WorldWideScience

Sample records for cervical cancer brachytherapy

  1. Multihelix rotating shield brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States); Kim, Yusung; Flynn, Ryan T., E-mail: ryan-flynn@uiowa.edu [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Wu, Xiaodong [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States)

    2015-11-15

    Purpose: To present a novel brachytherapy technique, called multihelix rotating shield brachytherapy (H-RSBT), for the precise angular and linear positioning of a partial shield in a curved applicator. H-RSBT mechanically enables the dose delivery using only linear translational motion of the radiation source/shield combination. The previously proposed approach of serial rotating shield brachytherapy (S-RSBT), in which the partial shield is rotated to several angular positions at each source dwell position [W. Yang et al., “Rotating-shield brachytherapy for cervical cancer,” Phys. Med. Biol. 58, 3931–3941 (2013)], is mechanically challenging to implement in a curved applicator, and H-RSBT is proposed as a feasible solution. Methods: A Henschke-type applicator, designed for an electronic brachytherapy source (Xoft Axxent™) and a 0.5 mm thick tungsten partial shield with 180° or 45° azimuthal emission angles and 116° asymmetric zenith angle, is proposed. The interior wall of the applicator contains six evenly spaced helical keyways that rigidly define the emission direction of the partial radiation shield as a function of depth in the applicator. The shield contains three uniformly distributed protruding keys on its exterior wall and is attached to the source such that it rotates freely, thus longitudinal translational motion of the source is transferred to rotational motion of the shield. S-RSBT and H-RSBT treatment plans with 180° and 45° azimuthal emission angles were generated for five cervical cancer patients with a diverse range of high-risk target volume (HR-CTV) shapes and applicator positions. For each patient, the total number of emission angles was held nearly constant for S-RSBT and H-RSBT by using dwell positions separated by 5 and 1.7 mm, respectively, and emission directions separated by 22.5° and 60°, respectively. Treatment delivery time and tumor coverage (D{sub 90} of HR-CTV) were the two metrics used as the basis for evaluation and

  2. Image-Based Brachytherapy for the Treatment of Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Harkenrider, Matthew M., E-mail: mharkenrider@lumc.edu; Alite, Fiori; Silva, Scott R.; Small, William

    2015-07-15

    Cervical cancer is a disease that requires considerable multidisciplinary coordination of care and labor in order to maximize tumor control and survival while minimizing treatment-related toxicity. As with external beam radiation therapy, the use of advanced imaging and 3-dimensional treatment planning has generated a paradigm shift in the delivery of brachytherapy for the treatment of cervical cancer. The use of image-based brachytherapy, most commonly with magnetic resonance imaging (MRI), requires additional attention and effort by the treating physician to prescribe dose to the proper volume and account for adjacent organs at risk. This represents a dramatic change from the classic Manchester approach of orthogonal radiographic images and prescribing dose to point A. We reviewed the history and currently evolving data and recommendations for the clinical use of image-based brachytherapy with an emphasis on MRI-based brachytherapy.

  3. IMAGE-GUIDED RADIOTHERAPY AND -BRACHYTHERAPY FOR CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Suresh eDutta

    2015-03-01

    Full Text Available Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT, and 2-dimensional intracavitary brachytherapy.Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron emission tomography (PET and magnetic resonance imaging (MRI has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT, allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.

  4. Image-guided radiotherapy and -brachytherapy for cervical cancer.

    Science.gov (United States)

    Dutta, Suresh; Nguyen, Nam Phong; Vock, Jacqueline; Kerr, Christine; Godinez, Juan; Bose, Satya; Jang, Siyoung; Chi, Alexander; Almeida, Fabio; Woods, William; Desai, Anand; David, Rick; Karlsson, Ulf Lennart; Altdorfer, Gabor

    2015-01-01

    Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT), and 2-dimensional intracavitary brachytherapy. Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron-emission tomography and magnetic resonance imaging has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT) may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT), allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer. PMID:25853092

  5. Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

    International Nuclear Information System (INIS)

    Stereotactic body radiation therapy (SBRT) administered via a helical tomotherapy (HT) system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI) showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO) stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT) followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were noted on the most recent follow-up. CCRT followed by SBRT appears to be an effective and safe modality for treatment of cervical cancer. Larger-scale studies are warranted

  6. Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

    Directory of Open Access Journals (Sweden)

    Chen Yu-Jen

    2010-11-01

    Full Text Available Abstract Background Stereotactic body radiation therapy (SBRT administered via a helical tomotherapy (HT system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. Case Presentation A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were noted on the most recent follow-up. Conclusions CCRT followed by SBRT appears to be an effective and safe modality for treatment of cervical cancer. Larger-scale studies are warranted.

