the suspicion of muscle metastasis.

  16. Recurrence in skeletal muscle from squamous cell carcinoma of the uterine cervix: a case report and review of the literature

    International Nuclear Information System (INIS)

    The occurrence of skeletal muscle metastases is a very rare event. Only two cases of late skeletal muscle recurrence from cervical cancer have been documented until now. A 38-year old patient, submitted to radical hysterectomy and pelvic lymphadenectomy for a squamous FIGO stage IB1 cervical carcinoma, presented after 76 months with a palpable, and painless swelling on the left hemithorax. MRI showed a nodule located in the context of the intercostal muscles. Pathology revealed the presence of metastasis of squamous cell carcinoma of similar morphology as the primary. On the basis of FDG-PET findings, which excluded other sites of disease, surgical excision of the lesion was performed. The patient was triaged to chemotherapy plus external radiotherapy. A case of skeletal muscle recurrence from cervical cancer after a very long interval from primary diagnosis is reported. Muscular pain or weakness, or just a palpable mass in a patient with a history of cancer has always to raise the suspicion of muscle metastasis

  17. 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)

  18. Pretreatment carcinoembryonic antigen level is a risk factor for para-aortic lymph node recurrence in addition to squamous cell carcinoma antigen following definitive concurrent chemoradiotherapy for squamous cell carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    To identify pretreatment carcinoembryonic antigen (CEA) levels as a risk factor for para-aortic lymph node (PALN) recurrence following concurrent chemoradiotherapy (CCRT) for cervical cancer. From March 1995 to January 2008, 188 patients with squamous cell carcinoma (SCC) of the uterine cervix were analyzed retrospectively. No patient received PALN irradiation as the initial treatment. CEA and squamous cell carcinoma antigen (SCC-Ag) were measured before and after radiotherapy. PALN recurrence was detected by computer tomography (CT) scans. We analyzed the actuarial rates of PALN recurrence by using Kaplan-Meier curves. Multivariate analyses were carried out with Cox regression models. We stratified the risk groups based on the hazard ratios (HR). Both pretreatment CEA levels ≥ 10 ng/mL and SCC-Ag levels < 10 ng/mL (p < 0.001, HR = 8.838), SCC-Ag levels ≥ 40 ng/mL (p < 0.001, HR = 12.551), and SCC-Ag levels of 10-40 ng/mL (p < 0.001, HR = 4.2464) were significant factors for PALN recurrence. The corresponding 5-year PALN recurrence rates were 51.5%, 84.8%, and 27.5%, respectively. The 5-year PALN recurrence rate for patients with both low (< 10 ng/mL) SCC and CEA was only 9.6%. CEA levels ≥ 10 ng/mL or SCC-Ag levels ≥ 10 ng/mL at PALN recurrence were associated with overall survival after an isolated PALN recurrence. Pretreatment CEA levels ≥ 10 ng/mL were also associated with survival after an isolated PALN recurrence. Pretreatment CEA ≥ 10 ng/mL is an additional risk factor of PALN relapse following definitive CCRT for SCC of the uterine cervix in patients with pretreatment SCC-Ag levels < 10 ng/mL. More comprehensive examinations before CCRT and intensive follow-up schedules are suggested for early detection and salvage in patients with SCC-Ag or CEA levels ≥ 10 ng/mL

  19. Expression of Tissue factor in Adenocarcinoma and Squamous Cell Carcinoma of the Uterine Cervix: Implications for immunotherapy with hI-con1, a factor VII-IgGFc chimeric protein targeting tissue factor

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    Rutherford Thomas J

    2011-06-01

    Full Text Available Abstract Background Cervical cancer continues to be an important worldwide health problem for women. Up to 35% of patients who are diagnosed with and appropriately treated for cervical cancer will recur and treatment results are poor for recurrent disease. Given these sobering statistics, development of novel therapies for cervical cancer remains a high priority. We evaluated the expression of Tissue Factor (TF in cervical cancer and the potential of hI-con1, an antibody-like-molecule targeted against TF, as a novel form of immunotherapy against multiple primary cervical carcinoma cell lines with squamous- and adenocarcinoma histology. Methods Because TF is a transmembrane receptor for coagulation factor VII/VIIa (fVII, in this study we evaluated the in vitro expression of TF in cervical carcinoma cell lines by immunohistochemistry (IHC, real time-PCR (qRT-PCR and flow cytometry. Sensitivity to hI-con1-dependent cell-mediated-cytotoxicity (IDCC was evaluated in 5-hrs-51chromium-release-assays against cervical cancer cell lines in vitro. Results Cytoplasmic and/or membrane TF expression was observed in 8 out of 8 (100% of the tumor tissues tested by IHC and in 100% (11 out of 11 of the cervical carcinoma cell lines tested by real-time-PCR and flow cytometry but not in normal cervical keratinocytes (p = 0.0023 qRT-PCR; p = 0.0042 flow cytometry. All primary cervical cancer cell lines tested overexpressing TF, regardless of their histology, were highly sensitive to IDCC (mean killing ± SD, 56.2% ± 15.9%, range, 32.4%-76.9%, p p = 0.025 while human serum did not significantly decrease IDCC against cervical cancer cell lines (p = 0.597. Conclusions TF is highly expressed in squamous and adenocarcinoma of the uterine cervix. hI-con1 induces strong cytotoxicity against primary cervical cancer cell lines overexpressing TF and may represent a novel therapeutic agent for the treatment of cervical cancer refractory to standard treatment modalities.

  20. Expression of Tissue factor in Adenocarcinoma and Squamous Cell Carcinoma of the Uterine Cervix: Implications for immunotherapy with hI-con1, a factor VII-IgGFc chimeric protein targeting tissue factor

    International Nuclear Information System (INIS)

    Cervical cancer continues to be an important worldwide health problem for women. Up to 35% of patients who are diagnosed with and appropriately treated for cervical cancer will recur and treatment results are poor for recurrent disease. Given these sobering statistics, development of novel therapies for cervical cancer remains a high priority. We evaluated the expression of Tissue Factor (TF) in cervical cancer and the potential of hI-con1, an antibody-like-molecule targeted against TF, as a novel form of immunotherapy against multiple primary cervical carcinoma cell lines with squamous- and adenocarcinoma histology. Because TF is a transmembrane receptor for coagulation factor VII/VIIa (fVII), in this study we evaluated the in vitro expression of TF in cervical carcinoma cell lines by immunohistochemistry (IHC), real time-PCR (qRT-PCR) and flow cytometry. Sensitivity to hI-con1-dependent cell-mediated-cytotoxicity (IDCC) was evaluated in 5-hrs-51chromium-release-assays against cervical cancer cell lines in vitro. Cytoplasmic and/or membrane TF expression was observed in 8 out of 8 (100%) of the tumor tissues tested by IHC and in 100% (11 out of 11) of the cervical carcinoma cell lines tested by real-time-PCR and flow cytometry but not in normal cervical keratinocytes (p = 0.0023 qRT-PCR; p = 0.0042 flow cytometry). All primary cervical cancer cell lines tested overexpressing TF, regardless of their histology, were highly sensitive to IDCC (mean killing ± SD, 56.2% ± 15.9%, range, 32.4%-76.9%, p < 0.001), while negligible cytotoxicity was seen in the absence of hI-con1 or in the presence of rituximab-control-antibody. Low doses of interleukin-2 further increased the cytotoxic effect induced by hI-con1 (p = 0.025) while human serum did not significantly decrease IDCC against cervical cancer cell lines (p = 0.597). TF is highly expressed in squamous and adenocarcinoma of the uterine cervix. hI-con1 induces strong cytotoxicity against primary cervical cancer cell

  1. Downregulation of six microRNAs is associated with advanced stage, lymph node metastasis and poor prognosis in small cell carcinoma of the cervix.

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    Long Huang

    Full Text Available BACKGROUND: Small cell carcinoma of the cervix (SCCC is very rare, and due to the long time period required to recruit sufficient numbers of patients, there is a paucity of information regarding the prognostic factors associated with survival. MicroRNAs (miRNAs have been used as cancer-related biomarkers in a variety of tumor types, and the objective of this study was to determine whether microRNA expression profiles can predict clinical outcome in SCCC. METHODOLOGY/PRINCIPAL FINDINGS: Forty-four patients with SCCC who underwent radical hysterectomy between January 2000 and October 2009 were enrolled. Using the GeneCopoeia All-in-One™ Customized Human qPCR Primer Array, the expression profiles of 30 miRNAs associated with tumor metastasis was obtained from the formalin-fixed paraffin embedded samples of all 44 patients. Seven miRNAs, has-let-7c, has-miR-10b, has-miR-100, has-miR-125b, has-miR-143, has-miR-145 and has-miR-199a-5p were significantly down-regulated in advanced stage SCCC patients (FIGO IB2-IV compared to early stage SCCC patients (FIGOIB1. Among, downregulation of six miRNAs, has-let-7c, has-miR-100, has-miR-125b, has-miR-143, has-miR-145 and has-miR-199a-5p were significantly associated with lymph node metastasis and reduced survival in SCCC. Kaplan-Meier survival analyses revealed that SCCC patients with low expression of has-miR-100 (P = 0.019 and has-miR-125b (P = 0.020 projected a significant tendency towards poorer prognosis. CONCLUSIONS/SIGNIFICANCE: This study demonstrates that downregulation of 7 miRNA associated with advanced stage, 6 miRNAs with metastasis and 2 with poor prognosis in SCCC. Functional analysis of these miRNAs may enhance our understanding of SCCC, as altered expression of specific miRNAs may regulate the metastatic pathway and provide novel targets for therapy.

  2. More Accurate Definition of Clinical Target Volume Based on the Measurement of Microscopic Extensions of the Primary Tumor Toward the Uterus Body in International Federation of Gynecology and Obstetrics Ib-IIa Squamous Cell Carcinoma of the Cervix

    International Nuclear Information System (INIS)

    Purpose: To more accurately define clinical target volume for cervical cancer radiation treatment planning by evaluating tumor microscopic extension toward the uterus body (METU) in International Federation of Gynecology and Obstetrics stage Ib-IIa squamous cell carcinoma of the cervix (SCCC). Patients and Methods: In this multicenter study, surgical resection specimens from 318 cases of stage Ib-IIa SCCC that underwent radical hysterectomy were included. Patients who had undergone preoperative chemotherapy, radiation, or both were excluded from this study. Microscopic extension of primary tumor toward the uterus body was measured. The association between other pathologic factors and METU was analyzed. Results: Microscopic extension toward the uterus body was not common, with only 12.3% of patients (39 of 318) demonstrating METU. The mean (±SD) distance of METU was 0.32 ± 1.079 mm (range, 0-10 mm). Lymphovascular space invasion was associated with METU distance and occurrence rate. A margin of 5 mm added to gross tumor would adequately cover 99.4% and 99% of the METU in the whole group and in patients with lymphovascular space invasion, respectively. Conclusion: According to our analysis of 318 SCCC specimens for METU, using a 5-mm gross tumor volume to clinical target volume margin in the direction of the uterus should be adequate for International Federation of Gynecology and Obstetrics stage Ib-IIa SCCC. Considering the discrepancy between imaging and pathologic methods in determining gross tumor volume extent, we recommend a safer 10-mm margin in the uterine direction as the standard for clinical practice when using MRI for contouring tumor volume

  3. More Accurate Definition of Clinical Target Volume Based on the Measurement of Microscopic Extensions of the Primary Tumor Toward the Uterus Body in International Federation of Gynecology and Obstetrics Ib-IIa Squamous Cell Carcinoma of the Cervix

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    Xie, Wen-Jia [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Wu, Xiao [Department of Pathology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Xue, Ren-Liang; Lin, Xiang-Ying [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Kidd, Elizabeth A. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Yan, Shu-Mei [Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province (China); Zhang, Yao-Hong [Department of Radiation Oncology, Chaozhou Hospital of Chaozhou City, Guangdong Province (China); Zhai, Tian-Tian; Lu, Jia-Yang; Wu, Li-Li; Zhang, Hao [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Huang, Hai-Hua [Department of Pathology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Chen, Zhi-Jian; Li, De-Rui [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China); Xie, Liang-Xi, E-mail: xieliangxi1@qq.com [Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province (China)

    2015-01-01

    Purpose: To more accurately define clinical target volume for cervical cancer radiation treatment planning by evaluating tumor microscopic extension toward the uterus body (METU) in International Federation of Gynecology and Obstetrics stage Ib-IIa squamous cell carcinoma of the cervix (SCCC). Patients and Methods: In this multicenter study, surgical resection specimens from 318 cases of stage Ib-IIa SCCC that underwent radical hysterectomy were included. Patients who had undergone preoperative chemotherapy, radiation, or both were excluded from this study. Microscopic extension of primary tumor toward the uterus body was measured. The association between other pathologic factors and METU was analyzed. Results: Microscopic extension toward the uterus body was not common, with only 12.3% of patients (39 of 318) demonstrating METU. The mean (±SD) distance of METU was 0.32 ± 1.079 mm (range, 0-10 mm). Lymphovascular space invasion was associated with METU distance and occurrence rate. A margin of 5 mm added to gross tumor would adequately cover 99.4% and 99% of the METU in the whole group and in patients with lymphovascular space invasion, respectively. Conclusion: According to our analysis of 318 SCCC specimens for METU, using a 5-mm gross tumor volume to clinical target volume margin in the direction of the uterus should be adequate for International Federation of Gynecology and Obstetrics stage Ib-IIa SCCC. Considering the discrepancy between imaging and pathologic methods in determining gross tumor volume extent, we recommend a safer 10-mm margin in the uterine direction as the standard for clinical practice when using MRI for contouring tumor volume.

  4. Carcinoma of the uterine cervix. High-resolution turbo spin-echo MR imaging with contrast-enhanced dynamic scanning and T2-weighting

    International Nuclear Information System (INIS)

    Purpose: To compare high-resolution contrast-enhanced (Gd-DTPA) dynamic MR imaging with T2-weighted turbo spin-echo (TSE) imaging in the evaluation of uterine cervical carcinoma. Material and Methods: Thirty-two patients with cervical carcinoma underwent MR imaging on a 1.5 T superconductive unit to have the extension of the disease assessed before treatment. A phased-array coil was used in all patients. In 25 patients, surgical confirmation of the diagnosis was obtained after imaging. Radiation therapy was selected for the remaining 7 patients with advanced carcinoma. Qualitative and quantitative image analyses were also performed. Results: The cervical carcinomas showed maximum contrast in the cervical stroma and myometrium in the early dynamic phase. The tumor/cervical-stroma contrast in the early dynamic phase obtained with the T1-weighted TSE technique (contrast-to-noise ratio 22.6) was significantly higher than that obtained in T2-weighted TSE imaging (contrast-to-noise ratio 4.3). In the evaluation of parametrial invasion, the accuracy of T2-weighted imaging was 71.8% and contrast-enhanced dynamic imaging 81.2%. Conclusion: High-resolution contrast-enhanced (Gd-DTPA) dynamic MR imaging in cervical cancer offers improved tumor/cervical-stroma contrast and provides useful information on parametrial invasion. (orig.)

  5. Evaluation of late morbidity in patients with carcinoma of the uterine cervix following a dose rate change

    International Nuclear Information System (INIS)

    Background: A retrospective analysis of late complications for patients with cervical cancer treated with two different brachytherapy schedules in one institute, using the French-Italian glossary. Materials and methods: From 1979 until 1986, a total of 77 patients were treated with external radiation followed by two intracavitary applications with the Gynatron Cs-137 afterloading (dose rate 0. 54 Gy/h). After 1986, 66 patients received intracavitary applications with Selectron-LDR (dose rate 1.07 Gy/h). Because of the expected increase in complications with increasing dose rate, the dose per application was reduced from 25 Gy to 20 Gy. Results: 49/77 late gastrointestinal and urinary complications were scored in the Gynatron group and 46/68 in the Selectron group. Actuarial estimates at 5 years showed 42% and 54.1% late gastrointestinal complications and 16.9% and 24.1% for late urinary complications in the patients treated with, respectively, the Gynatron and Selectron. Conclusions: Despite the dose reduction, there remains a clear dose rate influence on the late morbidity. Correction for this influence is essential

  6. Late radiotherapeutic morbidity in patients with carcinoma of the uterine cervix: the application of the French-Italian glossary

    International Nuclear Information System (INIS)

    Background and purpose. The aim of this study was to perform a retrospective analysis of the complications observed and the importance of delayed symptoms for radiotherapeutic morbidity in patients treated by radiotherapy alone for cervical cancer. Materials and methods. From 1979 to 1991, 145 patients with primary uterine cervical cancer were treated with external radiotherapy and intracavitary applications. During the follow-up, all signs, symptoms and therapy of late treatment complications were recorded. Complications were graded according to the French-Italian glossary. This glossary is used for recording morbidity after treatment of gynaecological cancer. Results. Overall, 119 late complications were recorded. They were most frequently located in the gastro-intestinal system (53%) with a median time to development of 9 months. Urinary complications were recorded in 20%. Very few complications were recorded in vagina/uterus (12%) and pelvic soft tissue (5%). The probability of surviving without tumour recurrence and/or late combined moderate to severe organ morbidity decreased with increasing FIGO stage. Conclusions. For reporting gynaecological morbidity, the French-Italian glossary is useful. Treatment optimization must take into account actuarial estimates of survival and morbidity

  7. [Human papillomavirus and carcinoma of the cervix vaccines against the human papillomavirus-promise of an efficacious prevention].

    Science.gov (United States)

    Kohl, Igor

    2006-06-01

    The persistent infection with high-risk (oncogenic) HPV types is the necessary cause of cervical cancer. HPV types 16 and 18 are the most important of the high-risk types all around the world. The low risk HPV types, include type 6, 11 and next, cause either benign genital warts or low-grade intraepithelial lesions. Cervical cancer is the third most important cause of cancer deaths in women worldwide, after, first, breast cancer and, second, lung cancer, and the leading cause of cancer deaths in women in the developing world. Every year, half a million women around the world are diagnosed as new cases, and more than 270,000 die from this disease. The majority of deaths, around 80 %, occur in developing countries (in Latin America and Sub-Saharan Africa). The main reason for these variations in incidence is probably the availability of screening programmes in many developed countries but not in poorer developing countries. Pap smear testing forms the basis of cervical cancer screening programmes round the world. A well-implemented screening programme can reduce the incidence of cervical cancer in a country by approximately 80 %. Although useful is fully implemented, a cytology-based screening programme does have limitations. It cannot prevent infection with high-risk HPV or the subsequent development of pre-cancerous lesions. It is also a very expensive and demanding system to set up and maintain. Knowledge that cervical cancer is caused by viral infection provided the exceptional way to use a vaccination as the next tool of cervical cancer prevention. There are the only two realistic approaches for the prevention of cervical cancer--cervical screening and vaccination. Vaccination of a healthy individual to protect them against a disease is an excellent example of primary prevention. Two pharmaceutical companies--GlaxoSmithKline (GSK) and Merck--developed a prophylactic vaccines which are already in the pre-licence phase. The results published up to now showed a

  8. Carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    There are few reports on uterine cancer in relation to radiation. This chapter discusses uterine cancer in A-bomb survivors, with special reference to the mortality rate, in a review of the literature. The Atomic Bomb Casualty Commission has first discovered 28 cases of uterine cancer among A-bomb survivors during the period 1953-1957. Since 1970, mortality rate from uterine cancer has been investigated statistically according to the T65D system. The Radiation Effect Research Foundation (RERF) has revealed 282 death cases from uterine cancer during the period 1950-1974. The RERF's data up to 1982 has revealed no radiation-dependent mortality from uterine cancer. More recent data (1950-1985) has revealed that mortality rate was increased by 22% in A-bomb survivors exposed to 1 Gy or more. When mortality of uterine cancer was investigated statistically using the 1968-1982 data for the population of the Research Institute for Nuclear Medicine and Biology, Hiroshima University, it was 1.2 times higher in the entire exposed group and 1.4 times higher in the group of proximally exposed A-bomb survivors (within 2 km from the hypocenter) than the non-exposed group, with statistically significant difference. It tended to be high in the group of distally exposed A-bomb survivors (who entered the city within 3 days after A-bombing) than the non-exposed group. When comparing the group of Hiroshima City with the group of Hiroshima Prefecture, mortality from uterine cancer was 1.3 times higher in the municipal group for proximally exposed A-bomb survivors and 1.3 times higher in the prefectural group for distally exposed A-bomb survivors and the others. Mortality rate was highest within one year after the acquisition of health handbook in the exposed group. (N.K.)

  9. Sensitivity of in situ detection with biotinylated probes of human papilloma virus type 16 DNA in frozen tissue sections of squamous cell carcinomas of the cervix.

    Science.gov (United States)

    Walboomers, J M; Melchers, W J; Mullink, H; Meijer, C J; Struyk, A; Quint, W G; van der Noordaa, J; ter Schegget, J

    1988-06-01

    The sensitivity of human papilloma virus type 16 (HPV-16) DNA detection by DNA in situ hybridization using biotinylated probes (bio-DISH) was estimated by performing this technique on snap-frozen tissue sections of 10 cervical squamous cell carcinomas containing increasing amounts of HPV-16 as determined by Southern blot hybridization. A protocol using serial sections for bio-DISH and DNA extraction was used. The number of positively stained cells and the detection limit were strongly dependent on the treatment of the sections with proteinase K prior to hybridization. At low proteinase K concentration (0.1 micrograms/ml), the detection limit appeared to be 30-40 HPV-16 DNA copies per carcinoma cell, whereas morphology was preserved. A high proteinase K concentration (1-5 micrograms/ml) often resulted in an increase in the number of positively stained cells but also in a poor morphology. The detection limit was improved to at least 20 HPV-16 DNA copies per carcinoma cell. PMID:2837906

  10. Prognostic factors in patients with cervix cancer treated by radiation therapy: results of a multiple regression analysis

    International Nuclear Information System (INIS)

    A retrospective analysis of 965 patients with invasive cervix cancer treated by radiation therapy between 1976 and 1981 was performed in order to evaluate prognostic factors for disease-free survival (DFS) and pelvic control. FIGO stage was the most powerful prognostic factor followed by radiation dose and treatment duration (P values = 0.0001). If the analysis was limited to patients treated with radical doses of 75 Gy or more, dose was no longer significant. Young age at diagnosis, non-squamous histology and transfusion during treatment were also adverse prognostic factors for survival and control. Para-aortic nodal involvement on lymphogram was associated with a reduction in DFS (P = 0.0027), whereas pelvic lymph node involvement alone was not. In patients with Stage I and IIA disease, tumour size was the most powerful prognostic factor for survival (P = 0.0001) and the extent of pelvic sidewall involvement was significant in patients with Stage III tumours (P = 0.007). Histological grade appeared to be a predictive factor but was only recorded in 712 patients. These features should be considered in the staging of patients and in the design of clinical trials

  11. [Cytological and bacteriological examinations of the cervix and vagina. A review of the results obtained in a laboratory for analyses in Guadeloupe (author's transl)].

    Science.gov (United States)

    Millan, J; Crenn, O; Lidome, E

    1981-01-01

    The authors give the results of their cytological and bacteriological examinations of the cervix and vagina carried out routinely in a laboratory. They emphasize, in detailing their method of working, the criteria that they feel must be adopted in an attempt to code the qualitative appraisal of direct examination and the result of studying the cultures. The first part of the paper deals with an overall survey of the 4,573 examinations which were carried out over a period of 8 years. The second part is concerned with a more detailed analysis of the 883 samples which were divided into 4 categories: pregnant women, those having oral contraception, those with an intra-uterine device, and others. There are several variations revealed between these 4 categories as far as the white cell count, the bacterial flora and even pathogenic organisms are concerned. PMID:7334191

  12. Is postoperative radiation beneficial in the management of Stage I-II squamous-cell carcinoma of the uterine cervix with negative metastatic nodes and positive parametrial involvement; A retrospective review of 70 patients

    Energy Technology Data Exchange (ETDEWEB)

    Takamura, Akio (Asahikawa Kosei Hospital, Hokkaido (Japan)); Mizoe, Jun-etsu; Arimoto, Takuro; Kamada, Tadashi; Shirato, Hiroki; Matsuoka, Yoshisuke; Tomita, Masayoshi; Irie, Goro

    1993-06-01

    Seventy patients having squamous-cell carcinoma of the uterine cervix FIGO (Federation Internationale de Gynecologie et d'Obstetrique : International Federation of Gynecology and Obstetrics) Stage I-II with negative lymph nodes and positive parametrial involvement received postoperative radiotherapy following radical hysterectomy and pelvic lymphadenectomy. In 48 patients with microscopic parametrial involvement had a 5-year survival rate of 75%. The overall recurrence was 13% (9 of 70). The sites of failure were 3 pelvic alone, 5 distant metastases alone, and 1 combined pelvis and para-aortic lymph node. All of those with recurrence were Stage-II cases. The absolute pelvic-control rate was 94.3% (66/70). Fifty-six percent of the patients experienced mild-to-moderate lymphedema. Severe complications requiring surgical intervention were observed in 6 patients (5 bowel obstructions and 1 femoral head fracture). A review of the literature suggests that early carcinoma can be successfully treated by surgery alone. Taking into consideration the risk and benefits involved, postoperative radiotherapy is not recommended for most patients with cervical carcinoma with negative lymph nodes and positive parametrial involvement in the present form, despite excellent local control. However, no definite conclusion can be drawn from this retrospective analysis. (author).

  13. Postirradiation sarcoma (malignant fibrous histiocytoma) following cervix cancer

    International Nuclear Information System (INIS)

    A case of postirradiation sarcoma is described. The tumor, a malignant fibrous histiocytoma, occurred in the radiation field 11 years following postoperative external beam radiation therapy (7,000 rad) for carcinoma of the cervix. Reports of postirradiation malignant fibrous histiocytoma are rare, and the occurrence of this neoplasm following treatment for cervix cancer has not previously been described. The literature concerning postirradiation bone and soft tissue sarcomas is briefly reviewed, with special attention to malignant fibrous histiocytomas. (author)

  14. Correlation of XRCC1 Polymorphism with Radiotherapy Response in Squamous Cell Carcinoma of Cervix%XRCC1基因多态性与宫颈鳞癌放疗敏感性的关系

    Institute of Scientific and Technical Information of China (English)

    樊晓妹; 李魁秀; 牛书怀; 房朝辉; 金鸽

    2014-01-01

    Objective To investigate the correlation of XRCC1 Arg194Trp Arg399Gln Single nucleotide polymor-phism (SNP) with radiotherapy response of squamous cell carcinoma of cervix. Methods Patients with exogenous type cer-vical squamous cell carcinoma confirmed by histopathology were selected for our study. These include:patients in stageⅠ(4 cases), patients in stageⅡ(36 cases), patients in stageⅢ(30 cases), patients in stageⅣ (3 cases). There are 30 patients with tumor diameter less than 4 cm and 43 patients with tumor diameter over 4 cm in our test. There are 36 cases with dose point A less than 80 Gy and 37 cases with dose point A over 80 Gy . Radiotherapy outcomes showed 47 cases of complete re-mission and 26 cases of part remission. Polymorphisms Arg194Trp, Arg399Gln of XRCC1 gene in 73 cervical cancer pa-tients were analyzed by mismatch amplification polymerase chain reaction (MAMA-PCR). Results Arg/Arg, Arg/Trp, TrP/Trp of Arg194Trp genotype distribution were 31 (42.5%), 37 (50.7%), 5 (6.8%) respectively. Arg/Arg, Arg/Gln, Gln/Gln of Arg399Gln distribution were 6 (35.6%), 39 (53.4%), 8 (11.0%) respectively. The response to radiotherapy was not statistical-ly significant in three genotypes, Arg/Arg, Arg/Trp, TrP/Trp of XRCC1 at codon 194(P>0.05). Neither was XRCC1 at codon 399. Multivariate analysis showed that late clinical stage was a risk factor of part remission. Conclusion SNP of XRCC1 gene at codon 194 and codon 399 could not predict clinical response of patients with squamous cell carcinoma of cervix to ra-diotherapy. The patients with advanced cervical cancer had poor response to radiotherapy.%目的:探讨XRCC1基因Arg194Trp、Arg399Gln单核苷酸多态性(SNP)与外生型宫颈鳞状细胞癌放疗敏感性的关系。方法选择经组织病理学确诊的外生型宫颈鳞状细胞癌患者73例。其中临床分期Ⅰ期4例,Ⅱ期36例,Ⅲ期30例,Ⅳ期3例。肿瘤直径≤4 cm 30例,肿瘤直径>4 cm 43例;A点剂量≤80 Gy

  15. [Ki-67 expression as a predictor of the effectiveness of radiotherapy and of outcome in locally advanced squamous cell carcinoma of the uterine cervix (immunohistochemical study)].

    Science.gov (United States)

    Kuznetsova, M E; Pozharisskiĭ, K M; Vinokurova, V L; Zharinov, G M; Neklasova, N Iu

    2007-01-01

    Retrospective immunohistochemical assay of antigen Ki-67 in tumor tissue was carried out prior to and in the course of radiotherapy (TFD - 14-20Gy) in 89 patients with squamous cervical carcinoma. Index of proliferation, i.e. number of Ki-67-positive cells per 1,000 of all cells, was found. Prior to therapy, the index was on the average 49.7%, during irradiation it decreased and its mean value was 24%. There was a correlation between proliferation level tumor progression and the former influenced the immediate effect of radiotherapy. Ki-67 expression in cervical carcinoma exceeded the median. It correlated with unfavorable end-results and was followed by higher relapse incidence. No significant proliferation index difference was reported visa-vis histological pattern, tumor cell differentiation or age. Yet, the drop in proliferative activity during therapy was significant, regardless of outcome. Our results pointed to the high prognostic significance of proliferative activity as far as therapy and outcome were concerned. PMID:17663171

  16. 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

  17. Clinicopathologic features of adenoid basal carcinoma of uterine cervix%宫颈腺样基底细胞癌临床病理观察

    Institute of Scientific and Technical Information of China (English)

    景竹春; 王作仁; 苏雅洁; 笪冀平

    2013-01-01

    Objective To further study the pathological morphology and clinical features of the cervical adenoid basal cell carcinoma.Methods Cytological characteristics,histopathological changes and immunohistochemical findings were analyzed in 1 cases of cervical adenoid basal cell carcinoma and the related literatures were reviewed.Results Abnormal squamous epithelial cells were seen through the liquid-based preparation cytology test,which were highly consistent with the pathological changes of intraepithelial lesions.There were some cell nests in the stroma,and the center of some nests arounded by a palisade structure showed squamous cell differentiation.The tumor cell nests were sometimes associated with cervical intraepithelial neoplasia.Immunohistochemically,the tumor cells were positive for P63,P16 and CK5/6,and a few of them positive for Ki-67.Actin in cervical stroma within the vascular smooth muscle and fibroblasts were positive,and negative in surrounding of the carcinoma nests.Conclusions Cervical adenoid basal cell carcinoma is a rare malignant tumor,and it has characteristic histopathological features.The tumor within cervical stroma might be misdiagnosed as squamous metaplasia or considered as CIN involving gland.As diagnosis of cervical adenoid basal cell carcinoma,we should carefully analyse and grasp the strict diagnostic standard.%目的 进一步认识宫颈腺样基底细胞癌的病理形态及临床特点.方法 应用细胞学、组织病理学、免疫组化等方法对1例宫颈腺样基底细胞癌进行分析,并结合相关文献讨论.结果 液基涂片细胞学显示有异型的鳞状上皮细胞,符合高级别鳞状上皮内病变的形态学改变.光学显微镜下观察发现,官颈鳞状上皮下方的间质内有圆形至卵圆形的小细胞巢,部分癌细胞巢的中央出现鳞状分化,周围呈栅栏状结构;肿瘤细胞巢与表面CIN3融合.免疫组化显示p63、p16和CK5/6(+),Ki-67灶状(+);宫颈间质内的部分血管

  18. Maxillary sinus carcinoma: result of radiation therapy

    International Nuclear Information System (INIS)

    This hundred and sixteen patients with carcinoma of the maxillary sinus received primary therapy consisting of external beam irradiation alone or in combination with surgery and/or chemotherapy at the Department of Radiology, Tokyo Medical and Dental University Hospital, between 1953 and 1982. In our institution, methods of treating cancer of the maxillary sinus have been changed from time to time and showed different control rates and clinical courses. An actuarial 10-year survival rate of 21% has been obtained by the megavoltage irradiation alone as well as 34% actuarial 10-year survival rate by megavoltage irradiation with surgery. After the introduction of conservative surgery followed by conventional trimodal combination therapy, the local control rate has been improved. The amount of functional, cosmetic, and brain damages have been remarkably decreased by this mode of therapy. The actuarial five year survival rate was 67%. In addition, along with the improvement of the local control rate, the control of nodal and distant organ metastases have been emerging as one of the important contributions to the prognosis of this disease

  19. 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.

  20. The Result of Radiotherapy in Esophageal Carcinoma

    International Nuclear Information System (INIS)

    During the period between March 1983 and December 1990, 74 patients with esophageal carcinoma(EC) were treated with radiation therapy(RT) at the Department of Therapeutic Radiology, Kangnam St. Mary Hospital, Catholic University Medical College. Of these, 6 patients were lost to follow-up, and 13 patients were interrupted. So the remaining 55 patients were analyzed, retrospectively. 32 patients were irradiated with curative aim, 12 patients with palliative intent, 10 patients postoperatively, and 1 patient pre- and post-operatively. Among these 55 patients, 28 patients were treated with chemoradiation modality, and 27 patients with RT alone. All patients were followed for a minimum of 20 months or Hntil death. of 32 patients irradiated by curative aim, 22 patients(69%) showed partial remission (PR), 6 patients(19%) complete remission(CR). Overall mean survival and two-year survival rate were 15.6 months and 22%. With respect to sex, age, pathologic differentiation, tumor location, tumor size, stage, RT aim, RT response, RT dose, use of chemotherapy and functional categories(FC) of dysphagia at initiation of RT and at finishing RT : Tumor size, stage, RT response had great influences on prognosis and FC at finishing RT had a slight influence on prognosis. Especially, the mean survival and 2-year survival rate in patients with postoperative RT were 24.7 months and 63%, which could be compared with 29.1 months and 43% in radically treated patients with CR. And the mean survival duration and 2-year survival rate in patients irradiated with doses more than 60 Gy were 22.4 months and 29%, and 50-60 Gy were 12.2 months and 12%, respectively. However, no significant difference was shown statistically. Among 12 patients treated with palliative intent, 9 patients (75%) had good improvement in dysphagia and the mean duration of palliative response was 10.6 months

  1. 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...

  2. The bovine cervix explored : the cow as a model for studies on functional changes in the cervix uteri

    OpenAIRE

    Breeveld-Dwarkasing, V.N.A.

    2002-01-01

    The cervix uteri is a rigid tube which connects the uterus with the vagina and during most of the time it is firmly closed. During oestrus, late pregnancy and parturition, the morphological appearance in the cervix changes markedly, resulting in a softer cervix, which during parturition can even be stretched open to a diameter that is more than a tenfold larger than before. During gyneacological interventions, such as artificial inseminations in several animal species, or in women it would be...

  3. Brachytherapy in Lip Carcinoma: Long-Term Results

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to evaluate the effectiveness of low-dose-rate brachytherapy for local control and relapse-free survival in squamous cell and basal cell carcinomas of the lips. We compared two groups: one with tumors on the skin and the other with tumors on the lip. Patients and methods: All patients had been treated at Claudius Regaud Cancer Centre from 1990 to 2008 for squamous cell or basal cell carcinoma. Low-dose-rate brachytherapy was performed with iridium 192 wires according to the Paris system rules. On average, the dose delivered was 65 Gy. Results: 172 consecutive patients were included in our study; 69 had skin carcinoma (squamous cell or basal cell), and 92 had squamous cell mucosal carcinoma. The average follow-up time was 5.4 years. In the skin cancer group, there were five local recurrences and one lymph node recurrence. In the mucosal cancer group, there were ten local recurrences and five lymph node recurrences. The 8-year relapse-free survival for the entire population was 80%. The 8-year relapse-free survival was 85% for skin carcinoma 75% for mucosal carcinoma, with no significant difference between groups. The functional results were satisfactory for 99% of patients, and the cosmetic results were satisfactory for 92%. Maximal toxicity observed was Grade 2. Conclusions: Low-dose-rate brachytherapy can be used to treat lip carcinomas at Stages T1 and T2 as the only treatment with excellent results for local control and relapse-free survival. The benefits of brachytherapy are also cosmetic and functional, with 91% of patients having no side effects.

  4. Brachytherapy in Lip Carcinoma: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Guibert, Mireille, E-mail: mireilleguib@voila.fr [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); David, Isabelle [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Vergez, Sebastien [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); Rives, Michel [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Filleron, Thomas [Department of Epidemiology, Claudius Regaud Institut, Toulouse (France); Bonnet, Jacques; Delannes, Martine [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France)

    2011-12-01

    Purpose: The aim of this study was to evaluate the effectiveness of low-dose-rate brachytherapy for local control and relapse-free survival in squamous cell and basal cell carcinomas of the lips. We compared two groups: one with tumors on the skin and the other with tumors on the lip. Patients and methods: All patients had been treated at Claudius Regaud Cancer Centre from 1990 to 2008 for squamous cell or basal cell carcinoma. Low-dose-rate brachytherapy was performed with iridium 192 wires according to the Paris system rules. On average, the dose delivered was 65 Gy. Results: 172 consecutive patients were included in our study; 69 had skin carcinoma (squamous cell or basal cell), and 92 had squamous cell mucosal carcinoma. The average follow-up time was 5.4 years. In the skin cancer group, there were five local recurrences and one lymph node recurrence. In the mucosal cancer group, there were ten local recurrences and five lymph node recurrences. The 8-year relapse-free survival for the entire population was 80%. The 8-year relapse-free survival was 85% for skin carcinoma 75% for mucosal carcinoma, with no significant difference between groups. The functional results were satisfactory for 99% of patients, and the cosmetic results were satisfactory for 92%. Maximal toxicity observed was Grade 2. Conclusions: Low-dose-rate brachytherapy can be used to treat lip carcinomas at Stages T1 and T2 as the only treatment with excellent results for local control and relapse-free survival. The benefits of brachytherapy are also cosmetic and functional, with 91% of patients having no side effects.

  5. Prevention and treatment of early radiation-induced injuries of the urinary bladder in carcinoma of the cervix and corpus uteri

    International Nuclear Information System (INIS)

    The report discusses early-onset radiation injuries in the urinary bladder of more than 1000 patients with cancer of the cervix and corpus uteri. Clinical symptoms of such injuries were observed in 487 patients (44.3%). In 47 (10%), the lesions were pronounced. The degree of radiation-induced cystitis was evaluated on a 6-point scale used by WHO classification (1982). Said lesions mainly occurred at stage III of tumor and predominantly in cases of cancer of the corpus uteri. Complications development was stimulated by vascular lesions, diabetes mellitus and inflammatiry processes in pelvic organs. Radiation injuries were treated by standard procedures as well as with immobilised trypsin administered in a cellulose powder vehicle. this method proved the immobilised trypsin adminstered in a cellulose powder vehicle. This method proved the most effective. Since patients suffering early-onset radiation-induced destructive injuries are at high risk of further exacerbation at later stages, they should be followed-up closely

  6. The effect of copaiba balsam on Walker 256 carcinoma inoculated into the vagina and uterine cervix of female rats Efeito do óleo de copaíba no tumor de Walker 256 inoculado em vagina e colo de útero de ratas fêmeas

    OpenAIRE

    Nara Macedo Botelho Brito; Marcus Vinicius Henriques Brito; Rita de Kássia Vidigal Carvalho; Lia Tavares de Moura Brasil Matos; Rodolfo Costa Lobato; Suelen Costa Correa; Rosângela Baía Brito

    2010-01-01

    PURPOSE: To verify the copaiba balsam (Copaifera officinalis) effect on Walker 256 carcinoma inoculated into vagina and uterine cervix of rats. METHODS: Eighteen female Wistar rats weighing between 180-250g were used, distributed into 2 groups (GCop, GC). On the 1st day of the experiment, 0.3 ml of Walker 256 carcinoma (2x10(6) concentration) was inoculated in both groups; on the 3rd day of the experiment, it was given 4.8 ml/kg of distilled water to the GC group, and 4.8 ml/kg of copaiba bal...

  7. Lymphoma of the Cervix

    Directory of Open Access Journals (Sweden)

    Juanita Parnis

    2012-01-01

    Full Text Available Primary non-Hodgkins lymphoma of the uterine cervix is a very rare diagnosis. A 54-year-old woman presented with a 3-month history of postmenopausal bleeding per vaginum. On examination, a friable, fungating lesion was seen on the cervix. Histology revealed a CD 20 positive high-grade non-Hodgkin’s diffuse large B cell lymphoma from cervical biopsies and endometrial curettage. She was diagnosed as stage IE after workup and subsequently treated with six cycles of R-CHOP chemotherapy followed by radiotherapy of the involved field.

  8. Definitive radiotherapy for uterine cervix cancer: long term results for patients treated in the period from 1998 till 2002 at the Institute of Oncology Ljubljana

    International Nuclear Information System (INIS)

    The aim of this retrospective study was to analyse results of the two-dimensional (2D) uterine cervix cancer treatment at the Institute of Oncology Ljubljana from 1998 till 2002, before the three-dimensional (3D) approach was introduced in our clinical practice. Ninety-eight patients with the following FIGO stage distribution were analysed: 10% IB, 7% IIA, 37% IIB, 4% IIIA and 42% IIIB. The influence of age, haemoglobin level, histology, grade, stage, lymph node status, cumulative point A dose, and an overall treatment time on the survival and local control (LC) were evaluated. Acute and late side effects were assessed. Five and 8-year overall survival (OS), disease specific survival (DSS) and LC rate were as follows: 47.2% and 43.0%, 54.7% and 53.4%, 74.9% and 72.5%, respectively. Point A dose and histology of the tumour influenced OS, positive lymph nodes DSS and point A dose LC rate. Probability of grade three and four late complications in the first five years was 7.1% for gastrointestinal tract and 3.3% for genitourinary system and vagina. Point A dose was independent predictor of OS and LC rate, lymph node status predicted DSS, while histology of the tumour influenced OS

  9. Associação entre a expressão das proteínas p53 e Ki-67 e os achados clínico-patológicos em pacientes com carcinoma invasor do colo uterino Association between p53 and Ki-67 expression and clinicopathologic features in patients with carcinoma of the cervix

    Directory of Open Access Journals (Sweden)

    Agnaldo L. Silva-Filho

    2005-05-01

    analyzed by histopathology (hematoxylin and eosin and immunohistochemically evaluated using monoclonal antibodies for p53 and Ki-67. Data were analyzed statistically by the chi2 test to evaluate eventual differences between the groups. RESULTS: the age of the patients ranged from 27 to 73 years (48.7±10.4 years. Clinical stage (FIGO was IB1 in 27 cases (75% and IB2 in 9 cases (25%. A positive tumoral expression of the p53 protein was found in half of the cases. In relation to the Ki-67 expression, a high cell proliferation index was shown in 73.3% of the cases. There was no association between tumoral p53 and Ki-67 expression with age (p=0.091 and 0.900, clinical stage (p=0.054 and 0.667, histological classification (p=0.674 and 0.674, grade of differentiation (p=0.070 and 0.282, presence of lymphatic vascular space invasion (p=0.248 and 0.667, parametrial involvement (p=0.729 and 0.763 and pelvic lymph node metastasis (p=0.729 and 0.636, respectively. CONCLUSIONS: tumoral expression of p53 and Ki-67 was not associated with the clinicopathological features in patients with stage IB carcinoma of the cervix.