  7. Current status and perspectives of brachytherapy for cervical cancer.

    Science.gov (United States)

    Toita, Takafumi

    2009-02-01

    Standard definitive radiotherapy for cervical cancer consists of whole pelvic external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT). In Japan, high-dose-rate ICBT (HDR-ICBT) has been utilized in clinical practice for more than 40 years. Several randomized clinical trials demonstrated that HDR-ICBT achieved comparative outcomes, both for pelvic control and incidences of late complications, to low-dose-rate (LDR) ICBT. In addition, HDR-ICBT has some potential advantages over LDR-ICBT, leading to further improvement in treatment results. Prior to the current computer planning systems, some excellent treatment planning concepts were established. At present, systems modified from these concepts, or novel approaches, such as image-guided brachytherapy (IGBT) are under investigation. One serious problem to be solved in HDR-ICBT for cervical cancer is that of the discrepancy in standard treatment schedules for combination HDR-ICBT and EBRT between the United States and Japan. Prospective studies are ongoing to assess the efficacy and toxicity of the Japanese schedule. PMID:19225920

  8. Study of factors influencing dose distribution of brachytherapy in cervical cancer

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To study the factors which influence the dose distribution of brachytherapy in cervical cancer.Methods Ninety-five patients with cervical cancer Ⅱ-Ⅲb received fundamental radiation therapy including brachytherapy in our department from Aug.2004 to Nov.2005.The deviation of isodose curve of brachytherapy was based on A-B reference system,and the deviation of dose was defined by measuring in a practical standard body model.Results The factors influencing isodose offset significantly were parametrial...

  9. Magnetic resonance imaging for planning intracavitary brachytherapy for the treatment of locally advanced cervical cancer.

    Science.gov (United States)

    Oñate Miranda, M; Pinho, D F; Wardak, Z; Albuquerque, K; Pedrosa, I

    2016-01-01

    Cervical cancer is the third most common gynecological cancer. Its treatment depends on tumor staging at the time of diagnosis, and a combination of chemotherapy and radiotherapy is the treatment of choice in locally advanced cervical cancers. The combined use of external beam radiotherapy and brachytherapy increases survival in these patients. Brachytherapy enables a larger dose of radiation to be delivered to the tumor with less toxicity for neighboring tissues with less toxicity for neighboring tissues compared to the use of external beam radiotherapy alone. For years, brachytherapy was planned exclusively using computed tomography (CT). The recent incorporation of magnetic resonance imaging (MRI) provides essential information about the tumor and neighboring structures making possible to better define the target volumes. Nevertheless, MRI has limitations, some of which can be compensated for by fusing CT and MRI. Fusing the images from the two techniques ensures optimal planning by combining the advantages of each technique.

  10. Surface membrane based bladder registration for evaluation of accumulated dose during brachytherapy in cervical cancer

    DEFF Research Database (Denmark)

    Noe, Karsten Østergaard; Tanderup, Kari; Sørensen, Thomas Sangild

    2011-01-01

    of the fixed surface. Optional landmark based matches can be included in the suggested iterative solver. The technique is demonstrated for bladder registration in brachytherapy treatment evaluation of cervical cancer. It holds promise to better estimate the accumulated but unintentional dose delivered...

  11. Current status of high dose rate brachytherapy in cervical cancer in Korea and optimal treatment schedule

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Seung Jae [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    1998-12-01