  10. Association between invasive cancer of the cervix and HIV-1 infection in Tanzania: the need for dual screening

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    Ngoma Twalib

    2008-07-01

    Full Text Available Abstract Background Cancer of the cervix is the second commonest malignancy in females worldwide and is the leading malignancy among women in Tanzania. Cancer of the cervix has been strongly associated with Human Papilloma Virus (HPV which is a sexually transmitted disease. However, the role of HIV-1 in the aetiology of cancer of the cervix is less clear. Studies suggest that HPV and HIV-1 infection are synergistic and therefore their dual occurrence may fuel increased incidence of cancer of the cervix and AIDS. We therefore conducted a study to determine the association between cancer of the cervix and HIV-1. Methods The study was carried out in Ocean Road Cancer Institute, Dar-es-salaam, Tanzania between January and March 2007. A hospital-based case control design was used to study 138 cases and 138 controls. The cases were consenting women 18 years and above with histologically confirmed squamous cell carcinoma of the cervix, while the controls were consenting non-cancer adult women attendants or visitors. The participants were counselled and tested for HIV-1 and interviewed to assess risk factors for cancer of the cervix and HIV-1. Estimation of risk was done by computing odds ratios and confidence intervals. Confounding and interaction between the factors were assessed using logistic regression. Results HIV-1 prevalence was much higher among the cases (21.0% than among the controls (11.6%. In logistic regression, HIV-1 was associated with cancer of the cervix (OR = 2.9, 95% CI = 1.4–5.9. Among the cases the mean age was lower for HIV-1 infected (44.3 years than HIV-1 uninfected women (54 years, p = 0.0001. Conclusion HIV-1 infection is associated with invasive cancer of the cervix. Resource-constrained countries with a high burden of HIV-1 and cervical cancer should adopt a high-risk approach that targets HIV-1 positive women for screening of cervical cancer initially by utilizing HIV/AIDS resources.

  11. Galectin-1 Is an Independent Prognostic Factor for Local Recurrence and Survival After Definitive Radiation Therapy for Patients With Squamous Cell Carcinoma of the Uterine Cervix

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Eng-Yen [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Chanchien, Chan-Chao; Lin, Hao [Department of Gynecologic Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Wang, Chung-Chi; Wang, Chong-Jong [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Huang, Chao-Cheng, E-mail: huangcc@cgmh.org.tw [Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China)

    2013-12-01

    Purpose: To investigate the role of galectin-1 in patients with cervical cancer after definitive radiation therapy. Methods and Materials: We reviewed 154 patients with International Federation of Gynecology and Obstetrics stage I-II squamous cell carcinoma. Patients underwent curative-intent radiation therapy. Paraffin-embedded tissues were analyzed using immunohistochemistry staining for galectin-1. The rates of cancer-specific survival (CSS), local recurrence (LR), and distant metastasis were compared among patient tissue samples with no, weak, and strong galectin-1 expression. The Kaplan-Meier method and the Cox proportional hazard model with hazard ratios and 95% confidence intervals (CIs) were used for univariate and multivariate analyses, respectively. Results: The areas under the curve for the intracellular expression scores of galectin-1 for both LR and CSS were significantly higher than those for stromal expression. There were no significant differences in the demographic data, such as stage and serum tumor markers, between patients with and without intracellular expression of galectin-1 in cancer tissue samples. Using multivariate analyses, the hazard ratios of LR and CSS were 2.60 (95% CI 1.50-4.52) (P=.001) and 1.94 (95% CI 1.18-3.19) (P=.010), respectively. Conclusion: Galectin-1 is an independent prognostic factor associated with LR and CSS in stage I-II cervical cancer patients undergoing definitive radiation therapy. Further studies targeting galectin-1 may improve the local control of cervical cancer.

  12. Comparison of absorbed dose in the cervix carcinoma therapy by brachytherapy of high dose rate using the conventional planning and Monte Carlo simulation; Comparacao da dose absorvida no tratamento do cancer ginecologico por braquiterapia de alta taxa de dose utilizando o planejamento convencional do tratamento e simulacao de Monte Carlo

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Aneli Oliveira da

    2010-07-01

    This study aims to compare the doses received for patients submitted to brachytherapy High Dose Rate (HDR) brachytherapy, a method of treatment of the cervix carcinoma, performed in the planning system PLATO BPS with the doses obtained by Monte Carlo simulation using the radiation transport code MCNP 5 and one female anthropomorphic phantom based on voxel, the FAX. The implementation of HDR brachytherapy treatment for the cervix carcinoma consists of the insertion of an intrauterine probe and an intravaginal probe (ring or ovoid) and then two radiographs are obtained, anteroposterior (AP) and lateral (LAT) to confirm the position of the applicators in the patient and to allow the treatment planning and the determination of the absorbed dose at points of interest: rectum, bladder, sigmoid and point A, which corresponds anatomically to the crossings of the uterine arteries with ureters The absorbed doses obtained with the code MCNP 5, with the exception of the absorbed dose in the rectum and sigmoid for the simulation considering a point source of {sup 192}Ir, are lower than the absorbed doses from PLATO BPS calculations because the MCNP 5 considers the chemical compositions and densities of FAX body, not considering the medium as water. When considering the Monte Carlo simulation for a source with dimensions equal to that used in the brachytherapy irradiator used in this study, the values of calculated absorbed dose to the bladder, to the rectum, to the right point A and to the left point A were respectively lower than those determined by the treatment planning system in 33.29, 5.01, 22.93 and 19.04%. These values are almost all larger than the maximum acceptable deviation between patient planned and administered doses (5 %). With regard to the rectum and bladder, which are organs that must be protected, the present results are in favor of the radiological protection of patients. The point A, that is on the isodose of 100%, used to tumor treatment, the results

  13. The results of postoperative radiotherapy for hypopharyngeal carcinoma

    International Nuclear Information System (INIS)

    This study was carried out to confirm clinical values and limitations of postoperative radiotherapy for hypopharyngeal carcinoma, to evaluate various prognostic factors which may affect to the treatment results and to use these results as fundamental data for making a new treatment strategy. A retrospective analysis was performed on 64 previously untreated patients with squamous cell carcinoma of the hypopharynx, seen between 1988 and 1999 at Pusan National University Hospital. Most of patients were treated by laryngopharyngectomy and neck dissection followed by conventional fractionated postoperative radiotherapy on surgical bed and cervical nodal areas. The five-year overall survival rate and cause-specific survival rate were 42.2 percent and 51.6 percent, respectively. Univariate analysis of various clinical and pathologic factors confirmed the overall stage, TN-stage, secondary primary cancers, surgical positive margin, nodal extracapsular extension, total radiation doses as significant prognostic factors of hypopharyngeal carcinomas. But in multivariate analysis. TN-stage, surgical positive margin and extracapsular extension were only statistically significant. In resectable cases of hypopharyngeal carcinoma, combined surgery and postoperative radiotherapy obtained good treatment results, even though sacrificing the function of larynx and pharynx. But in advanced and unresectable cases, with respect to survivals and quality of life issues, we were able to confirm some limitations of combined therapy. So we recommend that comparative of recent various chemo-radiotherapy methods and advanced radiotherapy techniques with these data should be needed

  14. 新辅助化疗对宫颈小细胞癌的效果评价%Effect Evaluation of Neoadjuvent Chemotherapy for Small Cell Carcinoma of Cervix

    Institute of Scientific and Technical Information of China (English)

    王蕾; 王纯雁

    2015-01-01

    目的:探讨新辅助化疗( NACT)治疗宫颈小细胞癌( SCCC)的临床效果。方法按照患者是否于术前接受NACT,将62例SCCC患者分为实验组(接受NACT)33例和对照组(未接受NACT)29例,记录实验组患者近期疗效,比较两组患者入院时与术前病灶大小变化情况、远期疗效及复发情况。结果实验组患者CR 5例(15.15%),PR 24例(72.73%),SD 4例(12.12%),总有效率为87.88%;实验组患者经NACT后病灶均有不同程度缩小,术前病理检查测量肿瘤病灶最大直径显著小于入院时影像学测量肿瘤病灶最大直径,差异具有统计学意义(P<0.05);实验组患者术前病理检查测量肿瘤病灶最大直径显著小于对照组,差异具有统计学意义(P<0.05);两组患者3年总生存率、3年无瘤生存率和局部复发率比较,差异无统计学意义(P>0.05);实验组患者远处复发率显著低于对照组,差异具有统计学意义(P<0.05)。结论 SCCC术前经NACT可有效缩小靶病灶,降低远处复发率,临床效果显著,应用价值较高。%Objective To explore the clinical effects of neoadjuvent chemotherapy ( NACT) for small cell carcinoma of cervix(SCCC).Methods 62 cases of SCCC were divided into the experiment group(33 cases,treated by NACT) and the control group(29 cases,not treated by NACT).The short-term effects of the experiment group were record,the tumor size,long-term effect,and relapse were compared between the 2 groups.Results The CR were 5 cases ( 15.15%) , PR were 24 cases (72.73%),SD were 4 cases(12.12%),the total effective rate was 87.88%;The tumor size reduced after NACT ,Preoperative maximum tumor lesion diameter by pathological examination was significantly smaller than maximum tumor lesion diameter by im-aging measurement on admission(P0.05);The distant recurrence rate in the ex-periment group was significantly lower than that

  15. Comparison of compliance and response rate of radiotherapy alone vs. chemo radiotherapy in stage IIIB carcinoma cervix patients having obstructive uropathy

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    Narendra Rathore

    2014-08-01

    Conclusions: It is hereby concluded that radiotherapy alone for locally advanced squamous cell cervical carcinoma patients having associated co morbid conditions like deranged RFT had a better compliance then with the concurrent chemoradiotherapy regime. [Int J Res Med Sci 2014; 2(4.000: 1548-1557

  16. Observation of hyperfractional integrated intracavitary brachytherapy on efficacy and complications in patients with middle and advanced squamous cell carcinoma of the cervix

    International Nuclear Information System (INIS)

    Objective: To observe and compare the efficacy and complications of hyperfractional integrated intracavitary brachtherapy in middle-advanced squamous-cell carcinoma with the traditional brachytherapy. Methods: In the observed group, 328 patients with cervical cancer received hyperfractional integrated intracavitary after loading therapy between Jan 2004 and Jan 2005 were selected. The dose of point A was 2.5 Gy-3.0 Gy/fraction, 2 fractions per week, and the total dose of reference point A was 49.8 Gy in stage IIb, 52.6 Gy in stage IIIb. In the control group, 331 cases treated with traditional afterloading brachytherapy between Jan 2002 and Dec 2003 were selected. The dose of point A was 5.0∼7.0 Gy/fraction, 1 fraction per week, and the total dose of point A was 50.1 Gy in stage IIb, 53.5 Gy in stage IIIb, In vitro irradiation began at the same time with the intracavitary brachytherapy. The whole pelvic was irradiated with 15 MV X-rays. Results: In the observed group, the recent control rate of stage IIb was 97.2% (104/107), 94.1% (208/221) for stage IIIb. The 3- year survival rate was 80.5% (264/328), and the 5-year survival rate was 68.6% (225/328). The complication rate was 5.2% (17/328) for cystitis, 14.6% (48/328) for proctitis. Out of 331 cases in control group, the recent control rate of stage IIb was 95.4% (103/108), 92.8% (207/223) for stage IIIb. The 3-year survival rate was 75.2% (249/332), the 5-year survival rate was 62.5% (207/331). The complication rate was 13.3% (44/331) for cystitis, and 32.3% (107/331) for proctitis. Conclusions: Compared with combination of traditional brachytherapy and external radiotherapy, combination of hyperfractional integrated brachtherapy therapy and external radiotherapy has no significant improvement for recent control rate and long-term survival rate, but could reduce the complication rates of cystitis and proctitis. (authors)

  17. Long-term results of treatment of cervical carcinoma in the United States in 1973, 1978, and 1983: Patterns of Care Study (PCS)

    International Nuclear Information System (INIS)

    Purpose: To extend the observations of patients with carcinoma of the cervix treated in 1973 for over 15 years, in 1978 for over 10 years, and in 1983 for over 5 years for survival and local control to compare treatment times and outcome. Methods and Materials: A nationwide survey of the patterns of practice in radiation therapy for patients with squamous carcinoma of the cervix collected pretreatment and treatment data using external surveyors who reviewed patients' records. Outcome information was updated for the three separate databases by mail survey. Overall survival, no evidence of disease (NED) survival, and local control curves by stage were plotted using the estimates derived by the Kaplan--Meier method. Results: Total number of patients surveyed was 1686: 937 patients in 1973, 565 patients in 1978, and 184 patients in 1983. These are the results from changes in treatment policy, particularly the increasing use of brachytherapy. Of Stage III patients, the percentage receiving brachytherapy was 60.5% in 1973, 76.5% in 1978, and 87.9% in 1983 (p < 0.001 by linear trend test). Also, there was an increased proportion in use of higher energy for external pelvic irradiation during the more recent time period, e.g., 28% in the 1973 study, 60% in the 1978 study, and 87% in the 1983 study compared to the usage of cobalt-60 equipment. Comparison of results including overall survival, local control, and NED survival for the three different time periods showed improvement in outcome for Stage III in 1983, but not Stages I and II. The 5-year survival for Stage III increased from 25% in the 1973 survey to 47% in the 1983 survey, a linear trend that is statistically significant (p = 0.02). Conclusion: The long-term results of radiotherapy for patients with carcinoma of the cervix show improved outcome for Stage III patients, which probably results from improved treatment, including higher energy for pelvic irradiation and increase in use of brachytherapy contributing

  18. MRT monitoring of prostate carcinoma after cryosurgery: initial results

    International Nuclear Information System (INIS)

    Purpose: To assess the morphological changes in the prostate gland and adjacent tissue after cryosurgery by high resolution MRI in patients with histological proven prostatic carcinoma. Method: 15 patients (mean age 66 years) with histologically proven prostate carcinoma underwent T2- and contrast-enhanced T1-weighted high-resolution MRI examinations with fat suppression. Follow-up MRI with an identical imaging protocol were performed at different time intervals (24-72 h, 2-6, 12, 26-52 weeks). Results: Mean prostate volume had decreased by 30% in all patients 12-52 weeks after cryosurgery. After cryosurgery, zonal differentiation was lost in all patients with abnormalities in the periprostatic tissue in all patients, and rectal wall thickening in 47% of patients. Cryosugery-induced changes in the prostate could not be differentiated from tumour recurrence. Conclusion: High resolution MRI allows precise recognition of intraprostatic and adjacent tissue alterations after cryosurgery of prostatic carcinomas. However, reliable detection of tumour recurrence was impossible due to cryosurgically induced signal changes. (orig.)

  19. High dose etretinate and interferon-alpha--a phase I study in squamous cell carcinomas and transitional cell carcinomas

    OpenAIRE

    Roth, Arnaud; Morant, Rudolf Hans Joséf; Alberto, Pierre

    1999-01-01

    Simultaneous exposure to retinoids and interferons can result in enhanced antiproliferative and differentiating effects on malignant lesions. We studied the toxicity and the potential efficacy of an association of high dose etretinate and Interferon-alpha (IFN-alpha) in squamous cell carcinomas of the lung, head and neck, the esophagus, cervix and the penis, as well as in transitional carcinomas of the bladder. The treatment consisted of etretinate (Tigason) 4 mg/kg/d on 2, 3, 4 and finally 5...

  20. The Reserve Cell in the Uterine Cervix: aspects of development, differentiation and diagnosis

    NARCIS (Netherlands)

    J.E. van Muyden-Martens (Jolise)

    2008-01-01

    textabstractCarcinoma of the uterine cervix is worldwide the second most common cancer in women1. It has been approximately 150 years since the first description of uterine cervical carcinoma, a century since the description of its precursor lesions2, and half a century since the introduction of the

  1. Metastasis of extra-ampullary duodenal adenocarcinoma to the uterine cervix.

    Science.gov (United States)

    Takahashi, K; Yoshida, H; Watanabe, R; Ishikawa, M; Ikeda, S I; Kato, T

    2016-04-01

    Secondary metastatic tumours of the uterine cervix are rare. There have been no reports of duodenal cancer metastasizing to the uterine cervix. Here we present a rare case of an extra-ampullary duodenal adenocarcinoma that has metastasized to the uterine cervix. The patient was a 71-year-old woman who had surgery for an extra-ampullary duodenal adenocarcinoma five years previously. Follow-up examination revealed a suspicious right ovarian mass and nodules in the cervix and posterior fornix of the vagina. Biopsies suggested squamous cell carcinoma in the cervix and adenocarcinoma in the fornix. Intraoperatively, the right ovary was enlarged and peritoneal disseminations were found in the pouch of Douglas and the sigmoid colon mesentery. Histopathology of the subsequent hysterectomy and bilateral salpingo-oophorectomy specimen revealed a cervical squamous cell carcinoma categorized as pT1b1. Adenocarcinoma infiltration into the ovaries, uterine cervix and vagina, with vascular involvement was detected. Immunohistochemistry revealed the tumour in the cervix and ovaries to be positive for CK7, MUC5AC and MUC6, and immunonegative for CK20, CDX2, Pax8, ER, MUC2 and CD10, similar to the original duodenal adenocarcinoma. This case illustrates the difficulty in making a preoperative diagnosis of metastatic adenocarcinoma in the uterine cervix with a coexisting primary cervical squamous cell carcinoma. The absence of atypia in cervical glandular cells and immunohistochemical profiling of the adenocarcinoma clusters helped to reach a final diagnosis. This is the first report of an extra-ampullary duodenal adenocarcinoma metastasis to the uterine cervix. PMID:27126664

  2. The effect of copaiba balsam on Walker 256 carcinoma inoculated into the vagina and uterine cervix of female rats Efeito do óleo de copaíba no tumor de Walker 256 inoculado em vagina e colo de útero de ratas fêmeas

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    Nara Macedo Botelho Brito

    2010-04-01

    Full Text Available PURPOSE: To verify the copaiba balsam (Copaifera officinalis effect on Walker 256 carcinoma inoculated into vagina and uterine cervix of rats. METHODS: Eighteen female Wistar rats weighing between 180-250g were used, distributed into 2 groups (GCop, GC. On the 1st day of the experiment, 0.3 ml of Walker 256 carcinoma (2x10(6 concentration was inoculated in both groups; on the 3rd day of the experiment, it was given 4.8 ml/kg of distilled water to the GC group, and 4.8 ml/kg of copaiba balsam to the GCop group. On the 12th day, euthanasia was performed and the tumor was grafted, being weighted and verified its volume. The data were submitted to statistical analysis with ANOVA test. RESULTS: It was observed that copaiba balsam presented a negative inhibitory potential of 70%. CONCLUSION: The copaiba balsam stimulated the tumor growth.OBJETIVO: Verificar o efeito do óleo de copaíba da espécie Copaifera officinalis no carcinoma de Walker 256 inoculado em vagina e colo de útero de ratas. MÉTODOS: Foram utilizadas 18 ratas da linhagem Wistar, pesando entre 180-250g, distribuídas em dois grupos (CCop, GC. No 1º dia de experimento, em ambos os grupos foi inoculado 0,3ml de tumor de Walker 256 na concentração de 2x10(6; no 3º dia após essa inoculação, foi iniciada a administração de água destilada na dose de 4,8 ml/kg ao GC, e copaíba na dose de 4,8 ml/kg ao GCop. No 12º dia foi realizada a eutanásia das ratas e ressecado o tumor, sendo este pesado e averiguado seu volume. Os dados obtidos foram submetidos à análise estatística pelo método ANOVA. RESULTADOS: Observou-se que o óleo de copaíba apresentou um potencial inibitório negativo de 70%. CONCLUSÃO: O óleo de copaíba estimulou o crescimento tumoral.

  3. Therapy of neuroendocrine carcinoma with Y-90 DOTA- preliminary results

    International Nuclear Information System (INIS)

    Full text: Aim: Cell membrane-specific somatostatin receptors are usually expressed by neuroendocrine tumors. Radiolabelled receptor-binding somatostatin analogues target tissues expressing these receptors and can be used for visualization and treatment. After the localization of tumors bearing somatostatin receptors with 111In or 99mTc labeled somatostatin analogues, in the case of high tumor uptake related to non target tissues, different radioisotopes have been used for their treatment. Thus, application of high doses of 111In- DTPA-octreotide had an impact on improvement of the clinical symptoms, without significant reduction of the tumor mass. However, 90Y somatostatin analogues (DOTA TOC, lanreotide) may be more effective for reduction of the tissue of the larger tumors while 177Lu labeled ones may be applied in smaller tumors. Combination of both of them seems to be the most effective therapy, particularly in tumors bearing both small and large lesions. The aim of this work is presentation of the preliminary results of the therapy of NETs with another octreotide analogue, 90Y DOTA TATE, which so far has been proved to have high therapeutic potential when labeled with 177Lu. Patients and methods: We investigated 7 patients with neuroendocrine tumors (two patients had neuroendocrine pancreatic carcinomas with liver metastases (one of them had metastases in peritoneal lymph nodes), one patient with operated (resected) bronchial carcinoid and liver metastases, three patients with neuroendocrine carcinomas of unknown origin and hepatic metastases (one with skeletal metastases) and one with pancreatic gastrinoma without metastases (surgery was impossible to perform). In all of them, together with other laboratory analyses and imaging methods, scintigraphy with somatostatin analogues was performed (in 3 with 111In Octreoscan and in the other 4 with 99mTc HYNIC TOC) and high tumor uptake was observed. The therapy was performed with 2- 4,5 GBq 90Y DOTA TATE per

  4. Ethmoid sinus carcinomas: natural history and treatment results

    International Nuclear Information System (INIS)

    Purpose: This retrospective study was undertaken to assess the clinical features and results of treatment of carcinomas of the ethmoid sinus. Materials and methods: The records of 34 patients with ethmoid sinus carcinomas treated with curative intent at the U.T.M.D. Anderson Cancer Center (UTMDACC) between January 1969 and December 1993 were reviewed. The age of the patients ranged from 28 to 73 years with a median of 57 years. There were 28 Whites, four Hispanics, one Black and one Asian. A simple staging based on anatomical criteria was used to describe the extent of the disease. Six patients had T1, 13 patients had T2 and 15 patients had T3 disease. Twenty-one patients were treated with surgery plus radiation and 13 patients were treated with radiotherapy alone; nine patients received adjuvant chemotherapy. Radiation was given at ∼2 Gy per fraction to total doses of 50 Gy preoperatively, 52-66 Gy (median 60 Gy) postoperatively and 50-70 Gy (median 63 Gy) when no surgery was performed. Results: The actuarial 5-year overall, disease-free and disease-specific survival rates were 55%, 58% and 63%, respectively. The actuarial 5-year local control rate was 71% for the whole group (74% for surgery plus radiation and 64% for radiation alone). Local recurrence occurred in nine patients, nodal relapse occurred in three patients and distant metastases occurred in four patients. Histologically proven dura mater invasion was associated with a poorer local control rate in patients undergoing surgery and radiation. The simple T-staging system used in this study was a good discriminator for local control. Of nine patients receiving chemotherapy, three had complete responses and four had partial responses; six of the seven responders had undifferentiated carcinoma. Severe complications of therapy occurred in patients treated between 1969 and 1984 and consisted mainly of visual impairment and brain necrosis. Conclusions: This retrospective review of a large single institutional

  5. 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

  6. Treatment results of pediatric nasopharyngeal carcinoma, NCI, Cairo University experience

    International Nuclear Information System (INIS)

    Investigate treatment outcome, prognostic factors and survival among selected group of Egyptian pediatric nasopharyngeal carcinoma patients. Patients and methods Thirty patients treated from non-metastatic nasopharyngeal carcinoma between 1997 and 2012 were retrospectively evaluated including: TNM staging, chemo-radiotherapy regimens. Survival analysis was done using Kaplan–Meier survival curves. Results Twenty-three males and 7 females (M:F 3.2:1) with median age of 14 years; 84% with stages III/IV. Neck node enlargement was reported in 90% (27/30). Induction chemotherapy followed by radiotherapy was implemented in 80% of patients. Mucositis (87%) was the commonest treatment related toxicity. Nineteen patients (63%) were in CR with a median FU of 69 months (range 24–160). Eleven patients had treatment local and distant failures (2 local, 7 distant and 2 local/distant) at a median FU of 24 and 34 months respectively. 5-year overall and event-free survival rates were 77% and 63% respectively. Prolonged OAP of RT ⩾ 50 days, Hb<11 g% and T4 stage affected EFS and OAS on UVA; while on MVA; prolonged OAP of RT ⩾ 50 days (ρ = 0.002) and T4 stage (ρ = 0.004) affected EFS and only Hb < 11 g% (ρ = 0.019) affected OAS. Late toxicity was reported in 70% of irradiated patients. Conclusion Radio-chemotherapy management for pediatric NPC resulted in comparable treatment outcomes with tolerable late effects. Response adapted radio-chemotherapy regimens in addition to the potential use of IMRT should be recommended to decrease treatment related side effects. Prolonged OAP of RT ⩾ 50 days and low Hb level were encountered as adverse prognostic factors; findings that need further investigation.

  7. The prognostic value of pimonidazole and tumour pO2 in human cervix carcinomas after radiation therapy: a prospective international multi-center study

    DEFF Research Database (Denmark)

    Nordsmark, Marianne; Loncaster, Julie; Aquino-Parsons, Christina;

    2006-01-01

    BACKGROUND AND PURPOSE: Hypoxia adversely affects treatment outcome in human uterine cervical cancer. Here, we present the results of a prospective international multi-centre study evaluating the prognostic value of pre-treatment tumour oxygen partial pressure (pO(2)) and the hypoxia marker...

  8. Shape priors for segmentation of the cervix region within uterine cervix images

    Science.gov (United States)

    Lotenberg, Shelly; Gordon, Shiri; Greenspan, Hayit

    2008-03-01

    The work focuses on a unique medical repository of digital Uterine Cervix images ("Cervigrams") collected by the National Cancer Institute (NCI), National Institute of Health, in longitudinal multi-year studies. NCI together with the National Library of Medicine is developing a unique web-based database of the digitized cervix images to study the evolution of lesions related to cervical cancer. Tools are needed for the automated analysis of the cervigram content to support the cancer research. In recent works, a multi-stage automated system for segmenting and labeling regions of medical and anatomical interest within the cervigrams was developed. The current paper concentrates on incorporating prior-shape information in the cervix region segmentation task. In accordance with the fact that human experts mark the cervix region as circular or elliptical, two shape models (and corresponding methods) are suggested. The shape models are embedded within an active contour framework that relies on image features. Experiments indicate that incorporation of the prior shape information augments previous results.

  9. Continuous low-dose oral chemotherapy in recurrent and persistent carcinoma of cervix following chemoradiation: A comparative study between prolonged oral cyclophosphamide and oral etoposide

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    Upasana Baruah

    2014-01-01

    Full Text Available Aim: To compare the efficacy and toxicities of low-dose oral cyclophosphamide and oral etoposide in patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy. Materials and Methods: 30 patients with recurrent and persistent cervical cancer with gross pelvic disease were enrolled in this trial. The patients were randomly divided into two groups of 15 patients each with one group receiving low dose oral cyclophosphamide (100 mg/day and the other group receiving low-dose oral etoposide (50 mg/day. Results were statistically analysed by IBM SPSS Statistics 19. Results: Oral etoposide was not well tolerated with grade 2 neutropenia occurring in 33.3% and grade 3 neutropenia in 6.6% and thrombocytopenia occurring in 13.3%. Oral cyclophosphamide group on the other hand was better tolerated with none of the patients having thrombocytopenia and 6.6% patients having grade 2 neutropenia. There were two complete response (15.38% and one partial response at the end of study (7.6% in the cyclophosphamide group whereas there was no complete response and two partial response (16.6% in the oral etoposide group. Conclusion: Long-term, low-dose oral etoposide was found to be less tolerated without any significant effect with patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy in contrast to oral cyclophosphamide which was found to be effective and well-tolerated by the patients.

  10. Assessment of morbidity in carcinoma of the cervix: a comparison of the LENT SOMA scales and the Franco-Italian glossary

    International Nuclear Information System (INIS)

    Background and purpose: To assess the correlation between the LENT (late effects on normal tissue) SOMA (subjective objective management analytic) system and the Franco-Italian glossary scores of late morbidity in cervical cancer patients treated with radiation, and to compare the ability of the scoring systems to detect differences between radiation treatment groups. Materials and methods: The study was retrospective. Patients, invited to take part in the study, had radiotherapy for cervical cancer and had a minimum of 3 years follow-up with no evidence of recurrence. One hundred patients agreed to take part. LENT subjective data were obtained using a patient questionnaire approach in order to complete the scales as published. The LENT objective, management and Franco-Italian glossary scores were obtained by a physician. Correlations between scores and differences between treatment groups were examined using non-parametric tests. Results: The average LENT SOMA scores had a greater resolution than the maximum scores, and using the maximum score alone underestimated treatment morbidity. The Franco-Italian glossary scores correlated strongly with the LENT objective scores (ρ=0.61, P<0.0005), and less strongly with the LENT subjective scores (ρ=0.45, P<0.0005). Significant differences in morbidity between the radiation treatment groups were measured using both the LENT SOMA system and the Franco-Italian glossary. Conclusions: The maximum and average LENT scores should be reported for each subsite. The LENT objective scores correlated well with the scores obtained using the established Franco-Italian glossary, but the LENT system provided additional information on subjective treatment effects. Both systems were able to measure significant differences in morbidity between radiation treatment groups. In conclusion, the LENT SOMA system is a valid and comprehensive approach for scoring the late normal tissue effects of radiotherapy

  11. Modeling correlation indices between bladder and Foley′s catheter balloon dose with CT-based planning using limited CT slices in intracavitary brachytherapy for carcinoma of cervix

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    Oinam Arun

    2008-01-01

    Full Text Available Purpose: To derive and validate an index to correlate the bladder dose with the catheter balloon dose using limited computed tomography (CT slices. Materials and Methods: Applicator geometry reconstructed from orthogonal radiographs were back-projected on CT images of the same patients for anatomy-based dosimetric evaluation. The correlation indices derived using power function of the catheter balloon dose and the bladder volume dose were validated in 31 patients with cervical cancer. Results: There was significant correlation between International Commission on Radiation Units (ICRU-38 balloon reference dose (Dr and the dose received by 25% bladder volume (D 25 (P < 0.0001. Significant correlation was also found between the reference dose of mid-balloon point (D rm and the dose to D 25 (P < 0.0001. Average percentage difference [100 x (observed index - expected index / expected index] of observed value of I′ 25 (index for the dose to D25 bladder with respect to mid-balloon reference point from that of expected value was 0.52%, when the index was modeled with reference dose alone. Similarly the average percentage difference for I′10cc (index for the dose to 10 cc volume of bladder with respect to mid balloon point was 0.84%. When this index was modeled with absolute bladder volume and reference dose, standard deviation of the percentage difference between observed and expected index for D rm reduced by approximately 2% when compared to D r . Conclusion: For clinical applications, correlation index modeled with reference dose and volume predicts dose to absolute volume of bladder. Correlation index modeled with reference dose gives a good estimate of dose to relative bladder volume. From our study, we found D rm to be a better indicator of bladder dose than D r .

  12. Clinical results of salvage surgery in hypopharynx carcinoma after chemoradiotherapy

    International Nuclear Information System (INIS)

    The incidence of post-operative complications and treatment results of 60 cases of hypopharynx carcinoma receiving laryngo-pharyngo-esophagectomy followed by reconstruction with jejunum after chemoradiotherapy (CRT) from 1997 to 2006 in 6 hospitals was analyzed. The overall complication rate was 57%. There were 3 cases with carotid artery rupture (5%), 4 with jejunum necrosis (6%), 6 with major salivary fistula (10%), 8 with minor salivary fistula (13%), 8 with abscess alone (13%), 3 with trachea stoma necrosis (5%), and 3 with skin flap necrosis (5%). The death rate due to surgical complications was 3% (2/60). When the cases were divided into two groups, namely the cases with fistula and the cases without fistula, the number of days that permitted drinking was 18.1 in the latter and 81.8 in the former. The 5-year overall survival rate among all cases was 37%. We found that salvage surgery after CRT was effective for recurrent cases. These findings suggest that reconstruction with jejunum is a suitable type of operation with better surgical results. Care is required to reduce the incidence of post-operative complications. (author)

  13. Impact of MRI in the management and staging of cancer of the uterine cervix

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    Stenstedt, Kristina (Centre of Surgical Gastroenterology, Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden)); Hellstroem, Ann-Cathrin (Dept. of Gynecological Oncology, Radiumhemmet, Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden)); Fridsten, Susanne; Blomqvist, Lennart (Dept. of Diagnostic Radiology Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden))

    2011-04-15

    Background. Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix. Material and methods. A retrospective single-centre analysis of 183 women referred to a tertiary referral centre for gynecological tumors (<= 65 years old) with cervical cancer diagnosed between January 1, 2003 and December 31, 2006 who have undergone an MRI investigation before start of treatment. Patient records were retrospectively reviewed and any change of the planned treatment after the MRI examination was noted. Results. In patients with cervical carcinoma FIGO stage Ia2-IIa treated surgically, the treatment plan was altered due to MRI results in 10/125 patients. In the smaller group of patients with clinically more advanced disease receiving radio-chemotherapy, the treatment plan was altered in 12/58 patients. Reasons for changing the treatment plan after MRI were findings indicating a higher (n = 8) or lower (n = 5) local tumor stage, findings of para aortic nodal disease (n = 4) or difficulty to clinically examine the patient due to obesity (n = 2). MRI was also an aid in deciding whether or not to offer fertility preserving treatment in three cases. Conclusion. The use of MRI affects treatment planning in patients with cancer of the uterine cervix. The impact is more obvious in more advanced stages of disease and in patients who are difficult to examine clinically due to, for example body constitution. The result of MRI is also an aid in deciding whether or not a fertility preserving operation is feasible

  14. Impact of MRI in the management and staging of cancer of the uterine cervix

    International Nuclear Information System (INIS)

    Background. Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix. Material and methods. A retrospective single-centre analysis of 183 women referred to a tertiary referral centre for gynecological tumors (≤ 65 years old) with cervical cancer diagnosed between January 1, 2003 and December 31, 2006 who have undergone an MRI investigation before start of treatment. Patient records were retrospectively reviewed and any change of the planned treatment after the MRI examination was noted. Results. In patients with cervical carcinoma FIGO stage Ia2-IIa treated surgically, the treatment plan was altered due to MRI results in 10/125 patients. In the smaller group of patients with clinically more advanced disease receiving radio-chemotherapy, the treatment plan was altered in 12/58 patients. Reasons for changing the treatment plan after MRI were findings indicating a higher (n = 8) or lower (n = 5) local tumor stage, findings of para aortic nodal disease (n = 4) or difficulty to clinically examine the patient due to obesity (n = 2). MRI was also an aid in deciding whether or not to offer fertility preserving treatment in three cases. Conclusion. The use of MRI affects treatment planning in patients with cancer of the uterine cervix. The impact is more obvious in more advanced stages of disease and in patients who are difficult to examine clinically due to, for example body constitution. The result of MRI is also an aid in deciding whether or not a fertility preserving operation is feasible

  15. Transarterial Chemoembolization (TACE) in hepatocellular carcinoma: Technique, indication and results

    International Nuclear Information System (INIS)

    To present current data on technique, indications and results of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). The principle of TACE is the intra-arterial injection of chemotherapeutic drug combinations like doxorubicin, cisplatin and mitomycin into the hepatic artery, followed by lipiodol injection, Gelfoam for vessel occlusion and degradable microspheres. The side effects and complications after TACE range from fever, upper abdominal pain and vomiting to acute or chronic liver cell failure. The palliative effect in unresectable HCC using TACE allows local tumor control in 15 to 60% of cases and 5-year survival rates ranging from 8 - 43%. The potentially curative treatment option allows local tumor control from 18 - 63%. The neoadjuvant treatment option of TACE in combination with other treatment options like percutaneous ethanol injection (PEI) or radiofrequency ablation (RFA) reach local tumor control rates between 80 - 96%. The bridging effect of TACE before liver transplantation reaches 5-year survival rates from 59 - 93%. The symptomatic therapy option of TACE is used to counteract pain directly caused by HCC and acute/subacute bleeding in the HCC. The local tumor response reaches up to 88% and the bleeding control is from 83 to 100%. (orig.)

  16. Results of combined therapy for maxillary sinus squamous cell carcinoma

    International Nuclear Information System (INIS)

    The results of 54 cases of maxillary sinus squamous cell carcinoma treated between 1980 and 2002 were analyzed retrospectively. The T classification according to the 1997 Union Internationale Contre le Cancer (UICC) was as follows: 2 with stage T1, 29 with T3, and 23 with T4. Ten patients (18.5 %) had lymph node metastases at diagnosis. All patients underwent combined therapy including radiotherapy, surgery, and regional or systemic chemotherapy. Fifteen patients received hyperfractionated twice-daily radiotherapy (1.2 Gy or 1.5 Gy/fraction), and the remaining 39 patients received a conventional once-daily regimen (1.5-2 Gy/fraction). The 5-year overall survival and 5-year disease-free survival for all patients were 56.0% and 46.7%, respectively. The N classification was the only significant prognostic factor for 5-year disease-free survival by univariate analysis (favoring N=0, p=0.04). There were no significant differences in other prognostic factors including gender, T classification (T1-3 vs. T4), hyperfractionated radiotherapy (yes vs. no), total dose (biological effective dose (BED): 10 vs. ≥69 Gy10), and intra-arterial chemotherapy (yes vs. no). Although radiation-induced cataract was observed in 9 patients, no other severe late complications developed. (author)

  17. Comparison of Treatment Results Between Adult and Juvenile Nasopharyngeal Carcinoma

    International Nuclear Information System (INIS)

    Purpose: Nasopharyngeal carcinoma (NPC) has a bimodal age distribution. In contrast to the adult variant, little is known about the juvenile form. This study examined the treatment results between adult (aNPC) and juvenile NPC (jNPC) patients for future treatment considerations in jNPC. Methods and Materials: The jNPC population included 53 patients treated at two institutions between 1972 and 2004. The aNPC population included 84 patients treated at one institution. The patients had received a median dose of 66 Gy of external beam radiotherapy and 72% underwent chemotherapy. The mean follow-up for surviving patients was 12.6 years for jNPC and 6.6 years for aNPC. Results: The jNPC patients presented with more advance stages than did the aNPC patients (92% vs. 67% Stage III-IV, p = .006). However, jNPC patients had significantly better overall survival (OS) than did aNPC patients. The 5-year OS rate was 71% for jNPC and 58% for aNPC (p = .03). The jNPC group also demonstrated a trend for greater relapse-free survival than the aNPC group (5-year relapse-free survival rate, 69% vs. 49%; p = .056). The pattern of failure analysis revealed that the jNPC patients had greater locoregional control and freedom from metastasis but the differences were not statistically significant. Univariate analysis for OS revealed that age group, nodal classification, and chemotherapy use were significant prognostic factors. Age group remained significant for OS on multivariate analysis, after adjusting for N classification and treatment. Conclusion: Despite more advance stage at presentation, jNPC patients had better survival than did aNPC patients. Future treatment strategies should take into consideration the long-term complications in these young patients.

  18. Clear cell adenocarcinoma of the uterine cervix with malignant pleural effusion in a 29-year old female- A case report

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    Dipti R. Samanta

    2015-07-01

    Full Text Available Primary adenocarcinoma of cervix constitute about 7-15% of all cervical cancer. Clear cell carcinoma, a form of cervical adenocarcinoma is a very rare tumor constituting only 4% of cervical carcinoma. Risk factor and pathogenesis of this disease are not exactly revealed. Intrauterine exposure to diethylstilbestrol and associated non-steroidal estrogen during pregnancy before 18 weeks is the only risk factor. Here we report an unusual case of clear cell carcinoma of cervix presented with bilateral pleural effusion, cytology of which shows adenocarcinoma. This is a rare case since patient had no history of diethylstilbestrol exposure and presented with bilateral pleural effusion. This is the first described case report of clear cell carcinoma of cervix with upfront malignant pleural effusion. [Int J Res Med Sci 2015; 3(7.000: 1795-1797

  19. Favourable results of Mohs micrographic surgery for basal cell carcinoma

    DEFF Research Database (Denmark)

    Gniadecki, Robert; Glud, Martin; Mortensen, Kia;

    2015-01-01

    INTRODUCTION: Basal cell carcinoma (BCC) is the most common malignant neoplasm with an annual incidence approaching 200/100,000 person-years. Mohs micrographic surgery (MMS) is widely used in North America and in Europe for treatment of BCC. This technique ensures radical tumour removal, sparing of...

  20. Role of neoadjuvant chemotherapy in cancer cervix: A brief review

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    Aramita Saha

    2013-01-01

    Full Text Available Neoadjuvant chemotherapy (NACT represents a promising modality apart from or radiotherapy as initial treatment of locally advanced cervical cancer. The primary objectives of NACT in the treatment of cervical cancer include improvement in tumor characteristics, to allow avoidance of radiotherapy, to prolong disease-free and overall survival, and facilitation of fertility-sparing surgery. Though several studies have shown promising results of NACT on tumor response, downstaging, decrease in local recurrence, improved progression free survival, yet its role is controversial and plenty of study results are waiting to establish its efficacy. After reviewing the available literatures in the internet, and focusing the light of our continuous 3 years experience, we have made an effort to find out the relevance of NACT in cancer cervix. NACT is feasible and produces impressive responses in cervical carcinoma, as has been demonstrated by several phase II and phase III trials. Some meta-analysis suggested that NACT followed by surgery improves overall survival compared with nonstandard radiotherapy alone.

  1. Valor da ressonância magnética no planejamento radioterápico dos tumores de colo de útero: resultados preliminares Value of magnetic resonance imaging in the radiotherapy planning of tumours of the uterine cervix: preliminary results

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    Pitágoras Baskara Justino

    2005-12-01

    Full Text Available OBJETIVO: Verificar o índice de erros geográficos no planejamento radioterápico convencional de pacientes com carcinoma de colo uterino por meio da ressonância magnética. MATERIAIS E MÉTODOS: Trinta e duas pacientes com diagnóstico histológico de carcinoma espinocelular de colo uterino, com indicação de radioterapia, foram analisadas. Foi realizada ressonância magnética da pelve, sendo essas imagens comparadas aos campos clássicos de radioterapia, técnica de quatro campos em "tijolo". Considerou-se erro geográfico quando o volume alvo não foi englobado pelos campos, com margens mínimas de 1 cm. RESULTADOS: Em 24 pacientes (75% foi detectada possibilidade de erro geográfico se fossem utilizados os campos convencionais. Em todos os casos o erro foi à custa dos limites anterior (46% ou posterior (40% dos campos laterais. CONCLUSÃO: A ressonância magnética evidenciou chance elevada de erro geográfico no planejamento radioterápico convencional na população analisada, tanto nas pacientes com doença em estádios iniciais quanto avançados.OBJECTIVE: To assess the rate of geographic miss on conventional radiotherapy planning of patients with cervical cancer, using magnetic resonance imaging. MATERIALS AND METHODS: Thirty-two patients with squamous cell carcinoma of the uterine cervix were studied. Magnetic resonance imaging of the pelvis was performed after clinical staging. Magnetic resonance imaging findings were compared with the classic fields described for the "box" technique. Target volume within less than 1 cm margins of the fields' limits was considered as geographic miss. RESULTS: Classical radiation field limits were inadequate in 24 cases (75%, all in the anterior (46% or posterior (40% border of the lateral fields. CONCLUSION: Magnetic resonance detected a high probability of geographic miss on conventional radiotherapy planning in this population, both in initial and advanced stages of the disease.