    Brachytherapy is an essential part of radiotherapy for uterine cervical cancer. The low dose rate (LDR) regimen has been the major technique of intracavitary therapy for cervical cancer. However, there has been an expansion in the last 20 years of high dose rate (HDR) machines using Ir-192 sources. Since 1979, HDR brachytherapy has been used for the treatment of uterine cervical cancer in Korea. The number of institutions employing HDR has been increasing, while the number of low dose rate system has been constant. In 1995, there was a total 27 HDR brachytherapy units installed and 1258 cases of patients with cervical cancer were treated with HDR. Most common regimens of HDR brachytherapy are total dose of 30-39 Gy at point A with 10-13 fractions in three fractions per week, 24-32 Gy with 6-8 fractions in two fractions per week, and 30-35 Gy with 6-7 fractions in two fractions per week. The average fractionation regimen of HDR brachytherapy is about 8 fractions of 4. 1 Gy each to point A. In Korea, treatment results for HDR brachytherapy are comparable with the LDR series and appears to be a safe and effective alternative to LDR therapy for the treatment of cervical carcinoma. Studies from the major centers report the five-year survival rate of cervical cancer as, 78-86% for Stage I, 68-85% for stage II, and 38-56% for Stage III. World-wide questionnaire study and Japanese questionnaire survey of multiple institutions showed no survival difference in any stages and dose-rate effect ratio (HDR/LDR) was calculated to be 0.54 to 0.58. However, the optimum treatment doses and fractionation schemes appropriate to generate clinical results comparable to conventional LDR schemes have yet to be standardized. In conclusion, HDR intracavitary radiotherapy is increasingly practiced in Korea and an effective treatment modality for cervical cancer. To determine the optimum radiotherapy dose and fractionation schedule, a nation-wide prospective study is necessary in Korea. In

  12. Higher caseload improves cervical cancer survival in patients treated with brachytherapy

    International Nuclear Information System (INIS)

    Increased caseload has been associated with better patient outcomes in many areas of health care, including high-risk surgery and cancer treatment. However, such a positive volume vs. outcome relationship has not yet been validated for cervical cancer brachytherapy. The purpose of this study was to examine the relationship between physician caseload and survival rates in cervical cancer treated with brachytherapy using population-based data. Between 2005 and 2010, a total of 818 patients were identified using the Taiwan National Health Insurance Research Database. Multivariate analysis using a Cox proportional hazards model and propensity scores was used to assess the relationship between 5-year survival rates and physician caseloads. As the caseload of individual physicians increased, unadjusted 5-year survival rates increased (P = 0.005). Using a Cox proportional hazard model, patients treated by high-volume physicians had better survival rates (P = 0.03), after adjusting for comorbidities, hospital type, and treatment modality. When analyzed by propensity score, the adjusted 5-year survival rate differed significantly between patients treated by high/medium-volume physicians vs. patients treated by low/medium-volume physicians (60% vs. 54%, respectively; P = 0.04). Provider caseload affected survival rates in cervical cancer patients treated with brachytherapy. Both Cox proportional hazard model analysis and propensity scores showed association between high/medium volume physicians and improved survival

  13. The changing landscape of brachytherapy for cervical cancer: a Canadian practice survey

    Science.gov (United States)

    Phan, T.; Mula-Hussain, L.; Pavamani, S.; Pearce, A.; D’Souza, D.; Patil, N.G.; Traptow, L.; Doll, C.M.

    2015-01-01

    Background We documented changes in practice from 2009 to 2012 for cervical cancer brachytherapy in Canada. Methods Centres with gynecologic brachytherapy services were sent an e-mail questionnaire querying their 2012 practice. Responses are reported and compared with practice patterns identified in a similar survey for 2009. Results The response rate was 77% (24 of 31 centres). Almost all use high-dose-rate brachytherapy (92%); low-dose-rate brachytherapy has been completely phased out. Most continue to move patients from the site of applicator insertion to the radiation treatment simulation suite (75%) or to a diagnostic imaging department (29%), or both. In 2012, the imaging modalities used for dose specification were computed tomography [ct (75%)], magnetic resonance imaging [mri (38%)], plain radiography (21%), and cone-beam ct (8%). The number of institutions using mri guidance has markedly increased during the period of interest (9 vs. 1). Most respondents (58% vs. 14%) prescribed using guidelines from the Groupe Européen de Curiethérapie and the European Society for Therapeutic Radiology and Oncology, but they also used point A as a reference. Commonly used high-dose radiation regimens included 30 Gy in 5 fractions and 24 Gy in 3 fractions. Conclusions In Canada, image-guided brachytherapy for cervical cancer continues to evolve. Although ct-based imaging remains the most commonly used modality, many centres have adopted mri for at least 1 brachytherapy treatment. More centres are using fewer fractions and a slightly lower biologically effective dose, but are still achieving EQD2 (2-Gy equivalent) doses of 80–90 Gy in combination with external-beam radiation therapy. PMID:26628868

  14. Determining DVH parameters for combined external beam and brachytherapy treatment: 3D biological dose adding for patients with cervical cancer

    NARCIS (Netherlands)

    J.B. van de Kamer; A.A.C. de Leeuw; M.A. Moerland; I.M. Jürgenliemk-Schulz

    2010-01-01

    Purpose: To compare two methods of DVH parameter determination for combined external beam and brachytherapy treatment of cervical cancer. Materials and methods: Clinical treatment plans from five patients were used in this study. We simulated two applications given with PDR (32 x 60 cGy per applicat

  15. The using of megavoltage computed tomography in image-guided brachytherapy for cervical cancer: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Tharavichitkul, Ekkasit; Janla-or, Suwapim; Wanwilairat, Somsak; Chakrabandhu, Somvilai; Klunklin, Pitchayaponne; Onchan, Wimrak; Supawongwattana, Bongkot; Chitapanarux, Imjai [Division of Therapeutic Radiology and Oncology, Dept. of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai (Thailand); Galalae, Razvan M. [Faculty of Medicine, Christian-Albrecht University (Campus Kiel), Kiel (Germany)

    2015-06-15

    We present a case of cervical cancer treated by concurrent chemoradiation. In radiation therapy part, the combination of the whole pelvic helical tomotherapy plus image-guided brachytherapy with megavoltage computed tomography of helical tomotherapy was performed. We propose this therapeutic approach could be considered in a curative setting in some problematic situation as our institution.

  16. Tolerance and efficacy of preoperative intracavitary HDR brachytherapy in IB and IIA cervical cancer

    Science.gov (United States)

    Bialas, Brygida; Fijalkowski, Marek; Raczek-Zwierzycka, Katarzyna

    2009-01-01

    Purpose The aim of this work is to analyze the efficacy and tolerance of preoperative intracavitary HDR brachytherapy (HDR-BT) in patients with IB and IIA cervical cancer. Material and methods 139 patients with cervical cancer IB-IIA with preoperative HDR-BT, out of which 60 patients with cervical cancer IB (43.2%) and 79 with IIA (56.8%) were treated since 1996 to 2002. In preoperative BT total dose to point A ranged from 30-45 Gy in 6-9 fractions twice a week. The fraction dose was 4-5 Gy at point A. Six weeks after BT all patients underwent radical Wertheim-Meigs hysterectomy. Patients with disadvantageous risk factors or with positive specimen histology had a complementary therapy: external-beam radiotherapy (EBRT) given to the whole pelvic volume in daily fractions of 2 Gy up to total dose of 36-52 Gy (20 patients) or EBRT with cisplatin-based chemotherapy with the dose of 30-40 mg/m2 in 5-7 fractions given weekly (7 patients) or chemotherapy (6 patients). Acute and late radiation toxicity was evaluated according to EORTC/RTOG. Results In postoperative specimen histopathology the number of 114 women (82%) had tumor-free specimen within brachytherapy target (in cervix and cavity), 96 women (60.1%) had tumor-free specimen both in and outside brachytherapy target (lymph nodes, parametra, adnexis). The 5-year and 10-year DFS were 93.8% and 88% for IB and 89.7% and 64.7% for IIA respectively. 7.9% of patients developed acute toxicity both in rectum and bladder (only in I and II grade of EORTC/RTOG). Late severe complication occurred in rectum in 2.2% of patients and in bladder 1.4%. Conclusions 1. Preoperative HDR-BT in patients with IB and IIA cervical cancer is an effective and well tolerated therapy with acceptable rate of side effects. 2. Preoperative HDR-BT followed by surgery in a group without risk factors is a sufficient treatment option with no additional adjuvant therapy requirement.

  17. SU-E-T-564: Multi-Helix Rotating Shield Brachytherapy for Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dadkhah, H; Wu, X [University of Iowa, Iowa City, IA (United States); Flynn, R; Kim, Y [University of Iowa Hospitals and Clinics, Iowa City, IA (United States)