  2. Immunohistochemical expression of MIB-1 and PCNA in precancerous and cancerous lesions of uterine cervix

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    Madhu Mati Goel

    2013-01-01

    Full Text Available Background and Objective: The present study was done to analyze the immunoexpression of diagnostic markers (MIB-1: molecular immunology borstel and PCNA: proliferating cell nuclear antigen in grading cervical intraepithelial lesion (CIN and squamous cell carcinoma (SCC in cervix. Setting and Design: Total 150 cervical biopsies were divided into four groups respectively; Group I-Normal (n = 32, Group II- CIN (n = 60, Group III- SCC (n = 44, Group IV- CA cervix (n = 14 respectively. Materials and Methods: These biopsies were stained with monoclonal antibodies by streptavidin--biotin method. Mean labeling index was calculated and grading was performed using the I--III scoring system. Statistical Analysis: Findings were correlated with age and menopausal status. Statistical analysis was done by using student sample′t′ test and analysis of variance (ANOVA by SPSS 10 package. Results: MIB-1 immunostaining was positive in 112/150 (74.6% cases and PCNA in 118 /150 (78.6% cases. Labeling indices showed linear progression from normal to CIN to SCC to cancer lesion. Few cases of low-grade CIN lesion had high proliferative index. A significant positive correlation was found between age and PCNA and MIB-1 values (P < 0.05 when comparison was made for all the cases. Conclusion: These markers may be useful in identifying low-grade CIN lesion with high proliferative index. These cases should be kept for follow up studies so that proper intervention can be taken at an early stage. This method is simple and cost effective and can easily be done in formaline-fixed paraffin embedded tissues in a clinical laboratory for grading CIN and SCC lesions in cervix.

  3. Contribution to the radiotherapy of collum and corpus carcinoma (Marburg results 1960-1979)

    International Nuclear Information System (INIS)

    The subject of this work is the therapeutic success of radiation therapy, respectively operation, with uterine carcinoma. For the evaluation 938 patients of the Marburg University Radiation Clinic from the years 1960 to 1979 were included. The 5-year survival rate with collum carcinoma was 56.99% (stage I 79.62%, II 57.29%, III 31.13%, IV 5.88%). With patients with corpus carcinoma the 5-year survival rate was 74.27% (stage II 80.79%, I 77.50%, III 57.50%, IV 30.00%). The results of various radiotherapeutic methods ('Duesseldorf method', 'Marburg method') were discussed. With respect to the international results published in 'Annual Report' the Marburg results for the treatment of collum carcinoma (the 5-year survival rates) are at world level, and the successes in the treatment of corpus carcinoma are clearly better. (TRV)

  4. Optimization of combined radiation therapy of the cervix cancer

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    Vladimir Philippenko

    2010-04-01

    Full Text Available Use of a new combination of known medical products - inhibitorsenzyme of cyclooxigenase-2 (diclofenac, ketoprofen with smalldoses cytostatics (methotrexate, 5-fluorouracil as“nonconventional” radiosensibilizators for optimization of combinedradial treatment of cervical cancer is offered. One hundred andtwenty patients with cervix cancer were involved into research(average age - 52.5±3.3, mainly II stage of process (50.8±4.6%,morphologically - nonkeratinizing squamous cell carcinoma(65.0±4.4%. Frequency of full regress of a tumor in the basicgroups has reached in 77.5±6.6% (1-basic group and 82.5±6.0% (2-basic group in comparison with a control group 70.0±7.2%(р<0.05. By results of the cytological research in cells thepathomorphosis of IV degree was recorded in 1-basic group - 60.0%(superficial smears and 57.5% (a puncture biopsy, in 2-basic group- 85.0% (superficial smears and 82.5% (a puncture biopsy incomparison with the control - 55.0% (superficial smears and apuncture biopsy, р<0.05.

  5. Surgery for recurrent biliary carcinoma: results for 27 recurrent cases

    OpenAIRE

    Noji, Takehiro; Tsuchikawa, Takahiro; Mizota, Tomoko; Okamura, Keisuke; Nakamura, Toru; Tamoto, Eiji; Shichinohe, Toshiaki; Hirano, Satoshi

    2015-01-01

    Background Various chemotherapies have been used as best practice to treat recurrent biliary malignancies. Conversely, relatively few surgeries have been described for recurrent extrahepatic biliary carcinoma (RExBC), so whether surgery for RExBC is feasible has remained unclear. This retrospective study was conducted to evaluate the feasibility of surgery for RExBC. Methods From February 2000 to January 2014, a total of 27 patients, comprising 18 patients with extrahepatic cholangiocarcinoma...

  6. Techniques and results of brachytherapy for carcinoma of the tongue

    International Nuclear Information System (INIS)

    Three hundred and twelve patients with 1987 UICC T1, 2 carcinoma of the tongue, who underwent definitive brachytherapy from November, 1978 to March, 1991 in the Department of Radiology, Kyushu University Hospital, and from January, 1985 to December, 1994 in the Department of Radiotherapy, Kyushu Cancer Center, were reviewed retrospectively. All patients were admitted 15-30 mg Pentazocine and O.25 mg Atropine sulfate as the premedication. Thirty to 60 minutes after, the tip of tongue and the lesion were put under local infiltration anesthesia with 10-20 ml of 1-2% Lidocaine or 1% Procaine HCL. The tongue was pulled out by the thread of the tip. Partial resection or wide excisional biopsy of the tumor was performed to reduce the tumor volume and the radiation volume and also to estimate Jacobson-Yamamoto's grading histologically in the bottom of the tumor. Radium needles or Iridium hair pins were implanted in the lesion following Paterson's method, and left for 3-10 days to the minimum tumor dose of 70 Gy calculated by computer. The secondary neck lymph node metastases rates of the patients with T1 carcinoma of the tongue were 27% and 53% in the Jacobson-Yamamoto grading 1-3 group and 4 group. The rates of the patients with T2 were 28% and 82% in 1-3 group and 4 group. Two year's local control rates of the patients with T1 and T2 carcinoma were 95% and 82%. Two year's late reaction (mandibular bone exposure or refractory ulcer of soft tissue) rates of the patients with T1 and T2 carcinoma were 7% and 12%. (author)

  7. Preliminary results of magnetic resonance imaging-aided high-dose-rate interstitial brachytherapy for recurrent uterine carcinoma after curative surgery

    International Nuclear Information System (INIS)

    This report presents initial experience with imaging-aided high-dose-rate interstitial brachytherapy (HDR-ISBT) for post-operative recurrence of uterine carcinoma. Fourteen patients presenting with post-operative recurrence of uterine carcinoma (nine cervix and five corpus) between July 2005 and October 2008 were enrolled in this study (median follow-up: 37 months, range: 6-59 months). We implanted magnetic resonance imaging (MRI)-compatible plastic applicators using our own ambulatory technique. HDR-ISBT treatment consisted of twice-a-day irradiation of 6 Gy each with at least a six-hour interval to provide the total prescribed dose. Treatment was based on treatment planning-computed tomography with MRI as a reference. Seven patients were treated with a combination of ISBT (median 30 Gy/5 fractions; range: 27-33 Gy) and external beam radiation therapy (EBRT), and the other seven with brachytherapy only (median 54 Gy/9 fractions; range: 48-54 Gy), one of whom had previously received pelvic EBRT. The three-year estimates of local control and overall survival rates were 77.9% (95% confidence interval (CI): 55.8-100%) and 77.1% (95% CI: 54.2-100%), respectively. Two patients, who had received combined treatment with EBRT showed untoward reactions, including a grade 3 subileus and grade 2 constipation. Another patient, who had been treated with ISBT alone, developed grade 2 urinary constriction. Our imaging-aided HDR-ISBT for post-operative recurrence of uterine carcinoma was found to be practical with promising preliminary results. (author)

  8. Are we justified for concomitant chemo-radiation in advanced stage cancer cervix?

    International Nuclear Information System (INIS)

    the survival rates have achieved a plateau of 30-45% at five years. Over the last decade there have been studies on the use of chemo-radiotherapy in carcinoma cervix. Over 19 randomized trials have been published addressing the issue of chemo-radiotherapy. However, heterogeneous data, poor randomization, inadequate number of patients, sub-optimal radiotherapy, non-uniform use of chemotherapeutic drugs, its sequencing and poor documentation have not yet provided the evidence to substantially alter the practice. The Cochrane and Canadian meta-analyses have to a large extent tried to address the role of concomitant chemo-radiation, but carcinoma cervix stage III accounted for only 30?35%. Moreover, evaluation with optimal radiation schedules and comparison of late toxicities still remain unanswered. What is more important is that the cisplatin is relatively inexpensive and is available worldwide. This means that cisplatin-based chemo-radiation is affordable in the developing countries where carcinoma cervix still forms the major cancer. However, the role of chemo-radiation in carcinoma cervix stage IIIB in developing countries including India still remains unexplored. With an aim to evaluate the role and benefit of chemo-radiation in- patients with cervical cancer we proposed this randomized study

  9. PRECANCEROUS AND CANCEROUS LESIONS OF CERVIX DIAGNOSED BY PAP’S SMEAR - A HOSPITAL BASED STUDY

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    Komal Singh

    2014-02-01

    Full Text Available BACKGROUND: Cervical intra - epithelial neoplasia (CIN and cervical cancer remain important health problems for women worldwide. It is largely a preventable disease that is characterized by a long lead time. The objective of this study was to determine the frequency of precancerous lesions of cervix by Pap smear screening. METHODS : A retrospective hospital based study was conducted at Department of Pathology, in a Tertiary Care Institute and associated hospital, Bhopal. Data was collected from the records of Pap’s smear testing done on 388 patients in years 2011 & 2012. Analysis was done by entering data in SPSS software and Chi - square test was applied to find statistical significance. RESULTS: Most common lesions on Pap’s smear was Low grade squamous intraepithelial les ion (LSIL in 104 (26.8% of cases and High grade squamous intraepithelial lesion (HSIL in 15 (3.9% of cases. 44 (11.3% were senile Atopic Changes, parasitic Infection in 27 (7% of cases and 2 (0.5% were carcinoma cervix cases. All the cervical lesion s were most common in age of 31 - 40 yrs. and were significantly associated with age. CONCLUSIONS: Pap’s smear examination information should be spread in community apart from hospitals. Especially the young women should be motivated for regular Pap’s smear. Pap’s smear is the single most important screening method for early detection of precancerous & cancerous cervical lesions

  10. Therapeutic and diagnostic procedures in preinvasive disease of the cervix and cervical cancer in pregnant women

    International Nuclear Information System (INIS)

    154 pregnant women with displasis and cervical carcinoma of the uterus treated in the Institute in years 1953-1990 underwent investigation. Authors noticed that only 50 pathologies were diagnosed in 1st trimester of pregnancy and 85% constituted precancerous and early forms of carcinoma of the uterine cervix. Authors presented the model of management and care of pregnancy, labour and puerperium in these patients. Due to this procedure we obtained 90% comparability of preliminary and final diagnosis. (author)

  11. Comparative performance analysis of cervix ROI extraction and specular reflection removal algorithms for uterine cervix image analysis

    Science.gov (United States)

    Xue, Zhiyun; Antani, Sameer; Long, L. Rodney; Jeronimo, Jose; Thoma, George R.

    2007-03-01

    Cervicography is a technique for visual screening of uterine cervix images for cervical cancer. One of our research goals is the automated detection in these images of acetowhite (AW) lesions, which are sometimes correlated with cervical cancer. These lesions are characterized by the whitening of regions along the squamocolumnar junction on the cervix when treated with 5% acetic acid. Image preprocessing is required prior to invoking AW detection algorithms on cervicographic images for two reasons: (1) to remove Specular Reflections (SR) caused by camera flash, and (2) to isolate the cervix region-of-interest (ROI) from image regions that are irrelevant to the analysis. These image regions may contain medical instruments, film markup, or other non-cervix anatomy or regions, such as vaginal walls. We have qualitatively and quantitatively evaluated the performance of alternative preprocessing algorithms on a test set of 120 images. For cervix ROI detection, all approaches use a common feature set, but with varying combinations of feature weights, normalization, and clustering methods. For SR detection, while one approach uses a Gaussian Mixture Model on an intensity/saturation feature set, a second approach uses Otsu thresholding on a top-hat transformed input image. Empirical results are analyzed to derive conclusions on the performance of each approach.

  12. Using of electrical impedance tomography for diagnostics of the cervix uteri diseases

    Science.gov (United States)

    Trokhanova, O. V.; Chijova, Y. A.; Okhapkin, M. B.; Korjenevsky, A. V.; Tuykin, T. S.

    2010-04-01

    The report presents results of investigation of the neck of the womb (cervix) of 64 women aged from 19 to 70, that formed 4 clinical groups (1st group: 15 women without any pathology of the cervix, 2nd group: 27 women with the erosion, 3rd group: 11 women with dysplasia, 4th group: 11 women with cancer of the cervix). The aim of this research is to assess the capabilities of electrical impedance tomography in the diagnostics of the cervix diseases. The methods of the research were: visual examination with the speculum, colposcopy, and biopsy of the cervix. Also the new method of visualization of the cervix was used - electrical impedance tomography with the help of gynecological impedance tomograph (GIT). The following results were obtained. The electrical conductivity of the cervix in norm and in different pathology has different indices, which allow differential diagnostics of benign and malignant diseases. Summary: the method of electrical impedance tomography allows not only visually estimate portio vaginalis, but receive indices of electrical conductivity of the cervix on the depth up to 0.8 cm and thereby reveal pathological changes in epithelium without invasive and operative intervention.

  13. Favourable results of Mohs micrographic surgery for basal cell carcinoma

    DEFF Research Database (Denmark)

    Gniadecki, Robert; Glud, Martin; Mortensen, Kia;

    2015-01-01

    INTRODUCTION: Basal cell carcinoma (BCC) is the most common malignant neoplasm with an annual incidence approaching 200/100,000 person-years. Mohs micrographic surgery (MMS) is widely used in North America and in Europe for treatment of BCC. This technique ensures radical tumour removal, sparing of...... to 40% smaller skin defects than standard excisions with 4 or 6 mm margins. Closure of skin defects was achieved by side-to-side closure in 49% and by local flaps in 40%. There were no relapses during the observation time. The safety, cosmetic and functional outcome were excellent. CONCLUSIONS: We...

  14. In vivo Raman spectroscopy of cervix cancers

    Science.gov (United States)

    Rubina, S.; Sathe, Priyanka; Dora, Tapas Kumar; Chopra, Supriya; Maheshwari, Amita; Krishna, C. Murali

    2014-03-01

    Cervix-cancer is the third most common female cancer worldwide. It is the leading cancer among Indian females with more than million new diagnosed cases and 50% mortality, annually. The high mortality rates can be attributed to late diagnosis. Efficacy of Raman spectroscopy in classification of normal and pathological conditions in cervix cancers on diverse populations has already been demonstrated. Our earlier ex vivo studies have shown the feasibility of classifying normal and cancer cervix tissues as well as responders/non-responders to Concurrent chemoradiotherapy (CCRT). The present study was carried out to explore feasibility of in vivo Raman spectroscopic methods in classifying normal and cancerous conditions in Indian population. A total of 182 normal and 132 tumor in vivo Raman spectra, from 63 subjects, were recorded using a fiberoptic probe coupled HE-785 spectrometer, under clinical supervision. Spectra were acquired for 5 s and averaged over 3 times at 80 mW laser power. Spectra of normal conditions suggest strong collagenous features and abundance of non-collagenous proteins and DNA in case of tumors. Preprocessed spectra were subjected to Principal Component-Linear Discrimination Analysis (PCLDA) followed by leave-one-out-cross-validation. Classification efficiency of ~96.7% and 100% for normal and cancerous conditions respectively, were observed. Findings of the study corroborates earlier studies and suggest applicability of Raman spectroscopic methods in combination with appropriate multivariate tool for objective, noninvasive and rapid diagnosis of cervical cancers in Indian population. In view of encouraging results, extensive validation studies will be undertaken to confirm the findings.

  15. Fast neutron therapy of bronchus carcinoma: the pooled results from two european centres

    International Nuclear Information System (INIS)

    The Berlin-Buch and Heidelberg centres used fast neutron therapy in bronchial carcinomas. The neutron source was a cyclotron in Berlin-Buch/Rossendorf and a d-t generator in Heidelberg. Three hundred twelve patients with inoperable bronchial carcinoma were treated with fast neutron therapy alone or in combination with photons. The results were then compared with those obtained from 594 patients treated only with photons. Altogether, 788 were treated in Berlin-Buch and 188 in Heidelberg. The results suggest that neutron therapy for bronchial carcinoma can be a good alternative in curative and palliative situations in the early stages. (author)

  16. Clinical Value of Serum HMGB1 Levels in Early Detection of Recurrent Squamous Cell Carcinoma of Uterine Cervix: Comparison with Serum SCCA, CYFRA21-1, and CEA Levels

    OpenAIRE

    Sheng, Xiugui; Du, Xuelian; Zhang, Xiaoling; Li, Dapeng; Lu, Chunhua; Li, Qinshui; Ma, Zhifang; Song, Quqing; Wang, Cong

    2009-01-01

    Aim To evaluate the clinical value of serum high mobility group box chromosomal protein 1 (HMGB1) levels in making the early diagnosis of recurrent cervical squamous cell carcinomas (CSCC) and compare it with the value of serum squamous cell carcinoma antigen (SCCA), cytokeratin fragment (CYFRA) 21-1, and carcinoembryonic antigen (CEA) levels. Methods Immunohistochemical staining of tissue from 64 patients with recurrent CSCCs, 72 patients with non-recurrent carcinoma,...

  17. Aggressive approach in a case of cancer cervix with uremia

    Directory of Open Access Journals (Sweden)

    M G Janaki

    2010-01-01

    Full Text Available Carcinoma of cervix is the most common cancer in developing countries. Majority of them present in locally advanced stages. A 36-year-old lady presented with bleeding and white discharge per vagina since four months, vomiting and reduced urine output since two weeks. Patient had an exophytic cervical growth. Investigation revealed elevated serum creatinine. Patient received single fraction radiation and underwent percutaneous nephrostomy. At one month follow-up, serum creatinine returned to almost normal level. Patient underwent bilateral ante grade stenting and completed concurrent chemoradiotherapy. In selected subsets of patients, aggressive management offered longer palliation and good quality of life.

  18. INVERTED CONDYLOMA OF UTERINE CERVIX: A RARE CONDYLOMATOUS LESION

    Directory of Open Access Journals (Sweden)

    Prem Charles

    2014-10-01

    Full Text Available Human papillomavirus (HPV is an epitheliotropic virus that can infect and cause disease of skin or mucosa at any site. HPV associated lesions can be broadly divided into cutaneous and mucous membrane lesions. Cutaneous lesions include: warts, Butcher’s wart and epidermodysplasia verruciformis. The anogenital diseases, include warts (condyloma, dysplasia (cervical, vaginal, vulvar, anal, and squamous cell carcinoma. Here we are presenting a case report of a 27 year old female who was histologically diagnosed as inverted condyloma a rare condylomatous lesion involving the uterine cervix.

  19. [Morphofunctional features of the cervix uteri in women using hormonal contraception].

    Science.gov (United States)

    Prilepskaia, V N; Kondrikov, N I; Nazarova, N M

    1991-12-01

    The causes of precancerous and cancerous diseases of the cervix are disputed. In women with menstrual disorders usually benign cervical disease is 5 times higher. In the 1960s the theory of hormonal genesis of cervical disease was advanced as similar pathogenetic processes in the cervix, endometrium, myometrium, and breasts resulted in hyperplastic changes in these organs. Ectopia can occur during sexual maturation under the influence of sex hormones. The maximum frequency (65.5%) of ectopia occurred up to age 20. Cervical ectopia can occur under use of oral contraceptives (OCs) for 6-12 months but it vanishes after discontinuation. In a study of 17,942 women aged 18-58 increased risk of preinvasive carcinoma of the cervix was found under longterm use of OCs. Increased frequency of cervical intraepithelial neoplasm from .9/10,000 women/year to 2.2/10,000 women/year was found only under longterm (up to 8 years) of OC use. An epidemiological investigation of 47,000 women using OCs for up to 10 years concluded that there was significant increase of frequency of cervical cancer compared with nonusers. It was 4 times higher in those taking OCs for over 10 years, although longterm use reduced uterine and ovarian cancer. Adenomatous hyperplasia of the endocervix was 14 times more frequent in OC users. In a sample of 128 women, 44% of whom were OC users, 24% had microglandular hyperplasia. Under the use of the 3-phase preparation Trisiston for 6 months-1 year ectopia was diagnosed in 13.6% of women that disappeared after cessation of use. Early cancer and dysplasia disappeared in 1/3 of women taking Enovid for 6-30 months after diagnosis. OCs promote the prophylaxis against genital cancer because women taking OCs undergo gynecological and cytological examinations more often, thus precancerous changes can be diagnosed early. The optimal and the safest method of contraception has to be chosen to minimize the effect on the cervix. PMID:1789353

  20. Sonography of the cervix at term gestation

    OpenAIRE

    Meijer-Hoogeveen, M.

    2007-01-01

    Abstract During pregnancy the firm cartilage-like consistency of the cervix is transformed to soft tissue. This transformation is called "cervical ripening" and enables the cervix to dilate and facilitate parturition. In 1960, the Bishop Score was introduced to assess cervical ripeness before induction of labour, which is determined by digital examination. The Bishop Score consists of five different aspects of the cervix, namely dilatation, effacement, consistency, position and station of the...

  1. Automatic evaluation of uterine cervix segmentations

    Science.gov (United States)

    Lotenberg, Shelly; Gordon, Shiri; Long, Rodney; Antani, Sameer; Jeronimo, Jose; Greenspan, Hayit

    2007-03-01

    In this work we focus on the generation of reliable ground truth data for a large medical repository of digital cervicographic images (cervigrams) collected by the National Cancer Institute (NCI). This work is part of an ongoing effort conducted by NCI together with the National Library of Medicine (NLM) at the National Institutes of Health (NIH) to develop a web-based database of the digitized cervix images in order to study the evolution of lesions related to cervical cancer. As part of this effort, NCI has gathered twenty experts to manually segment a set of 933 cervigrams into regions of medical and anatomical interest. This process yields a set of images with multi-expert segmentations. The objectives of the current work are: 1) generate multi-expert ground truth and assess the diffculty of segmenting an image, 2) analyze observer variability in the multi-expert data, and 3) utilize the multi-expert ground truth to evaluate automatic segmentation algorithms. The work is based on STAPLE (Simultaneous Truth and Performance Level Estimation), which is a well known method to generate ground truth segmentation maps from multiple experts' observations. We have analyzed both intra- and inter-expert variability within the segmentation data. We propose novel measures of "segmentation complexity" by which we can automatically identify cervigrams that were found difficult to segment by the experts, based on their inter-observer variability. Finally, the results are used to assess our own automated algorithm for cervix boundary detection.

  2. Results of radiation therapy for squamous cell carcinoma of vulva

    International Nuclear Information System (INIS)

    From 1962 to 1982, 20 cases of patients with squamous cell carcinoma of the vulva were treated by radiation alone at National Cancer Center Hospital, Tokyo. 80% (16/20) of these cases were over 60 years old. Treatment was made by interstitial irradiation (Radium needle or Au-Grain) and external irradiation (Betatron electron or Linac X-rays), alone or with various combinations. As for the stage of these cases, Stage I was 3 cases (15%), Stage II was 5 (25%) and Stage III was 12 (60%). Serious complications after treatment were observed in 15% (3/20) and all cases were treated with external irradiation alone. The 5 year survival rates by stage were as follows; Stage I 100% (3/3), Stage II 50% (2/4) and Stage III 22.2% (2/9). Surgery is considered the treatment of choice in this disease. However, radiation therapy may be indicated when the tumor has extended beyond the limit of surgical resections; when distant metastases are present; when the patient's general condition precludes surgery, or when surgery is refused. (author)

  3. Results of radiation therapy for squamous cell carcinoma of vulva

    Energy Technology Data Exchange (ETDEWEB)

    Tsukiyama, Iwao; Kakehi, Masae; Ono, Ryosuke (National Cancer Center, Tokyo (Japan). Hospital)

    1984-04-01

    From 1962 to 1982, 20 cases of patients with squamous cell carcinoma of the vulva were treated by radiation alone at National Cancer Center Hospital, Tokyo. 80% (16/20) of these cases were over 60 years old. Treatment was made by interstitial irradiation (Radium needle or Au-Grain) and external irradiation (Betatron electron or Linac X-rays), alone or with various combinations. As for the stage of these cases, Stage I was 3 cases (15%), Stage II was 5 (25%) and Stage III was 12 (60%). Serious complications after treatment were observed in 15% (3/20) and all cases were treated with external irradiation alone. The 5 year survival rates by stage were as follows; Stage I 100% (3/3), Stage II 50% (2/4) and Stage III 22.2% (2/9). Surgery is considered the treatment of choice in this disease. However, radiation therapy may be indicated when the tumor has extended beyond the limit of surgical resections; when distant metastases are present; when the patient's general condition precludes surgery, or when surgery is refused.

  4. The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review

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    Mohammed Osman

    2014-09-01

    Full Text Available Cervical cancer is the second most common cancer in women. Neoadjuvant chemotherapy for patients with locally advanced cervix cancer has comparable benefits to concurrent chemoradiotherapy (CCRT, but with fewer side effects. This systematic review aims to provide a comprehensive summary of the benefits of neoadjuvant chemotherapy for the management of locally advanced cervix cancer from stage IB2 (tumor >4.0 cm to IIIB (tumor extending to the pelvic wall and/or hydronephrosis. Our primary objective was to assess benefits in terms of survival. The data source included the USA national library of medicine, Medline search, and the National Cancer Institute PDQ Clinical Protocols. Inclusion criteria for consideration in the current systematic review included studies published between January 1997 and December 2012. In terms of histology, they had to be focused on squamous cell carcinoma, adenosquamous carcinoma, and/or adenocarcinoma. Patients should be either chemotherapy naïve or cervix cancer chemotherapy naïve, and have a performance status ≤2. The search in the above-mentioned scientific websites led to identify 49 publications, 19 of which were excluded, as they did not meet the inclusion criteria of this systematic review. Therefore only 30 studies were deemed eligible. Data was collected from 1760 patients enrolled in the current systematic review study. The mean age was 45.2 years. The mean tumor size was 4.7 cm. The most commonly used chemotherapies were cisplatin doublets. Paclitaxel was the most commonly used chemotherapeutic agent in the doublets. The mean chemotherapy cycles were 2.7. After chemotherapy, patients underwent surgery after a mean time of 2.5 weeks. The standard operation was radical hysterectomy with pelvic lymphadenectomy. Chemotherapy achieved an objective response rate of 84%. The 5-year progression-free survival and overall survival were 61.9% and 72.8% respectively. The treatment protocol was associated

  5. Results of Surgical Therapy in Patients with Medullary Thyroid Carcinoma.

    Science.gov (United States)

    Vlad, Mihaela; Zosin, Ioana; Timar, Bogdan; Lazar, Fulger; Vlad, Adrian; Timar, Romulus; Cornianu, Marioara

    2016-08-01

    Medullary thyroid carcinoma (MTC) is a rare form of malignancy, having an intermediate prognosis. Controversies exist regarding the best surgical approach. The aim of the study was to analyze the outcome in a group of patients with MTC, diagnosed and followed up in a single care center. We performed a retrospective analysis of all the patients diagnosed with MTC in the Department of Endocrinology from the County Emergency Hospital Timisoara between 1992 and 2012. The study group included 19 patients, 6 men (31.6 %), mean age 41.2 ± 12.5 years (20-72 years). The preoperative diagnosis was based on the protocol for nodular thyroid disease. Total or near-total thyroidectomy was performed in 10 out of 16 patients who could be operated. Postoperative follow-up included repeated measurements of serum calcitonin and imaging investigations. Nine out of the total of 19 (47.3 %) patients had hereditary forms of MTC. Most of the cases (84.2 %) were submitted to surgery. The median duration of follow-up was 84 months. The pTNM staging indicated that the majority of the patients with hereditary MTC were diagnosed in an earlier stage. Disease remission was achieved in 7 cases (43.8 %). Four patients, all with sporadic forms, died. Survival rates at 1, 5 and 10 years were significantly higher (p = 0.048) in patients with hereditary MTC. An early diagnosis of MTC allows a better surgical approach and an improved survival rate. We support the general recommendation that modified radical neck dissection is not necessary for all the patients with MTC. PMID:27574350

  6. Hypoxia and metastasis in an orthotopic cervix cancer xenograft model

    International Nuclear Information System (INIS)

    Background: Hypoxia can promote tumor metastasis by mechanisms that are believed to result from changes in gene expression. The current study examined the role of putative metastatic genes regulated by cyclic hypoxia in relation to metastasis formation in orthotopic models of cervix cancer. Methods: Orthotopic tumors derived from ME180 human cervix cancer cells or from early generation human cervix cancer xenografts were exposed to cyclic hypoxic conditions during growth in vivo and tumor growth and lymphnode metastases were monitored. Expression of the chemokine receptor CXCR4 and various genes in the Hedgehog (Hh) pathway were inhibited using genetic (inducible shRNA vs CXCR4) small molecule (AMD3100) or antibody (5E1) treatment (CXCR4 and Hh genes, respectively) during tumor growth. Results: As reported previously, exposure of tumor bearing mice to cyclic hypoxia caused a reduction of tumor growth but a large increase in metastasis. Inhibition of CXCR4 or Hh gene activity during tumor growth further reduced primary tumor size and reduced lymphatic metastasis to levels below those seen in control mice exposed to normoxic conditions. Conclusion: Blocking CXCR4 or Hh gene expression are potential therapeutic pathways for improving cervix cancer treatment

  7. Ultrastructural changes in the architecture of collagen in the human cervix treated with urea.

    OpenAIRE

    Kischer, C. W.; Droegemueller, W; Shetlar, M.; Chvapil, M.; Vining, J.

    1980-01-01

    Injection of a solution of 30% urea in acetate buffer at pH 4.0 into the stroma of the uterine cervix results in a marked change in the mechanical properties of the tissue with subsequent easy dilatation. This study analyzes the changes in the collagenous matrix of the cervix by ultrastructural and biochemical methods. Collagen fibrils in urea-treated sections of the cervix are swollen and unravelled, showing spiral configuration of subunits in both cross-sections and longitudinal sections. T...

  8. [Cervix factors as a cause of infertility].

    Science.gov (United States)

    Helm, P; Westergaard, L

    1990-04-23

    The uterine cervix plays an important role in the natural fertilization process and, consequently, it is also a significant factor in infertility. In about 6% of infertile couples, the infertility is caused by the cervical factor. The post coital test (PCT) is the most essential diagnostic procedure. A good PCT result excludes the cervical factor as the cause of infertility. A poor or negative PCT result, on the other hand, only indicates that the cervical tract is the cause in the case of women with verified ovulation and in whom other causes have been excluded. Treatment of the cervical factor has always been difficult. Intrauterine insemination is the best documented treatment method with a pregnancy rate of about 30%. In future, gamete intrafallopian transfer (GIFT) and in vitro fertilization (IVF) may be alternatives in the treatment of infertility owing to the cervical factor. PMID:2184560

  9. Subclinical human papillomavirus infection of the cervix

    International Nuclear Information System (INIS)

    A prospective study to investigate a group of Iraqi woman with proved genital vulval warts, to seek evidence of human papillomavirus infection in apparently normal looking cervixes and to investigate the natural history of infection. From December 1997 to August 1998, 20 women with vulval warts were enrolled along with 20 aged-matched control cases without warts. Their ages ranged between 19-48 years with a mean of 30.4 years, (+/- standard deviation = 2.3) for patients and 18-48 years with a mean of 29.7 (+/- standard deviation = 2.7) for the control group. General and gynecological examinations were carried out. Cervical swabs for associated genital infection, papilloma smears, speculoscopy and directed punch biopsies were carried out to detect subclinical human papillomavirus infections of the cervix and associated intraepithelial neoplasm. Cytology results showed that 11 (55%) of patients had evidence of cervical infection by human papillomavirus, 6 (30%) showed mild dysplastic changes, 3 (15%) showed moderate dysplastic changes, whilst 2 (10%) showed no dysplastic changes. Speculoscopy and acetowhitening was positive in 11 (55%) and collated histological results showed evidence of human papillomavirus infection in 9 patients (45%). As for the control group one case (5%) had evidence of human papillomavirus infection. Subclinical human papillomavirus infection is more common than was previously thought among Iraqi women. It may appear alone or in association with vulval or exophytic cervical warts, or both, and may be more common than the clinically obvious disease. Speculoscopy as an adjunctive method to colposcopy was found to be a simple and an easy to perform technique. Its combination with cytology gave relatively good results when it was used as a triage instrument, and may have a more promising performance in the future. (author)

  10. Cosmetic result with radiations in lip carcinoma treatment

    International Nuclear Information System (INIS)

    The lip forms a complex sphinterian mechanism which is part of several functions: speaking, feeding, breathing and swallowing. Modern technical surgical of reconstruction exist, that conserve partially the anatomy and function of the lip, without getting the functional and a sthetic results of excellence. The radiotherapy gets results with intact skin and muscular innervation. (The author)

  11. Xanthogranulomatous cholecystitis mimicking gallbladder carcinoma with a false-positive result on fluorodeoxyglucose PET

    Institute of Scientific and Technical Information of China (English)

    Isamu Makino; Takahiro Yamaguchi; Nariatsu Sato; Toshiaki Yasui; Ichiro Kita

    2009-01-01

    Recently, several reports have demonstrated that fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is useful in differentiating between benign and mal ignant lesions in the gallbladder. However, there is a limitation in the ability of FDG-PET to differentiate between inflammatory and malignant lesions. We herein present a case of xanthogranulomatous cholecystitis misdiagnosed as gallbladder carcinoma by ultrasonography and computed tomography. FDG-PET also showed increased activity. In this case, FDG-PET findings resulted in a false-positive for the diagnosis of gallbladder carcinoma.

  12. Treatment results of pediatric nasopharyngeal carcinoma, NCI, Cairo University experience

    Directory of Open Access Journals (Sweden)

    Ehab M. Khalil

    2015-09-01

    Conclusion: Radio-chemotherapy management for pediatric NPC resulted in comparable treatment outcomes with tolerable late effects. Response adapted radio-chemotherapy regimens in addition to the potential use of IMRT should be recommended to decrease treatment related side effects. Prolonged OAP of RT ⩾ 50 days and low Hb level were encountered as adverse prognostic factors; findings that need further investigation.

  13. Feasibility and early results of accelerated radiotherapy for head and neck carcinoma in the elderly

    OpenAIRE

    Allal, Abdelkarim Said; Maire, Daphne Isabel; Becker, Minerva; Dulguerov, Pavel

    2000-01-01

    Accelerated radiotherapy (RT) represents a promising method with which to improve the treatment outcome in patients with head and neck carcinoma. However, its applicability to elderly patients has not been well established. This study assessed treatment toxicities, patient compliance, and oncologic results in patients age >/= 70 years who were treated with an accelerated concomitant boost RT schedule.

  14. Investigation of rectal complication after RALS-therapy for uterine cervix cancer using multivariate analysis

    International Nuclear Information System (INIS)

    Rectal injury is one of the major side effects after radiation therapy for carcinoma of the uterine cervix. According to our previous reports, the cases of rectal complication were mainly related to the measured rectal dose in half of patients, and the other causes were related to the following factors; such as diabetes mellitus, hemorrhagic tendency, syphilis and so on. Concerning to rectal complication, these factors were investigated by means of the discriminant analysis, one of the multivariate analyses, in this paper. Twenty-eight factors as to radiation dose, laboratory tests and physical condition of patients were analyzed. From August 1978 through January 1980, 52 cases of previously untreated carcinoma of the uterine cervix were treated using RALS, remotely controlled high dose rate intracavitary radiotherapy, at our department. The data from 49 out of 52 cases were available for the discriminant analysis. By m eans of this analysis, it was found that these factors, such as the dose of whole pelvic irradiation, Point A dose of RALS, measured rectal dose by RALS, WGC-Z and TPHA were important factors for occurence of rectal complication. According to the discriminant score, 46 out of 49 cases (94 %) could be correctly discriminated. There were two cases of false positive and one false negative. Form February 1980 through July 1980, 27 cases of previously untreated carcinoma of the uterine cervix were treated at our department. The obtained discriminant function was applied to these 27 cases, and 24 out of 27 cases (89 %) were correctly predicted. There were two cases of false positive, and one of false negative. Discriminant analysis is useful for the prediction of rectal complication after radiation therapy for carcinoma of the uterine cervix. (J.P.N.)

  15. Morphology of draining lymph nodes after local immune stimulation with C. parvum: comparison of pelvic nodes in carcinoma of cervix and popliteal and inguinal nodes of guinea-pig.

    OpenAIRE

    Mignot, M. H.; Lens, J.W.; Stolk, J. G.; Oort, J.; Veldhuizen, R.W.; Dijkhuizen, G. H.; Drexhage, H. A.

    1982-01-01

    Morphological changes are described in pelvic lymph nodes excised 10 days after C. parvum (CP) treatment of patients with cervical carcinoma. Guinea-pig popliteal and inguinal lymph nodes were investigated from Days 1 to 10 after an injection of 70 micrograms CP into the footpad. Eosinophils were detected from the first few hours after stimulation, initially in the marginal sinus, then in the medullary sinuses and subsequently in the efferent lymphatics. From Day 2 to Day 6, histiocyte accumu...

  16. Immunophenotype and human papillomavirus status of serous adenocarcinoma of the uterine cervix.

    Science.gov (United States)

    Togami, Shinichi; Sasajima, Yuko; Kasamatsu, Takahiro; Oda-Otomo, Rie; Okada, Satoshi; Ishikawa, Mitsuya; Ikeda, Shun-ichi; Kato, Tomoyasu; Tsuda, Hitoshi

    2015-04-01

    Serous adenocarcinoma of the cervix (SACC) is a very rare tumor. Our study aimed to characterize the immune profile and human papillomavirus (HPV) status of SACC, in comparison with other serous adenocarcinomas arising in the female genital tract. The pathological specimens obtained from 81 patients with serous carcinoma of the uterine cervix (n = 12), 29 endometrium, 20 ovary and 20 patients with mucinous carcinoma of the uterine cervix were reviewed. We assessed the expression of WT-1, p53, p16, HER2, CEA, and CA125 by immunohistochemistry and HPV DNA by PCR in 12 SACC samples. Their immune profile was compared with that of uterine papillary serous carcinoma (UPSC), ovarian serous adenocarcinoma (OSA), and mucinous endocervical adenocarcinoma (MEA). WT-1 and HER2 were expressed in very few SACC samples (0 and 0%, respectively), but p16, CA125, CEA and p53 were present in 100, 92, 58 and 50%, respectively. The difference in WT-1 expression between SACC and UPSC, MEA is not significant, but SACC differ significantly from OSA (p UPSC, whereas the frequency of expression of WT-1 was significantly lower in SACC than OSA. It appeared that p53 expression was associated with worse clinical outcome in patients with SACC, and that HPV infection was related to its occurrence. PMID:25370301

  17. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas

    Directory of Open Access Journals (Sweden)

    Almir Galvão Vieira Bitencourt

    2014-04-01

    Full Text Available Objective To correlate the results of 18F-fluoro-2-deoxy-D-glucose (18F-FDG positron emission tomography/computed tomography (PET/CT performed with a specific protocol for assessment of breasts with histological/immunohistochemical findings in breast carcinoma patients. Materials and Methods Cross-sectional study with prospective data collection, where patients with biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT examination in prone position, with a specific protocol for assessment of breasts. PET/CT findings were compared with histological and immunohistochemical data. Results The authors identified 59 malignant breast lesions in 50 patients. The maximum diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm. Invasive ductal carcinoma was the most common histological type (n = 47; 79.7%. At PET/CT, 53 (89.8% of the lesions demonstrated anomalous concentrations of 18F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5. A statistically significant association was observed between higher values of maximum SUV and histological type, histological grade, molecular subtype, tumor diameter, mitotic index and Ki-67 expression. Conclusion PET/CT performed with specific protocol for assessment of breasts has demonstrated good sensitivity and was associated with relevant histological/immunohistochemical factors related to aggressiveness and prognosis of breast carcinomas.

  18. Value of three-dimensional reconstructions in pancreatic carcinoma using multidetector CT: Initial results

    Institute of Scientific and Technical Information of China (English)

    Miriam Klauβ; Max Sch(o)binger; Ivo Wolf; Jens Werner; Hans-Peter Meinzer; Hans-Ulrich Kauczor; Lars Grenacher

    2009-01-01

    AIM: To evaluate the use of three-dimensional imaging of pancreatic carcinoma using multidetector computed tomography (CT) in a prospective study. METHODS: Ten patients with suspected pancreatic tumors were examined prospectively using multidetector CT (Somatom Sensation 16, Siemens, Erlangen, Germany). The images were evaluated for the presence of a pancreatic carcinoma and invasion of the peripancreatic vessels and surrounding organs. Using the isotropic CT data sets, a three-dimensional image was created with automatic vascular analysis and semiautomatic segmentation of the organs and pancreatic tumor by a radiologist. The CT examinations and the three-dimensional images were presented to the surgeon directly before and during the patient's operation using the Medical Imaging Interaction Toolkit-based software "ReLiver". Immediately after surgery, the value of the two images was judged by the surgeon. The operation and the histological results served as the gold standard. RESULTS: Nine patients had a pancreatic carcinoma (all pT3), and one patient had a serous cystadenoma. One tumor infiltrated the superior mesenteric vein. The infiltration was correctly evaluated. All carcinomas were resectable. In comparison to the CT image with axial and coronal reconstructions, the three-dimensional image was judged by the surgeons as better for operation planning and consistently described as useful. CONCLUSION: A 3D-image of the pancreas represents an invaluable aid to the surgeon. However, the 3D-software must be further developed in order to be integrated into daily clinical routine.

  19. Carcinoma of vagina 10 or more years following pelvic irradiation therapy

    International Nuclear Information System (INIS)

    Gynecologic cancer records of 4,238 patients treated between 1956 and 1974 were reviewed. Sixteen patients developed neoplasia in the cervix or vagina 10 or more years following pelvic irradiation. Three patients had squamous carcinoma in situ; the other 13 patients had invasive squamous cancer involving the upper vagina. Only 1.26 percent of invasive carcinoma of the cervix treated by radiation therapy from 1956 to 1966 presented with a late or recurrent or new primary tumor involving the vagina or cervix 10 or more years after primary treatment. The authors conclude that the risk of developing radiation-induced carcinoma in the upper vagina or cervix following pelvic irradiation is low. Follow-up Pap smears are indicated for all patients treated for cervical or vaginal malignancies by radiation therapy in order to detect vaginal neoplasia as well as recurrent carcinoma of the cervix

  20. Adenovirus mediated homozygous endometrial epithelial Pten deletion results in aggressive endometrial carcinoma

    International Nuclear Information System (INIS)

    Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten+/- mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten+/- mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ERα as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

  1. Adenovirus mediated homozygous endometrial epithelial Pten deletion results in aggressive endometrial carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Ayesha; Ellenson, Lora Hedrick, E-mail: lora.ellenson@med.cornell.edu

    2011-07-01

    Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten{sup +/-} mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten{sup +/-} mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ER{alpha} as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

  2. Treatment results and prognostic factors of clear cell ovarian carcinomas and ovarian carcinomas with clear cell component

    Directory of Open Access Journals (Sweden)

    M. D. Ahmedova

    2014-07-01

    Full Text Available The most important prognostic factors for clear cell carcinoma (CCC are clinical and morphological signs and clinical stage of the disease. Analyses of 5-year survival in patients with I stage of CCC is 69 %, in II stage – 55 %, in III stage – 14 % and in IV stage – 4 % patients. We analyzed distant results of treatment of 71 patients with CCC and of 25 patients with mixed malignant ovaries neoplasm with obligatory clear cell component taking into consideration main clinical and morphological sings of disease. On the base of performed reseal we revealed that morphological structure of the tumors and stage of the disease exerted heist influence on the exponent of survival of the patients with clear CCC ovaries neoplasm. Besides, there is a correlation between exponent of patients’ survival and radicalized of surgery, character of tumor growth, differentiation degree, cell anaplasia and mitotic activity of tumor cells.

  3. Outcome of Patients With Metastatic Sarcomatoid Renal Cell Carcinoma: Results From the International Metastatic Renal Cell Carcinoma Database Consortium

    DEFF Research Database (Denmark)

    Kyriakopoulos, Christos E; Chittoria, Namita; Choueiri, Toni K;

    2015-01-01

    BACKGROUND: Sarcomatoid renal cell carcinoma is associated with poor prognosis. Data regarding outcome in the targeted therapy era are lacking. PATIENTS AND METHODS: Clinical, prognostic, and treatment parameters in metastatic renal cell carcinoma patients with and without sarcomatoid histology...... of sRCC is needed to develop alternative therapeutics....

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

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    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

  5. Results of radiation therapy in carcinomas of the floor of the mouth

    International Nuclear Information System (INIS)

    This report is chiefly based on the results achieved with radiation therapy alone in a group of patients suffering from floor-of-the-mouth carcinomas which, at an advanced stage (T3 and T4), are suggestive of a particularly unfavourable patient outcome in no less than 85% of the cases. In addition to results of treatment recorded at this clinic, a general survey is given on the various regimens currently used for radiotherapeutic procedures. (orig.)

  6. Immunolocalization of Prostaglandin E2 Receptor Subtype 4 (EP4 in the Cervix of Cyclic Bitches and Those with Pyometra

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    P Linharattanaruksa1, K Chatdarong1, S Ponglowhapan1, M Khalid3 and S Srisuwatanasagul2*

    2013-07-01

    Full Text Available Cervix is an important part of the reproductive tract; in non-pregnant animals it remains closed during anestrus and diestrus and is open only during estrus. In pathological conditions like pyometra, the cervix may be open or closed but the control mechanism is not clearly known. Prostaglandin E2 (PGE2 is considered to be involved in changes of extracellular matrix via coupling to prostaglandin E receptor subtype 4 (EP4. This study investigated the expression of EP4 in the cervices of bitches during different stages of estrous cycle and those with pyometra. After ovariohysterectomy, cervices were collected from anestrus (n=6, estrus (n=12 and diestrus (n=6, open- (n=10 and closed-cervix pyometra (n=10 bitches. Cervical EP4 expression was observed at all the layers and the stages but the differences in EP4 expression either among bitches in different stages of the estrous cycle and between open- and closed-cervix pyometra were limited to only surface epithelium (SE. In cyclic bitches during estrus and in open-cervix pyometra bitches, significantly higher (P<0.05 EP4 expression was found in SE of uterine part than vaginal part. In SE of the uterine part, the expression was higher in the bitches during estrus than in anestrus and diestrus, and in the bitches affected by open-cervix than those with closed-cervix pyometra. The results suggest that regulation of cervical dilation appeared in the uterine part of the cervix. Moreover, EP4 may be involved in stimulating dilation of the cervix in both estrus and open-cervix pyometra bitches.

  7. Packing effects on the intracavitary radiation therapy of the uterine cervix cancer

    International Nuclear Information System (INIS)

    Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachytherapy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192Ir gives medical treatment intracavity. Intracavitary radiation of the uterine cervix cancer, critical organ take 20% below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherapy make use of packing.

  8. Pain management in cancer cervix

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    Palat Gayatri

    2005-01-01

    Full Text Available Cancer of the cervix uteri is a common cause of pain among women. On the physical realm, the cancer may cause somatic [soft tissue and bone], visceral and neuropathic pain [lumbosacral plexopathy]. Radiotherapy and chemotherapy may cause neuropathy too. Psychological, social and cultural factors modify the pain. Evaluation of the individual type of pain and a patient-centred approach are fundamental requirements for rational management. Disease modifying treatment like radiotherapy and chemotherapy must be considered when applicable. Pain control is usually achieved by the use of WHO three-step ladder, remembering that possible association of renal dysfunction would necessitate caution in the use of NSAIDs and opioids. Side effects must be anticipated, prevented when possible, and aggressively treated; nausea and vomiting may already be present, and constipation can worsen pain when there is a pelvic mass. Pain emergencies can be treated by quick titration with intravenous morphine bolus doses. Neuropathic pain may warrant the use of usual adjuvants, with particular reference to cortico-steroids and the NMDA antagonist, ketamine. In intractable pain, many neurolytic procedures are tried, but a solid evidence base to justify their use is lacking. Continuous epidural analgesia with local anaesthetic and opioid may be needed when drug therapy fails, and desperate situations may warrant interventions such as neurolysis. Such physical measures for pain relief must be combined with psychosocial support and adequate explanations to the patient and the family.

  9. A comparison of results by sequential and concurrent chemo radiotherapy in locally advanced carcinoma esophagus

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    V Bhandari

    2013-01-01

    Full Text Available Aim: Many Trials using sequential and concurrent chemo radiotherapy have been done so far and has established the role of concurrent chemo radiotherapy in treatment of inoperable carcinoma esophagus. In this study, we have compared the results of concurrent chemo radiotherapy with sequential chemo radiotherapy. We have treated inoperable carcinoma esophagus in both the settings and present here the comparison of results in the two settings. Materials and Methods: There were 26 patients of carcinoma esophagus in sequential and 31 in concurrent chemo radiotherapy arm. In sequential arm methotrexate and Cisplatin followed by radiotherapy was given whereas in concurrent arm, Cisplatin was given once weekly along with radiotherapy. Results: The 2 year survival was 38% in sequential and35.5% in the concurrent setting and the median survival was 19.5 and 18 months respectively in the two arms.The toxicities in both the arms were comparable. P value of 0.4774 with confidence interval of 95% was obtained, which is not significant. Dysphagia was improved earlier in sequential than in the concurrent arm. Conclusion: As the results and toxicities in both the arms are almost similar with better symptom control, so larger randomized trials are required to assess the response and the use of methotrexate in sequential chemo radiotherapy can be further explored.

  10. Long-term results of radiotherapy in primary carcinoma of the vagina

    Energy Technology Data Exchange (ETDEWEB)

    Hegemann, Stefan; Willich, Normann [University Hospital, Muenster (Germany). Dept. of Radiotherapy and Radiation Oncology; Schaefer, Ulrich [University Hospital, Muenster (Germany). Dept. of Radiotherapy and Radiation Oncology; Lippe Hospital, Lemgo (Germany). Dept. of Radiotherapy; Lelle, Ralph [University Hospital, Muenster (Germany). Dept. of Gynecology and Gynecologic Oncology; Micke, Oliver [University Hospital, Muenster (Germany). Dept. of Radiotherapy and Radiation Oncology; Franziskus Hospital, Bielefeld (Germany). Dept. of Radiotherapy and Radiation Oncology

    2009-03-15

    Background: The long-term results of radiotherapy in primary carcinoma of the vagina are not well defined. Patients and Methods: The treatment results of 41 patients with primary malignancies of the vagina were analyzed. The mean follow-up period was 77.3 months (2.3-404 months). The predominant histology was squamous cell carcinoma, FIGO stages I: n = 7 (17.1%), II: n = 13 (31.7%), III: n = 13 (31.7%), and IVa: n = 8 (19.5%). Radiotherapy was the primary treatment for all patients. None of the patients had undergone prior surgery for vaginal carcinoma. The majority of patients received pelvic irradiation, including treatment of the inguinal lymphatics (median dose: 50 Gy). 26 patients received additional intravaginal brachytherapy. Results: Overall, 21 patients (51.2%) achieved complete remission, 17 patients (41.5%) had partial responses, and three patients (7.3%) had no change or progressive disease. The total median survival of the analyzed patients was 41.3 months. The 1-year survival probability was 85.4%, the 5-year survival probability 40.6%, and the 10-year survival probability 27.2%. Univariate analysis revealed a survival advantage for earlier tumor stages (FIGO I and II) compared to advanced stages (FIGO III and IV), with a median survival of 58.1 months compared to 26.8 months. Treatment side effects were tolerable and easily managed. Conclusion: Definite radiotherapy is the treatment of choice for primary carcinomas of the vagina. Considering that primary malignancies of the vagina are typically diseases of the elderly, it should be noted that radiotherapy is especially well tolerated in this population. (orig.)

  11. Results of radiotherapy and a combined radio- and chemotherapy for hypopharyngeal carcinomas

    International Nuclear Information System (INIS)

    We analyzed the results of radiotherapy in 36 patients with hypopharyngeal carcinoma. The overall 2-year and 5-year survival rates were 45.3% and 31.1%, respectively. For 23 patients given radical irradiation, the corresponding figures were 37.8% and 28.3%. However, in 16 patients receiving a combined therapy of radical irradiation and chemotherapy, mainly an intraarterial injection of cisplatin, the survivals were better; the 2-year survival rate was 50.0% and four patients have survived for more than three years without recurrence. In managing patients with hypopharyngeal carcinoma, this combined therapy would improve therapeutic outcome and also assist in larynx preservation. (J.P.N.)

  12. Preliminary results of chemoradiation as a primary treatment for vulvar carcinoma

    International Nuclear Information System (INIS)

    Purpose: To assess the role of chemoradiation as a primary treatment for vulvar carcinoma. Methods and Materials: Between December 1989 and August 1997, there were 14 patients with the diagnosis of squamous cell carcinoma of the vulva. Two patients were excluded from this study because of advanced stage at presentation. Key information about the remaining 12 patients was extracted from their charts. All patients had biopsy prior to treatment, and were treated with chemoradiation. Radiation was administered to the vulva only. Surgical biopsies from the vulva and inguinal nodal dissection were done 4-6 weeks after radiation treatment. All patients were followed for evaluation of response and clinical detection of recurrence. The period of follow-up ranged from 8 to 125 months. Mean follow-up period was 41 months. Results: All 12 patients showed complete response to the treatment. Only 1 patient (8.3%) developed local recurrence at 3 months posttreatment. Another patient (8.3%) developed nodal recurrence at 30 months posttreatment. Both patients were salvaged by surgical treatment and remained disease free. The actuarial 5-year disease-free survival was 43%. The actuarial 3-year disease-free survival was 84%. The majority of patients developed mild-to-moderate complications due to chemoradiation. These were well tolerated and responded to medical treatment. None of the patients developed late complications to chemoradiation treatment. Conclusions: Chemoradiation is an effective primary treatment for vulvar carcinoma as shown by these successfully managed cases

  13. Long-term results of curative intraluminal high dose rate brachytherapy for endobronchial carcinoma

    International Nuclear Information System (INIS)

    The treatment strategy of central lung tumors is not established. Intraluminal brachytherapy (ILBT) is widely used for palliative treatment of endobronchial tumors, however, it is also a promising option for curative treatment with limited data. This study evaluates the results after ILBT for endobronchial carcinoma. Sixteen-endobronchial carcinoma of 13 patients treated with ILBT in curative intent for 2000 to 2008 were retrospectively reviewed. ILBT using high dose rate 192 iridium thin wire system was performed with 5 Gy/fraction at mucosal surface. The patient age ranged from 57 to 82 years old with median 75 years old. The 16 lesions consisted of 13 central endobronchial cancers including 7 roentgenographically occult lung cancers and 3 of tracheal cancers. Of them, 10 lesions were treated with ILBT of median 20 Gy combined with external beam radiation therapy of median 45 Gy and 6 lesions were treated with ILBT alone of median 25 Gy. Median follow-up time was 32.5 months. Two-year survival rate and local control rate were 92.3% and 86.2%, respectively. Local recurrences were observed in 2 lesions. Three patients died due to lung cancer (1 patient) and intercurrent disease (2 patients). Complications greater than grade 2 were not observed except for one grade 3 dyspnea. ILBT combined with or without EBRT might be a curative treatment option in inoperable endobronchial carcinoma patients with tolerable complication

  14. Amelanotic malignant melanoma of the uterine cervix diagnosed by cervical smear.

    Science.gov (United States)

    Arık, Deniz; Öge, Tufan; Kabukçuoğlu, Sare; Yalçın, Ömer Tarık; Özalp, Sinan

    2016-06-01

    The melanocytic cells of the cervical epithelium are capable of forming the complete spectrum of melanocytic lesions, from benign lentigines to melanoma. Primary malignant melanoma of the uterine cervix is a rare neoplasm with aggressive behavior. The absence of melanin pigment can lead to misdiagnosis as carcinomas, sarcomas, or lymphoma. Immunohistochemical studies should be used for confirmation. In order to consent the cervix as a primary site, exclusion of any other probable primary sites of melanoma is needed. Here, we present a 61-year-old female patient with postmenopausal vaginal bleeding. After cervical smear, diagnosis was confirmed by cervical punch biopsy. Diagn. Cytopathol. 2016;44:535-537. © 2016 Wiley Periodicals, Inc. PMID:26991516

  15. Early results of combined chemotherapy followed by Co60 radiotherapy in patients with undifferentiated pulmonary carcinoma

    International Nuclear Information System (INIS)

    The results of combined treatment of a group of 17 patients with the diagnosis of microcellular pulmonary carcinoma are reported. The received chemotherapy with three drugs (cyclophosphamide, vincristine, methotrexate) and radiotherapy from Co60 by the sandwich method as suggested by the ALGB group. The obtained results resembled those reported from other clinical centres: 29% of the patients survived one year after treatment onset. Complete remission was achieved in 60% of cases, its mean duration was 11.3 months, and the mean survival time of these patients was 15.5 months. Side effects were slight, and the survival time of the patients achieving complete remission was evidently prolonged. (author)

  16. Comparison of Measurements of the Uterus and Cervix Obtained by Magnetic Resonance and Transabdominal Ultrasound Imaging to Identify the Brachytherapy Target in Patients With Cervix Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dyk, Sylvia van, E-mail: sylvia.vandyk@petermac.org [Radiation Therapy Services, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Kondalsamy-Chennakesavan, Srinivas [Rural Clinical School, University of Queensland, Toowoomba, Queensland (Australia); Schneider, Michal [Department of Medical Imaging and Radiation Science, Monash University, Clayton, Victoria (Australia); Bernshaw, David [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Narayan, Kailash [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Department of Obstetrics and Gynaecology, Melbourne University, Melbourne, Victoria (Australia)

    2014-03-15

    Purpose: To compare measurements of the uterus and cervix obtained with magnetic resonance imaging (MRI) and transabdominal ultrasound to determine whether ultrasound can identify the brachytherapy target and be used to guide conformal brachytherapy planning and treatment for cervix cancer. Methods and Materials: Consecutive patients undergoing curative treatment with radiation therapy between January 2007 and March 2012 were included in the study. Intrauterine applicators were inserted into the uterine canal while patients were anesthetized. Images were obtained by MRI and transabdominal ultrasound in the longitudinal axis of the uterus with the applicator in treatment position. Measurements were taken at the anterior and posterior surface of the uterus at 2.0-cm intervals along the applicator, from the external os to the tip of the applicator. Data were analyzed using Bland Altman plots examining bias and 95% limits of agreement. Results: A total of 192 patients contributed 1668 measurements of the cervix and uterus. Mean (±SD) differences of measurements between imaging modalities at the anterior and posterior uterine surface ranged from 1.5 (±3.353) mm to 3.7 (±3.856) mm, and −1.46 (±3.308) mm to 0.47 (±3.502) mm, respectively. The mean differences were less than 3 mm in the cervix. The mean differences were less than 1.5 mm at all measurement points on the posterior surface. Conclusion: Differences in the measurements of the cervix and uterus obtained by MRI and ultrasound were within clinically acceptable limits. Transabdominal ultrasound can be substituted for MRI in defining the target volume for conformal brachytherapy treatment of cervix cancer.

  17. Radiation therapy alone in the treatment of cervix cancer stages IIB and IIB. Results from Hospital Mario Gatti, Pontificia Universidade Catolica de Campinas; Radioterapia exclusiva no tratamneto do cancer de colo do utero estadios IIB e IIIB. Resultados do Convenio Hospital Mario Gatti/Pontificia Universidade Catolica de Campinas

    Energy Technology Data Exchange (ETDEWEB)

    Ferrigno, Robson [Fundacao Antonio Prudente, Sao Paulo, SP (Brazil). Hospital A.C. Camargo; Oliveira Faria, Sergio Luis Campos de [Pontificia Univ. Catolica de Campinas, SP (Brazil). Hospital Mario Gatti

    1995-05-01

    From September 1989 to December 1992, 178 patients with cervix cancer were treated with radiation therapy alone, being 81 stage IIIB patients were randomized according to the number of intracavitary brachytherapy insertion realized after external irradiation. Of these, 34 were treated with two intracavitary insertion (group A) and 47 with one insertion (group B). Among stage IIIB patients, 54 were treated with one intracavitary insertion after external irradiation (group C) and 47 with external irradiation alone as they had no geometrical condition for intracavitary insertion (group D). There were no statistical difference in 50 months disease free survival among patients stage IIB treated with one or two intracavitary insertion, 72,3% and 70.6% respectively (P=0,711). The 50 months disease free survival were better in patients stage IIIB treated with external irradiation followed by one intracavitary insertion, compared with those treated with external irradiation alone, 51,8% and 30,2% respectively (P=0,007). This series suggests that there is no difference in the treatment of stage IIB cervix cancer with one or two intracavitary insertion. Among stage IIIB patients, the worse result of those treated with external irradiation alone was probably due to the unfavorable prognostic factors, as they were excluded for brachytherapy because they showed no geometrical condition for intracavitary insertion and larger tumor volume. (author) 18 refs., 2 figs., 5 tabs.

  18. 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

  19. Retrospective study of the local control and the cosmetic result of 147 face carcinomas after interstitial brachytherapy

    International Nuclear Information System (INIS)

    The purpose was to evaluate retrospectively the local control rate and the cosmetic results for patients that received an interstitial brachytherapy for a base or spino-cellular carcinoma of face orifices areas. The interstitial brachytherapy by iridium 192 is an excellent alternative to surgery in the skin carcinomas of the face, as well at the level of local control as the cosmetic and functional results. (N.C.)

  20. [Results of a case-control study of the current effect of various factors on risk of cervix cancer. 1. Factors in reproduction, sex behavior and infectious genital diseases].

    Science.gov (United States)

    Köhler, U; Wuttke, P

    1994-01-01

    We performed a case control study to determine factors which influence the development of cervical carcinoma. Factors like reproduction, sexual behaviour and genital infections were considered. 309 patients with cervical intraepithelial neoplasia (CIN) or invasive cervical carcinoma were interviewed as a study group. 490 patients with no cervical changes served as control group. The two groups of patients had a different age distribution with an early age summit in the study group. No differences were observed in relation to residence areas and attendance of screening for cervical carcinoma. 83.5% of the women in the study group (n = 258) and 81.0% (n = 397) of the control group attended the screening for cervical carcinoma. According to our observation, the following factors increased the risk of CIN or invasive cervical carcinoma: early menarche ( 14 years), multiparity (0 vs 1-3 vs > 4), first pregnancy before the age of 20, divorced women, early sexual contact ( 21 years), multiple sexual partners, vaginal discharge and venereal diseases (gonorrhea, syphilis). Factors like reproductive characteristics and genital infections can be interpreted as expressions of sexual behaviour. Despite the improving social status, increasing health consciousness and extensive mass-screening for cervical cancer, the above mentioned risk factors still play an important role. Risk group should be followed and examined strictly so as to reduce the rate of invasive cervical carcinoma in screened patients. PMID:8048284

  1. Supply with the vitamins B1, B2 and B6 in carcinomas before and after radiotherapy

    International Nuclear Information System (INIS)

    In 108 breast cancer, 63 cervix carcinoma, 35 corpus carcinoma and 15 ovarial cancer patients the erythrocyte transketolase, gluthathione reductase and aspartate aminotransferase activity were determined as parameters for the supply with vitamin B1, B2 and B6 before and after radiotherapy. The effects of thiamine pyrophosphate determined in cancer patients were normal but the effects of flavin adenine dinucleotide and pyridoxal-5-phosphate were significantly increased compared to the controls. These results revealed radiation-induced disorders in the B2 metabolism and tumor-induced disorders in the B6 metabolism. Both disorders can be avoided by treatment with vitamin B complex. (author)

  2. Glycosaminoglycan distribution in the rat uterine cervix during the estrous cycle

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    Jairo Jose Matozinho Cubas

    2010-01-01

    Full Text Available OBJECTIVE: To analyze the amount of glycosaminoglycans in the uterine cervix during each phase of the rat estrous cycle. DESIGN: Based on vaginal smears, forty female, regularly cycling rats were divided into four groups (n = 10 for each group: GI - proestrous, GII - estrous, GIII - metaestrous and GIV - diestrous. Animals were sacrificed at each phase of the cycle, and the cervix was immediately removed and submitted to biochemical extraction and determination of sulfated glycosaminoglycans and hyaluronic acid. The results were analyzed by ANOVA followed by the Bonferroni post-hoc test. RESULTS: The uterine cervix had the highest amount of total sulfated glycosaminoglycans and dermatan sulfate during the estrous phase (8.90 ± 0.55 mg/g of cetonic extract, p<0.001; and 8.86 ± 0.57 mg/g of cetonic extract, p<0.001. In addition, there was more heparan sulfate at the cervix during the proestrous phase (0.185 ± 0.03 mg/g of cetonic extract than during any other phase (p<0.001. There were no significant changes in the concentration of hyaluronic acid in the uterine cervix during the estrous cycle. CONCLUSION: Our data suggest that the amount of total sulfated glycosaminoglycans may be influenced by hormonal fluctuations related to the estrous cycle, with dermatan sulfate and heparan sulfate being the glycosaminoglycans most sensitive to hormonal change.

  3. Investigation of the results of therapy of anaplastic thyroid gland carcinomas

    International Nuclear Information System (INIS)

    The results of the treatment of 28 patients with an anaplastic thyroid gland carcinoma are investigated, to see whether an optimal therapy is indicated. The execution of an operation before radiotherapy does not appear to improve the prognosis (statistically this conclusion is not wholly justified). The presence of metastases at the beginning of the therapy gave rise to a worse prognosis than the absence of metastases. The combination treatment of chemotherapy and either surgery or radiotherapy was only applied to two patients so no conclusions can be made about its benefit. (C.F.)

  4. Treatment and outcome in cancer cervix patients treated between 1979 and 1994: A single institutional experience

    Directory of Open Access Journals (Sweden)

    Shyamkishore Shrivastava

    2013-01-01

    Materials and Methods: This is a retrospective study of 6234 patients with carcinoma of the cervix treated with radical intent between 1979 and 1994. All the work-up, staging investigations, treatment details, radiation protocols, outcomes, and toxicities were noted, compiled, and analyzed. Results: With a mean age of 46 years (range: 18-90 years; median: 45 years, 669 (11% patients were in stage Ib, 284 (5% were in stage IIa, 1891 (30% were in stage IIb, 69 (1% were in stage IIIa, and 3321 (53% were in stage IIIb. With a median follow-up of 68 months (57-79 months for the entire group, there was no significant difference in the outcome of 953 patients with international federation of gynecology and obstetrics (FIGO Ib-IIa treated after radical surgery, pre-operative radiation therapy (pre-op RT + Sx or after radical radiation; their disease-free survival (DFS was 60-62% at 8 years. In our series of 1891 patients with stage IIb and 3321 with stage IIIb, a respective DFS of 56% and 40% was achieved at 8 years. Conclusion: Over the last two decades, with the acquisition of newer facilities and inception of Joint Clinics, there has been a significant refinement in the treatment protocols and outcome. Improving radiation strategies to improve therapeutic ratio is the key to success.

  5. Long-term results of curative intraluminal high dose rate brachytherapy for endobronchial carcinoma

    Directory of Open Access Journals (Sweden)

    Kawamura Hidemasa

    2012-07-01

    Full Text Available Abstract Background The treatment strategy of central lung tumors is not established. Intraluminal brachytherapy (ILBT is widely used for palliative treatment of endobronchial tumors, however, it is also a promising option for curative treatment with limited data. This study evaluates the results after ILBT for endobronchial carcinoma. Method Sixteen-endobronchial carcinoma of 13 patients treated with ILBT in curative intent for 2000 to 2008 were retrospectively reviewed. ILBT using high dose rate 192 iridium thin wire system was performed with 5 Gy/fraction at mucosal surface. The patient age ranged from 57 to 82 years old with median 75 years old. The 16 lesions consisted of 13 central endobronchial cancers including 7 roentgenographically occult lung cancers and 3 of tracheal cancers. Of them, 10 lesions were treated with ILBT of median 20 Gy combined with external beam radiation therapy of median 45 Gy and 6 lesions were treated with ILBT alone of median 25 Gy. Results Median follow-up time was 32.5 months. Two-year survival rate and local control rate were 92.3% and 86.2%, respectively. Local recurrences were observed in 2 lesions. Three patients died due to lung cancer (1 patient and intercurrent disease (2 patients. Complications greater than grade 2 were not observed except for one grade 3 dyspnea. Conclusions ILBT combined with or without EBRT might be a curative treatment option in inoperable endobronchial carcinoma patients with tolerable complication.

  6. Preliminary results of 3-dimensional conformal radiotherapy for primary unresectable hepatocellular carcinoma

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    Keum, Ki Chang; Park, Hee Chul; Seong, Jin Sil; Chang, Sei Kyoung; Han, Kwang Hyub; Chon, Chae Yoon; Moon, Young Myoung; Kim, Gwi Eon; Suh, Chang Ok [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2002-06-15

    The purpose of this study was to determine the potential role of three-dimensional conformal radiotherapy (3D-CRT) in the treatment of primary unresectable hepatocellular carcinoma. The preliminary results on the efficacy and the toxicity of 3D-CRT are reported. Seventeen patients were enrolled in this study, which was conducted prospectively from January 1995 to June 1997. The exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child-Pugh classification C, tumors occupying more than two thirds of the entire liver, and a performance status of more than 3 on the ECOG scale. Two patients were treated with radiotherapy only while the remaining 15 were treated with combined transcatheter arterial chemoembolization. Radiotherapy was given to the field including the tumor plus a 1.5 cm margin using a 3D-CRT technique. The radiation dose ranged from 36 {approx} 60 Gy (median: 59.4 Gy). Tumor response was based on a radiological examination such as the CT scan, MR imaging, and hepatic artery angiography at 4 {approx} 8 weeks following the completion of treatment. The acute and subacute toxicities were monitored. An objective response was observed in 11 out of 17 patients, giving a response rate of 64.7%. The actuarial survival rate at 2 years was 21.2% from the start of radiotherapy (median survival; 19 months). Six patients developed a distant metastasis consisting of a lung metastasis in 5 patients and bone metastasis in one. The complications related to 3D-CRT were gastro-duodenitis ({>=} grade 2) in 2 patients. There were no treatment related deaths and radiation induced hepatitis. The preliminary results show that 3D-CRT is a reliable and effective treatment modality for primary unresectable hepatocellular carcinoma compared to other conventional modalities. Further studies to evaluate the definitive role of the 3D-CRT technique in the treatment of primary unresectable hepatocellular carcinoma are needed.

  7. Preliminary results of 3-dimensional conformal radiotherapy for primary unresectable hepatocellular carcinoma

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the potential role of three-dimensional conformal radiotherapy (3D-CRT) in the treatment of primary unresectable hepatocellular carcinoma. The preliminary results on the efficacy and the toxicity of 3D-CRT are reported. Seventeen patients were enrolled in this study, which was conducted prospectively from January 1995 to June 1997. The exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child-Pugh classification C, tumors occupying more than two thirds of the entire liver, and a performance status of more than 3 on the ECOG scale. Two patients were treated with radiotherapy only while the remaining 15 were treated with combined transcatheter arterial chemoembolization. Radiotherapy was given to the field including the tumor plus a 1.5 cm margin using a 3D-CRT technique. The radiation dose ranged from 36 ∼ 60 Gy (median: 59.4 Gy). Tumor response was based on a radiological examination such as the CT scan, MR imaging, and hepatic artery angiography at 4 ∼ 8 weeks following the completion of treatment. The acute and subacute toxicities were monitored. An objective response was observed in 11 out of 17 patients, giving a response rate of 64.7%. The actuarial survival rate at 2 years was 21.2% from the start of radiotherapy (median survival; 19 months). Six patients developed a distant metastasis consisting of a lung metastasis in 5 patients and bone metastasis in one. The complications related to 3D-CRT were gastro-duodenitis (≥ grade 2) in 2 patients. There were no treatment related deaths and radiation induced hepatitis. The preliminary results show that 3D-CRT is a reliable and effective treatment modality for primary unresectable hepatocellular carcinoma compared to other conventional modalities. Further studies to evaluate the definitive role of the 3D-CRT technique in the treatment of primary unresectable hepatocellular carcinoma are needed

  8. 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.

  9. Bacterial flora of the cervix in women using different methods of contraception.

    Science.gov (United States)

    Haukkamaa, M; Stranden, P; Jousimies-Somer, H; Siitonen, A

    1986-03-01

    Bacteriologic culture samples were taken from the cervix in three groups of 10 healthy, sexually active women using barrier contraception, oral contraceptives, or a levonorgestrel-releasing intrauterine contraceptive device. Culture samples for Candida albicans and Trichomonas vaginalis were taken, a cytologic vaginal smear was obtained, and an amine sniff test was performed; these were in addition to a routine gynecologic examination. Multiple bacteria were isolated from the cervix in women using oral contraceptives or an intrauterine contraceptive device, whereas lactobacilli alone dominated the flora of women using barrier contraception. Significantly more anaerobic bacteria were isolated from the cervix in oral contraceptive and intrauterine contraceptive device users when compared with the barrier method users. Symptoms and findings evident of anaerobic vaginosis were associated with the occurrence of anaerobic bacteria in the cervix of three patients using the intrauterine contraceptive device. The results showed that the cervical bacterial flora in sexually active healthy women is rich in anaerobes that can be regarded as a normal finding in women using oral contraceptives or intrauterine contraceptive devices. Barrier contraception with a condom prevents this anaerobic shift and maintains a lactobacilli-dominated flora in the cervix. PMID:3953700

  10. A COMPARATIVE STUDY OF CAREGIVER BURDEN IN CANCER CERVIX AND CANCER BREAST ILLNESSES

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    Srinivasagopalan, Nappinnai, Solayappan

    2015-07-01

    Full Text Available Background: Caregivers of individuals suffering from cancer illnesses are at risk of having subjected to mental health consequences. There is a paucity of data comparing the caregiver burden of cancer breast and cancer cervix patients. Aim: The aim of the present study is to compare the caregiver burden of cancer breast and cancer cervix patients. To study the association of caregiver burden with demographic factors like age, gender, duration of caregiving etc. Materials & Methods: This Cross sectional study is performed on the key relatives of patients of 31 cancer cervix and 31 cancer breast patients. Burden assessment schedule was used. Results: Our findings suggest burden is more in male caregivers of breast cancer patients. It is not so in caregivers of cancer cervix patients. Whenever the caregiver is closely related to the patients the burden is high in both groups. Whenever the burden scores were high the depression scores were also high. Treatment modalities as a whole correlates with burden scores in caregivers of breast cancer patients but not in cancer cervix patients. Conclusion: Caregivers with breast and cervical cancer patients are vulnerable if the caregiver is male, from low socioeconomical background, more closely related and when the patients received poor treatment modalities.

  11. Analysis of treatment and results in patients with advanced hypopharyngeal carcinomas

    International Nuclear Information System (INIS)

    Between 1991 and 1997, 42 patients with advanced stage III or IVA or IVB hypopharyngeal cancer received primary treatment at our clinic. Treatment and results in these cases were analyzed retrospectively. Thirty three patients with resectable hypopharyngeal carcinomas received 1-3 courses of neoadjuvant chemotherapy (NAC) involving a combination of cisplatin 60 mg/m2 and 5-fluorouracil 800 or 1,000 mg/m2 x 5 days, followed by total laryngopharyngectomy plus postoperative radiotherapy in 24 patients (group A) or followed by 70 Gy radiotherapy with radiation sensitizer in 9 patients because of self rejection of the operation (group B). Nine patients with unresectable hypopharyngeal carcinomas received neoadjuvant chemotherapy followed by radiotherapy or received radiotherapy only (group C). For the entire group, 5-year overall survival was 38% (group A 53%, group B 22%, group C 0%). The survival was statistically better (p<0.05) in group A than in group B. Better results were obtained for combined therapy including radical surgery in terms of overall survival. The response rate of NAC was 70%. In the patients who received operation, clinical and pathological CR rate was (8% in primary lesion, clinical CR rate was 5% and pathological CR rate was 23% in regional lymph nodes. Therefore sensitivity of the clinical CR evaluation was 50% in primary lesion and 20% in regional lymph nodes. Specificity of the clinical CR evaluation was 95% in primary lesion and 100% in regional lymph nodes. (author)

  12. Treatment of locally recurrent rectal carcinoma--results and prognostic factors

    International Nuclear Information System (INIS)

    Purpose: To assess the local control and survival in patients who received pelvic irradiation for locally recurrent rectal carcinoma. Methods and Materials: The records of 519 patients with locally recurrent rectal carcinoma treated principally with external-beam radiation therapy between 1975 to 1985 at a single institute were retrospectively reviewed. These included 326 patients who relapsed locally following previous abdominoperineal resection, 151 after previous low anterior resection, and 42 after previous local excision or electrocoagulation for the primary. No patients had received adjuvant radiation therapy or chemotherapy for the primary disease. Concurrent extrapelvic distant metastases were found in 164 (32%) patients at local recurrence and, in the remaining 355, the relapse was confined to the pelvis. There were 290 men and 229 women whose age ranged from 23 to 91 years (median = 65). Median time from initial surgery to radiation therapy for local recurrence was 18 months (3-138 months). Radiation therapy was given with varying dose-fractionation schedules, total doses ranging from 4.4 to 65.0 Gy (median = 30 Gy) over 1 to 92 days (median = 22 days). For 214 patients who received a total dose ≥35 Gy, radiation therapy was given in 1.8 to 2.5 Gy daily fractions. Results: The median survival was 14 months and the median time to local disease progression was 5 months from date of pelvic irradiation. The 5-year survival was 5%, and the pelvic disease progression-free rate was 7%. Twelve patients remained alive and free of disease at 5 years after pelvic irradiation. Upon multivariate analysis, overall survival was positively correlated with ECOG performance status (p = 0.0001), absence of extrapelvic metastases (p = 0.0001), long intervals from initial surgery to radiation therapy for local recurrence (p 0.0001), total radiation dose (p = 0.0001), and absence of obstructive uropathy (p = 0.0013). Pelvic disease progression-free rates were positively

  13. P53 overexpression in head and neck carcinoma and radiotherapy results

    International Nuclear Information System (INIS)

    Purpose: P53 gene mutations are the common genetic changes encountered in human cancers, and there is extensive evidence that the P53 status may determine tumor response to therapy. This study was carried out to investigate whether there is any correlation between accumulation (overexpression) of P53 protein and poor prognosis in patients with head and neck carcinomas treated with radical radiotherapy. Methods and Materials: Seventy-nine patients with head and neck carcinomas who were diagnosed and treated in 1989-90 with curative radiotherapy were studied retrospectively. Paraffin sections from archival material were studied using immunohistochemical staining (IHC) with mouse monoclonal antibodies (D0-7) to human P53 protein. Univariate and multivariate analysis of loco-regional tumor control and patient survival were performed on possible prognostic factors. Results: Forty-two (53%) patients showed positive IHC staining in their tumors. Fifty-three percent of the laryngeal, 64% of the oropharyngeal, and 43% of the oral cavity carcinomas showed P53 overexpression. All tumor specimens with vascular, lymphatic, and/or sarcolemmal invasion showed P53 overexpression. The proportion of tumor-stained nuclei was higher in the poorly differentiated than in the well and moderately differentiated tumors (p < 0.05), but there was no correlation with the patient overall or disease-free 5-year actuarial survival. There was no difference in the 5-year actuarial survival and disease-free survival between patients with P53 immunostaining in their tumors and those with no immunostaining (59% vs. 65% and 57% vs. 51%, respectively). The TNM tumor stage was the most significant prognostic factor with 5-year actuarial survival of 87% for early and 14% for late stages (p << 0.0001). There was a significant correlation between immunostaining and history of smoking (p = 0.02). Conclusion: The data demonstrate that the P53 accumulation as detected by immunohistochemical staining in a

  14. Results of radiotherapy for cancer of head and neck region, 3. Pharyngeal cancer, carcinoma of the oral tongue and oral cavity

    Energy Technology Data Exchange (ETDEWEB)

    Fujimura, Noriharu; Shinzato, Jintetsu; Watanabe, Keikichi; Habu, Kenjiro; Hirayama, Haruyuki

    1988-04-01

    A total of 122 patients with pharyngeal cancer (55 cases), carcinoma of the oral tongue (28 cases) and carcinoma of the oral cavity (39 cases) were treated by external irradiation at the Department of Radiology, Kumamoto National Hospital. In the retrospective study, therapeutic results in pharyngeal cancer (39 cases), in carcinoma of the oral tongue (20 cases) and in carcinoma of the oral cavity (30 cases) were analyzed. 1) Thirty-nine cases of pharyngeal cancer consitituted 9 cases of epipharyngeal cancer, 17 of mesopharyngeal cancer and 13 of hypopharyngeal cancer. The five-year survival rate was 35 % for epipharyngeal cancer, 13 % for mesopharyngeal cancer and 10 % for hypopharyngeal cancer. 2) Twenty cases of carcinoma of the oral tongue were treated by external irradiation and intraoral electron therapy. The five-year survival rate was 28 %. Three cases survived more than five years ; 2 were preoperative irradiation and 1 undergoing a curative irradiation was salvaged with surgery. 3) Thirty cases of carcinoma of the oral cavity consitituted 10 cases of carcinoma of the floor of the mouth, 9 of carcinoma of the cheek mucosa, 7 of carcinoma of the gum, 2 of carcinoma of the hard palate and 2 of carcinoma of the lip. An overall survival rate was 27 %. Five cases survived more than five years ; 3 were carcinoma of the gum and 2 were carcinoma of the cheek mucosa.

  15. Invasive neuroendocrine carcinoma of the breast: a population-based study from the surveillance, epidemiology and end results (SEER) database

    International Nuclear Information System (INIS)

    Neuroendocrine carcinoma (NEC) of the breast is a rare type of carcinoma that has not been well studied or characterized. Of the limited number of studies reported in the literature, most are case reports. A few small retrospective series studies have been reported. We reviewed data on 142 cases of mammary NEC recorded in the surveillance, epidemiology, and end results (SEER) database during 2003–2009 and evaluated disease incidence and patient age, sex, and race/ethnicity; clinicopathologic characteristics; and survival in comparison to invasive mammary carcinoma, not otherwise specified. We also performed univariate and multivariate analyses to identify prognostic factors in this disease. Review of the 142 SEER cases revealed that NEC is an aggressive variant of invasive mammary carcinoma. It generally occurred in older women (>60 years); present with larger tumor size (>20 mm), higher histologic grade, and higher clinical stage; and result in shorter overall survival and disease-specific survival than invasive mammary carcinoma, not otherwise specified (IMC-NOS). Overall survival and disease-specific survival were shorter in NEC at each stage than in IMC-NOS of the same stage. Furthermore, when all NEC and IMC-NOS cases were pooled together, neuroendocrine differentiation itself was an adverse prognostic factor independent of other known prognostic factors, including age, tumor size, nodal status, histologic grade, estrogen/progesterone receptor status, and therapy. NEC is a rare but aggressive type of mammary carcinoma. Novel therapeutic approaches should be explored for this uniquely clinical entity

  16. Treatment results for nasopharyngeal carcinoma in the modern era: The Hong Kong experience

    International Nuclear Information System (INIS)

    Purpose: To analyze the treatment results achievable for nasopharyngeal carcinoma in the modern era to identify the key failures for future improvement and to provide an updated baseline for future trials. Methods and materials: The results of 2687 consecutive patients treated at all public oncology centers in Hong Kong during 1996-2000 were retrospectively analyzed. The stage distribution (by American Joint Committee on Cancer and International Union Against Cancer staging system, 1997) was 7% Stage I, 41% Stage II, 25% Stage III, and 28% Stage IVA-B. All patients were irradiated with 6-MV photons and the median total dose was 66 Gy. Only 23% of patients had additional treatment with chemotherapy. Results: The 5-year local, nodal, and distant failure-free rates were 85%, 94%, and 81%, respectively; patients with local failure had significantly higher risk of nodal and distant failures. The 5-year progression-free, overall, and cancer-specific survival rates were 63%, 75%, and 80%, respectively. The presenting stage was the most important prognostic factor for all endpoints: with overall survival decreasing from 90% for Stage I to 58% for Stage IVA-B. The results achieved by the 2070 patients treated by radiotherapy alone were almost identical to that of the whole series, the distant failure-free rate among patients with locoregional control was 89% for Stage I-II and 75% for Stage III-IVB. The 860 patients (32%) staged with magnetic resonance imaging achieved significantly better results than those staged by computed tomography, the overall survival being 93% vs. 83% for Stages I-II, and 72% vs. 63% for Stages III-IVB (p = 0.001). Conclusions: Treatment results for nasopharyngeal carcinoma have substantially improved in the modern era; future trials should be based on updated baseline results. Further reduction of distant failure is important for future breakthrough, particularly for patients with advanced disease

  17. Sexual dysfunction after radiotherapy for cancer of the cervix uteri

    International Nuclear Information System (INIS)

    Investigations of sexual consciousness and sexual dysfunction after radiotherapy for cancer of the cervix uteri were performed on patients of middle and old ages by questionnaires and questionning by doctors, and the following results were obtained. 1. Before radiotherapy, sexual activity was most prominent in their twenties and thirties. However, patients who were in fifties when this study was performed had most active sexual lives during the ages from 35 to 50 years. 2. Frequencies of sexual intercourse decreased markedly just before radiotherapy, and many patients received radiotherapy when sexual activity fell. 3. 32% of the patients have not experienced sexual intercourse after radiotherapy. 4. Decreases in the sex urge, sexuality, vaginal dicharge, and frequency of sexual intercourse after radiotherapy were recognized in 77%, 77%, 70%, and 93% respectively. 5. Patients who became unwilling to maintain sexual lives after radiotherapy because of fear about recurrence or aggravation of cancer were 38% by questionnaires and 49% by questionning by doctors. 6. Pains on sexual intercourse were found in 69% by questionnaires and 49% by questionning by doctors. Most pains occurred at pennis insertion and was thought to be due to atrophy and inflammation of vagina and external genitalia in most cases. 7. Both vaginal damages and sexual dysfunction in patients with radiotherapy following surgery for cancer of the cervix uteri, in patients with radiotherapy alone for cancer of the cervix uteri, and in patients with radiotherapy following surgery for cancer of the ovary and corpus uteri were marked, modest and mild, respectively. 8. Vaginal damage score was higher in patients treated more than 5 years before than those less than 2 years ago, but there were no differences in sexual dysfunction score between both groups. (Tsunoda, M.)