    2015-06-15

    Purpose: To present a novel and practical brachytherapy technique, called multi-helix rotating shield brachytherapy (H-RSBT), for the precise positioning of a partial shield in a curved applicator. H-RSBT enables RSBT delivery using only translational motion of the radiation source/shield combination. H-RSBT overcomes the challenges associated with previously proposed RSBT approaches based on a serial (S-RSBT) step-and-shoot delivery technique, which required independent translational and rotational motion. Methods: A Fletcher-type applicator, compatible with the combination of a Xoft Axxent™ electronic brachytherapy source and a 0.5 mm thick tungsten shield, is proposed. The wall of the applicator contains six evenly-spaced helical keyways that rigidly define the emission direction of the shield as a function of depth. The shield contains three protruding keys and is attached to the source such that it rotates freely. S-RSBT and H-RSBT treatment plans with 180° and 45° azimuthal emission angles were generated for five cervical cancer patients representative of a wide range of high-risk clinical target volume (HR-CTV) shapes and applicator positions. The number of beamlets used in the treatment planning process was nearly constant for S-RSBT and H-RSBT by using dwell positions separated by 5 and 1.7 mm, respectively, and emission directions separated by 22.5° and 60°, respectively. For all the treatment plans the EQD2 of the HR-CTV was escalated until the EQD{sub 2cc} tolerance of either the bladder, rectum, or sigmoid colon was reached. Results: Treatment times for H-RSBT tended to be shorter than for S-RSBT, with changes of −38.47% to 1.12% with an average of −8.34%. The HR-CTV D{sub 90} changed by −8.81% to 2.08% with an average of −2.46%. Conclusion: H-RSBT is a mechanically feasible technique in the curved applicators needed for cervical cancer brachytherapy. S-RSBT and H-RSBT dose distributions were clinically equivalent for all patients

  18. Deformable anatomical templates for brachytherapy treatment planning in radiotherapy of cervical cancer

    Science.gov (United States)

    Christensen, Gary E.; Williamson, Jeffrey F.; Chao, K. S. C.; Miller, Michael I.; So, F. B.; Vannier, Michael W.

    1997-10-01

    This paper describes a new method to register serial, volumetric x-ray computed tomography (CT) data sets for tracking soft-tissue deformation caused by insertion of intracavity brachytherapy applicators to treat cervical cancer. 3D CT scans collected from the same patient with and without a brachytherapy applicator are registered to aid in computation of the radiation dose to tumor and normal tissue. The 3D CT image volume of pelvic anatomy with the applicator. Initial registration is accomplished by rigid alignment of the pelvic bones and non-rigid alignment of gray scale CT data and hand segmentations of the vagina, cervix, bladder, and rectum. A viscous fluid transformation model is used for non-rigid registration to allow for local, non-linear registration of the vagina, cervix, bladder, and rectum without disturbing the rigid registration of the bony pelvis and adjacent structures. Results are presented in which two 3D CT data sets of the same patient - imaged with and without a brachytherapy applicator - are registered.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-01

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

  20. Metronidazole in the treatment of cervical cancer using Cf-252 neutron brachytherapy

    International Nuclear Information System (INIS)

    Metronidazole was tested for its possible use in the Cf-252 brachytherapy of cervical cancer as a radiosensitizer and to deal with anaerobic pelvic infection. 15 patients were treated by only 14 were evaluable. All stages from stage IB-IVB were treated and complete local tumor regression was noted in all cases although it could take place very slowly. 5/14 (36%) are 1.5-3 year survivors but only among the patients with stage I-II disease. No unusual radio-enhancing action was observed but metronidazole appeared to be useful to treat the vaginal, cervix and uterine infections often associated with high stage disease and bulky, ulcerative or necrotic tumors

  1. Unified registration framework for cumulative dose assessment in cervical cancer across external beam radiotherapy and brachytherapy

    Science.gov (United States)

    Roy, Sharmili; Totman, John J.; Choo, Bok A.

    2016-03-01

    Dose accumulation across External Beam Radiotherapy (EBRT) and Brachytherapy (BT) treatment fractions in cervical cancer is extremely challenging due to structural dissimilarities and large inter-fractional anatomic deformations between the EBRT and BT images. The brachytherapy applicator and the bladder balloon, present only in the BT images, introduce missing structural correspondences for the underlying registration problem. Complex anatomical deformations caused by the applicator and the balloon, different rectum and bladder filling and tumor shrinkage compound the registration difficulties. Conventional free-form registration methods struggle to handle such topological differences. In this paper, we propose a registration pipeline that first transforms the original images to their distance maps based on segmentations of critical organs and then performs non-linear registration of the distance maps. The resulting dense deformation field is then used to transform the original anatomical image. The registration accuracy is evaluated on 27 image pairs from stage 2B-4A cervical cancer patients. The algorithm reaches a Hausdorff distance of close to 0:5 mm for the uterus, 2:2 mm for the bladder and 1:7 mm for the rectum when applied to (EBRT,BT) pairs, taken at time points more than three months apart. This generalized model-free framework can be used to register any combination of EBRT and BT images as opposed to methods in the literature that are tuned for either only (BT,BT) pair, or only (EBRT,EBRT) pair or only (BT,EBRT) pair. A unified framework for 3D dose accumulation across multiple EBRT and BT fractions is proposed to facilitate adaptive personalized radiation therapy.