  18. Sexual dysfunction after radiotherapy for cancer of the cervix uteri

    Energy Technology Data Exchange (ETDEWEB)

    Ohkawa, R.; Takamizawa, H. (Chiba Univ. (Japan). School of Medicine); Arai, T.; Morita, S.

    1981-03-01

    Investigations of sexual consciousness and sexual dysfunction after radiotherapy for cancer of the cervix uteri were performed on patients of middle and old ages by questionnaires and questioning by doctors, and the following results were obtained. 1. Before radiotherapy, sexual activity was most prominent in their twenties and thirties. However, patients who were in fifties when this study was performed had most active sexual lives during the ages from 35 to 50 years. 2. Frequencies of sexual intercourse decreased markedly just before radiotherapy, and many patients received radiotherapy when sexual activity fell. 3. 32% of the patients have not experienced sexual intercourse after radiotherapy. 4. Decreases in the sex urge, sexuality, vaginal discharge, and frequency of sexual intercourse after radiotherapy were recognized in 77%, 77%, 70%, and 93% respectively. 5. Patients who became unwilling to maintain sexual lives after radiotherapy because of fear about recurrence or aggravation of cancer were 38% by questionaires and 49% by questioning by doctors. 6. Pains on sexual intercourse were found in 69% by questionaires and 49% by questionning by doctors. Most pains occurred at penis insertion and was thought to be due to atrophy and inflammation of vagina and external genitalia in most cases. 7. Both vaginal damage and sexual dysfunction in patients with radiotherapy following surgery for cancer of the cervix uteri, in patients with radiotherapy alone for cancer of the cervix uteri, and in patients with radiotherapy following surgery for cancer of the ovary and corpus uteri were marked, modest and mild, respectively. 8. Vaginal damage score was higher in patients treated more than 5 years before than those less than 2 years ago, but there were no differences in sexual dysfunction score between both groups.

  19. Comparison of abdominopelvic CT results and findings at second-look laparotomy in ovarian carcinoma patients

    International Nuclear Information System (INIS)

    Restaging in epithelial ovarian carcinoma after primary therapy has proven difficult by standard noninvasive methods and commonly requires second-look laparotomy. In the authors' study to date preoperative abdominopelvic CT (CBT) results and operative findings have been compared in 24 patients (25 studies) with ovarian adenocarcinoma currently clinically free of disease originally graded as FIGO stage III or IV, except for one patient with stage IC, undergoing second-look laparotomy to determine tumor status. There were ten true-negative, three false-negative, 12 true-positive, and no false-positive CBTs. Negative studies were associated with positive findings at laparotomy, including microscopic foci, in only 12% of all cases; thus, CBT in the series has shown a better correlation with surgery than in previous studies. Currently the authors are combining monoclonal antibody scanning with the CBT results with the goal of possibly avoiding second-look surgery in certain patients

  20. METASTATIC BREAST CANCER TO THE UTERINE CERVIX MIMICKING A GIANT CERVICAL LEIOMYOMA

    Science.gov (United States)

    HORIKAWA, MAI; MORI, YUKIKO; NAGAI, SACHI; TANAKA, SHIHO; SAITO, SHIGEKO; OKAMOTO, TOMOMITSU

    2012-01-01

    ABSTRACT Metastasis to the uterine cervix is a complication of breast cancer that is not commonly known. Detection of cervical metastasis before the diagnosis of the primary tumor is even rarer. The present report describes a case of a 52-year-old woman who had a large cervical tumor appearing as a leiomyoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological examination of the cervical tumor showed patterns characteristic of invasive lobular carcinoma of the breast, leading to the discovery of the primary in the left breast. She subsequently underwent mastectomy, hormone therapy and chemotherapy, and is alive at 7-year follow-up. PMID:23092107

  1. Protocol and result of neoadjuvant chemotherapy for locally advanced esophageal carcinoma

    International Nuclear Information System (INIS)

    The protocol and result were described of chemotherapy and radiotherapy for locally advanced esophageal carcinoma, especially for A3 stage one with metastasis at neighboring tissues such as aorta, trachea and bronchia. Chemotherapy was done with 5-FU and CDDP and radiotherapy, with 30 Gy/15 fx/3 wk. Double contrast roentgenography, dynamic CT and MRI were performed to follow the process. The efficacy rate was 55.0% with 4 CR and 7 PR in 20 cases. Three CR patients survived at present. Major adverse effects were leukopenia and thrombocytopenia, of which grade 4 were found in 14 and 12% cases, respectively. Low-dose FP therapy might be useful for lowering the adverse effects and for elevating the efficacy rates. (K.H.)

  2. Results of radiotherapy for carcinomas of the floor of the mouth

    International Nuclear Information System (INIS)

    Results and problems of radiotherapy for carcinomas of the floor of the mouth were analyzed for 54 patients treated from 1967 through 1995. Twenty-six of the 52 patients who received external irradiation were treated also with brachytherapy. Five-year cause-specific survival rates were 89% in stage I, 85% in stage II, 64% in stage III, and 63% in stage IV. The survival rate was 57% for patients with clinically positive nodes but was 88% in node-negative patients. Surgical treatment was performed in seven patients (13%) with late complications, such as osteoradionecrosis and severe soft tissue ulcers. Multiple primary cancers arose in 12 of 54 (22%) patients. Although radiotherapy was confirmed to be an excellent procedure because of its high curability and preservation of function and appearance, ways must be found improve survival in node-positive patients, reduce complications, and early detect secondary cancers at an earlier stage. (author)

  3. 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)....

  4. Low Dose BCG Regimen in T1 Transitional Cell Carcinoma of the Bladder: Long Term Results

    International Nuclear Information System (INIS)

    BCG has been used for more than 30 years and is currently the most effective agent for non-muscle invasive bladder cancer therapy after transurethral resection. The high-grade T1 lesion treated by transurethral resection alone is reported to progress to muscle invasion in 30% to 50% of the patients. Until now, optimal treatment schedule and optimal dose have not been defined as the toxicity related to BCG therapy is significant. In this study we tried to evaluate the efficacy and toxicity of 60 mg intravesical BCG (Pasteur strain) therapy in patients with T1 transitional cell carcinoma of the bladder. Patients and Methods: From January 2000 till December 2007, 74 patients with single T1 transitional cell carcinoma (TCC) of the urinary bladder (grade 3 in 24 patients and grade 2 in 50 patients) were treated by complete transurethral resection followed by a 6-weeks course of 60 mg BCG intravesically. Follow-up ranged from 26- 96 months with median of 61 months. Results: Nine patients (12.1%) exhibited recurrence with muscle invasion after 6-18 months (5 with grade 3 tumors and 4 with grade 2), all were subjected to radical cystectomy and urine diversion. Whereas 19 patients (29.2%) showed recurrent T1 tumor after 16-45 months (7 with grade 3 tumors and 12 with grade 2) and were treated by TUR-T followed by a second 6-weeks course of 60 mg BCG intravesically. Recurrence index was 0.82/100 patients/month and the median tumor free period was 20 months. Regarding toxicity; irritative symptoms occurred in 24% of patients, fever in 9%, microscopic hematuria in 14%; which appeared to be significantly low when compared with the rates reported for higher doses of BCG. Conclusion: Intravesical therapy of 60 mg BCG is effective in prophylaxis against recurrence and progression of T1 TCC of the bladder. Decreasing the dose resulted

  5. Accelerated radiotherapy for T1, 2 glottic carcinoma: analysis of results with KI-67 index

    International Nuclear Information System (INIS)

    Purpose: Hyperfractionated and accelerated radiotherapy without a split was performed to improve the local control probability of early glottic carcinomas. We analyzed the results of this regimen by using the Ki-67 index. Methods and Materials: Over a 12-year period, 85 T1N0M0 glottic cancers and 50 T2N0M0 glottic cancers were treated with conventional fractionation (CF) from 1984 to 1989 and with accelerated fractionation (AF) since 1990. The CF program consisted of five daily fractions of 2 Gy per week, for a total of 64 Gy. The AF program consisted of 1.72 Gy per fraction, two fractions per day, 5 days a week, for a total of 55 or 58 Gy. The specimens, taken before radiotherapy, were immunohistochemically stained with anti-Ki-67 antibody. Results: The 5-year local control probability for T1 tumors was 79.6 ± 6.9% with CF treatment, whereas with AF it was 86.9 ± 5.6%. For T2 tumors it was 62.7 ± 12.2% with CF, whereas it was 74.7 ± 7.8% with AF. The difference between CF and AF did not reach the point of statistical significance. However, when T1 tumors had a Ki-67 index lower than 50%, the local control rate achieved with AF was significantly better than that with CF (p = 0.018). When the tumors had a Ki-67 index that was 50% or more, there was no difference in the local control rate between CF and AF, whether they were T1 or T2. The peak mucosal reactions at the larynx and/or hypopharynx were much more severe and appeared at smaller doses and earlier in AF than in CF. The patients with AF showed no severe late complications. Conclusions: AF could not obtain statistically significant improvement in local control probability of T1 or T2 glottic carcinomas

  6. Efficacy of sorafenib on metastatic renal cell carcinoma in Asian patients: Results from a multicenter study

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    Shen Yijun

    2009-07-01

    Full Text Available Abstract Background The effects of sorafenib in the treatment of advanced renal cell carcinoma (RCC have been confirmed in an international collaborative phase III trial. This study aims to confirm similar efficacy and treatment-induced toxicities of sorafenib in the treatment of metastatic RCC in ethnic Chinese patients. Methods Ninety-eight consecutive and non-selected patients with pathologically confirmed metastatic RCC were treated according to an institutional treatment protocol. All patients were treated with 400 mg of sorafenib orally twice daily on a continuous basis until disease progression or intolerance to treatment occurred. Dose reduction to 400 mg once daily was required if grade 3 or 4 toxicities occurred. All patients except for 7 received nephrectomy in the course of their disease. All patients were assessed for tumor response, progression-free survival (PFS, overall survival (OS, and treatment-induced toxicities. Results The median follow-up time was 76 weeks (range 2–296 weeks for the entire group of patients. Radiologically confirmed complete response (CR, partial response (PR, stable disease (SD of more than 4 months, and disease progression as best objective responses were observed in 1 (1%, 23 (23.5%, 62 (63.3%, and 12 (12.2% patients, respectively. The tumor control rate (CR+PR+SD of >4 months was 87.8%. The 1-year estimated PFS and OS were 58.4% and 64.6%, respectively. The median progression-free survival (PFS time was 60 weeks (95% CI 41–79; and the median overall survival (OS time was not reached with a follow-up of 76 weeks. Reduction of sorafenib dose was required in 26 patients who developed grade 3 or 4 treatment-cause adverse-effects. An additional 9 patients discontinued sorafenib treatment due to severe adverse-effects. No grade 5 toxicity occurred. Multivariate analysis revealed that independent predictive factors for tumor response to sorafenib treatment included ECOG status, presence of lymph node

  7. Concomitant mucin-producing tumors of ovary and adenocarcinoma of cervix: a case report

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    Mousavi A

    2013-05-01

    Full Text Available Background: Ovarian mucinous borderline tumors are divided into two morphologic groups: endocervical-like and intestinal type. Most endocervical adenocarcinomas exhibit mucinous and/or endometrioid differentiation, they infrequently metastasize to the ovaries but may simulate primary ovarian tumors (both atypical proliferative or borderline and carcinoma. In patients with mucinous adenocarcinoma in the abdominal cavity, caution should be exercised in interpreting the possible primary site of the tumor on the basis of the immunohistochemical profiles. The presence of human papillomavirus (HPV DNA is assessed to determine whether the ovarian neoplasms were metastases or primary independent neoplasm. Approximately 90% of endocervical adenocarcinomas are related to high-risk human papillomavirus (hr-HPV with the remainder being unrelated to HPV. Both types metastasize to the ovaries very infrequently. Ovarian endocervical-type (mullerian mucinous tumors and tumors composed of a mixture of endocervical-type mucinous, serous endometrioid, squamous, and indifferent cells with abundant eosinophilic cytoplasm reported to date have been primarily limited to borderline and micro invasive types. We report a-36-yr old woman with adenocarcinomas of uterine cervix who also had ovarian mucinous borderline tumor.Case presentation: The patient presented with abnormal uterine bleeding and lower abdominal pain. She had a history of uterine cervix polyps. Pelvic ultrasound showed a right adnexal mass and a large cervical size. Histological diagnosis in uterine cervix biopsy revealed adenocarcinoma of cervix. Radical hysterectomy type III with bilateral salpingo-oophorectomy was performed. Histological finding in adnexal mass revealed borderline mucinous tissue of ovarian tumor. Testing for HPV DNA in the tumoral tissue was negative. This confirms that the ovarian tumor is not metastatic from endocervical adenocarcinoma. Conclusion: We conclude that in a patient with

  8. 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

  9. Squamous cell carcinoma of the oropharynx--an analysis of treatment results in 289 consecutive patients

    International Nuclear Information System (INIS)

    In this retrospective study the results of primary and salvage treatment of oropharyngeal carcinoma were evaluated. A total of 289 consecutive patients (103 females and 186 males) were included in the study. Most tumours originated in the tonsil area (58%) and comprised stages I 8%, II 19%, III 46% and IV 28%. The primary treatment was delivered with curative intent in 276 cases (96%). Of these, 266 received primary radiotherapy. The median radiation dose was 62 Gy, given as laterally opposed fields to the primary tumour and bilateral neck. Eight patients were treated with primary surgery and two with chemotherapy as part of a curatively intended treatment programme including radiotherapy. Six patients received palliative treatment, and seven were not treated at all. Out of 276 tumours treated with curative intent, 173 reappeared; 72% recurred in T position, 38% in N position, and 12% at distant metastatic sites, some in combination. Salvage surgery was possible in 52 patients, and 24 treatments were successful. Salvage radiotherapy or cryotherapy was used in 22 patients and 4 were controlled. For the entire group, the 5-year locoregional tumour control, disease-specific survival and overall survival rates were 38%, 44% and 31%, respectively. For patients treated with curative intent, clinical T- and N-stage, stage, tumour size, gender, age, and pretreatment haemoglobin were significant prognostic parameters in a univariate analysis. The Cox multivariate analysis showed that T-stage, N-stage and gender were independent prognostic factors. It is concluded that T-stage, N-stage and gender are significant independent prognostic factors. The primary control of the carcinoma in the T-position is crucial for overall success, but salvage surgery is found to have a favourable success rate in patients suitable for relapse treatment

  10. Squamous cell carcinoma of the oropharynx--an analysis of treatment results in 289 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, L.V.; Grau, C.; Overgaard, J. [Aarhus Univ. Hospital (Denmark). Dept. of Experimental Clinical Oncology

    2001-01-01

    In this retrospective study the results of primary and salvage treatment of oropharyngeal carcinoma were evaluated. A total of 289 consecutive patients (103 females and 186 males) were included in the study. Most tumours originated in the tonsil area (58%) and comprised stages I 8%, II 19%, III 46% and IV 28%. The primary treatment was delivered with curative intent in 276 cases (96%). Of these, 266 received primary radiotherapy. The median radiation dose was 62 Gy, given as laterally opposed fields to the primary tumour and bilateral neck. Eight patients were treated with primary surgery and two with chemotherapy as part of a curatively intended treatment programme including radiotherapy. Six patients received palliative treatment, and seven were not treated at all. Out of 276 tumours treated with curative intent, 173 reappeared; 72% recurred in T position, 38% in N position, and 12% at distant metastatic sites, some in combination. Salvage surgery was possible in 52 patients, and 24 treatments were successful. Salvage radiotherapy or cryotherapy was used in 22 patients and 4 were controlled. For the entire group, the 5-year locoregional tumour control, disease-specific survival and overall survival rates were 38%, 44% and 31%, respectively. For patients treated with curative intent, clinical T- and N-stage, stage, tumour size, gender, age, and pretreatment haemoglobin were significant prognostic parameters in a univariate analysis. The Cox multivariate analysis showed that T-stage, N-stage and gender were independent prognostic factors. It is concluded that T-stage, N-stage and gender are significant independent prognostic factors. The primary control of the carcinoma in the T-position is crucial for overall success, but salvage surgery is found to have a favourable success rate in patients suitable for relapse treatment.

  11. Results of electron beam therapy using intra-oral cone for carcinoma of the oral tongue

    International Nuclear Information System (INIS)

    Retrospective analyses were performed to evaluate the therapeutic efficacy of intra-oral cone (IOC) radiation therapy for carcinoma of the oral tongue, especially about its faculty of local control and complications. Thirty-nine patients with squamous cell carcinoma of the oral tongue were treated with IOC radiation therapy alone or in combination with external irradiation. IOC radiation therapy was given not only for T1 and T2, but also for T3 tumors. Hypofractionation was used for IOC radiation therapy. The 2 year local control rates, including surgical salvage, for T1, T2, T3 and T4 were 100%, 73.3%, 40% and 0%, respectively. The 5 year actuarial survival rates for Stage I, II, III and IV were 100%, 65.3%, 35.4% and 0%, respectively. The incidences of radiation complications, i.e. soft tissue ulceration and osteoradionecrosis, were 42.9% and 2.9%, respectively. It is suggested that relatively high rate of soft tissue ulceration was due to hypofractionation. We have found summated Gy dosage correlate better than summated TDF values for both local control and complication rates for IOC radiation therapy with hypofractionation method. If complete disappearance of primary tumor was not achieved after IOC radiation therapy of 30 Gy, it is not reasonable to add external irradiation. Surgical resection of the residual tumor is the treatment of choice in view of local control and complication. These results suggest that selection of the cases suitable for IOC is important and re-evaluation of the adequate fractionation scheme for IOC is necessary. (author)

  12. Acquired Lymphangioma Of Vulva Secondary To Radiotherapy For Carcinoma Cervix

    Directory of Open Access Journals (Sweden)

    Mehta Vandana

    2003-01-01

    Full Text Available Lymphagioma circumscriptum is a rare disorder of lymphatic channels, characterized by occurrence of thin walled frogspawn like vesicles. We report 2 cases of lymphangioma circumscriptum as a late sequel to radiotherapy.

  13. Cancer of the cervix: a training guide to promote awareness.

    Science.gov (United States)

    1997-01-01

    This 4-page training guide presents factual information and suggested community activities related to the prevention of cervical cancer in developing countries. After describing the risk factors for cervical carcinoma and possible signs of advanced disease, the guide presents the story of Maya--a woman in an arranged marriage whose husband would not permit her to seek medical care for abdominal pain and bleeding until her cervical cancer had advanced beyond treatment. Health educators are encouraged to use Maya's story as a learning tool to identify the chain of physical, social, economic, and political factors that contributed to her premature death. Audiences can be encouraged to identify links in Maya's story (e.g., not receiving a Pap test) that could have been changed to produce a different ending. It is recommended that, in low-resource communities, Pap smears be provided at least every 5 years to women over 35 years of age. Under development is a simple, inexpensive alternative to Pap tests that involves putting a vinegar solution on the cervix and examining it with the aid of a low-power magnifying tool; the vinegar causes abnormal cervical tissue to turn white. PMID:12292697

  14. Bladder and rectal complications following radiotherapy for cervix cancer

    International Nuclear Information System (INIS)

    One-hundred and thirty-two patients with cervix carcinoma who were treated with whole pelvis irradiation and two intracavitary applications had bladder and rectal dosimetry during brachytherapy with contrast agents placed into the bladder and rectum prior to orthogonal simulator radiographs. Doses were computer calculated at points A and B, F (bladder), R1 (rectum), and R2 (rectosigmoid). Late occurring bladder and rectal complications were graded on a severity scale of 1 to 3, and 14% had grade 2 or 3 injuries (9% developed fistulas). Statistical evaluation of the data showed that severe bladder and rectal injuries occur more commonly in stage IIIA and IIIB disease and in those receiving high external beam doses (5000 rad +). Analysis of variance tests revealed a significant correlation of brachytherapy dose to points R1 and R2 with severe rectal injuries but there was not a correlation of dose to F with bladder injuries. Nor was there correlation of injuries with dose to point A or the milligram-hour dose. We conclude that our technique for rectal dosimetry is adequate but that an improved technique of bladder dosimetry is needed. Also, when combining whole pelvis irradiation with two intracavitary applications (4000 rad to point A), the whole pelvis dose should probably not exceed 4000-4500 rad

  15. Influence of peripheral blood hemoglobin concentration on the result of radiotherapy for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To determine the influence of peripheral blood hemoglobin concentration on the radiotherapy result of nasopharyngeal carcinoma (NPC). Methods: From January 1989 to December 1998, 304 patients with pathologically confirmed NPC received radical radiation. There were 209 males and 95 females. The ages ranged from 16 to 77 years with a median of 42. All patients were irradiated by 60Co or 6 MV external beam with a total dose of 64 - 76 Gy for the primary tumor and 46 - 77 Gy for the cervical lymph nodes. The peripheral blood hemoglobin concentration for all patients was measured before, during and after radiotherapy. These patients were divided into three groups according to the peripheral blood hemoglobin concentration before radiotherapy: anemia ( 160 g/L), and into two groups according to the change in the peripheral blood hemoglobin concentration during radiotherapy as increased and decreased groups. Results: All patients were followed with a follow-up rate of 90.5%. The peripheral blood hemoglobin concentration had a significant effect on the survival of NPC patients. Its decrease or increase during radiotherapy affected the survival and local control rates of NPC patients. Conclusions: The change of peripheral hemoglobin concentration affecting the oxygen content in the blood, can influence the local control and survival rates of NPC patients. Increase results in higher survival

  16. The Swedish National Care Programme for Anal Carcinoma. Implementation and overall results

    International Nuclear Information System (INIS)

    The Swedish National Care Programme for Anal Carcinoma (SNCPAC) was instituted in order to create a uniform handling policy for anal cancer and thus to accrue a population-based material allowing unbiased analyses. This study evaluates the degree of implementation of the SNCPAC guidelines, and presents overall treatment results in a total of 356 patients with epidermoid cancer of the anus and the perianal region diagnosed in Sweden between 1985 and 1989. Primary treatment according to the guidelines was irradiation up to 40 Gy. Bleomycin was administered intramuscularly before the first 18 fractions. After a 3-week pause, radiotherapy was to be continued up to a dose of 60-64 Gy, if at least an almost complete response was achieved. Otherwise, the patient was recommended surgery within a week. The guidelines were applied in 90% of cases where such treatment was possible. The 5-year tumour-specific survival rate was 72%. The survival rate was more favourable in perianal tumours (90%) than in anal canal tumours (68%, p<0.01). The 5-year probability of having a preserved anus was 64% (anal canal/perianal 58%/91%, p<0.001). Bleomycin did not appear to have any effect on treatment results. The care programme has had a rapid and almost complete nation-wide penetration, and has created the desired uniformity allowing proper analyses. The treatment results also appear comparable with specialised referral centres. (orig.)

  17. Law 16.097 Prevention program of uterine cervix cancer in Uruguay: Uterine cervix cancer

    International Nuclear Information System (INIS)

    Every year in Uruguay, is diagnosed around 600 new cases of cancer of uterine cervix. Next important information was related on this cancer and the evolution that will have the carrying of this illness, it was informed about the prevention, symptoms, I diagnose and treatment of the same one

  18. Imaging of brain metastases of bronchial carcinomas with 7 T MRI. Initial results

    Energy Technology Data Exchange (ETDEWEB)

    Moenninghoff, C. [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Maderwald, S.; Theysohn, J.M.; Kraff, O.; Ladd, S.C.; Wanke, I. [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Duisburg-Essen Univ. (Germany). Erwin L. Hahn Inst. fuer Magnetresonanztomographie; Schuett, P.; Gauler, T. [Universitaetsklinikum Essen (Germany). Klinik fuer Innere Medizin, Konservative Onkologie; Ladd, M.E. [Duisburg-Essen Univ. (Germany). Erwin L. Hahn Inst. fuer Magnetresonanztomographie

    2010-09-15

    Purpose: To compare the depiction of brain metastases of bronchial carcinomas on susceptibility-weighted and contrast-enhanced images with 7 T and at 1.5 T MRI. Materials and Methods: Twelve patients with brain metastases of bronchial carcinomas underwent 7 T and 1.5 T MRI. Minimum intensity projections (MinIP) of a 1.5 T SWI sequence (voxel size = 0.9 x 0.9 x 2.0 mm{sup 3}) were compared to 7 T SWI MinIPs (voxel size = 0.4 x 0.4 x 1.5 mm{sup 3}). A T 1-w 3D MPRAGE at 1.5 T (voxel size = 1 x 1 x 1 mm{sup 3} after double-dose (DD) gadoterate meglumine, Gd-DOTA) was compared to a 7 T MPRAGE sequence (voxel size = 0.7 x 0.7 x x 0.7 mm{sup 3}, single dose (SD) Gd-DOTA) in all patients, and to DD Gd-DOTA in 6 patients after a 10 minute delay. The number of intracranial microhemorrhages in SWI MinIPs and the number of contrast-enhancing metastases in MPRAGE images were compared in each patient grouped into three size ranges ({<=} 2 mm, > 2 mm and < 6 mm, {>=} 6 mm) by two radiologists in consensus. Results: In all 12 patients the 7 T SWI with spatially higher resolution allowed the identification of 87 versus 67 cerebral microhemorrhages at 1.5 T. 7 T T 1-w images after SD Gd-DOTA depicted 198 brain metastases versus 238 at 1.5 T after DD Gd-DOTA. After doubling the contrast dose in six patients, 4 additional brain metastases were identified at 7 T. Conclusion: Our preliminary results indicate that despite the higher spatial resolution the detection of brain metastases on 7 T MPRAGE images is almost equal to 1.5 T MPRAGE images. The 7 T SWI sequence with spatially higher resolution allowed the detection of 20 % more microhemorrhages in brain metastases compared to the 1.5 T SWI sequence. (orig.)

  19. 18F-fluorodeoxyglucose PET in ovarian carcinoma: methodology and preliminary results

    International Nuclear Information System (INIS)

    Aim of the present study was to evaluate 18FDG PET as a diagnostic tool in primary and recurrent ovarian cancer. Methods: PET of the abdomen and the pelvis was performed in 26 patients suspected for primary (n=17) or recurrent (n=9) ovarian cancer with an ECAT 953/15 scanner 45 min after intravenous administration of 245 MBq 18F-FDG (mean). PET findings were validated by surgery, histology and/or cytology. Results: Ovarian malignancies or recurrent ovarian cancer were demonstrated by PET in 16 out of 19 cases. Malignancy was excluded in six out of seven cases. False negative findings were obtained in two cases of low malignant potential tumors (LMP) and in one case of low grade serous/mucinous ovarian cystadenocarcinoma. PET yielded one false positive result in a case of salpingoophoritis. Quantitative analysis revealed a mean SUV of 6.8±2.3 in primary ovarian carcinoma vs. 2.6±1.2 in benign masses (p18FDG PET to be useful in diagnosis of recurrent ovarian cancer. PET is of limited use in differentiating LMP from benign tumors and ovarian cancer from inflammatory processes. Concerning this differentiation, quantitative analysis does not improve diagnostic accuracy. (orig.)

  20. Consumption of vegetables and fruits and risk of ovarian carcinoma: Results from the Netherlands Cohort Study on Diet and Cancer

    NARCIS (Netherlands)

    Mommers, M.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2005-01-01

    BACKGROUND. To the authors' knowledge, only a few prospective studies to date have investigated the correlation between vegetable and fruit consumption and the risk of ovarian carcinoma and their results have been inconclusive. METHODS. Vegetable and fruit intake was assessed in relation to ovarian

  1. Treatment results and prognostic factors in 101 men treated for squamous carcinoma of the penis

    International Nuclear Information System (INIS)

    Purpose: This retrospective study was performed to assess the treatment outcome and prognostic factors in 101 men with invasive squamous carcinoma of the penis treated at the Royal Marsden Hospital between 1960-1990. Methods and Materials: The tumor was confined to the glans penis (T1) in 79 patients, 82 were node negative (N0), and two patients had distant metastases at presentation. The histology was Grade 1 (G1) in 36, Grade 2 (G2) in 18, Grade 3 (G3) in 28, and unknown in 19 patients. Node-positive disease was commoner in patients with G3 (p = 0.02) or T2/3/4 tumors (p = 0.007). Treatment for the primary tumor was external beam radiotherapy (EBRT) in 59, interstitial brachytherapy in 13, and partial or total penectomy in 29 patients. The median dose, dose/fraction, and treatment time for EBRT was 60 Gy, 2 Gy/fraction, and 46 days, respectively. Eighty patients received no inguinal node treatment, 13 had EBRT (4 with chemotherapy), and 8 underwent groin dissection at presentation. Results: During a median follow-up of 5.2 years (2 months-22 years), 56 patients died (penile cancer 31, inter-current illness 23 and unknown cause 2), giving 10 year overall and cause-specific survival (CSS) of 39 and 57%, respectively. Adverse prognostic factors for CSS on univariate analysis were G3, ulcerative/fungating or T2/3/4 tumors, node positive, Jackson's Stage 2/3/4, and surgical treatment for the primary. All but the last two were significant independent prognostic factors for CSS on multivariate analysis. Penile or perineal recurrence or residual disease after initial treatment was seen in 36 out of 98 evaluable patients, giving a 10-year local failure rate (LFR) of 45%. Local failure after initial treatment was successfully salvaged in the majority (26 out of 36) of patients with further surgery or radiotherapy, and local control was achieved ultimately in 74 out of 77 T1, 7 out of 12 T2; 3 out of 3 T3, and 3 out of 5 T4 tumors. In the 44 evaluable patients with T1

  2. 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.

  3. 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.

  4. Indications and results of postoperative radiotherapy in case of vulvar carcinoma

    International Nuclear Information System (INIS)

    Between 1968 and 1979, 132 patients with squamous cell carcinomas of the vulva were submitted to a more or less radical operation. Then they were irradiated at the Radiologic Center of the GHS Essen. All patients received irradiations of the vulvar region with high energy electrons combined with photons (n=78) as well as photons or electrons alone (n=15 and 39, respectively). The dose was generally 40 to 60 Gy. 81 patients (61.4%) were additionally irradiated in the inguinal region. The overall three-year and five-year survival rate is 48.5 and 34.1%, respectively. The median survival time is 31.5 months. Contrary to expectation there were no significantly different recurrence rates after radical vulvectomy and large excision combined with postoperative irradiation. This is attributed to the favorable effect of radiotherapy. A graduated conception has been elaborated based on the results of our retrospective analysis and the communications of literature. Radical vulvectomy and inguinal lymphadenectomy is the therapy of choice. Radiotherapy in the vulvar region should be applied if radical surgery seems problematic or is not possible. Irradiation of lymph node regions is indicated if they are involved or if a resection is not possible. (orig.)

  5. Indications and results of postoperative radiotherapy in case of vulvar carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Alberti, W.; Katsilieris, I.; Schulz, U.; Callies, R.

    1986-08-01

    Between 1968 and 1979, 132 patients with squamous cell carcinomas of the vulva were submitted to a more or less radical operation. Then they were irradiated at the Radiologic Center of the GHS Essen. All patients received irradiations of the vulvar region with high energy electrons combined with photons (n=78) as well as photons or electrons alone (n=15 and 39, respectively). The dose was generally 40 to 60 Gy. 81 patients (61.4%) were additionally irradiated in the inguinal region. The overall three-year and five-year survival rate is 48.5 and 34.1%, respectively. The median survival time is 31.5 months. Contrary to expectation there were no significantly different recurrence rates after radical vulvectomy and large excision combined with postoperative irradiation. This is attributed to the favorable effect of radiotherapy. A graduated conception has been elaborated based on the results of our retrospective analysis and the communications of literature. Radical vulvectomy and inguinal lymphadenectomy is the therapy of choice. Radiotherapy in the vulvar region should be applied if radical surgery seems problematic or is not possible. Irradiation of lymph node regions is indicated if they are involved or if a resection is not possible.

  6. Very accelerated radiation therapy: preliminary results in locally unresectable head and neck carcinomas

    International Nuclear Information System (INIS)

    Purpose: To report preliminary results of a very accelerated radiation therapy Phase I/II trial in locally advanced head and squamous cell carcinomas (HNSCC). Methods and Materials: Between 01/92 and 06/93, 35 patients with an unresectable HNSCC were entered in this study. Thirty-two (91%) had Stage IV, and 3 had Stage III disease. The mean nodal diameter, in patients with clinically involved nodes (83%), was 6.3 cm. The median Karnovsky performance status was 70. The treatment consisted of a twice daily schedule (BID) giving 62 Gy in 20 days. Results: In all cases, confluent mucositis was observed, which started about day 15 and resolved within 6 to 10 weeks. Eighty percent of patients had enteral nutritional support. The nasogastric tube or gastrostomy was maintained in these patients for a mean duration of 51.8 days. Eighteen patients (53%) were hospitalized during the course of treatment due to a poor medical status or because they lived far from the center (mean 25 days). Nineteen patients (56%) (some of whom were initially in-patients) were hospitalized posttreatment for toxicity (mean 13 days). Five patients (15%) were never hospitalized. During the follow-up period, 12 local and/or regional failures were observed. The actuarial 18-month loco-regional control rate was 59% (95% confidence interval, 45-73%). Conclusions: The dramatic shortening of radiation therapy compared to conventional schedules in our series of very advanced HNSCC resulted in: (a) severe acute mucosal toxicity, which was manageable but required intensive nutritional support in all cases; and (b) high loco-regional response rates, strongly suggesting that the time factor is likely to be critical for tumor control in this type of cancer

  7. Parotid carcinoma

    DEFF Research Database (Denmark)

    Sørensen, Kristine Bjørndal; Godballe, Christian; de Stricker, Karin;

    2006-01-01

    OBJECTIVES: Our aim is to investigate the expression of kit protein (KIT) and epidermal growth factor receptor (EGFR) in parotid carcinomas in order to correlate the expression to histology and prognosis. Further we want to perform mutation analysis of KIT-positive adenoid cystic carcinomas....... PATIENTS AND METHODS: Formalin-fixed paraffin-embedded sections from 73 patients with parotid gland carcinomas were used for the study. The sections were stained with both KIT and EGFR polyclonal antibodies. Twelve KIT-positive adenoid cystic carcinomas were examined for c-kit mutation in codon 816....... RESULTS: Of all carcinomas 25% were KIT-positive and 79% were EGFR-positive. Ninety-two percentage of the adenoid cystic carcinomas were KIT-positive. None of the adenoid cystic carcinomas had mutations in codon 816 of the c-kit gene. CONCLUSION: Neither KIT- nor EGFR-expression seem to harbour...

  8. Treatment Result in Advanced T3 and T4 Glottic Carcinoma; YUMC Experience

    International Nuclear Information System (INIS)

    Between January 1980 and September 1988, 68 patients with advanced T3 and T4 glottic carcinoma were treated with RT and surgery/RT in the Department of Radiation Oncology, Yonsei Cancer Center and ENT, Yonsei University College of Medicine. The mean age was 60 years old (range 33 to 79 year old). The 34 patients were treated with irradiation alone, and the remaining 34 patients with surgery and irradiation. Initial nodal presentation was 37% (25/68); 31% (11/34) in RT alone group and 41% (14/34) in combined treatment group. The minimum follow-up was 2 years. The local control rate after treatment was 47% in RT alone group and 65% in combined treatment group; 57% for node negative and 27% for node positive patients treated with RT alone; 65% for node negative and 64% for node positive patients treated with combined treatment. The treatment failure was observed in 30 patients; 14 patients for primary local failure, 6 patients for regional nodal failure, 6 patients for local and regional failure, 26 patients for primary failure and/or distant metastasis, and 2 patient for regional failure and/or distant metastasis. The overall 5-year survival rate was 57%; 37% in RT alone group and 76% in combined treatment group; 55% for node negative and 20% for node positive patients treated with RT alone; 73% for node negative and 77% for node positive patients treated with combined treatment. In conclusion, the combined treatment groups in the treatment of advanced T3 and T4 glottic cancer showed the better results in local control rates and 5-year actuarial survival rates than RT alone group. We suggest that total laryngectomy and postoperative RT in the most patients of advanced glottic cancer were performed. However, in cases of node negative patients, RT alone is prefer as a treatment modality over combined surgery and RT since the treatment results were comparable and furthermore functional preservation could be achieved

  9. The midterm results of concurrent superselective arterial chemoradiotherapy for carcinoma of the external auditory canal and middle ear

    International Nuclear Information System (INIS)

    This study retrospectively reports the midterm results of concurrent superselective arterial chemoradiotherapy for carcinoma of the external auditory canal and middle ear. Fifteen patients (7 males and 8 females) who were treated for carcinoma of the external auditory canal and middle ear between March 2003 and July 2009 were enrolled in this study. The median follow-up period was 14 months (4-44 months). All patients were staged according to the Pittsburgh staging system by Moody as follows: T1 (n=1), T2 (n=1), T3 (n=1), T4 (n=12). Thirteen patients had squamous cell carcinoma, one had adenocarcinoma, and one had undifferentiated carcinoma. All catheterizations were performed via a transfemoral approach by the Seldinger method. After identifying the feeding arteries of the primary tumor, cisplatin (50 mg/body) was injected. Simultaneously a cisplatin antagonist, sodium thiosulfate, was administered intravenously. Four or five courses of arterial infusion were given weekly. The catheter was removed after each session. External beam irradiation was performed five times a week at 2 Gy per fraction. Total dose ranged from 40 to 60 Gy (median: 60 Gy). The toxicity was evaluated by Common Terminology Criteria for Adverse Events (CTC-AE) ver. 3.0. The 2-year overall survival (OS) rate was 73.4%, and progression free survival (PFS) rate was 53.3% for all patients. Concerning acute toxicity, one patient had Grade 3 dermatitis, and one had Grade 3 leucopenia. No catheter-related complications and no treatment-related deaths were observed. No severe late complications were observed, but one patient had a mild inflammation on the subcutaneous tissue. These results are comparable with those of other reports, suggesting that this method for carcinoma of the external auditory canal and middle ear is acceptable, but the OS rate and PFS rate need improvement. Further investigations are required with larger series to evaluate the long-term survival rate with this treatment. (author)

  10. Laser therapy as the method of choice in treating young women with CIN lesions of the uterine cervix and VIN lesions of the vulva

    Science.gov (United States)

    Knapp, Piotr A.

    1996-03-01

    The aim of the studies was to attempt to investigate the results of treating young women with CIN I - III of the cervix and epithelial VIN I - III lesions of the vulva by means of the laser technique (vaporization).

  11. The Dosimetric Consequences of Intensity Modulated Radiotherapy for Cervix Cancer: The Impact of Organ Motion, Deformation and Tumour Regression

    Science.gov (United States)

    Lim, Karen Siah Huey

    Hypothesis: In intensity modulated radiotherapy (IMRT) for cervix cancer, the dose received by the tumour target and surrounding normal tissues is significantly different to that indicated by a single static plan. Rationale: The optimal use of IMRT in cervix cancer requires a greater attention to clinical target volume (CTV) definition and tumour & normal organ motion to assure maximum tumour control with the fewest side effects. Research Aims: 1) Generate consensus CTV contouring guidelines for cervix cancer; 2) Evaluate intra-pelvic tumour and organ dynamics during radiotherapy; 3) Analyze the dose consequences of intra-pelvic organ dynamics on different radiotherapy strategies. Results: Consensus CTV definitions were generated using experts-in-the-field. Substantial changes in tumour volume and organ motion, resulted in significant reductions in accumulated dose to tumour targets and variability in accumulated dose to surrounding normal tissues. Significance: Formalized CTV definitions for cervix cancer is important in ensuring consistent standards of practice. Complex and unpredictable tumour and organ dynamics mandates daily soft-tissue image guidance if IMRT is used. To maximize the benefits of IMRT for cervix cancer, a strategy of adaptation is necessary.

  12. Cosmetic results after breast conserving carcinoma treatment in patients with intramammarian seromas

    International Nuclear Information System (INIS)

    Introduction: There were 373 patients irradiated after breast conserving carcinoma treatment. A planning computed tomography revealed in 97 of these patients seromas and tissue defects exceeding 2 cm in diameter. The cosmetic results in those patients and the impact of seromas herein had to be evaluated. Patients and methods: Mean age was 59 years. A quadrant resection was performed in 17,5 percent of the patients, a segmental resection in 27,8 percent and a tumour excision in 54,6 percent. Radiation therapy was applied with the linear accelerator and 6 MeV photons up to a total dose in the residual breast of 50 Gy followed by a boost dose to the former tumour bed on 10 Gy. A distinct evaluation and documentation of therapy related side effects and the resulting cosmesis was done in 51 patients. Results: In all the examined seroma patients there were moderate acute skin reactions grade 1 to 3. As late effects in 82,3 percent scar indurations were noticed. At the skin 51 percent showed enhanced pigmentation, 68,6 percent atrophia and only 11 percent teleangiectasia. Subcutaneous fibrosis occurred in 56,9 percent of the patients, 78,4 percent of the women had breast asymmetries. In 41,2 percent there were a lymphedema subcutaneously, in 72,5 percent impaired sensibility. The overall cosmetic result documented with a 5 point score was 'very good' (score 1) in 19,6 percent and 'good' (score 2) in 33,3 percent, 37,3 percent were 'satisfactory' (score 3) and 9,8 percent 'bad' (score 4) respectively. No 'very bad' results (score 5) were seen. Conclusions: The cosmetic results in the examined group of seroma and hematoma patients were inferior to those reported in the literature. We conclude that post-operative seroma and hematoma have an adverse effect on the resulting cosmesis and that their frequency and extent have to be reduced in future by the responsible surgeons. (orig.)

  13. INDIVIDUALIZED TREATMENT OF PREINVASIVE LESIONS OF THE CERVIX

    Directory of Open Access Journals (Sweden)

    Neacsu Dorin

    2010-09-01

    Full Text Available The management of cervical preinvasive lesions in primary medical practice is characterized by a wide variety of attitudes, objectives and therapeutic decisions. The purpose of the study. To supply new landmarks referring to the preinvasive lesions of cervical cancer from the perspective of the clinician. Materials and methods. The study was made on a number of 16732 patients who were monitored comparatively in the Family Planning offices in the counties of Ia�i and Buz�u, between 2007 and 2011. Results and discussions. The treatment was applied according to the type of the lesion. Conclusions. The individualized treatment of the preinvasive lesions of the cervix targeted the destruction of the pathogenic agent and the infected tissues and caused a fibroblast proliferation and re-epithelisation

  14. Pre- and post-radiotherapy MRI results as a predictive model for response in laryngeal carcinoma

    NARCIS (Netherlands)

    Ljumanovic, Redina; Langendijk, Johannes A.; Hoekstra, Otto S.; Knol, Dirk L.; Leemans, C. Rene; Castelijns, Jonas A.

    2008-01-01

    The purpose was to determine if pre-radiotherapy (RT) and/or post-radiotherapy magnetic resonance (MR) imaging can predict response in patients with laryngeal carcinoma treated with RT. Pre- and post-RT MR examinations of 80 patients were retrospectively reviewed and associated with regard to local

  15. Vegetable and fruit consumption and risk of renal cell carcinoma: Results from the Netherlands cohort study

    NARCIS (Netherlands)

    Dijk, B.A.C. van; Schouten, L.J.; Kiemeney, L.A.L.M.; Goldbohm, R.A.; Brandt, P.A. van den

    2005-01-01

    Vegetable and fruit consumption is generally inversely associated with various cancer types, including renal cell carcinoma (RCC). The Netherlands cohort study on diet and cancer (NLCS) consists of 120,852 men and women, aged 55-69 years, who filled out a self-administered questionnaire that include

  16. Vegetable and fruit consumption and risk of renal cell carcinoma: results from the Netherlands cohort study.

    NARCIS (Netherlands)

    Dijk, B.A. van; Schouten, L.J.; Kiemeney, L.A.L.M.; Goldbohm, R.A.; Brandt, P.A. van den

    2005-01-01

    Vegetable and fruit consumption is generally inversely associated with various cancer types, including renal cell carcinoma (RCC). The Netherlands cohort study on diet and cancer (NLCS) consists of 120,852 men and women, aged 55-69 years, who filled out a self-administered questionnaire that include

  17. Preliminary results of phase I/II study of simultaneous modulated accelerated (SMART) for nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jin Hong; Lee, Sang Wook; Back, Geum Mun [College of Medicine, University of Ulsan, Asan Medical Center, Seoul (Korea, Republic of)] (and others)

    2006-03-15

    To present preliminary results of intensity-modulated radiotherapy (IMRT) using the simultaneous modulated accelerated radiation therapy (SMART) boost technique in patients with nasopharyngeal carcinoma (NPC). Twenty patients who underwent IMRT for non-metastatic NPC at the Asan Medical Center between September 2001 and December 2003 were prospectively evaluated. IMRT was delivered using the 'step and shoot' SMART technique at prescribed doses of 72 Gy (2.4 Gy/day) to the gross tumor volume (GTV), 60 Gy (2 Gy/day) to the clinical target volume (CTV) and metastatic nodal station, and 46 Gy (2 Gy/day) to the clinically negative neck region. Eighteen patients also received concurrent chemotherapy using cisplatin once per week. The median follow-up period was 27 months. Nineteen patients completed the treatment without interruption; the remaining patient interrupted treatment for 2 weeks owing to severe pharyngitis and malnutrition. Five patients (25%) had RTOG grade 3 mucositis, whereas nine (45%) had grade 3 pharyngitis. Seven patients (35%) lost more than 10% of their pretreatment weight, whereas 11 (55%) required intravenous fluids and/or tube feeding. There was no grade 3 or 4 chronic xerostomia. All patients showed complete response. Two patients had distant metastases and loco-regional recurrence, respectively. IMRT using the SMART boost technique allows parotid sparing, as shown clinically and by dosimetry, and may also be more effective biologically. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.

  18. Intensity-modulated radiation therapy for T4 nasopharyngeal carcinoma. Treatment results and locoregional

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.L.Y.; Tsai, C.L.; Chen, W.Y.; Wang, C.W. [National Taiwan Univ. Hospital, Taipei (China). Div. of Radiation Oncology; Huang, Y.S.; Chen, Y.F. [National Taiwan Univ. Hospital, Taipei (China). Dept. of Medical Imaging; Kuo, S.H. [National Taiwan Univ. Hospital, Taipei (China). Div. of Radiation Oncology; National Taiwan Univ. College of Medicine, Taipei (China). Graduate Inst. of Clinical Medicine; Hong, R.L. [National Taiwan Univ. Hospital, Taipei (China). Div. of Medical Oncology; Ko, J.Y.; Lou, P.J. [National Taiwan Univ. Hospital, Taipei (China). Dept. of Otolaryngology

    2013-12-15

    Purpose: The purpose of this work was to examine outcomes in patients with T4 nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Methods and materials: Between 2007 and 2010, 154 patients with nonmetastatic T4 NPC were treated with IMRT to a total dose of 70 Gy in 33-35 fractions. In addition, 97 % of patients received concurrent platinum-based chemotherapy. The median follow-up time was 52.8 months. Results: The rates of 5-year actuarial locoregional control, distant metastasis-free survival, progression free-survival, and overall survival (OS) were 81.2, 72.2, 61.9, and 78.1 %, respectively. A total of 27 patients had locoregional recurrence: 85.2 % in-field failures, 11.1 % marginal failures, and 3.7 % out-of-field failures. Fourteen patients with locoregional recurrence received aggressive treatments, including nasopharyngectomy, neck dissection, or re-irradiation, and the 5-year OS rate tended to be better (61.9 %) compared to those receiving conservative treatment (32.0 %, p = 0.051). In patients treated with 1 course of radiotherapy, grade {>=} 3 toxicities of ototoxicity, neck fibrosis, xerostomia, epistaxis, and radiographic temporal lobe necrosis occurred in 18.2, 9.8, 6.3, 2.1, and 5.6 % of patients, respectively. Increased ototoxicity, osteonecrosis, severe nasal bleeding, and temporal necrosis were observed in patients treated by re-irradiation. Conclusion: IMRT offers good locoregional control in patients with T4 NPC. For patients with locoregional recurrence after definitive radiotherapy, aggressive local treatment may be considered for a better outcome. (orig.)

  19. Relationship between Co-expression of Vascular Endothelial Growth Factor and its Receptor, Kinase Insert Domain Containing Receptor and Tumor Angiogenesis in Invasive Carcinoma of the Cervix

    Institute of Scientific and Technical Information of China (English)

    ZhongqingJiang; FengChuanZhu; JunyingQu; XiuZheng; BinZhang; GuizhuWu

    2004-01-01

    OBJECTIVE The aim of the present study was to determine the expression of vascular endothelial growth factor (VEGF) and its receptor, kinase insert domain containing receptor (KDR), and their significance in regulating tumor angiogenesis in the early stages of cervical cancer.METHODS Using the immunohistochemical SP method, the expression of VEGF and KDR was determined in the cancer cells. In addition, the microvessel density (MVD), labeled by CD34 in the tumor stroma, was examined in 18 cases of cervical intraepithelial neoplasms (ClN), 75 cases of early invasive cervix carcinomas (ICC) and 15 specimens of normal cervical epithelium (NCE).RESULTS In ICC cases, VEGF and KDR were mainly expressed in the cellular membrane and/or cytoplasm of tumor cells, while expression of CD34 was found mainly in the vascular epithelial cells of the tumor stroma. The positive expression rate of VEGF and KDR, and the MVD increased remarkably from NCE through CIN to ICC (P<0.01). For the ICC group, in the patients with positive expression of VEGF and KDR, the MVD was significantly higher than those with negative expression of VEGF and KDR (P<0.05). Expression of VEGF in ICC was positively related to KDR expression (r=0.56, P<0.01 ). The MVD was also positively related to both the expression of VEGF (r=0.60, P<0.01), and KDR (r=0.33, P<0.01). In the cases with both positive expression of VEGF and KDR, the MVD was significantly higher than those in which there was negative expression of both (P<0.01 ).CONCLUSION Expression of VEGF and its receptor KDR plays a key role in up-regulating tumor angiogenesis in cervical carcinoma. Co-overexpression of VEGF and KDR results in rapid tumor vasculogenesis. Detection of co-expression of VEGF and KDR may be of value in further understanding tumor angiogenesis and in searching for new targets for anti-angiogenesis therapy in invasive carcinoma of the cervix.

  20. Results of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS)

    International Nuclear Information System (INIS)

    Purpose: The role of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS) is controversial. In particular, there is little data for outcome with radiation in a group of patients comparable to those treated with local excision and surveillance (mammographic calcifications ≤2.5cm, negative resection margins, negative post biopsy mammogram). This study reports outcome of conservative surgery and radiation for mammographically detected DCIS with an emphasis on results in patients considered candidates for excision alone. Methods and Materials: >From 1983 to 1992, 110 women with mammographically detected DCIS (77% calcifications ± mass) and no prior history of breast cancer underwent needle localization and biopsy with (55%) or without a re excision and radiation. Final margins of resection were negative in 62%, positive 7%, close 11%, and unknown 20%. The median patient age was 56 years. The most common histologic subtype was comedo (54%), followed by cribriform (22%). The median pathologic tumor size was 8 mm (range 2 mm to 5 cm). Forty-seven percent of patients with calcifications only had a negative post biopsy mammogram prior to radiation. Radiation consisted of treatment to the entire breast (median 50.00 Gy) and a boost to the primary site (97%) for a median total dose of 60.40 Gy. Results: With a median follow-up of 5.3 years, three patients developed a recurrence in the treated breast. The median interval to recurrence was 8.8 years and all were invasive cancers. Two (67%) occurred outside the initial quadrant. The 5- and 10-year actuarial rates of recurrence were 1 and 15%. Cause-specific survival was 100% at 5 and 10 years. Contralateral breast cancer developed in two patients. There were too few failures for statistical significance to be achieved with any of the following factors: patient age, family history, race, mammographic findings, location primary, pathologic size, histologic subtype, re excision, or

  1. The pigmented portio: benign lentigo of the uterine cervix.

    Science.gov (United States)

    Schneider, V; Zimberg, S T; Kay, S

    1981-01-01

    The first case of benign lentigo of the uterine cervix is reported, providing further evidence that the cervix is able to form the entire spectrum of melanocytic lesions known to occur in the skin. Review of the literature reveals 19 cases of primary malignant melanoma of the cervix and 30 cases of blue nevus. The reported case offers support that benign lentigines may play a role as premalignant lesions of malignant melanoma not only in the skin, but aldo in mucous membranes. PMID:7327080

  2. Analysis of the expression of genes involved in proliferation and apoptosis in cervical intraepithelial neoplasias and cancer of the cervix uteri

    Directory of Open Access Journals (Sweden)

    V. K. Bozhenko

    2014-08-01

    Full Text Available The viral nature of many female genital cancers is now beyond question. By taking into account this fact, the problem of qualitative assessment ofthenatureofcervicalintraepithelialneoplasia(CINanditsfocusonprogressiontoinvasivecarcinomabecomesquitenatu ral.Studiesof a number of biological markers of carcinogenesis have recently provided a possibility for prospective prediction. The paper con siders the as- pects of importance of the molecular biological markers of proliferation and apoptosis in the etiopathogenesis of genital cancers. It gives the results of examinations of 16 patients with histologically verified squamous cell carcinoma of the cervix uteri, 40 patients di agnosed as having CIN of different grades (CIN-1, CIN-2, CIN-3 — squamous cell carcinoma in situ, and 6 patients with the morphologically unaltered cervi- calepithelium,whosecervicalscrapeswereanalyzedfortheexpressionofthemRNAgenesССNB1,Ki-67,BA G,BCL-2,ESR1,andPRG. It is shown that the molecular genetic findings may be new prognostic markers that reflect the possible disease developmental pathways, sug- gesting the need for further investigation of biomarkers in order to prevent malignancies and to reduce their morbidity.

  3. Therapeutic and diagnostic procedures in preinvasive disease of the cervix and cervical cancer in pregnant women; Postepowanie diagnostyczne i terapeeutyczne w stanach przedrakowych i raku szyjki macicy u ciezarnych

    Energy Technology Data Exchange (ETDEWEB)

    Wolna, M.; Pisarski, T.; Kedzia, H. [Instytut Ginekologii i Poloznictwa, Akademia Medyczna, Poznan (Poland)] [and others

    1993-12-31

    154 pregnant women with displasis and cervical carcinoma of the uterus treated in the Institute in years 1953-1990 underwent investigation. Authors noticed that only 50 pathologies were diagnosed in 1st trimester of pregnancy and 85% constituted precancerous and early forms of carcinoma of the uterine cervix. Authors presented the model of management and care of pregnancy, labour and puerperium in these patients. Due to this procedure we obtained 90% comparability of preliminary and final diagnosis. (author) 18 refs, 7 tabs

  4. Resultados oncológicos da laringectomia parcial no carcinoma glótico inicial Oncologic results of the partial laryngectomy for early glottic carcinoma

    Directory of Open Access Journals (Sweden)

    Otávio Alberto Curioni

    2002-10-01

    for 5 years of 65%-70%. Aim: Evaluation of the results after partial laringectomy for early glottic squamous cell carcinoma. Study design: Clinical retrospective. Material and Method: Retrospective analysis of the 59 patients' handbook was accomplished submitted to the partial laringectomy. There were excluded patients with previous treatment, tumor extension larger than 10 mm below the glottis, lesions with macroscopicextension for vestibular folds and lesions with decrease of the mobility vocal cords laryngoscopy and follow-up of 36 months or more. Results: 12 patients (20,3% presented recurrence, being 1 a regional recurrence (1,7% and 11 local recurrences (18,6%, with surgical rescue (total laringectomy and oncologic control in 75% of those cases. Severe complications (glottic stenosis and aspiration happened in only 2 patients (3,4%. Conclusions: The partial laringectomy is safe and an effective procedure for the treatment of majority of early glottic carcinoma. In addition, for its versatility, check safety in the oncologic radically and make possible, also, the functional readaptation for the patient

  5. Urothelial cells in smears from cervix uteri

    Directory of Open Access Journals (Sweden)

    Luis Alberto Palaoro

    2012-01-01

    Conclusions: The umbrella cells may be mistaken for dysplastic cells originating in low grade squamous intraepithelial lesions lesions (LSILs due to their nuclear and cytoplasm sizes. Therefore, it is important to know the possibility of their appearance in the cervical smears, especially in post menopausal patients in order to avoid a false diagnosis of an intraepithelial lesion. It is unlikely that deeper cells of urothelium would be confused with high grade squamous intraepithelial lesion (HSIL cells. However, their presence might be a reason of mistake in the diagnosis. TCM is an under-recognized metaplastic phenomenon of the cervix and vagina, which is a mimicker of high-grade squamous intraepithelial lesion. The differential characteristic between umbrella cells, cells from TCM and the deeper urothelial cells, and LSIL and HSIL are detailed in the present paper.

  6. Poor results with technetium-99m (V) DMS and iodine-131 MIBG in the imaging of medullary thyroid carcinoma

    International Nuclear Information System (INIS)

    The value of [/sup 99m/Tc(V)]DMS and [131I]MIBG in imaging medullary carcinoma of the thyroid was investigated in five patients. Results with [/sup 99m/Tc(V)]DMS were negative in all five patients as well as with [131I]MIBG in four patients; however, there was significant tumor uptake in one patient with [131I]MIBG

  7. The Leeds results for radiotherapy in HBO for carcinoma of the head and neck

    International Nuclear Information System (INIS)

    Follow-up data at five years are reported for 24 patients with squamous cell carcinoma of the head and neck, included in a randomised prospective MRC study of radiotherapy in hyperbaric oxygen (10 fractions) or air (15 or 20 fractions). Although few, the data show a significant gain in local control (P < 0.001) and survival (P < 0.05) with the use of hyperbaric oxygen but no increased tissue reactions or morbidity. (author)

  8. Rhenium-188 Lipiodol Therapy of Hepatocellular Carcinoma: Results of a multicentre-multinational study

    International Nuclear Information System (INIS)

    Full text: A multi-centre study was sponsored by the IAEA to assess the safety and efficacy of trans-arterial Rhenium-188 HDD Lipiodol in the treatment of inoperable Hepatocellular Carcinoma. The radioconjugate was prepared by using an HDD kit and Lipiodol. Over three years, 185 patients received at least one treatment. The dose administered was based on radiation absorbed dose to critical normal organs, calculated following a ''scout'' dose (approximately 4 mCi) of radioconjugate. The organs at greatest risk for radiation toxicity are the liver, the lung and the bone marrow. An Excel spreadsheet was used to determine maximum tolerated activity, defined as the amount of radioactivity calculated to deliver no more than 12 Gy to lungs, 30 Gy to liver, or 1.5 Gy to bone marrow. A single treatment was given to 134 patients, 42 patients received two doses, 8 received three and one patient received four treatments. The total injected activity including the scout dose during the first treatment ranged from 21 to 364 mCi (average 108 mCi). Patients were followed for at least l2 weeks after therapy. The clinical parameters evaluated included toxicity, response as determined objectively by contrast enhanced computed tomography, palliation of symptoms, overall survival, performance status (Karnofsky), and hepatic function (Child's classification). Liver function tests, serum alpha-fetoprotein (AFP) levels and complete blood counts were done at each follow-up visit. Side effects were minimal and usually presented as loss of appetite, right hypochondrial discomfort and low-grade fever. Liver function tests at 24 and 72 hours showed no significant changes and complete blood counts at 1 week, 4 weeks and 12 weeks showed no changes (no bone marrow suppression). Data on largest tumour diameter after therapy and/or tumour response as evaluated from CT scans are available for 88 patients. Complete disappearance of tumour was recorded in 3 (3%), partial response in 19 (22%), stable

  9. 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.

  10. Metastatic large cell neuroendocrine carcinoma of the lung arising from the uterus: A pitfall in lung cancer diagnosis.

    Science.gov (United States)

    Ono, Kyoko; Yokota, Naho Ruiz; Yoshioka, Emi; Noguchi, Akira; Washimi, Kota; Kawachi, Kae; Miyagi, Yohei; Kato, Hisamori; Yokose, Tomoyuki

    2016-07-01

    A 41-year-old female smoker presented with a vaginal mass. Gynecological examination showed a mass filling the uterine corpus, cervix, and vagina. A total abdominal hysterectomy was performed. Macroscopic findings included a large fragile mass involving the uterine cavity, cervix, and vagina. Histology revealed atypical ducts admixed with solid components consisting of large atypical cells. The initial pathological diagnosis was grade 3 endometrioid adenocarcinoma. The patient was designated as stage II according to the 2008 International Federation of Gynecology and Obstetrics (FIGO) staging. Two years later, two nodules were found in the upper lobe of the left lung, and the patient underwent an upper lobectomy. The masses, which exhibited solid and organoid growth patterns of large atypical cells, had histological characteristics of large cell neuroendocrine carcinoma (LCNEC) of the lung. However, the tumor was immunohistochemically positive for neuroendocrine markers, such as synaptophysin in addition to estrogen receptor and progesterone receptor, and the tumor was negative for thyroid transcription factor-1. These immunohistochemical results were almost identical to those of the solid portions of the uterine carcinoma. The final diagnosis was LCNEC combined with endometrioid adenocarcinoma of the uterine corpus and lung metastasis of the LCNEC component of the endometrial carcinoma. LCNEC often arises in the lung, but it rarely arises in other organs. Some patients with metastatic components exhibited only a LCNEC pattern although the primary tumor was a mixed carcinoma consisting of LCNEC and other histology, like the present case. LCNEC is often poorly differentiated, especially in extrapulmonary primary organ LCNEC. Therefore, pathologists should consider metastatic carcinoma when they encounter lung LCNEC in a patient with a preceding extrapulmonary carcinoma composed of a poorly differentiated component or LCNEC component, and they should clarify tumor

  11. Long-term results of the maxillary sinus carcinoma with irradiation and intraarterial infusion of 5-FU

    International Nuclear Information System (INIS)

    Therapeutic results of 33 primary cases of maxillary sinus carcinoma treated with irradiation and intraarterial infusion of 5-FU between 1972 and 1984 were analyzed. The 5-year crude survival rate for the group with stage T2 carcinoma (n=10) was 50.0%, and for those with T3 (n=15) and T4 (n=8) it was 46.7% and 25.0%, respectively. The overall 5-year crude survival rate was 42.4%. Eight patients who did not undergo maxillectomy survived for 5 years after irradiation and intraarterial infusion. Recurrence of the tumor after the irradiation and intraarterial infusion occurred in 63.6%, and was frequently observed at the ethmoidal region and the orbita. In the areas in which the tumor extended to regions such as the ethmoid sinus and orbita, which are nourished by arteries other than the maxillary artery, conventional intraarterial infusion was ineffective for complete tumor eradication. Therefore, in most of the patients with advanced maxillary sinus carcinoma, partial or total maxillectomy following combined therapy of intraarterial infusion and irradiation is necessary to improve a prognosis. (author)

  12. 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)

  13. Vascularisation Pattern of Chronic Pancreatitis Compared with Pancreatic Carcinoma: Results from Contrast-Enhanced Endoscopic Ultrasound

    Directory of Open Access Journals (Sweden)

    Michael Hocke

    2012-01-01

    Full Text Available Discriminating between focal chronic pancreatitis and pancreatic cancer is always a challenge in clinical medicine. Contrast-enhanced endoscopic ultrasound using Doppler techniques can uniquely reveal different vascularisation patterns in pancreatic tissue alterated by chronic inflammatory processes and even allows a discrimination from pancreatic cancer. This paper will describe the basics of contrast-enhanced high mechanical index endoscopic ultrasound (CEHMI EUS and contrast enhanced low mechanical index endoscopic ultrasound (CELMI EUS and explain the pathophysiological differences of the vascularisation of chronic pancreatitis and pancreatic carcinoma. Furthermore it will discuss how to use these techniques in daily clinical practice.

  14. Prognostic Role of microRNA-155 in Various Carcinomas: Results from a Meta-Analysis

    OpenAIRE

    Jing He; Fengmei Zhang; Ying Wu; Xiaoli Zhu; Xuelian He; Yuhang Zhao; , Wei Zhang; Yulan Zhao

    2013-01-01

    BACKGROUND: Recent studies have shown that microRNAs (miRNA) have prognostic values in cancers. This meta-analysis seeks to summarize the global predicting role of miR-155 for survival in patients with a variety of carcinomas. METHODS: Eligible studies were identified through multiple search strategies. Data were extracted from studies investigating the relationship between miR-155 expression and survival in cancer patients. Combined hazard ratios (HRs) of miR-155 for outcome were analyzed. R...

  15. Tumour size in cancer of the cervix

    International Nuclear Information System (INIS)

    In a randomized trial comprising 204 patients with operable cervical carcinomas stages I and II, two low-dose rates in gynaecological brachytherapy were compared. Treatment consisted of Cs-137 uterovaginal application followed by surgery (either immedidate or delayed). The results for the two dose rates have been published previously. The present paper concerns the correlation between outcome and tumour size. Tumour size was carefully estimated in two ways: by clinical examination under general anaesthesia and by measurements on the customized vaginal mould used for the brachytherapy. Ninety-one patients (45%) were classified as stage I, and 113 were classified as stage II proximal. The mean tumour size was 39 mm (range 15-64 mm). Cox's multivariate analysis indicated that the factors with a poor prognostic value were for survival: node involvement (N+) (p<0.001), large tumour size (T+) (p<0.001); for local control; N+ (p=0.0001); for metastasis and regional relapse: N+ (p<0.001) and T+ (p<0.001). Stage was not a prognostic factor over the present range in either univariate or multivariate analysis. In this series tumour size is a powerful independent prognostic factor. It is therefore suggested that for the classification of cervical cancer and the indications for surgical staging and adjuvant treatment, tumour size should be taken into account. (orig.)

  16. Investigation of the interacorporcal decay, elimination rate and diagnostic confidence of 57Co-bleomycine in patients with the uterine cervix cancer

    International Nuclear Information System (INIS)

    In 20 women with diagnosed squamous carcinoma of the uterine cervix the 57Co-Bleomycine was used for the estimation of the intracorporeal decay, elimination rate and neoplasmic tissue storage of the complex. Whole body scanner ''Scan modus'' type and gamma chamber were used. A rapid elimination of the examined complex with urine was noted, the blood concentration was significantly higher (p57Co-Bleomycine) can be applied as diagnostic means in cases of uterine squamous carcinoma and in its metastases. (author)

  17. Fast neutron therapy of bronchus carcinoma: the pooled results from two european centres; Utilisation de neutrons rapides dans le traitement des carcinomes bronchiques. Experience de deux centres europeens

    Energy Technology Data Exchange (ETDEWEB)

    Lessel, A. [Humboldt-Universitaet, Berlin (Germany)

    1996-12-31

    The Berlin-Buch and Heidelberg centres used fast neutron therapy in bronchial carcinomas. The neutron source was a cyclotron in Berlin-Buch/Rossendorf and a d-t generator in Heidelberg. Three hundred twelve patients with inoperable bronchial carcinoma were treated with fast neutron therapy alone or in combination with photons. The results were then compared with those obtained from 594 patients treated only with photons. Altogether, 788 were treated in Berlin-Buch and 188 in Heidelberg. The results suggest that neutron therapy for bronchial carcinoma can be a good alternative in curative and palliative situations in the early stages. (author). 14 refs.

  18. Combined treatment of corpus carcinoma. Results and side-effects in 496 patients

    International Nuclear Information System (INIS)

    At the case histories of 496 patients with corpus carcinoma, the clinical findings, the stage classification which took place afterwards, and the different forms of therapy are listed and evaluated. With an average age of 62,3 years, relapse-free 5-years-survival rates of 70,8% were achieved for stage I, of 50% for stage II, of 12% for stage III, and 0% for stage IV. Metastases appeared on 19,1% all female patients treated, vaginal relapses on 1,8%. Evaluating the therapy-caused side effects and delayed effects an increase in the complication rate is seen which is due to higher total focal doses applied. In total, in 21,9% of the patients complications appeared within the first year after beginning the therapy and 8,7% had radiation-caused delayed effects after this period. A radiation therapy adjusted to the individual stages which, in addition to the macroscopic aspects and the histologic differentiation, also leans on the histologically judged degree of invasion of the carcinoma tissue into the myometrium must on the one hand guarantee a safe degree of destroying the tumour and, on the other keep radiation-caused side effects and delayed effects as low as possible. The experiences meanwhile gained with the application of hard X radiation plus the application of modern adjuvants in the irradiation planning by means of computerized tomography seem likely to bring a decreased frequency in the appearance of radiation-caused complications. (orig.)

  19. Pre-operative irradiation with rectal carcinoma - clinical practices and results

    International Nuclear Information System (INIS)

    The goal of this work is to portray the effect of a high-dosed short-timed pre-irradiation on intra- and post-operative therapy of rectal carcinoma and the appearance of recidivistic tumors, respectively distant metastasis. This intermediate balance should help make the decision easier as to whether to continue to use this combined treatment form. The subjects consisted of 65 rectal carcinoma patients - pre-irradiated and operated - and 95 only operated patients. The irradiation was completed using a 8 MeV linear accelerator with ultra hard x-radiation. Dosing - (more than 80%) as short-timed irradiation with 16 Gy (4 x 4 Gy in 2 days) - 25 Gy (10 x 2,5 Gy in 12 days); average field size 150 mm x 150 mm. There were no significant differences with regard to intra- and post-operative complications, late complications or distant metastasis, but there was with tumor recidivision reduced with pre-irradiated. Regarding the survival rate, there was a slight tendency in favor of the pre-irradiated. (orig./MG)

  20. Fatores de risco não habituais para metástase linfonodal no câncer do colo do útero Unusual risk factors for lymph node metastasis in cancer of the uterine cervix

    Directory of Open Access Journals (Sweden)

    José Humberto Tavares Guerreiro Fregnani

    2007-08-01

    collected from patient's records and from review of the histological sections from the uterine cervices and the lymph nodes, including sociodemographic data (age at diagnosis, skin color, clinical data (disease stage, preoperative hemoglobin level, body mass index and histopathological data (histological type, histological grade, blood and/or lymphatic capillary embolization, perineural invasion, depth of tumor invasion into cervical stroma, intensity of inflammatory reaction in the uterine cervix, tumor necrosis, tumor size, invasion of the lateral cervical ligaments and uterine body, and lymph node status. Associations between lymph node metastasis and the different variables were evaluated by means of the chi-square test, Fisher's exact test and multiple logistic regression. RESULTS: Pelvic lymph node metastasis was found in 65 patients (22.5%. The following risk factors for lymph node metastasis were identified by multivariate analysis: hemoglobin level <10.0 g% (OR = 3.6; 95% CI: 1.210.7, tumor invasion of the middle third (OR = 3.3; 95% CI: 1.110.7 and deep third of the uterine cervix (OR = 5.4; 95% CI: 1.717.3, absent or slight inflammatory reaction in the uterine cervix (OR = 2.4; 95% CI: 1.15.2 and keratinizing squamous cell carcinoma (OR = 3.3; 95% CI: 1.47.6. CONCLUSIONS: This study identified four risk factors for pelvic lymph node metastasis in patients with carcinoma of the uterine cervix at stages IB and IIA. Of these, three are not usually described in literature as predictive variables for lymph node metastasis (preoperative anemia, absent or slight inflammatory reaction and keratinizing of squamous cell carcinoma.

  1. Economic evaluation of temsirolimus on the basis of the results of the ARCC (Advanced Renal-Cell Carcinoma study

    Directory of Open Access Journals (Sweden)

    Simona de Portu

    2009-06-01

    Full Text Available Introduction: metastatic renal cell carcinoma (mRCC is highly resistant to chemotherapeutics, rendering limited antitumor effect. Temsirolimus, a specific inhibitor of the mammalian target of rapamycin kinase, may benefit patients with this disease. The Global ARCC Trial (Temsirolimus, Interferon Alfa, or Both for Advanced Renal-Cell Carcinoma compared temsirolimus alone or temsirolimus plus interferon alfa with interferon alfa alone in mRCC. It has demonstrated that, as compared with interferon alfa, temsirolimus improved overall survival among patients with metastatic renal-cell carcinoma and a poor prognosis while the addition of temsirolimus to interferon did not improve survival. Aim: the objective of our study was to investigate the pharmacoeconomic impact in the Italian context of temsirolimus vs interferon alfa in patients with metastatic renal-cell carcinoma and a poor prognosis. Methods: economic evaluation is based on clinical outcome data from the ARCC trial and was carried out conducting a cost/effectiveness analysis, comparing economic and clinical consequences of temsirolimus (25 mg weekly vs interferon alfa (18 MU 3 times weekly in the perspective of the Italian National Health Service. Direct medical costs included in the analysis were drug costs, costs associated with the management of treatment-related serious adverse events (grade 3 and 4, cost related to progression and best supportive care. Effects were measured in terms of overall survival. A sensitivity analysis was performed. Results: the cost of temsirolimus or interferon alfa therapy amounted to approximately € 14,000 and € 2,000 patient respectively. The cost of hospitalization related to drug toxicity was about € 1,500 for temsirolimus and € 2,100 for interferon alfa. Temsirolimus shows an incremental cost per patient per month saved of € 3,767. Sensitivity analysis demonstrates that cost consequences parameters are sensitive to fluctuation. Discussion

  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. Prognostic factors influencing the result of postoperative radiotherapy in endometrial carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ki, Yong Kan; Kwon, Byung Hyun; Kim, Won Taek; Nam, Ji Ho; Yun, Man Su; Kim, Dong Won [Pusan National University School of Medicine, Busan (Korea, Republic of); Lee, Hyung Sik [Dong-A University School of Medicine, Busan (Korea, Republic of)

    2006-06-15

    This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range 35 {approx} 76). The distribution by surgical FIGO stages were 63.0% for 0 Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to 41.4 {approx} 54 Gy (median: 50.4 Gy). Additional intravaginal brachytherapy was applied to 20 patients (37.0% of all). Median follow-up time was 35 months (5 {approx} 115 months). Significant factors of this study: histologic grade, lymphovascular space invasion and myometrial invasion depth were scored (GLM sore) and analyzed. Survival analysis was performed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. 5-year overall and disease-free survival rates were 87.7% and 87.1%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, lymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, lymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival ({rho} = 0.0090, {rho} = 0.0073, respectively) and distant recurrence ({rho} = 0.0132), which was the sum of points of histologic grade, lymphovascular space invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic lymph nodes, 2 lungs, a supraclavicular lymph node and a vagina. The prognosis in patients with endometrial carcinoma treated by

  4. Brachytherapy for carcinoma of the floor of mouth. Clinical results and considerations

    International Nuclear Information System (INIS)

    Forty-six patients with T1 and T2 carcinomas of the floor of mouth (FOM), who underwent brachytherapy from February 1979 to March 1991, were reviewed retrospectively. Four of the 46 patients died within 2 years of their initial treatment, without a local recurrence and/or radiation injury. Therefore, they were excluded from the evaluation of two-year local control and radiation injury rate. The two-year local control rate of the remaining 42 patients was 93% (39/42). The rate was 100% (27/27) in patients treated by brachytherapy (BT) alone, and 80% (12/15) in those treated by BT with external radiation (ERT) and chemotherapy. This rate was not elevated from that achieved at a dose of 70 Gy by BT (88%) when a dose of 80 Gy was given by BT with ERT (90%) in the dose-response relationship. According to tumor extension, the local control rates for pelvic-gingival (PG), pelvic (P) and pelvic-lingual (PL) tumors were 75% (6/8), 100% (19/19) and 93% (14/15), respectively. The two-year radiation injury (mandibular exposure) rate was 10% (4/42). The rate was 7% (2/27) in patients treated by BT alone and 13% (2/15) in those treated by BT with ERT, and was greatly elevated from that occurring with a dose of 70 Gy by BT (5%) when a dose of 80 Gy was given by BT with ERT (13%) in the dose-response relationship. According to tumor extention, the radiation injury rates for PG, P and PL tumors were 13% (1/8), 5% (1/19) and 13% (2/15), respectively. In conclusion, BT with ERT did not improve the local control rate of T1 and T2 carcinomas of FOM, and elevated the radiation injury rate greatly. Therefore, we believe that T1 and T2 carcinoma, even when extending to the gingiva, should be treated by BT alone. Multiple cancer incidence in these patients was 28% (13/46), and the incidence of digestive tract cancer was especially high. Therefore, a complete work-up is necessary before treatment and during the follow-up period. (author)

  5. Efficacy of sorafenib on metastatic renal cell carcinoma in Asian patients: Results from a multicenter study

    International Nuclear Information System (INIS)

    The effects of sorafenib in the treatment of advanced renal cell carcinoma (RCC) have been confirmed in an international collaborative phase III trial. This study aims to confirm similar efficacy and treatment-induced toxicities of sorafenib in the treatment of metastatic RCC in ethnic Chinese patients. Ninety-eight consecutive and non-selected patients with pathologically confirmed metastatic RCC were treated according to an institutional treatment protocol. All patients were treated with 400 mg of sorafenib orally twice daily on a continuous basis until disease progression or intolerance to treatment occurred. Dose reduction to 400 mg once daily was required if grade 3 or 4 toxicities occurred. All patients except for 7 received nephrectomy in the course of their disease. All patients were assessed for tumor response, progression-free survival (PFS), overall survival (OS), and treatment-induced toxicities. The median follow-up time was 76 weeks (range 2–296 weeks) for the entire group of patients. Radiologically confirmed complete response (CR), partial response (PR), stable disease (SD) of more than 4 months, and disease progression as best objective responses were observed in 1 (1%), 23 (23.5%), 62 (63.3%), and 12 (12.2%) patients, respectively. The tumor control rate (CR+PR+SD of >4 months) was 87.8%. The 1-year estimated PFS and OS were 58.4% and 64.6%, respectively. The median progression-free survival (PFS) time was 60 weeks (95% CI 41–79); and the median overall survival (OS) time was not reached with a follow-up of 76 weeks. Reduction of sorafenib dose was required in 26 patients who developed grade 3 or 4 treatment-cause adverse-effects. An additional 9 patients discontinued sorafenib treatment due to severe adverse-effects. No grade 5 toxicity occurred. Multivariate analysis revealed that independent predictive factors for tumor response to sorafenib treatment included ECOG status, presence of lymph node metastasis, and nephrectomy prior to the

  6. Large and small cells non-keratinizing epidermoid vaginal carcinoma

    International Nuclear Information System (INIS)

    Five case reports of patients who were assisted at the cervix Pathology Department from 'Mariana Grajales Coello' Provincial Gynecological Obstetrical Hospital in Santiago de Cuba due to vaginal bleeding, low abdominal pain, leukorrhea and vaginal injuries are presented. The pathological study confirmed the diagnosis of squamous or epidermoid cells carcinoma

  7. Comparison of prognosis values of pre therapy PET-T.D.M. with {sup 18}F-F.D.G. and MRI in the uterus cervix cancer; Comparaison des valeurs pronostiques des TEP-TDM au 18F-FDG et IRM pretherapeutiques dans le cancer du col de l'uterus

    Energy Technology Data Exchange (ETDEWEB)

    Chastan, M.; Baron, M.; Diologent, B.; Edet Sanson, A.; Guernou, M.; Vera, P.; Hitzel, A. [Centre Henri-Becquerel, Rouen, (France); Manrique, A. [GIP Cyceron, Caen, (France)

    2009-05-15

    The objective is to compare the prognosis value of the pre-therapy pelvis PET--T.D.M. with {sup 18}F-F.D.G. and MRI in the uterine cervix carcinoma. The conclusions: in the uterine cervix carcinomas, the existence of a pelvis ganglion injury on the pre-therapy PET-T.D.M. with {sup 18}F-F.D.G. is a prognosis factor independent of recurrence and death at one year. The MRI does not bring any additional information relative to the prognosis of the disease. (N.C.)

  8. Results of external beam irradiation for rectal carcinomas locally recurrent after local excision or electrocoagulation

    International Nuclear Information System (INIS)

    The outcome of 42 patients who developed locally recurrent rectal carcinoma after initial local excision or electrocoagulation was presented. Five patients received combined surgery and radiotherapy (XRT). The remaining 37 patients were managed by XRT alone. The overall 5 years actuarial survival and local control rates were 21 and 22 percent, respectively. For patients who received XRT alone, the 5 year actuarial survival and local control rates were 20 and 15 percent, resp. The corresponding figures were 35 and 40 percent for patients who received a total XRT dose of 50 Gy or more. One patient who underwent combined treatment developed rectal and bladder incontinence requiring surgery. For patients with rectal recurrence after initial conservative surgery, XRT is an alternative to abdominoperipheral resection if major resection is contraindicated. (author). 13 refs.; 2 tabs

  9. Superselective radioembolization of hepatocellular carcinoma: 5-year results of a prospective study.

    Science.gov (United States)

    Rösler, H; Triller, J; Baer, H U; Geiger, L; Beer, H F; Becker, C; Blumgart, L H

    1994-10-01

    Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with 90Y-resin particles. Diagnostic radioembolizations of 99mTc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumour occurred even after > or = 300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided. PMID:7997379

  10. Superselective radioembolization of hepatocellular carcinoma: 5-year results of a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Roesler, H. (Dept. of Nuclear Medicine, Paul Scherrer-Inst., Villigen (Switzerland)); Triller, J. (Dept. of Diagnostic Radiology, Paul Scherrer-Inst., Villigen (Switzerland)); Baer, H.U. (Clinic of Visceral Surgery, Paul Scherrer-Inst., Villigen (Switzerland)); Geiger, L. (Dept. of Nuclear Medicine, Paul Scherrer-Inst., Villigen (Switzerland)); Beer, H.F. (Paul Scherrer-Inst., Villigen (Switzerland)); Becker, C. (Dept. of Diagnostic Radiology, Paul Scherrer-Inst., Villigen (Switzerland)); Blumgart, L.H. (Clinic of Visceral Surgery, Paul Scherrer-Inst., Villigen (Switzerland))

    1994-10-01

    Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with [sup 90]Y-resin particles. Diagnostic radioembolizations of [sup 99m]Tc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumor occurred even after [>=]300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided. (orig.)