  2. Quality assurance in MR image guided adaptive brachytherapy for cervical cancer: Final results of the EMBRACE study dummy run

    DEFF Research Database (Denmark)

    Kirisits, Christian; Federico, Mario; Nkiwane, Karen;

    2015-01-01

    PURPOSE: Upfront quality assurance (QA) is considered essential when starting a multicenter clinical trial in radiotherapy. Despite the long experience gained for external beam radiotherapy (EBRT) trials, there are only limited audit QA methods for brachytherapy (BT) and none include the specific...... aspects of image guided adaptive brachytherapy (IGABT). METHODS AND MATERIALS: EMBRACE is a prospective multicenter trial aiming to assess the impact of (MRI)-based IGABT in locally advanced cervical cancer. An EMBRACE dummy run was designed to identify sources and magnitude of uncertainties and errors...

  3. Quality Assurance of Multifractionated Pelvic Interstitial Brachytherapy for Postoperative Recurrences of Cervical Cancers: A Prospective Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate three-dimensional needle displacements during multifractionated interstitial brachytherapy (BT) for cervical cancers. Methods and Materials: Patients scheduled to undergo pelvic interstitial BT for postoperative and or postradiation vault recurrences were included from November 2009 to December 2010. All procedures were performed under spinal anesthesia. Postprocedure BT planning CT scans were obtained with patients in supine position with arms on the chest (interslice thickness of 3 mm). Thereafter, verification CT was repeated at every alternate fraction. Needle displacements were measured in reference to a relocatable bony point. The mean cranial, caudal, anteroposterior, and mediolateral displacements were recorded. Statistical significance of mean interfraction displacements was evaluated with Wilcoxon Test. Results: Twenty patients were included. Seventeen received boost BT (20 Gy/5 fractions/3 days) after external radiation, three received radical BT alone (36 Gy/9 fractions/5–8 days). An average of three scans (range, 2–3) were available per patient, and 357 needle displacements were analyzed. For the entire study cohort, the average of mean needle displacement was 2.5 mm (range, 0–7.4), 17.4 mm (range, 0–27.9), 1.7 mm (range, 0–6.7), 2.1 mm (range, 0–9.5), 1.7 mm (range, 0–9.3), and 0.6 mm (range, 0–7.8) in cranial, caudal, anterior, posterior, right, and left directions, respectively. The mean displacement in the caudal direction was higher between Days 1 and 2 than that between Days 2 and 3 (13.4 mm vs. 3.8 mm; p = 0.01). The average caudal displacements were no different between reirradiation and boost cohort (15.2 vs. 17.8 mm). Conclusions: Clinically significant caudal displacements occur during multifractionated pelvic brachytherapy. Optimal margins need to be incorporated while preplanning brachytherapy to account for interfraction displacements.

  4. 18F-fluorodeoxyglucose Positron Emisson Tomography/Computed Tomography Guided Conformal Brachytherapy for Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Heerim [Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Huh, Seung Jae, E-mail: sj5201.huh@samsung.com [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Ju, Sang Gyu; Park, Won; Lee, Jeong Eun [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choi, Joon Young; Kim, Byung-Tae [Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Chan Kyo; Park, Byung Kwan [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-09-01