  11. Ten-year results comparing mastectomy to excision and radiation therapy for ductal carcinoma in situ of the breast

    International Nuclear Information System (INIS)

    The 10-year results of 300 patients with ductal carcinoma in situ (DCIS) without microinvasion are reported; 167 treated with mastectomy and 133 treated with excision and radiation therapy. There was a significant difference in disease-free survival at 10 years, in favour of those treated with mastectomy, 98% versus 81% (P = 0.0004). Multivariate analysis confirmed nuclear grade as the only significant predictor of local recurrence (P = 0.02) or invasive local recurrence (P = 0.03) in patients with DCIS treated with excision and radiation therapy. There was no difference in breast cancer-specific survival or overall survival between the two treatment groups. (author)

  12. Percutaneous microwave coagulation therapy combined with transcatheter arterial chmoembolization for hepatocellular carcinoma: preliminary results

    International Nuclear Information System (INIS)

    To evaluate the efficacy of percutaneous microwave coagulation therapy (PMCT) combined with transcatheter arterial chemoemboization (TACE) for the treatment of hepatocellular carcinoma (HCC). Twenty-five nodular HCCs (long diameter of 1.2-10 (mean, 3.4) cm) in 19 patients (15 males and 4 females) were treated by PMCT 4-138 days after TACE. Under ultrasound guidance, the carcinoma were punctured with a 14-G guideneedle through which a microwave electrode (25.0 cm in length, 1.6 mm in diameter) was inserted. To coagulate the HCCs and surrounding hepatic parenchyma, microwave irradiation at 60W for 45-60 seconds was then applied. One to three sessions of PMCT were performed at intervals of 2-6 days, and one week to 29 months later, the therapeutic effect was evaluated by spiral CT, angiography, and serum alpha-fetoprotein. Eighteen of 25 HCCs (72.0%) were necrotized completely, but seven (28.0%) recurred. Ninety percent of HCCs smaller than 4 cm in long diameter showed complete remission, but all those larger than 4 cm recurred. Alpha-fetoprotein levels decreased markedly in five patients (26.3 %), while in 12 (63.2%), asparate aminotransferase (AST)/alanine aminotransferase (ALT) showed transient elevation. Minor complications occurred after PMCT (mild abdominal pain in 8 patients, fever in 7, pleural effusion in 3, portal vein thrombosis in 1, and hepatic abscess in 1), but in no case was this serious. PMCT combined with TACE provides effective and safe treatment for nodular HCCs with a long diameter of less than 4 cm. (author)

  13. Radical radiotherapy for cervix cancer: The effect of waiting time on outcome

    International Nuclear Information System (INIS)

    Purpose: To assess the effect of treatment waiting time on clinical outcome for patients with cervix cancers treated with radical radiotherapy. Methods and materials: A retrospective analysis was conducted on all cervix cancer patients treated with radical radiotherapy between 1990 and 2001 at the Ottawa Regional Cancer Centre. Analyses were performed according to the three following separate definitions of waiting times: interval from start of radiotherapy to (1) date of initial biopsy (2) date of examination under anesthesia, and (3) date of radiation oncology consultation. Associations between waiting times and patient characteristics and disease control were investigated using t-tests, analyses of variance, and Cox regression analyses. Results: A total of 195 patients were studied. The vast majority of patients were treated within 5, 6, and 8 weeks of their consultation (91%), examination under anesthesia (88%), and biopsy (81%), respectively. On average, delays between initial biopsy and treatment start were greater for older patients (p = 0.025) (5.8 weeks for 70 years old) and those with smaller tumors (p 4 cm vs. 6.3 weeks for ≤4 cm). Univariate analysis revealed no adverse effect of treatment delay on tumor control. Multivariate analysis, with the inclusion of multiple prognostic tumor and treatment parameters, revealed an adverse effect of treatment delay on survival outcomes. Conclusions: Longer radiotherapy waiting times were found to be associated with diminished survival outcomes for patients treated radically for cervix cancer. The significance of this observed association requires further investigation

  14. Preliminary results of transarterial Rhenium-188 HDD Lipiodol in treatment of inoperable primary hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Full text: In this paper we present our early experience with a new radio-conjugate, namely rhenium-188 HDD Lipiodol (Re-188 lipiodol). Imported radiopharmaceuticals are generally expensive, particularly for developing countries. A Tungsten (W-188-Re 188) generator obtained from ORNL (Oak Ridge National Laboratory, Tennessee, USA) allows us on-site production of a beta emitting therapeutic isotope (Re-188) for up to 6 months from a single generator. The objectives of this study were to establish the safety of trans-arterial Re-188 lipiodol in patients with inoperable HCC, and determine the adverse effects and efficacy for this radio-conjugate treatment in a multi-center study of patients with advanced HCC. A multi-center study was sponsored by the International Atomic Energy Agency (Vienna) to assess the safety and efficacy of trans-arterial Re-188 HDD conjugated lipiodol (radio-conjugate) in the treatment of patients with inoperable hepatocellular carcinoma (HCC), The radio-conjugate was prepared by using a HDD (4-hexadecyl 1-2, 9, 9-tetramethyl-4, 7-diaza-1, 10-decanethiol) kit developed in Korea, and lipiodol. Over a period of eighteen months seventy patients received at least one treatment of radio-conjugate. Some patients were re-treated if there was no evidence of disease progression. The level of radio-conjugate administered was based on radiation-absorbed dose to critical normal organs, calculated following a 'scout' dose of radio-conjugate. The organs at greatest risk for radiation toxicity are the normal liver, the lung and the bone marrow. A specially designed spreadsheet was used to determine maximum tolerated activity (MTA), defined as the amount of radioactivity calculated to deliver no more than 12 Gray (Gy) to lungs, or 30 Gy to liver, or 1.5 Gy to bone marrow. These doses have been found to be safe in multiple trials using external beam therapy and systemically administered radiopharmaceuticals. Patients were followed for at least twelve weeks

  15. 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

  16. Concurrent radiochemotherapy in locally-regionally advanced oropharyngeal squamous cell carcinoma: analysis of treatment results and prognostic factors

    International Nuclear Information System (INIS)

    Concurrent radiochemotherapy is a recommended treatment option for patients with locally advanced squamous cell head and neck carcinomas with recent data showing the most significant absolute overall and event-free survival benefit achieved in patients with oropharyngeal tumours. The aim of this study was to analyse the results of three-dimensional conformal radiotherapy given with concomitant weekly cisplatin in patients with advanced oropharyngeal carcinoma and to identify prognostic factors influencing outcomes of this patients category. Sixty-five patients with stage III or IV squamous cell carcinoma of the oropharynx who underwent concurrent radiochemotherapy between January 2005 and December 2010 were retrospectively analyzed. All patients received radiotherapy to 70 Gy/35 fractions/2 Gy per fraction/5 fractions per week. Concurrent chemotherapy consisted of weekly cisplatin (30 mg/m2) started at the first day of radiotherapy. Median age was 57 years (range, 36 to 69 years) and 59 (90.8%) patients were male. Complete composite response was achieved in 47 patients (72.3%). Local and/or regional recurrence was the most frequent treatment failure present in 19 out of 25 patients (76.0%). At a median follow-up of 14 months (range, 5 to 72 months), 2-year local relapse-free, regional relapse-free, locoregional relapse-free, disease-free, and overall survival rates were 48.8%, 57.8%, 41.7%, 33.2% and 49.7%, respectively. On multivariate analysis the only significant factor for inferior regional relapse-free survival was the advanced N stage (p = 0.048). Higher overall stage was independent prognostic factor for poorer local relapse-free survival, locoregional relapse-free survival and disease-free survival (p = 0.022, p = 0.003 and p = 0.003, respectively). Pre-treatment haemoglobin concentration was an independent prognostic factor for local relapse-free survival, regional relapse-free survival, locoregional relapse-free survival, disease-free survival, and

  17. Overall survival and final efficacy and safety results from a Japanese phase II study of axitinib in cytokine-refractory metastatic renal cell carcinoma

    OpenAIRE

    Eto, Masatoshi; Uemura, Hirotsugu; Tomita, Yoshihiko; Kanayama, Hiroomi; Shinohara, Nobuo; Kamei, Yoichi; Fujii, Yosuke; Umeyama, Yoshiko; Ozono, Seiichiro; Naito, Seiji; Akaza, Hideyuki; ,

    2014-01-01

    In an open-label, multicenter phase II study of Japanese patients with cytokine-refractory metastatic renal cell carcinoma, axitinib showed substantial antitumor activity with an acceptable safety profile. Here, we report overall survival and updated efficacy and safety results. Sixty-four Japanese patients with metastatic renal cell carcinoma following prior therapy with cytokines were treated with axitinib at a starting dose of 5 mg b.i.d. Following median treatment duration of 14.2 months,...

  18. Distinct genetic alterations in small cell carcinoma from different anatomic sites

    OpenAIRE

    Zheng, Xiaoyong; Liu, Delong; Fallon, John T.; Zhong, Minghao

    2015-01-01

    Small cell carcinoma (SmCC) is a distinct clinicopathological entity first described in the lung. It represents approximately 15% of all bronchogenic carcinoma. Extrapulmonary small cell carcinoma (EPSmCC) morphologically indistinguishable from small cell lung cancer (SCLC) was first reported in 1930. Since its first description, EPSmCC has been reported in virtually all anatomical sites, including: gynecologic organs (ovary and cervix); genitourinary organs (urinary bladder and prostate); th...

  19. High dose rate 60Co remote afterloading irradiation in cancer of the cervix in Haiti, 1977-1984

    International Nuclear Information System (INIS)

    From 1977 through 1984, 293 previously untreated patients with biopsy proven carcinoma of the uterine cervix were treated by whole pelvis irradiation and high intensity 60Co remote afterloading (RAL) intrauterine tandem techniques in Haiti. The treatment results were analyzed retrospectively to evaluate the therapeutic results and prognostic factors of a strict protocol involving 40 Gy to the whole pelvis (2 Gy/day, 5 days/week). In addition, on the 5th day of the 3rd week, the first outpatient 60Co remote afterloading intracavitary insertion, delivering 7.5 Gy to point A with each insertion, repeated 3 times by a week separation for a total of 4 times. The total TDF for external beam plus RAL was 158 and 175 for early and late effects respectively. One hundred-four patients were evaluable after 1 year or more follow-up, with a median of 26.5 months. No evidence of disease (NED) by Stage at 1 year was: Stage I of 100% (3/3), Stage II of 82% (9/11), Stage III of 80% (47/59), and Stage IV of 58% (18/31). The post-therapeutic complication rate was 7.7%, with no fistulas or requirement of surgical intervention. Those with documented follow-up of at least 2 years (74 patients) had comparable survival to other high dose rate and low dose rate studies. This study shows that outpatient brachytherapy can be carried out without sophisticated and expensive equipment with minimal staff trained in radiation therapy. A detailed description of this outpatient RAL technique and results are described so that this method can be adapted to other developing and industrialized nations where cost containment is becoming a key issue

  20. Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

    Directory of Open Access Journals (Sweden)

    Marín Alicia

    2009-09-01

    Full Text Available Abstract Background In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Methods Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE, version 3. Results At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. Conclusion In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control.

  1. Diagnostic imaging in staging, results and follow-up of nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Ninety-seven patients affected with nasopharyngeal carcinoma (NPC) were examined with both conventional and Computed Tomography (CT) to evaluate the involved sites with both methods. CT staging was more accurate, showing involvement in more locations than conventional tomography, so that staging was modified in 23 of 97 patients. Two hundred and seventeen patients treated from 1970 to 1985 were subdivided into group A (111 patients who underwent conventional tomography only) and group B (106 patients examined with CT, from 1978 on). A trend toward more advanced stages at presentation was observed in group B; nevertheless, local control at 5 years was higher in group B (59%) than in group A (42%). The role of Magnetic Resonance (MR) imaging in NPC staging was also evaluated in 30 patients: there was disagreement in 2 cases. Involvement of different structures was shown in 10 of 28 cases with the same CT and MR staging. MR imaging proved a valuable tool in the follow-up as well: in fact, it clarified 12 questionable opacities on CT in a group of 35 followed patients as inflammatory lesions in 10 patients and tumors in 2

  2. Squamous cell carcinoma of the maxillary sinus and the oral part of the upper jaw. Comparison of treatment results

    International Nuclear Information System (INIS)

    The treatment results were compared in 77 patients with maxillary sinus squamous cell carcinoma (MC) and 53 patients with squamous cell carcinoma arising from the oral part of the upper law (OC). Both sets of patients received radiotherapy alone, or radiotherapy combined with surgery and/or chemotherapy. Computerized tomography was useful for the definition of the treatment volume. Intraarterial chemotherapy was given in 89 of 130 patients and in these patients the total radiation dose was reduced by about 10 Gy. No difference was found in the 5-year survival rate between the MC (65%) and the OC (66%) groups. The cumulative incidence of local failure was higher in MC (36%) than in OC (26%), whereas the ultimate incidence of neck node metastasis was higher in OC (43%) than in MC patients (18%). Half of the inoperable patients (9/18) were older than 80 years and had contraindications to anaesthesia and major surgery. The local recurrence rate was high in the inoperable MC patients (6/8). Contralateral simus cancers occurred in 4 patients in the MC group. (orig.)

  3. Lobar Hepatocellular Carcinoma with Ipsilateral Portal Vein Tumor Thrombosis Treated with Yttrium-90 Glass Microsphere Radioembolization: Preliminary Results

    Directory of Open Access Journals (Sweden)

    M. Pracht

    2013-01-01

    Full Text Available Portal vein tumor thrombosis (PVTT is a common complication of hepatocellular carcinoma (HCC and has a negative impact on prognosis. This characteristic feature led to the rationale of the present trial designed to assess the efficacy and the safety of yttrium-90 glass-microsphere treatment for advanced-stage lobar HCC with ipsilateral PVTT. 18 patients with unresectable lobar HCC and ipsilateral PVTT were treated in our institution with 90Y-microS radioembolization. Patients were evaluated every 3 to 6 months for response, survival, and toxicity. Mean follow-up was 13.0 months (2.2–50.6. Outcomes were: complete response (n=2, partial response (n=13, stable disease (n=1, and progressive disease (n=2 giving a disease control rate of 88.9%. Four patients were downstaged. Treating lobar hepatocellular carcinoma with ipsilateral portal vein thrombosis with yttrium-90 glass-microsphere radioembolization is safe and efficacious. Further clinical trials are warranted to confirm these results and to compare 90Y-microS with sorafenib, taking into account not only survival but also the possibility of secondary surgery for putative curative intention after downstaging.

  4. Gamma-knife radiosurgery for brain metastasis of renal cell carcinoma. Results in 42 patients

    International Nuclear Information System (INIS)

    The present study provides data from clinical experience with gamma-knife radiosurgery (GK) in patients with brain metastasis from renal cell carcinoma (RCC) and shows the value of this less invasive treatment modality. Forty-two patients received GK. Twenty of the 42 cases had multiple brain metastases. Extracranial metastases were observed in the lung (38 cases), bone (12 cases), liver (9 cases), lymph node (5 cases) and skin (6 cases). Neurological symptoms seen in 40 patients were rapidly improved after GK in 32 patients (80%). Magnetic resonance imaging (MRI) evaluation after GK in 32 patients showed the disappearance of brain tumor in 9 patients (28%). Complete response was obtained by GK in tumors up to 30 mm in diameter. Repeated GK for newly developed lesions was conducted in 11 patients. Extracranial tumor resection was conducted in 7 cases (lung: 3, skin: 2, liver: 1, adrenal: 1). Chemoradiotherapy or immunotherapy was effective in 8 cases (lung: 5, liver: 2, bone: 1). The actual one-, two- and three-year survival rates were 44.9%, 16.8%, and 11.2%, respectively. The median survival time was 12.5 months. In univariate analysis, the patients with successfully treated extracranial metastases had significantly better prognosis. In multivariate analysis, the patients with Karnofsky performance scale (KPS)≥80%, who were treated by GK more than once and obtained complete response (CR) or partial response (PR) by GK, had significantly better prognosis. Gamma-knife radiosurgery for RCC is an effective non-invasive modality of treatment. It offers a high local control rate and an improved quality of life and survival rate. (author)

  5. Results of radiotherapy for T2N0 glottic carcinoma: does the ''2'' stand for twice-daily treatment?

    International Nuclear Information System (INIS)

    Purpose: Radiotherapy (RT) is often the therapy of choice for patients with Stage T2 glottic carcinoma. This retrospective study updated the results of RT for patients treated at our center. The primary focus of this study was whether a policy of using hyperfractionated RT for these patients resulted in a therapeutic gain. Methods and Materials: A search of the database of patients treated in the Department of Radiation Oncology at The University of Texas M. D. Anderson Cancer Center was performed to identify patients with Stage T2 glottic carcinoma treated with RT alone between 1970 and 1998. A total of 230 patients formed the study cohort. Results: The median follow-up for all patients was 82 months. Of the 230 patients, 180 were treated with parallel-opposed fields, and the median field size was 30 cm2. Eighty-one patients (36%) were treated with twice-daily fractionation to 74-80 Gy. Eighty-nine patients (38%) were treated with 32-75 Gy at 2-Gy per fraction once daily, and 57 patients (25%) were treated with 2.06-2.26 Gy, once daily, to 66-70 Gy. The 2- and 5-year actuarial local control rate was 75% and 72%, respectively. After salvage therapy, the ultimate 5-year local control and disease-specific survival rate was 91% and 92%, respectively. The presence of subglottic extension and treatment with a daily dose of ≤2 Gy were associated with poorer local control (p <0.01) on both univariate and multivariate analyses. The 5-year local control rate for patients treated with twice-daily and once-daily RT was 79% and 67%, respectively (p=0.06). Conclusion: The 5-year local control rates with hyperfractionated RT for Stage T2 glottic carcinoma approach 80%. Patients treated with twice-daily fractionation to a median dose of 77 Gy had an improvement in local control compared with patients treated with 70 Gy in 35 fractions. The Radiation Therapy Oncology Group is testing these two fractionation schedules in a randomized study. High control rates were also seen in

  6. Carcinoma de cérvix y embarazo Carcinoma of the cervix associated with pregnancy

    Directory of Open Access Journals (Sweden)

    Gildardo Gallego Noreña

    1994-04-01

    Full Text Available Se presenta una revisión bibliográfica de la asociación entre cáncer de cerviz y embarazo. Se analizan los siguientes puntos: diagnóstico, manejo, Influencia del embarazo sobre el comportamiento del cáncer e Implicaciones que éste tiene para la gestación. Se concluye que el factor pronóstico más Importante es el estadio del cáncer al momento de iniciar el tratamiento y que variables como el trimestre cuando se hace el diagnóstico, la edad y la paridad no tienen Influencia pronostica.

    This is a review of the literature on the association of cervical cancer and pregnancy; the following aspects are Included: diagnosis, treatment and the reciprocal influence of pregnancy and cancer. It is concluded that the main prognostical variable Is the stage of the cancer when treatment Is started, while gestational age, chronological age and parity have no prognostical influence.

  7. Health Economic Changes as a Result of Implementation of Targeted Therapy for Metastatic Renal Cell Carcinoma: National Results from DARENCA Study 2

    DEFF Research Database (Denmark)

    Sørensen, Anne V; Donskov, Frede; Kjellberg, Jakob;

    2015-01-01

    BACKGROUND: Limited data exist on the economic consequences of implementing targeted therapy (TT) for metastatic renal cell carcinoma (RCC) in a real-world setting. OBJECTIVE: To analyze health care and productivity costs for TT implementation in a national cohort of patients. DESIGN, SETTING, AND...... STATISTICAL ANALYSIS: Generalized linear models were used to analyze costs adjusted for age, gender, and civil status. RESULTS AND LIMITATIONS: A total of 439 patients were included for 2006-2009 and 192 for 2002-2005. Comparison of the health care cost per patient per year between 2006-2009 and 2002...... productivity were €7852 and €8265, respectively. CONCLUSIONS: A different pattern of health care costs were observed but total health care costs per patient per year did not significantly differ after implementation of TT for patients with mRCC. PATIENT SUMMARY: In this nationwide study, we found changes in...

  8. 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.

  9. Potentiality and Boundaries of Use of Sorafenib in Patients with Hepatocellular Carcinoma: Awaiting the Results of Ongoing Clinical Trials

    Directory of Open Access Journals (Sweden)

    Bruno Daniele

    2012-06-01

    Full Text Available No systemic therapy had been proven effective in patients with advanced hepatocellular carcinoma (HCC until 2007, when a large randomized trial with sorafenib demonstrated a clinically relevant prolongation of survival. Currently, sorafenib represents standard treatment for patients with advanced HCC and well-preserved liver function, whilst the evidence about its effectiveness in patients with more severe liver impairment is less robust. A randomized trial to demonstrate the efficacy of sorafenib in Child-Pugh B patients with advanced HCC is currently ongoing. In the meantime, several trials are testing the role of sorafenib in early HCC (as adjuvant treatment after potentially curative loco-regional therapies and in intermediate stage (exploring different modalities of integration of sorafenib with trans-arterial chemo-embolization. The results of all these trials will better define the potentiality and the boundaries of use of sorafenib in HCC patients.

  10. Potentiality and Boundaries of Use of Sorafenib in Patients with Hepatocellular Carcinoma: Awaiting the Results of Ongoing Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Di Maio, Massimo; Daniele, Gennaro; Piccirillo, Maria Carmela; Giordano, Pasqualina [Clinical Trials Unit, National Cancer Institute-“G. Pascale” Foundation, via Mariano Semmola, Napoli 80131 (Italy); Signoriello, Giuseppe [Medical Statistics, Second University, v. L. Armanni 5, Napoli 80138 (Italy); Daniele, Bruno [Medical Oncology Unit, “G.Rummo” Hospital, Benevento 82100 (Italy); Perrone, Francesco, E-mail: fr.perrone@agora.it [Clinical Trials Unit, National Cancer Institute-“G. Pascale” Foundation, via Mariano Semmola, Napoli 80131 (Italy)

    2012-06-05

    No systemic therapy had been proven effective in patients with advanced hepatocellular carcinoma (HCC) until 2007, when a large randomized trial with sorafenib demonstrated a clinically relevant prolongation of survival. Currently, sorafenib represents standard treatment for patients with advanced HCC and well-preserved liver function, whilst the evidence about its effectiveness in patients with more severe liver impairment is less robust. A randomized trial to demonstrate the efficacy of sorafenib in Child-Pugh B patients with advanced HCC is currently ongoing. In the meantime, several trials are testing the role of sorafenib in early HCC (as adjuvant treatment after potentially curative loco-regional therapies) and in intermediate stage (exploring different modalities of integration of sorafenib with trans-arterial chemo-embolization). The results of all these trials will better define the potentiality and the boundaries of use of sorafenib in HCC patients.

  11. Potentiality and Boundaries of Use of Sorafenib in Patients with Hepatocellular Carcinoma: Awaiting the Results of Ongoing Clinical Trials

    International Nuclear Information System (INIS)

    No systemic therapy had been proven effective in patients with advanced hepatocellular carcinoma (HCC) until 2007, when a large randomized trial with sorafenib demonstrated a clinically relevant prolongation of survival. Currently, sorafenib represents standard treatment for patients with advanced HCC and well-preserved liver function, whilst the evidence about its effectiveness in patients with more severe liver impairment is less robust. A randomized trial to demonstrate the efficacy of sorafenib in Child-Pugh B patients with advanced HCC is currently ongoing. In the meantime, several trials are testing the role of sorafenib in early HCC (as adjuvant treatment after potentially curative loco-regional therapies) and in intermediate stage (exploring different modalities of integration of sorafenib with trans-arterial chemo-embolization). The results of all these trials will better define the potentiality and the boundaries of use of sorafenib in HCC patients

  12. Resultados do transplante hepático em portadores de hepatocarcinoma Results of orthotopic liver transplantation for hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Mônica Beatriz PAROLIN

    2001-10-01

    hepatocarcinoma em fase inicial. Com seleção adequada, o transplante hepático oferece excelentes índices de sobrevida livre de recurrência tumoral.Background - Hepatocellular carcinoma is one of the most common malignancies worldwide. Liver transplantation has emerged as a good option for early-stage hepatocellular carcinoma yielding survival rates as good as for recipients without this type of tumor. Objective - To assess the outcome of cirrhotic patients with hepatocellular carcinoma undergoing liver transplantation at the Liver Transplantation Service of the "Hospital de Clínicas", Federal University of Paraná, Curitiba, PR, Brazil. Methods - Retrospective study of cirrhotic patients with hepatocellular carcinoma undergoing orthotopic liver transplantation at the mentioned Institution between September 1991 and September 2000. The diagnosis of hepatocellular carcinoma was established during the pretransplant workup in five patients and the tumor was an incidental finding in the native liver in three. The indication for liver transplantation was restricted to solitary tumor equal to or less than 5 cm or up to 3 nodules, with each nodule measuring less than 3 cm, and no evidence of vascular invasion or extrahepatic spread. Patient survival and evidence of tumoral recurrence posttransplant were evaluated. Results - The most common cause for pretransplantation liver disease was hepatitis C virus (50%. On examination of the explanted liver, the majority of patients (6/8, 75% had a single lesion; one patient had two nodules and one had a multifocal hepatocellular carcinoma found incidentally in the native liver. Tumor size ranged from 0,2 to 5,0 cm. All cases had neither vascular invasion nor linfonodal envolvement. All patients remained alive and free of tumor recurrence at the time of the study with a mean follow-up of 18,5 months (range, 5-29 months. Conclusion - Liver transplantation is a good therapeutic option for early stage hepatocellular carcinoma arising in

  13. Comparison of remote results of conventional fractionation radiotherapy and late course accelerated hyperfractionation radiotherapy for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To compare the long-term effects of conventional fractionation (CF) radio-therapy and late course accelerated hyperfractionation (LCAHF) radiotherapy of nasopharyngeal carcinoma (NPC), and to arrive at a appropriate NPC radiotherapy protocol. Methods: According to the criteria, 496 patients with NPC were allotted to our retrospective analysis, including 269 in the CF group and 227 in the LCAHF group. Two large lateral opposing fields were first used to treat the nasopharynx and the upper neck at a fraction of 2 Gy daily, 5 days per week. After 36-40 Gy, two small lateral opposing fields were used to boost the primary tumor while the spinal cord shielded. In the CF group, the accumulated total dose of naso-pharynx was 68-76 Gy at 2 Gy daily. In the LCAHF group, the radiation fraction of primary tumor was 1.5 Gy twice daily, with a minimum of six-hour interval in the late course. The accumulated total dose was 69-72 Gy. Survival was assessed by Kaplan-Meier method and Logrank analysis. Results: The 5-year primary site control, tumor-free survival and overall survival rates was 65.4% ,61.5% and 68.1% in the LCAHF group and 52.8%, 49.4% and 57.5% in the CF group. The difference between the two groups were significant (P=0.006, 0.006 and 0.031). Further analysis showed that LCAHF improved the primary site control, tumor-free survival and overall survival rates of T2-T3 NPC (P0.05). Conclusions: When compared with conventional fractionation radiotherapy, late course accelerated hyperfractionation radiotherapy, being tolerable, definitely can improve the local control, tumor-free survival and overall survival in patients with nasopharyngeal carcinoma. But the recurrence rates of cervical lymph nodes and distant metastasis were similar in between these two groups. (authors)

  14. Gemcitabine and irinotecan as first-line therapy for carcinoma of unknown primary: results of a multicenter phase II trial.

    Directory of Open Access Journals (Sweden)

    Shernan G Holtan

    Full Text Available Metastatic carcinoma of unknown primary (CUP has a very poor prognosis, and no standard first-line therapy currently exists. Here, we report the results of a phase II study utilizing a combination of gemcitabine and irinotecan as first-line therapy. Treatment was with gemcitabine 1000 mg/m(2 and irinotecan 75 mg/m(2 weekly times four on a six week cycle (Cohort I. Due to excessive toxicity, the dose and schedule were modified as follows: gemcitabine 750 mg/m(2 and irinotecan 75 mg/m(2 given weekly times three on a four week cycle (Cohort II. The primary endpoint was the confirmed response rate (CR + PR. Secondary endpoints consisted of adverse events based upon the presence or absence of the UDP glucuronosyltransferase 1 family, polypeptide A1*28 (UGT1A1*28 polymorphism, time to progression, and overall survival. Thirty-one patients were enrolled with a median age of 63 (range: 38-94, and 26 patients were evaluable for efficacy. Significant toxicity was observed in Cohort 1, characterized by 50% (7/14 patients experiencing a grade 4+ adverse event, but not in cohort II. The confirmed response rate including patients from both cohorts was 12% (95% CI: 2-30%, which did not meet the criteria for continued enrollment. Overall median survival was 7.2 months (95% CI: 4.0 to 11.6 for the entire cohort but notably longer in cohort II than in cohort I (9.3 months (95% CI: 4.1 to 12.1 versus 4.0 months (95% CI: 2.2 to 15.6. Gemcitabine and irinotecan is not an active combination when used as first line therapy in patients with metastatic carcinoma of unknown primary. Efforts into developing novel diagnostic and therapeutic approaches remain important for improving the outlook for this heterogeneous group of patients.ClinicalTrials.gov NCT00066781.

  15. Superselective intra-arterial infusion chemotherapy for stage III/IV squamous cell carcinomas of the oral cavity: Midterm results

    International Nuclear Information System (INIS)

    Purpose: We performed superselective intra-arterial infusion chemotherapy (SIC) according to a protocol in which drug distribution is evaluated by the use of interventional radiology (IVR)-computed tomography (CT) system, and the chemotherapy is combined with medium-dose conformal radiation therapy (CRT). We analyzed retrospectively the factors that affect the midterm survival ratio, including local response, for stage III and IV squamous cell carcinomas of the oral cavity. Materials and methods: Forty consecutive patients with stage III and IV squamous cell carcinomas of the oral cavity and who had undergone both SIC and CRT were enrolled. A microcatheter was placed in the appropriate feeding artery of the tumor and cisplatin (50 mg/body) was infused twice. CRT was administered with a dual-energy (4 and 10 MV) linear accelerator. The total and daily doses delivered were 30 and 2.0 Gy, respectively. Histopathologic effects were classified into five grades: grade 0 or 1 was defined as a poor response, and grade II or higher as a good response. Age, sex, stage, local response to treatment, mode of invasion and lymph node metastasis were analyzed, and differences in the midterm survival ratio were assessed. Results: The 3-year survival ratio of the 40 cases was 67%. A good local response (III or IV) was achieved in 75% of the cases. The survival ratio of the good local response group was significantly better than that of the poor response group (p = 0.04). Mode of invasion (p = 0.03) and lymph node metastasis (p = 0.01) were also predictive of survival. In the multivariable analysis of survival, however, no variables including good local response (p = 0.12), were predictive. Conslusion: Our new protocol improved local response, but it did not contribute to the survival ratio

  16. Tumor perfusion assessed by dynamic contrast-enhanced MRI correlates to the grading of renal cell carcinoma: Initial results

    International Nuclear Information System (INIS)

    In this study, we investigated whether assessment of the tumor perfusion by dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) enables to estimate the morphologic grading of renal cell carcinomas. A total of 21 patients with suspected renal cell cancer were examined using a Gadobutrol-enhanced, dynamic saturation-recovery, turbo-fast, low-angle shot sequence. Tumor perfusion and the tissue-blood ratio within the entire tumor and the most highly vascularized part of the tumor were calculated according to the model of Miles. Immediately after examination, patients underwent surgery, and the results from imaging were compared with the morphological analysis of the histologic grading. Fourteen patients had G2 tumors, and seven patients had G3 tumors. Significantly higher perfusion values (p < 0.05) were obtained in G3 tumors than in G2 tumors when the entire tumor area was considered (1.59 ± 0.44 (ml/g/min) vs. 1.08 ± 0.38 (ml/g/min)) or its most highly vascularized part (2.14 ± 0.89 (ml/g/min) vs. 1.40 ± 0.49 (ml/g/min)). By contrast, the tissue-blood ratios did not differ significantly between the two groups. In conclusion, unlike tissue-blood ratio, surrogate parameters of the tumor perfusion determined by DCE MRI seem to allow an estimation of the grading of renal cell carcinoma. However, further studies with high case numbers and including patients with G1 tumors are required to evaluate the full potential and clinical impact.

  17. Tumor perfusion assessed by dynamic contrast-enhanced MRI correlates to the grading of renal cell carcinoma: Initial results

    Energy Technology Data Exchange (ETDEWEB)

    Palmowski, Moritz, E-mail: mpalmowski@ukaachen.d [Department of Experimental Molecular Imaging, Medical Faculty, RWTH Aachen University, Aachen (Germany); Department of Diagnostic Radiology, Medical Faculty, RWTH Aachen University, Aachen (Germany); Schifferdecker, Isabel [Department of Diagnostic and Interventional Radiology, Heidelberg University, Heidelberg (Germany); Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany); Zwick, Stefan [Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany); Macher-Goeppinger, Stephan [Institute of Pathology, Heidelberg University, Heidelberg (Germany); Laue, Hendrik [MeVis Research, Center for Medical Image Computing, Bremen (Germany); Haferkamp, Axel [Department of Urology, Heidelberg University (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, Heidelberg University, Heidelberg (Germany); Kiessling, Fabian [Department of Experimental Molecular Imaging, Medical Faculty, RWTH Aachen University, Aachen (Germany); Hallscheidt, Peter [Department of Diagnostic and Interventional Radiology, Heidelberg University, Heidelberg (Germany)

    2010-06-15

    In this study, we investigated whether assessment of the tumor perfusion by dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) enables to estimate the morphologic grading of renal cell carcinomas. A total of 21 patients with suspected renal cell cancer were examined using a Gadobutrol-enhanced, dynamic saturation-recovery, turbo-fast, low-angle shot sequence. Tumor perfusion and the tissue-blood ratio within the entire tumor and the most highly vascularized part of the tumor were calculated according to the model of Miles. Immediately after examination, patients underwent surgery, and the results from imaging were compared with the morphological analysis of the histologic grading. Fourteen patients had G2 tumors, and seven patients had G3 tumors. Significantly higher perfusion values (p < 0.05) were obtained in G3 tumors than in G2 tumors when the entire tumor area was considered (1.59 {+-} 0.44 (ml/g/min) vs. 1.08 {+-} 0.38 (ml/g/min)) or its most highly vascularized part (2.14 {+-} 0.89 (ml/g/min) vs. 1.40 {+-} 0.49 (ml/g/min)). By contrast, the tissue-blood ratios did not differ significantly between the two groups. In conclusion, unlike tissue-blood ratio, surrogate parameters of the tumor perfusion determined by DCE MRI seem to allow an estimation of the grading of renal cell carcinoma. However, further studies with high case numbers and including patients with G1 tumors are required to evaluate the full potential and clinical impact.

  18. Clinical results in heavy particle radiotherapy

    International Nuclear Information System (INIS)

    The chapter presents an overview of the use of heavy particles in human cancer radiotherapy. The biophysical characteristics and rationale for using heavy charged particle therapy are explored. The clinical experience with carbon, neon, argon and helium are summarized for various types of tumors including carcinomas of the uterine cervix and lung, skin melanomas and metastatic sarcomas. No obvious normal tissue complications have appeared

  19. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas; Correlacao entre resultado do PET/CT e achados histologicos e imuno-histoquimicos em carcinomas mamarios

    Energy Technology Data Exchange (ETDEWEB)

    Bitencourt, Almir Galvao Vieira; Lima, Eduardo Nobrega Pereira; Chojniak, Rubens; Marques, Elvira Ferreira; Souza, Juliana Alves de; Graziano, Luciana; Andrade, Wesley Pereira; Osorio, Cynthia Aparecida Bueno de Toledo, E-mail: almirgvb@yahoo.com.br [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil)

    2014-03-15

    Objective: to correlate the results of {sup 18}F-fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) positron emission tomography/computed tomography (PET/CT) performed with a specific protocol for assessment of breasts with histological/immunohistochemical findings in breast carcinoma patients. Materials and methods: cross-sectional study with prospective data collection, where patients with biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT examination in prone position, with a specific protocol for assessment of breasts. PET/CT findings were compared with histological and immunohistochemical data. Results: the authors identified 59 malignant breast lesions in 50 patients. The maximum diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm). Invasive ductal carcinoma was the most common histological type (n = 47; 79.7%). At PET/CT, 53 (89.8%) of the lesions demonstrated anomalous concentrations of {sup 18}F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5). A statistically significant association was observed between higher values of maximum SUV and histological type, histological grade, molecular subtype, tumor diameter, mitotic index and Ki-67 expression. Conclusion: PET/CT performed with specific protocol for assessment of breasts has demonstrated good sensitivity and was associated with relevant histological/immunohistochemical factors related to aggressiveness and prognosis of breast carcinomas. (author)

  20. 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.)

  1. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Science.gov (United States)

    Herrera, Higmar; Yañez, Elvia; López, Jesús

    2012-10-01

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerología de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  2. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Herrera, Higmar; Yanez, Elvia; Lopez, Jesus [Centro Estatal de Cancerologia de Durango, Victoria de Durango, Durango (Mexico); ISSSTE General Hospital Dr. Santiago Ramon y Cajal, Victoria de Durango, Durango (Mexico)

    2012-10-23

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerologia de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  3. Functional and oncologic results after coloanal anastomosis for low rectal carcinoma.

    Science.gov (United States)

    Hautefeuille, P; Valleur, P; Perniceni, T; Martin, B; Galian, A; Cherqui, D; Hoang, C

    1988-01-01

    Thirty-five patients who had adenocarcinoma of the middle third of the rectum were treated by resection and coloanal anastomosis. The aim of this study was to assess functional and oncologic results of an original technique of coloanal anastomosis. There was no operative mortality, and operative morbidity consisted of seven anastomotic leaks with two failures. Among 31 patients assessed for functional results only one had unsatisfactory results. Good continence was obtained within a few weeks for the 30 patients who had satisfactory results. No patients were lost to follow-up, which was over 5 years in 24 patients (68%). The 5-year survival rate was 64%, identical to that for other series. PMID:3337562

  4. Accelerated hyperfractionated radiotherapy for locally advanced cervix cancer

    International Nuclear Information System (INIS)

    Purpose: A phase II trial was designed to evaluate the toxicity and outcome of patients with locally advanced cervix cancer treated with accelerated hyperfractionated radiotherapy (AHFX). Methods and Materials: In this prospective trial, AHFX doses of 1.25 Gy were administered twice daily at least 6 hours apart to a total pelvic dose of 57.5 Gy. A booster dose was then administered via either low-dose rate brachytherapy or external beam therapy to a smaller volume. All patients were accrued and treated at Peter MacCallum Cancer Institute (PMCI) between 1986 until April 1991. Results: Sixty-one eligible patients were enrolled in this protocol; 2 (3.2%) had Stage IIB; 42 (68.9%) had Stage III; 8 (13.1%) had Stage IV and 9 (14.8%) had recurrent cervical cancer. Fifty-two patients (85%) completed the planned external beam without a treatment break. Thirty patients had acute toxicity that required regular medication. One patient died of acute treatment related toxicity. Fifty-five patients received booster therapy: 45 with intrauterine brachytherapy, 6 with interstitial brachytherapy, and 4 with external beam. The median follow-up of surviving patients was 6 years. Overall 5-year survival is 27% and 5-year relapse free survival is 36%. Nineteen patients died with pelvic disease and the actuarial local control rate was 66%. There were 8 severe late complications observed in 7 patients. Seven required surgical intervention (an actuarial rate of 27%). Five patients also required total hip replacement. Conclusions: The local control rate was favorable compared with other series that have used standard fractionation, although overall survival remained similar. The severe late complication rate was high for this protocol and higher than similar protocols reported in the literature

  5. Radiochemotherapy in the conservative treatment of anal canal carcinoma: Retrospective analysis of results and radiation dose effectiveness

    International Nuclear Information System (INIS)

    Purpose: This retrospective analysis reports the results on patients with anal canal carcinoma treated by combined radiotherapy and chemotherapy. Methods and materials: Between March 1993 and December 2001, 43 patients with anal canal carcinoma were treated with radiochemotherapy at the Hospital do Ca-hat ncer A.C. Camargo. Stage distribution was as follows: I, 3 (7%); II, 23 (53.5%); IIIA, 8 (18.6%); and IIIB, 9 (21%). The median age was 56 years (range, 36-77 years) with most patients being women (4:1). External radiotherapy (RT) was delivered at the whole pelvis followed by a boost at the primary tumor. The median dose of RT at the whole pelvis and at the primary tumor was 45 Gy and 55 Gy, respectively. Chemotherapy was carried out during the first and last 4 days of RT with continuous infusion of 5-fluorouracil (1000 mg/m2) and bolus mitomycin C (10 mg/m2). Median overall treatment time was 51 days (range, 30-129 days). Thirty-four patients (79%) did not receive elective RT at the inguinal region. Patient's age, tumor stage, overall treatment time, and RT dose at primary tumor were variables analyzed for survival and local control. Results: Median follow-up time was 42 months (range, 4-116 months). Overall survival and colostomy-free survival at 5 years was 68% and 52%, respectively. Overall survival according to clinical stage was as follows: I, 100%; II, 82%; IIIA, 73%; and IIIB, 18% (p = 0.0049). Complete response was observed in 40 patients (93%). Local recurrence occurred in 9 (21%) patients, and of these, 6 were rescued by surgery. Local control with a preserved sphincter was observed in 34 patients (79%). According to the RT dose, local control was higher among patients who received more than 50 Gy at primary tumor (86.5% vs. 34%, p = 0.012). Inguinal failure was observed in 5 patients (15%) who did not receive inguinal elective RT. Distant metastasis was observed in 11 patients (25.6%). Temporary interruption of the treatment as a result of acute

  6. Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast

    International Nuclear Information System (INIS)

    In 31 cases of Stages I or II carcinoma of the breast treated by primary radiation therapy, the cosmetic results were analyzed with regard to the details of treatment. Three principal treatment factors were identified which influenced the cosmetic outcome: (1) the extent and location of the biopsy procedure; (2) the time/dose factors of the radiation therapy; and (3) the technique of the radiation therapy. Cosmetic results were lessened when the biopsy procedure included a wide resection of adjacent breast tissue or when the biopsy scar was obvious. Increasing doses of external beam radiation were associated with greater degrees of retraction and fibrosis of the treated breast. All 6 patients who received 6000 rad by external beam had significant retraction, and fibrosis while patients who received 5000 rad rarely showed significant changes. Local boost doses by interstitial implantation did not diminsh the cosmetic outcome. All patients were treated using supervoltage equipment without bolus and skin changes secondary to treatment were infrequent. Seventeen patients developed localized areas of fibrosis and skin changes at the matchline between adjacent radiation fields. Recommendations are made for improved cosmetic results based on these findings

  7. Association of Trichomonas vaginalis and cytological abnormalities of the cervix in low risk women.

    Directory of Open Access Journals (Sweden)

    Gilbert G G Donders

    Full Text Available OBJECTIVE: Is Trichomonas vaginalis (TV an inducing factor for the development of (pre-cancerous lesions of the cervix? DESIGN: Cross sectional study. SETTING: Screening healthy Belgian women with low infection risk. SAMPLE: 63,251 consecutive liquid based cervical samples. METHODS: Real time quantitative PCR for presence of TV, 18 HPV types and Pap smear analysis of cytologic abnormalities. MAIN OUTCOME MEASURES: Association of TV and HPV with cervix dysplasia. RESULTS: The overall prevalence of TV DNA was 0.37%, of low risk HPV 2%, of high risk HPV 13.2%, and 8.8 % had cytological abnormalities. Both LR-HPV and HR-HPV were significantly associated with all cytological abnormalities. Presence of TV was associated with LR- and HR-HPV, ASC-US and HSIL, but not with other abnormalities. All women with TV and HSIL also had HR-HPV, while the latter was present in only 59% of women with TV and ASC-US. Amongst HPV negative women, TV was found in 1.3% of women with ASC-US, but only in 0.03% of women with normal cytology (OR 4.2, CL95% 2.1-8.6. In HR-HPV positive women, presence of TV increased the likelihood of cytological abnormalities somewhat (P=0.05, mainly due to an increase in ASC-US and LSIL, but not HSIL. CONCLUSIONS: We conclude that TV infection is associated with both LR and HR-HPV infection of the cervix, as well as with ASC-US and HSIL. TV is a concomitant STI, but is not thought to be a co-factor in the causation of HSIL and cervical cancer. However, TV may cause false positive diagnoses of ASC-US.