    Purpose: To evaluate the feasibility of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT)-guided conformal brachytherapy treatment planning in patients with cervical cancer. Methods and Materials: Pretreatment FDG-PET/CT was performed for 12 patients with cervical cancer. Brachytherapy simulation was performed after an external-beam radiation therapy median dose of 4140 cGy. Patients underwent FDG-PET/CT scans with placement of tandem and ovoid applicators. The gross tumor volume (GTV) was determined by adjusting the window and level to a reasonable value and outlining the edge of the enhancing area, which was done in consultation with a nuclear medicine physician. A standardized uptake value profile of the tumor margin was taken for each patient relative to the maximum uptake value of each tumor and analyzed. The plan was designed to deliver 400 cGy to point A (point A plan) or to cover the clinical target volume (CTV) (PET/CT plan). Results: The median dose that encompassed 95% of the target volume (D95) of the CTV was 323.0 cGy for the point A plan vs 399.0 cGy for the PET/CT plan (P=.001). The maximum standardized uptake values (SUV{sub max}) of the tumors were reduced by a median of 57% (range, 13%-80%). All but 1 patient presented with discernable residual uptake within the tumors. The median value of the thresholds of the tumors contoured by simple visual analysis was 41% (range, 23%-71%). Conclusions: In this study, the PET/CT plan was better than the conventional point A plan in terms of target coverage without increasing the dose to the normal tissue, making optimized 3-dimensional brachytherapy treatment planning possible. In comparison with the previously reported study with PET or CT alone, we found that visual target localization was facilitated by PET fusion on indeterminate CT masses. Further studies are needed to characterize the metabolic activity detected during radiation therapy for more reliable targeting.

  5. Clinical Outcomes of Computed Tomography–Based Volumetric Brachytherapy Planning for Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Daniel R., E-mail: drsimpson@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Scanderbeg, Daniel J.; Carmona, Ruben; McMurtrie, Riley M.; Einck, John; Mell, Loren K. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); McHale, Michael T.; Saenz, Cheryl C.; Plaxe, Steven C.; Harrison, Terry [Department of Gynecologic Oncology, University of California San Diego, La Jolla, California (United States); Mundt, Arno J.; Yashar, Catheryn M. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)

    2015-09-01

    Purpose/Objectives: A report of clinical outcomes of a computed tomography (CT)-based image guided brachytherapy (IGBT) technique for treatment of cervical cancer. Methods and Materials: Seventy-six women with International Federation of Gynecology and Obstetrics stage IB to IVA cervical carcinoma diagnosed between 2007 and 2014 were treated with definitive external beam radiation therapy (EBRT) with or without concurrent chemotherapy followed by high-dose-rate (HDR) IGBT. All patients underwent planning CT simulation at each implantation. A high-risk clinical target volume (HRCTV) encompassing any visible tumor and the entire cervix was contoured on the simulation CT. When available, magnetic resonance imaging (MRI) was performed at implantation to assist with tumor delineation. The prescription dose was prescribed to the HRCTV. Results: The median follow-up time was 17 months. Thirteen patients (17%) had an MRI done before brachytherapy, and 16 patients (21%) were treated without MRI guidance. The mean EBRT/IGBT sum 2-Gy equivalent dose (EQD2) delivered to the 90% volume of the HRCTV was 86.3 Gy. The mean maximum EQD2s delivered to 2 cm{sup 3} of the rectum, sigmoid, and bladder were 67.5 Gy, 66.2 Gy, and 75.3 Gy, respectively. The 2-year cumulative incidences of local, locoregional, and distant failure were 5.8% (95% confidence interval [CI]: 1.4%-14.8%), 15.1% (95% CI: 5.4%-29.4%), and 24.3% (95% CI: 12.1%-38.9%), respectively. The 2-year overall and disease-free survival rates were 75% (95% CI, 61%-91%) and 73% (95% CI, 60%-90%), respectively. Twenty-nine patients (38%) experienced grade ≥2 acute toxicity, with 5 cases of acute grade 3 toxicity and no grade ≥4 toxicities. One patient experienced grade 3 gastrointestinal toxicity. No other late grade ≥3 events were observed. Conclusions: This is the largest report to date of CT/MRI-based IGBT for the treatment of cervical cancer. The results are promising, with excellent local control and acceptable

  6. Robotic radiosurgery as an alternative to brachytherapy for cervical cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Neumann, Oliver; Kluge, Anne; Lyubina, Olga; Wlodarczyk, Waldemar; Jahn, Ulrich; Budach, Volker; Marnitz, Simone [Charite University Hospital, Department of Radiation Oncology, Berlin (Germany); Koehler, Christhardt [Charite University Hospital, Department of Gynecology, Berlin (Germany); Kufeld, Markus [Charite CyberKnife Center, Berlin (Germany)