  8. Is Ovarian Preservation Feasible in Early-Stage Adenocarcinoma of the Cervix?

    Science.gov (United States)

    Lu, Huaiwu; Li, Jing; Wang, Lijuan; Zhou, Hui; Liu, Yunyun; Wang, Dongyan; Lin, Zhongqiu

    2016-01-01

    BACKGROUND In cervical adenocarcinoma, surgical treatment involves bilateral oophorectomy, which affects the long-term quality of life. The aim of our study was to access the incidence of ovarian metastasis in early-stage cervical adenocarcinoma and to suggest an algorithm for the triage of these patients to preserve the ovaries. MATERIAL AND METHODS A total 101 patients with cervical adenocarcinoma who had undergone radical hysterectomy with pelvic lymphadenectomy and bilateral oophorectomy were included in this study. Data on the clinicopathologic characteristics of the cases were collected and low risk factors for ovarian metastasis in early-stage cervical adenocarcinoma were analyzed. RESULTS The ovary metastasis rate of cervical adenocarcinoma in this study was 4.95%, while it is only 2% in stage IB1. Pathological grade, LSVI, lymph node status, tumor size, depth of stromal invasion, and involvement of the junction of the cervix and the body of the uterus were associated with ovarian metastasis, while LSVI, lymph node status, depth of stromal invasion, and involvement of the junction of the cervix and the body of the uterus were associated with ovarian metastasis in stage IB. Multivariate analysis revealed that LVSI and lymph node metastasis were independent risk factors for ovarian metastasis in all stages of cervical adenocarcinoma, but involvement of the junction of the cervix and the body of the uterus was an independent risk factor for ovarian metastasis in stage IB. CONCLUSIONS The incidence of ovarian metastasis in cervical adenocarcinoma is low. Our study suggests that ovarian preservation is safe and feasible in patients with no risk factors for ovarian metastasis. Further prospective studies are warranted. PMID:26852916

  9. CLINICAL ASSESSMENT AND CORRILATION OF PAP SMEAR AND LIQUID BASED CYTOLOGY IN BAD CERVIX

    Directory of Open Access Journals (Sweden)

    Khushboo

    2014-10-01

    Full Text Available AIM: Aim of our study to analyze the prevalence of premalignant lesion based on Pap smear and liquid based cytology in patients of bad cervix. OBJECTIVE: To compare sensitivity and specificity of two methods for screening of bad cervix and to know IDR (increase detection rate of cervical cancer by conventional Pap smear and liquid based cytology. MATERIAL AND METHOD: 200 women attending Gynaecology OPD were random selection on the basis of inclusion criteria. All 200 selected women were subjected for down staging through per speculum examination for identification of bad cervix. Pap smears of all 200 selected women were taken and ensured that no local douche, antiseptic cream and no local internal examination was done on the day of test. The prepared smears were then stained according to Papanicolaou's technique. Liquid based cytology smears preparing by using cervical brush 1-1.5cm were inserted into the cervical os until the large outer bristles of the brush touch ectocervix. Data collected for sociodemographic, parity, down staging clinical examination Pap smear and LBC was organised, interpreted and analysis on appropriate statistical software. P value < 0.05 is considered significant RESULT: Analysis revealed that the maximum number of women in our study are from middle age group(31-40yrs, low socioeconomic status, married before 18 yrs, multipara, do not use any contraceptive, uneducated, urban, Muslim population.in this study more abnormal smear is seen in LBC as compared to pap smear. Sensitivity and specificity for LBC is more as compare to pap smear. CONCLUSION: In low resource setting like ours were facilities for radiology, chemo- radiotherapy and supportive care are limited or unavailable. It is important to identify which resources fill healthcare need most effectively and to consider alternative approaches, LBC is strongly advocated in the best interest of public health, by improving the quality of the sample and reducing the

  10. The probability of involvement of human papillomavirus in the carcinogenesis of bladder small cell carcinoma, prostatic ductal adenocarcinoma, and penile squamous cell carcinoma: a case report

    OpenAIRE

    Ogawa, Soichiro; Yasui, Takahiro; Taguchi, Kazumi; Umemoto, Yukihiro; Kojima, Yoshiyuki; Kohri, Kenjiro

    2014-01-01

    Background Human papillomavirus is associated with urogenital carcinogenesis such as penile and uterine cervix cancer. On the other hand, association between human papillomavirus infection and risk of bladder and prostatic cancer remains controversial. Case presentation We report a rare case of a 67-year-old Japanese man with synchronous triple urogenital cancer including bladder small cell carcinoma, prostatic ductal adenocarcinoma, and penile squamous cell carcinoma, who presented with a hi...

  11. Cosmetic Evaluation of long term results following intraoperative radiotherapy (IORT) of conservative surgery for breast carcinoma

    International Nuclear Information System (INIS)

    Introduction In breast conserving therapy (BCT) of breast cancer, cosmetic results have become next to tumor-related outcome parameters a criterion of increasing awareness. The aim of this study is the evaluation of long term cosmetic results after conservative surgery and intraoperative radiotherapy with 10 Gy electrons (IOERT), followed by whole breast radiotherapy (WBRT) with 50-54 Gy. Patients and Methods From October 1998 to October 2005, 818 patients (median age 57.89 years) were treated by IOERT during breast conserving surgery, 12 of them for bilateral cancer. 32 patients were referred to mastectomy within primary treatment, 50 were reported as dead at the beginning of the study, 4 patients had developed an in-breast-recurrence and had been salvaged by secondary mastectomy, and in 41 cases an intercurrent dissemination was noted. All 679 remaining patients were invited in written form to participate in the cosmesis study. 403 of them (59.4%) have answered and were object of the evaluation (August 2006 to April 2007). To provide reproducible examination conditions, a standardized photo-documentation in four positions (frontal, loose-hanging and elevated arms; left and right lateral, elevated arms) was accomplished. Patients and treating physicians evaluated the cosmetic results separately within a 5-point-score (Excellent, Good, Moderate, Bad, Complications). Patient-, tumor- and treatment-related factors were investigated with regard to possible impact on the cosmetic outcome in all patients (group 1). A separate subgroup analysis was carried out for 261 patients with a follow-up of at least three years after completion of local treatment (group 2). For computation of the statistic correlation between the variables and the cosmetic evaluation the rank correlation coefficients Kendall's τ Spearman's ρ were used. A correlation is significant below a p-value of 0.05. Results The self-assessment of the patients in group 1 yielded around 69% excellent, 25

  12. Six Years of Experience in Photodynamic Therapy for Basal Cell Carcinoma: Results and Fluorescence Diagnosis from 191 Lesions

    Directory of Open Access Journals (Sweden)

    M. Fernández-Guarino

    2014-01-01

    Full Text Available Background. Photodynamic therapy (PDT has become a therapeutic option for basal cell carcinoma (BCC in the last decade. Objectives. To study the results and predictors of BCC response to treatment with PDT and to evaluate fluorescence diagnosis of BCC. Methods. A descriptive, retrospective, and observational study was carried out. Patients with biopsy-confirmed BCC who were treated with methyl aminolevulinate and red light according to standard treatment protocols (2 sessions separated by 2 weeks, 630 nm, 37 J/cm2, 8 minutes, Aktilite were selected. Response was scored as clinically complete and incomplete and the patients were followed up every three months. Results. Data from 191 BCC in 181 patients with a mean age of 69.55 years and a mean follow-up period of 34.4 months were collected. The overall response was 74% of the BCC treated, with the best response in superficial BCC with a 95% of complete response. The regression analysis revealed that the superficial histological type was the primary factor predictive of a complete response. Conclusions. In the treatment of BCC with PDT, the most significant factor for predicting response is the histological type.

  13. Clear Cell Carcinoma Presented as a Large Polypoid Mass Expanding the Vaginal Fornix: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Young; Cho, Jae Ho [Dept. of Radiology, College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2012-11-15

    Primary clear cell carcinoma of the vagina or uterine cervix is a very rare tumor. We report radiologic findings of two cases of clear cell carcinoma, arising in the vagina and uterine cervix in a 16-year-old and a 26-year-old female. These were presented as a large polypoid mass with a stalk and expanding the vaginal fornix. One case with ultrasonography showed relatively homogeneous echoic solid mass; the other case with a CT showed heterogeneously and strongly enhancing mass. All of the two cases showed non-specific signal intensity with heterogeneous and strong enhancement on MRI.

  14. Clear Cell Carcinoma Presented as a Large Polypoid Mass Expanding the Vaginal Fornix: Report of Two Cases

    International Nuclear Information System (INIS)

    Primary clear cell carcinoma of the vagina or uterine cervix is a very rare tumor. We report radiologic findings of two cases of clear cell carcinoma, arising in the vagina and uterine cervix in a 16-year-old and a 26-year-old female. These were presented as a large polypoid mass with a stalk and expanding the vaginal fornix. One case with ultrasonography showed relatively homogeneous echoic solid mass; the other case with a CT showed heterogeneously and strongly enhancing mass. All of the two cases showed non-specific signal intensity with heterogeneous and strong enhancement on MRI.

  15. Cloprostenol treatment of feline open-cervix pyometra.

    Science.gov (United States)

    García Mitacek, María C; Stornelli, María C; Tittarelli, Claudia M; Nuñez Favre, Romina; de la Sota, Rodolfo L; Stornelli, María A

    2014-02-01

    Treatment with cloprostenol, a prostaglandin synthetic analogue, was evaluated in five queens with open-cervix pyometra. Cloprostenol was administered (5 μg/kg body weight SC) on 3 consecutive days and amoxicillin (20 mg/kg body weight IM) on 7 consecutive days. Transient post-injection reactions caused by cloprostenol administration included diarrhea, vomiting and vocalizations. Reactions began as quickly as 10 mins after cloprostenol administration and lasted as long as 30 mins. All queens improved clinically after cloprostenol treatment and remained healthy until the end of the study, 1 year after treatment. All queens resumed normal estrous cycles without further treatment and two (40%) delivered a normal litter. In conclusion, use of cloprostenol is an acceptable treatment for open-cervix pyometra in queens. PMID:23884637

  16. Results of fast neutron therapy of adenoid cystic carcinoma of the salivary glands

    International Nuclear Information System (INIS)

    72 consecutive patients with ACC were treated with fast neutrons, 66 after surgery, 6 for primarily unresectable disease, 43/66 for macroscopic residual disease, 23/66 for unresectable recurrent disease. 45/72 tumors were localized in the minor, 27 in the major salivary glands. T-stage was in 13 pts T2, in 33 T3, in 26 T4; positive nodes were in 10 pts. M+ in 15 pts. Mean tumor volume was 89 cm3. Neutron therapy was 15.03 Gy in 3 weeks with 1.67 Gy per fraction three times per week. Individual computer assisted treatment planning was performed based on CT and/or MRI, using bolus material if necessary. Target volume was the macroscopic tumor volume with a generous safety margin. Results: Complete response was achieved in 28 pts, partial response in 35 pts. Local control was observed in 73.4% after a mean observation period of 36 months. Overall and recurrence free survival was 85%/81% at two years, and 58%/53% at 5 years (Kaplan-Meier). In univariate analysis tumor volume (> 100 cm3), distant metastases, histologic subtype (solid) and neutron dose (<15 Gy) turned out to be significant parameters for predicting outcome, in multivariate analysis tumor volume and histologic subtype remained the only significant parameters. Acute morbidity was grade III/IV (EORTC/RTOG) in 6% for skin (desquamation), in 4% for mucosa (ulceration), late morbidity (grade III/IV) in one patient with local temporal brain necrosis. (orig.)

  17. Results of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS)

    International Nuclear Information System (INIS)

    Purpose: The role of conservative surgery and radiation for mammographically detected DCIS is controversial. In particular, there is a paucity of data for outcome with radiation in a group of patients comparable to those treated with local excision and surveillance (mammographically detected DCIS ≤2.5 cm, negative resection margins, negative post-biopsy mammogram). The purpose of this study is to report long term outcome of conservative surgery and radiation for mammographically detected DCIS with emphasis on the results in patients (pts.) considered candidates for excision alone. Materials and Methods: From 1983 to 1992, 110 women with mammographically detected DCIS (calcifications 72%, mass ± calcifications 27%) and no prior history of breast cancer underwent needle localization biopsy followed by radiation. The median age of the patient population was 56 yrs. (range 37-81). The median followup was 5.3 yrs. (range .5-12). Re-excision was performed in 55%. Final margins of resection were negative in 62%, positive 7%, close 11%, and unknown 20%. Axillary dissection was performed in 31 pts. and all had negative nodes. 31% had a positive family history of breast cancer (1 affected relative-25 pts., two-7 pts., three-2 pts.). The most common predominant histologic subtype was comedo (54%) followed by cribriform (22%). The median pathologic tumor size was 8 mm (range 2 mm to 5 cm). A post-biopsy mammogram prior to radiation was performed in 46% of the patients. Radiation consisted of treatment to the entire breast (median 5000 cGy) with a boost to the primary site (97%) of an additional 1000 cGy. The median total dose to the primary site was 6040 cGy (range 5000 to 6660). Results: Three patients developed a recurrence in the treated breast at 52, 106, and 107 months. All 3 recurrences were invasive ductal cancers and all were treated with mastectomy. The location of the recurrence was in the same quadrant as the primary in 1 pt. and in a separate quadrant in 2 pts

  18. Carcinoma of the base of the tongue: results of radical irradiation with surgery reserved for irradiation failure

    Energy Technology Data Exchange (ETDEWEB)

    Parsons, J.T.; Million, R.R.; Cassisi, N.J.

    1982-06-01

    Between 1964 and 1977, 95 previously untreated patients with squamous cell carcinoma of the base of the tongue received treatment with curative intent at the University of Florida. Eighty-six of the 95 patients (91%) had Stage III or IV disease at presentation. Eighty-nine patients received radical courses of irradiation to the primary with or without neck dissection(s), with surgery reserved for salvage of irradiation failure. Six patients underwent planned combined treatment of the primary lesion. Of the 89 patients whose primary lesions were radically irradiated, failure at the primary site occurred in 24% of those with T1-3 lesions and 78% with T4 lesions. Control results were related to irradiation treatment technique. None of the 9 patients with Stage I-II disease died of the cancer. Actuarial survival at 5 years for Stage III patients was 46%. Within the Stage IV population there is a subgroup of patients with highly treatable and curable disease. The addition of a neck dissection following irradiation of N2-N3 neck disease decreased the incidence of failure in the neck. No patient developed severe soft tissue necrosis or required mandibulectomy for bone exposure following irradiation.

  19. Carcinoma of the base of the tongue: results of radical irradiation with surgery reserved for irradiation failure

    International Nuclear Information System (INIS)

    Between 1964 and 1977, 95 previously untreated patients with squamous cell carcinoma of the base of the tongue received treatment with curative intent at the University of Florida. Eighty-six of the 95 patients (91%) had Stage III or IV disease at presentation. Eighty-nine patients received radical courses of irradiation to the primary with or without neck dissection(s), with surgery reserved for salvage of irradiation failure. Six patients underwent planned combined treatment of the primary lesion. Of the 89 patients whose primary lesions were radically irradiated, failure at the primary site occurred in 24% of those with T1-3 lesions and 78% with T4 lesions. Control results were related to irradiation treatment technique. None of the 9 patients with Stage I-II disease died of the cancer. Actuarial survival at 5 years for Stage III patients was 46%. Within the Stage IV population there is a subgroup of patients with highly treatable and curable disease. The addition of a neck dissection following irradiation of N2-N3 neck disease decreased the incidence of failure in the neck. No patient developed severe soft tissue necrosis or required mandibulectomy for bone exposure following irradiation

  20. Transarterial Chemoembolization (TACE) in hepatocellular carcinoma: Technique, indication and results; Transarterielle Chemoembolisation (TACE) des hepatozellulaeren Karzinoms: Technik, Indikationsstellung und Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Zangos, S.; Balzer, J.O.; Nabil, M.; Rao, P.; Eichler, K.; Abdelkader, A. [Inst. fuer Diagnostische und Interventionelle Radiologie, J.W. Goethe-Univ., Frankfurt (Germany); Bechstein, W.O. [Klinik fuer Allgemeinchirurgie, J.W. Goethe-Univ., Frankfurt (Germany); Zeuzem, S. [Klinik fuer Innere Medizin, Hepatologie, J.W. Goethe-Univ., Frankfurt (Germany)

    2007-11-15

    To present current data on technique, indications and results of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). The principle of TACE is the intra-arterial injection of chemotherapeutic drug combinations like doxorubicin, cisplatin and mitomycin into the hepatic artery, followed by lipiodol injection, Gelfoam for vessel occlusion and degradable microspheres. The side effects and complications after TACE range from fever, upper abdominal pain and vomiting to acute or chronic liver cell failure. The palliative effect in unresectable HCC using TACE allows local tumor control in 15 to 60% of cases and 5-year survival rates ranging from 8 - 43%. The potentially curative treatment option allows local tumor control from 18 - 63%. The neoadjuvant treatment option of TACE in combination with other treatment options like percutaneous ethanol injection (PEI) or radiofrequency ablation (RFA) reach local tumor control rates between 80 - 96%. The bridging effect of TACE before liver transplantation reaches 5-year survival rates from 59 - 93%. The symptomatic therapy option of TACE is used to counteract pain directly caused by HCC and acute/subacute bleeding in the HCC. The local tumor response reaches up to 88% and the bleeding control is from 83 to 100%. (orig.)

  1. Lymphoma of uterine cervix: magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Kanaan, Daniel; Constantino, Carolina Pesce Lamas; Souza, Rodrigo Canellas de, E-mail: daniel.kanaan@hotmail.com [Department of Radiology, Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil); Parente, Daniella Braz [Instituto D' Or de Pesquisa e Ensino, Rio de Janeiro, RJ (Brazil)

    2012-05-15

    Lymphoma of the cervix is a rare disease. About 1.0% to 1.5% of extranodal lymphomas originates in the female genital tract. The clinical presentation of this condition is nonspecific and magnetic resonance imaging is important for diagnostic elucidation. The present report describes the case of a 80-year-old patient with lumbar pain, whose magnetic resonance imaging showed a large uterine mass. The final diagnosis was lymphoma. (author)

  2. Modern Data about Morphofunctional Features of the Cervix

    OpenAIRE

    Guzik, O. V.; Slobodian, O. M.; Navarchuk, N. M.

    2015-01-01

    The objective of the research was to study the macro- and microstructure of the cervix during human ontogenesis using study materials and analysis of Ukrainian and foreign literature. Various cervical lesions are observed in all age periods and require thorough investigation of cervical epithelium for early detection, diagnosis and clear differentiation of precancerous diseases of this region. The development of modern methods of investigation of the internal organs of the fetus requires more...

  3. Screening of cancer cervix: Pap smear in rural India

    OpenAIRE

    Parimala A; Nidhi Sharma; Jayashree K. Srinivasan

    2016-01-01

    Background: The incidence of cervical premalignant lesions in rural India is likely to be high due to presence of several risk factors like early marriage, early coitarche and multiparity. Hence prospective cross sectional study was conducted to find the incidence of pre-invasive state and cancer of cervix in women between the age group 30 and 60 years, visiting Thirumazhisai health centre by Pap's smear method. Methods: Cervical mucosa is scraped, using Ayre spatula a 360 and deg; tu...

  4. Preliminary results of transarterial rhenium-188 HDD lipiodol in the treatment of inoperable primary hepatocellular carcinoma

    International Nuclear Information System (INIS)

    of the study, when the activities administered started at 1.8 GBq (50 mCi) and rose to 7.7 GBq (206 mCi). In the efficacy phase of the study a further 54 patients were treated. Both groups of patients are included in this paper. The treatment activity of 188Re-lipiodol administered transarterially ranged from 1.8 to 9.8 GBq (50-265 mCi), with a mean activity of 4.6 GBq (124 mCi). Survival at 3 months was 90%, and at 6 months, 60%; 19% survived for 1 year. Mean survival after treatment in the total treated group of 70 patients was 9.5 months, with a range of 1-18 months. The results of the study show that 188Re-lipiodol is a safe and cost-effective method to treat primary HCC via the transarterial route. (orig.)

  5. Comparison of visual inspection of cervix and pap smear for cervical cancer screening

    International Nuclear Information System (INIS)

    Objective: To evaluate the performance of visual inspection of cervix (VIA) after application of 3% acetic acid in cervical cancer screening in comparison with PAP smear. Results: Out of 540 subjects, 356 were negative with both screening techniques. One hundred and fifty-six subjects were positive with VIA (28.9%) while PAP smear was positive in seventy-eight subjects (14.4%). The sensitivity of VIA was 93.9% and of PAP smear was 46.9%. Corresponding specificities were 30.4% and 69.5%. There was no significant difference between the positive predictive value (PPV) of both test (p<0.05). The accuracy of VIA was 77.5% compared to 52.8% of PAP smear. The difference was highly significant (p < 0.01). Conclusion: These results indicate that VIA is more sensitive and has a higher accuracy as compared to PAP smear. It could, therefore, be valuable in detection of precancerous lesions of cervix. Low cost, easy applicability and immediate results make VIA a useful screening test in developing countries like Pakistan as compared to PAP smear. (author)

  6. Treatment Results of Postoperative Radiotherapy on Squamous Cell Carcinoma of the Oral Cavity: Coexistence of Multiple Minor Risk Factors Results in Higher Recurrence Rates

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to investigate the treatment results of postoperative radiotherapy (PORT) on squamous cell carcinoma of the oral cavity (OSCC). Materials and Methods: This study included 302 OSCC patients who were treated by radical surgery and PORT. Indications for PORT include Stage III or IV OSCC according to the 2002 criteria of the American Joint Committee on Cancer, the presence of perineural invasion or lymphatic invasion, the depth of tumor invasion, or a close surgical margin. Patients with major risk factors, such as multiple nodal metastases, a positive surgical margin, or extracapsular spreading, were excluded. The prescribed dose of PORT ranged from 59.4 to 66.6Gy (median, 63Gy). Results: The 3-year overall and recurrence-free survival rates were 73% and 70%, respectively. Univariate analysis revealed that differentiation, perineural invasion, lymphatic invasion, bone invasion, location (hard palate and retromolar trigone), invasion depths ≥10mm, and margin distances ≤4mm were significant prognostic factors. The presence of multiple significant factors of univariate analysis correlated with disease recurrence. The 3-year recurrence-free survival rates were 82%, 76%, and 45% for patients with no risk factors, one or two risk factors, and three or more risk factors, respectively. After multivariate analysis, the number of risk factors and lymphatic invasion were significant prognostic factors. Conclusion: PORT may be an adequate adjuvant therapy for OSCC patients with one or two risk factors of recurrence. The presence of multiple risk factors and lymphatic invasion correlated with poor prognosis, and more aggressive treatment may need to be considered.

  7. ({sup 18}F)-fluorodeoxyglucose PET/CT in cervix cancer: Lymph node assessment and prognostic/predictive value of primary tumour analysis; Tomographie par emission de positons au ({sup 18}F)-fluorodesoxyglucose dans les cancers du col uterin: evaluation ganglionnaire et valeur pronostique/predictive des donnees de la tumeur primitive

    Energy Technology Data Exchange (ETDEWEB)

    Leseur, J.; Williaume, D.; Le Prise, E.; De Crevoisier, R. [Departement des radiations, centre Eugene-Marquis, rue de la Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France); Devillers, A.; Garin, E. [Service de medecine nucleaire, centre Eugene-Marquis, rue de la Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France); Fougerou, C. [Service de pharmacologie, CHU de Rennes, 35033 Rennes cedex 09 (France); Inserm 0203, centre d' investigations cliniques, CHU de Rennes, 35033 Rennes cedex 09 (France); Universite de Rennes 1, CS 46510, 35065 Rennes cedex (France); Bouriel, C. [Service de radiologie, centre Eugene-Marquis, rue de la Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France); Leveque, J. [Departement de gynecologie et obstetrique, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, 35203 Rennes cedex 2 (France); Monpetit, E. [Departement des radiations, clinique Oceane, 11, rue du Docteur-Joseph-Audic, Le Tenenio, BP 50020, 56001 Vannes cedex (France); Blanchot, J. [Departement de gynecologie et obstetrique, clinique mutualiste La Sagesse, 4, place Saint-Guenole, CS 44345, 35043 Rennes cedex (France)

    2011-12-15

    Purpose. - In cervix carcinoma: (a) to evaluate the ability of ({sup 18}F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the lymph node detection; (b) to investigate the prognostic and predictive value of the primary cervical PET parameters. Patients and methods. - Ninety patients treated for cervix carcinoma and evaluated initially by MRI and FDG PET were included. The performances of FDG-PET for lymph node detection (relatively to the lymph node dissection) have been described (sensitivity, specificity, positive predictive value and negative predictive value). PET tumour parameters analyzed were: maximum standard uptake value (SUV{sub max}), the volume and the maximum diameter. The prognostic and predictive values of these parameters were investigated. The tumour response was evaluated on surgical specimens. Results. - PET detected the cervical tumour with a sensitivity of 97% (mean values: SUV{sub max} = 15.8, volume = 27 mm{sup 3}, maximum diameter = 47). For the detection of the lymph nodes, the values of sensibility, specificity, positive predictive value and negative predictive value were: 86, 56, 69 and 78% in the pelvic, and 90, 67, 50 and 95% for the para-aortic area, respectively. The SUV{sub max} was correlated with histologic response (P = 0.04). The frequency of partial histological response was significantly higher for tumour SUV{sub max}> 10.9 (P = 0.017). The maximum PET diameter and pathologic response had an impact on disease-free survival and overall survival in multivariate analysis (P < 0.05). Conclusion. - PET has high sensitivity in detecting pelvic and para-aortic lymph nodes. Some primary cervical tumour PET parameters are useful as prognostic and predictive factors. (authors)

  8. Monitoring by nuclear magnetic resonance imaging in combined radio- and chemotherapy of advanced bladder carcinomas - first results

    International Nuclear Information System (INIS)

    A combination of cis-platinum and radiotherapy was applied in five patients with advanced bladder carcinomas. The patients were examined by nuclear magnetic resonance imaging prior to and following to therapy. Corresponding to cellcinetic considerations regarding tissues with slow cell turnover, a maximum therapy effect is shown about nine months after the end of local therapy. Smaller control intervals are recommended in case of bladder carcinomas with lymph node metastases. Due to the possibility of multiple slice imaging, the nuclear magnetic resonance technique is particularly suited for the monitoring of bladder carcinomas. Sagittal and coronary slices show a better image of tumoral extension at the roof and floor of the bladder than axial computed tomography. Lymph node metastases are represented relatively late by both methods. (orig.)

  9. Biometric analysis of uterine cervix during pregnancy using trans vaginal ultrasonography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Objective: To evaluate the uterine cervix length with magnetic resonance imaging in comparison with findings at trans vaginal ultrasonography. Materials and methods: Twenty pregnant women between the 19th and 30th gestational weeks underwent magnetic resonance imaging and trans vaginal ultrasonography for evaluation of their uterine cervix. Measurements by means of magnetic resonance imaging were performed by two specialists in imaging diagnosis for calculating the interobserver variability of the method. Results: Calculation of the Pearson's correlation coefficient between measurements of the cervical length demonstrated a significant correlation between the results of both methods (r=0.628; p<0.01). The paired t test demonstrated no statistically significant difference between measurements obtained by trans vaginal ultrasonography and magnetic resonance imaging (p=0.068). Interobserver agreement in cervical measurements by magnetic resonance imaging was high (α=0.96), demonstrating the reliability of the method. Conclusion: The comparison between both imaging methods in the evaluation of cervical biometry showed no statistically significant difference thus reinforcing the utilization of ultrasonography. However, in some cases where trans vaginal ultrasonography is contraindicated, magnetic resonance imaging can be alternatively utilized for measurement of the cervical length. (author)

  10. Computer-assisted dosimetry in the radiotherapy of cancer of the cervix

    International Nuclear Information System (INIS)

    Cancer of the cervix is the third leading cause of cancer in the Philippines. The Department of Radiotherapy of the Jose R. Reyes Memorial Medical Center has participated in the Regional Coordinated Research project sponsored by the International Atomic Energy Agency (IAEA) to undertake a study to compare computer treatment planning and manual calculations in radiotherapy of the cancer of the cervix; and to perform actual measurements on bladder and rectal points using TLDs. Twenty-seven patients with Stage II-B to III-B were included in the study. External beam teletherapy of 40 Gy without shielding for 4 weeks and 50 Gy with blocks plus brachytherapy of 20-40 Gy were given using LDR or HDR machine. Point A, bladder and rectal points were defined following ICRU 38 recommendations. The results showed dose calculations between commercially available computers and IAEA - provided computers agree to within 20%. Results of TLD measurement in bladder and rectum have shown wide range of variation. (author). 3 refs.; 4 tabs.; 8 figs

  11. Role of magnetic resonance imaging in the diagnosis of recurrent cancer of the cervix uteri

    Directory of Open Access Journals (Sweden)

    Z. N. Shavladze

    2014-07-01

    Full Text Available Objective: to define a role of magnetic resonance imaging (MRI in the follow-up of patients with cancer of the cervix uteri (CCU, who have undergone radiation therapy and chemoradiation therapy and to describe the types of the MRI pattern of recurrent CCU in the pelvic region.Materials and methods. The results of a follow-up of 82 patients with a 4-47- (median 12 months month history of invasive CCU were analyzed.Results. Out of the 82 patients with invasive CCU, 25 were found to have pelvic recurrences; in 23 cases MRI revealed the latter (in the cervix uteri (n = 6, corpus uteri (n = 2, vagina (n = 2, parametrium (n = 2, iliac (n = 10, paraaortic (n = 5 lymph nodes, and pelvic wall (n=5.Conclusion. The findings suggest that pelvic MRI is an effective technique to detect and estimate the extent of a pelvic recurrence and it is expedient to incorporate it into the scope of a follow-up after radiation therapy and chemoradiation therapy in patients with invasive CCU.

  12. Abnormalities of uterine cervix in women with inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Jyoti Bhatia; Panayota Kotsali; Oana Vele; Jason Bratcher; Burton Korelitz; Katherine Vakher; Shlomo Mannor; Maria Shevchuk; Gworgia Panagopoulos; Adam Ofer; Ecaterina Tamas

    2006-01-01

    AIM: To evaluate the prevalence of abnormalities of the uterine cervix in women with inflammatory bowel disease (IBD) when compared to healthy controls.METHODS: One hundred and sixteen patients with IBD [64 with Crohn's disease (CD) and 52 with ulcerative colitis (UC)] were matched to 116 healthy controls by age (+/- 2 years) at the time of most recent papanicolaou (Pap) smear. Data collected consisted of age, race, marital status, number of pregnancies,abortions/miscarriages, duration and severity of IBD,Pap smear results within five years of enrollment, and treatment with immunosuppressive drugs. Pap smear results were categorized as normal or abnormal including atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LGSIL), and high-grade squamous intraepithelial lesion (HGSIL). RESULTS: The median age at the time of Pap smear was 46 (range: 17-74) years for the IBD group and matched controls (range: 19-72 years). There were more Caucasian subjects than other ethnicities in the IBD patient group (P = 0.025), as well as fewer abortions (P = 0.008), but there was no significant difference regarding marital status. Eighteen percent of IBD patients had abnormal Pap smears compared to 5% of controls (P = 0.004). Subgroup analysis of the IBD patients revealed no significant differences between CD and UC patients in age, ethnicity, marital status, number of abortions, disease severity, family history of IBD, or disease duration. No significant difference was observed in the number of abnormal Pap smears or the use of immunosuppressive medications between CD and UC patients (P = 0.793). No definitive observation could be made regarding HPV status, as this was not routinely investigated during the timeframe of our study.CONCLUSION: Diagnosis of IBD in women is related to an increased risk of abnormal Pap smear, while type of IBD and exposure to immunosuppressive medications are not. This has significant implications for

  13. A Rare Case of Primary Insitu Squamous Cell Carcinoma of the Endometrium with Extensive Icthyosis Uteri

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    Pailoor K

    2014-08-01

    Full Text Available Primary squamous cell carcinoma of the endometrium is exceedingly rare. We report a case of 52 years old postmenopausal woman who presented with pelvic pain of four months duration. Gynecologic examination revealed a normal cervix. A possibility of pyometra was considered through pelvic ultrasound. Total abdominal hysterectomy was performed and histopathologically, it was diagnosed as a case of primary in situ squamous cell carcinoma of the endometrium.

  14. Prognostic Factors for Long-Term Survival in Patients with Ampullary Carcinoma: The Results of a 15-Year Observation Period after Pancreaticoduodenectomy

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    Fritz Klein

    2014-01-01

    Full Text Available Introduction. Although ampullary carcinoma has the best prognosis among all periampullary carcinomas, its long-term survival remains low. Prognostic factors are only available for a period of 10 years after pancreaticoduodenectomy. The aim of this retrospective study was to identify factors that influence the long-term patient survival over a 15-year observation period. Methods. From 1992 to 2007, 143 patients with ampullary carcinoma underwent pancreatic resection. 86 patients underwent pylorus-preserving pancreaticoduodenectomy (60% and 57 patients underwent standard Kausch-Whipple pancreaticoduodenectomy (40%. Results. The overall 1-, 5-, 10-, and 15-year survival rates were 79%, 40%, 24%, and 10%, respectively. Within a mean observation period of 30 (0–205 months, 100 (69% patients died. Survival analysis showed that positive lymph node involvement P=0.001, lymphatic vessel invasion P=0.0001, intraoperative administration of packed red blood cells P=0.03, an elevated CA 19-9 P=0.03, jaundice P=0.04, and an impaired patient condition P=0.01 are strong negative predictors for a reduced patient survival. Conclusions. Patients with ampullary carcinoma have distinctly better long-term survival than patients with pancreatic adenocarcinoma. Long-term survival depends strongly on lymphatic nodal and vessel involvement. Moreover, a preoperative elevated CA 19-9 proved to be a significant prognostic factor. Adjuvant therapy may be essential in patients with this risk constellation.

  15. Conservative treatment of anal canal carcinoma with external radiotherapy and interstitial brachytherapy, with or without chemotherapy: long-term results

    International Nuclear Information System (INIS)

    Purpose: a retrospective analysis of conservative treatment of anal canal cancers with external radiation therapy and interstitial brachytherapy with or without chemotherapy. Patients and methods: from 1986 to 1996, 69 patients were treated with external radiotherapy (40 Gy/20 fractions) and interstitial brachytherapy (20 Gy) after a mean interval of six weeks for a localized epidermoid carcinoma of the anal canal. Patients who did not complete the whole therapeutic sequence were not included. Forty-five patients received additional 5-fluorouracil- and/or mitomycin C-based chemotherapy regimen. Results: acute toxicity was acceptable. Complete response rate was 81%. Actuarial local control rate was at two and five years, 65% and 59% respectively (median follow-up: eight years). At two, five and ten years, actuarial colostomy rate was 26%, 33% and 33% respectively, and colostomy-free survival rates 61%, 47% and 37%. Overall survival at two, five and ten years was 81%, 65% and 53% respectively. Distant metastases occurred in 11 patients (16%). Prognostic factors for overall survival were performance status (PS) (79% survival at five years for patients with PS 0 versus 50% for patients with PS 1-3, P = 0.04) and tumor stage (80% at five years for T1-T2 versus 53% for T3-T4, P = 0.03). Overall treatment time less than 12 weeks and time interval between external radiotherapy and brachytherapy inferior than six weeks were associated with a better local control (P = 0.05). In multivariate analysis, these prognostic factors were not significant. Conclusion: these results confirm the efficacy of external radiotherapy and brachytherapy in the treatment of small anal canal cancers, and point out the need for improving treatment outcome of larger tumors. (author)

  16. Treatment results of 165 pediatric patients with non-metastatic nasopharyngeal carcinoma: A Rare Cancer Network study

    International Nuclear Information System (INIS)

    Purpose: This Rare Cancer Network (RCN) study was performed in pediatric nasopharyngeal carcinoma (PNPC) patients to evaluate the optimal dose of radiotherapy and to determine prognostic factors. Patients and Methods: The study included 165 patients with the diagnosis of PNPC treated between 1978 and 2003. The median age was 14 years. There were 3 (1.8%) patients with stage I, 1 (0.6%) with IIA, 10 (6.1%) with IIB, 60 (36.4%) with III, 44 (26.7%) with IVA, and 47 (29%) with IVB disease. While 21 (12.7%) patients were treated with radiotherapy (RT) alone, 144 (87.3%) received chemotherapy and RT. The median follow-up time was 48 months. Results: The actuarial 5-year overall survival (OS) was 77.4% (95% CI: 70.06-84.72), whereas the actuarial 5-year disease-free survival (DFS) rate was 68.8% (95% CI: 61.33-76.31). In multivariate analysis, unfavorable factors were age >14 years for LRC (p = 0.04); male gender for DMFS (p = 0.03); T3/T4 disease for LRFS (p = 0.01); and N3 disease for DFS (p = 0.002) and OS (p = 0.002); EBRT dose of less than 66 Gy for LRFS (p = 0.02) and LRRFS (p = 0.0028); and patients treated with RT alone for LRFS (p = 0.0001), LRRFS (p = 0.007) and DFS (p = 0.02). Conclusion: Our results support the current practice of using combined radiation and chemotherapy for optimal treatment of NPC. However, research should be encouraged in an attempt to reduce the potential for long-term sequelae in pediatric patients given their relatively favorable prognosis and potential for longevity

  17. Cost of illness of advanced ovarian carcinoma in Italy: results of an empirical, single-centre study

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    Carlo Lazzaro

    2015-09-01

    Full Text Available AIM: To perform an empirical, single-centre, retrospective and secondary cost of illness (COI study of advanced ovarian carcinoma (AOC in Italy. METHODS: Demographic, clinical, health care and non-health care resource consumption data concerning a convenience sample of subsequent patients in 1st line of treatment (100 patients, 2nd line of treatment A (surgery + chemotherapy; 30 patients and 2nd line of treatment B (chemotherapy only; 20 patients were obtained from a database created in 2011 by the Obstetrics and Ginecology Unit at Campus Biomedico teaching hospital, Rome. Patients were followed-up for 2 years. Resources were valued according to the above mentioned database and literature, following the societal viewpoint. Costs are expressed in Euro (€ 2014 and reported as mean and standard deviation (SD. RESULTS: One-year COI for 1st line of treatment reaches € 44,999.7 (SD: €28,757.3, € 55,410.8 (SD: € 32,454.6 and €46,895.6 (SD: € 28,407.4 for 2nd line of treatment A and B, respectively. Regardless the line of treatment, COI is mainly driven by cost borne by patient and her family. Due to the high costs of relapse the mean COI per patient after 2 years from the diagnosis of AOC equals € 81,869.4 (SD: € 30,660.9, or 182% of the COI for the 1st line of treatment. CONCLUSIONS: Despite some limitations, our results show that increasing progression-free survival could well reduce the COI for AOC in Italy.

  18. Long-Term Results of Brachytherapy for Carcinoma of the Penis Confined to the Glans (N- or NX)

    International Nuclear Information System (INIS)

    Purpose: To analyze the results of exclusive interstitial low-dose-rate brachytherapy (BT) for squamous cell carcinoma (SCC) of the penis, strictly confined to the glans. Methods and Materials: A total of 144 patients with SSC of the glans penis were treated with BT. Inguinal nodal dissection was performed in 19% of patients (all N-). After circumcision, BT was performed using the hypodermic needle technique. Median iridium length per patients was 24 cm (range, 4-108) and median dose was 65 Gy (range, 37-75). Median treated volume was 22 cm3 (range, 5-110) and median reference isodose rate was 0.4 Gy/h (range, 0.2-1.2). Results: Median follow-up was 5.7 years (range, 0.5-29). The 10-year penile recurrence, inguinal lymph node recurrence, and inguinal nodal metastasis rates were: 20% (CI 95%, 11-29), 11% (CI 95%, 5-17), and 6% (CI 95%, 2-10), respectively. After salvage treatment, 86% patients with local failure were in a complete remission at last follow-up. The 10-year probability of avoiding penile surgery (for complication or local recurrence) was 72% (CI 95%, 62-82). The 10-year cancer-specific survival rate was 92% (CI 95%, 87-97). Diameter of tumor significantly increased the risk of recurrence (p = 0.02). The 10-year painful ulceration and stenosis risk rates were: 26% (CI 95%, 17-35) and 29% (CI 95%, 18-40), respectively. Seven patients required excision for necrosis. Treated volume and reference isodose rate significantly increased the risk of complications. Conclusion: BT is an effective conservative treatment for SCC confined to the glans. Salvage local treatment is effective. Dose rate should be limited to decrease toxicity.

  19. Therapeutic strategies for adenoid cystic carcinoma of the nasal and paranasal sinus from the long-term treatment results

    International Nuclear Information System (INIS)

    This article presents long-term treatment results by analyzing 24 cases with adenoid cystic carcinoma (ACC) of the nasal and paranasal sinus treated from 1975 to 1995 at Akita University Hospital and Chiba University Hospital. The basic strategies for treatment for ACC of the nasal and paranasal sinuses are en bloc tumor resection, followed by primary reconstruction of the maxilla. Preoperative and postoperative radiation were combined. Cumulative 5-year and 10-year survival rates were 70.6% and 47.1% for maxillary sinus tumors, respectively. Cumulative 5-year and 10-year survival rates for nasal tumors were 100% and 75.0%, and those for sphenoid sinus tumors were 50.0% and 0%, respectively. The patient with ethomoid sinus who needed skull base surgery is alive at 8.1 years after therapy. Treatment results closely correlated with tumor extension. Cumulative 5-year survival rates for T2, T3 and, T4 patients with maxillary sinus tumors were 85.7%, 71.4%, and 33.3%, respectively. And cumulative 10-year survival rates for T2, T3, and T4 were 71.4%, 42.9%, and 0%, respectively. The histopathological effects of preoperative radiation were Shimosato II a in 6 out of 10 patients, II b in 2, and III in 2, respectively. Only fast neutron therapy reached Shimosato III. Two of the patients with Shimosato II a died of distant metastasis. The above data suggests that, although radiation therapy alone cannot cure tumors, preoperative full-dose radiation may prevent the development of distant metastasis if it can achieve histopathological effects of a higher classification than Shimosato II b. Because chemotherapy and radiation is not very effective on ACC, the role of skull base surgeries for nasal-paranasal sinus malignancies that invade the skull base is valuable, particularly in cases having a relatively small mass in the ethmoid sinus. (author)

  20. Dietary intake of minerals and risk of esophageal squamous cell carcinoma: results from the Golestan Cohort Study123

    Science.gov (United States)

    Hashemian, Maryam; Poustchi, Hossein; Abnet, Christian C; Boffetta, Paolo; Dawsey, Sanford M; Brennan, Paul J; Pharoah, Paul; Etemadi, Arash; Kamangar, Farin; Sharafkhah, Maryam; Hekmatdoost, Azita; Malekzadeh, Reza

    2015-01-01

    Background: Dietary factors have been hypothesized to affect the risk of esophageal cancer via different mechanisms, but the intake of minerals is understudied and the evidence is conflicting. Objective: The objective was to evaluate the associations of dietary intake of minerals with risk of esophageal squamous cell carcinoma (ESCC). Design: We used data from the Golestan Cohort Study, which was launched in a high-risk region for esophageal cancer in Iran. Participants were enrolled in 2004–2008 and were followed to 2014. Intakes of minerals were assessed with a validated food-frequency questionnaire. A Cox proportional hazards model was used to estimate HRs and 95% CIs of ESCC for dietary intakes of selected minerals. Results: We identified 201 ESCC cases among 47,405 subjects. Calcium intake was significantly inversely associated with the risk of ESCC (HR per 100-mg/d increase: 0.88; 95% CI: 0.81, 0.96; P = 0.005; quartile 4 vs. quartile 1 HR: 0.49; 95% CI: 0.29, 0.82; P-trend = 0.013). Zinc intake was also inversely associated with ESCC, but the quartile association did not reach significance (HR per 1-mg/d increase: 0.87; 95% CI: 0.77, 0.98; P = 0.027; quartile 4 vs. quartile 1 HR: 0.56; 95% CI: 0.28, 1.12; P-trend = 0.097). The relations between dietary intakes of selenium, magnesium, and copper and risk of ESCC were nonlinear (P-nonlinear trend = 0.001, 0.016, and 0.029, respectively). There was no relation between dietary intake of manganese and the risk of ESCC. Conclusion: The results suggest that higher intakes of calcium and zinc are associated with a lower risk of ESCC in a high-risk region of Iran. PMID:26016858

  1. Increased SHP-1 expression results in radioresistance, inhibition of cellular senescence, and cell cycle redistribution in nasopharyngeal carcinoma cells

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    Radioresistance is the main limit to the efficacy of radiotherapy in nasopharyngeal carcinoma (NPC). SHP-1 is involved in cancer progression, but its role in radioresistance and senescence of NPC is not well understood. This study aimed to assess the role of SHP-1 in the radioresistance and senescence of NPC cells. SHP-1 was knocked-down and overexpressed in CNE-1 and CNE-2 cells using lentiviruses. Cells were irradiated to observe their radiosensitivity by colony forming assay. BrdU incorporation assay and flow cytometry were used to monitor cell cycle. A β-galactosidase assay was used to assess senescence. Western blot was used to assess SHP-1, p21, p53, pRb, Rb, H3K9Me3, HP1γ, CDK4, cyclin D1, cyclin E, and p16 protein expressions. Compared with