    2014-06-15

    To compare MRI-guided brachytherapy (BT) and two different dose prescriptions for robotic radiosurgery (RRS) in locally advanced cervical cancer. Eleven patients with FIGO stage IIB-IIIB cervical cancer underwent RRS instead of BT for various reasons. A total dose of 30 Gy was administered in five fractions. The maximum dose was chosen such that the prescribed dose was 70 % of the maximum dose (RRS{sub 70}). To simulate BT more closely, additional plan calculations were carried out for a higher maximum dose with the same enclosing dose of 30 Gy being now 25 % of the maximum dose (RRS{sub 25}). BT plans were calculated for the same patients (BT{sub RRS}). Finally, the resulting three sets of treatment plans were compared with 38 other patients treated with MRI-guided BT and the same dose prescription (BT{sub ref}). Plan comparisons were performed based on DVH parameters with regard to target coverage (V100), conformation number (CN), and sparing of the organs at risk (OARs). The best coverage of V100 = 100 ± 0 % was obtained with RRS{sub 25}, followed by RRS{sub 70} with 97.1 ± 2.7 %, BT{sub ref} with 90.9 ± 8.9 %, and the intraindividual BT{sub RRS} with 80.6 ± 6.4 %. The sparing of OARs was associated with D0.1 cc, D2 cc, and D5 cc to the rectum, sigmoid, and bladder walls. OAR doses were compliant with the GEC-ESTRO guidelines and comparable among RRS{sub 70}, RRS{sub 25}, BT{sub RRS}, and BT{sub ref}. By contrast, RRS{sub 25} could not fulfill these guidelines, exceeding considerably the tolerable dose constraints for the walls of the critical OARs. Despite of the excellent coverage and higher maximum dose, the unacceptably high exposure to the OARs disqualified RRS{sub 25} as an alternative for BT in cervical cancer patients. By contrast, RRS{sub 70} offered the best protection for the OARs, comparable to BT, and even better target coverage and conformity than BT. (orig.) [German] Vergleich der MRT-basierten Brachytherapie mit zwei unterschiedlichen

  7. Brachytherapy in Gynecologic Cancers: Why Is It Underused?

    Science.gov (United States)

    Han, Kathy; Viswanathan, Akila N

    2016-04-01

    Despite its established efficacy, brachytherapy is underused in the management of cervical and vaginal cancers in some parts of the world. Possible reasons for the underutilization of brachytherapy include the adoption of less invasive techniques, such as intensity-modulated radiotherapy; reimbursement policies favoring these techniques over brachytherapy; poor physician or patient access to brachytherapy; inadequate maintenance of brachytherapy skills among practicing radiation oncologists; transitioning to high-dose-rate (HDR) brachytherapy with increased time requirements; and insufficient training of radiation oncology residents.

  8. Stereotactic body radiation therapy via helical tomotherapy to replace brachytherapy for brachytherapy-unsuitable cervical cancer patients – a preliminary result

    Directory of Open Access Journals (Sweden)

    Hsieh CH

    2013-02-01

    Full Text Available Chen-Hsi Hsieh,1–3 Hui-Ju Tien,1 Sheng-Mou Hsiao,4 Ming-Chow Wei,4 Wen-Yih Wu,4 Hsu-Dong Sun,4 Li-Ying Wang,5 Yen-Ping Hsieh,6 Yu-Jen Chen,3,7–9 Pei-Wei Shueng1,101Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan; 2Department of Medicine, 3Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 4Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Taipei, Taiwan; 5School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; 6Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan; 7Department of Radiation Oncology, 8Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; 9Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan; 10Department of Radiation Oncology, National Defense Medical Center, Taipei, TaiwanAim: To review the experience and to evaluate the results of stereotactic body radiation therapy (SBRT via helical tomotherapy (HT, for the treatment of brachytherapy-unsuitable cervical cancer.Methods: Between September 1, 2008 to January 31, 2012, nine cervical cancer patients unsuitable for brachytherapy were enrolled. All of the patients received definitive whole pelvic radiotherapy with or without chemotherapy, followed by SBRT via HT.Results: The actuarial locoregional control rate at 3 years was 78%. The mean biological equivalent dose in 2-Gy fractions of the tumor, rectum, bladder, and intestines was 76.0 ± 7.3, 73.8 ± 13.2, 70.5 ± 10.0, and 43.1 ± 7.1, respectively. Only two had residual tumors after treatment, and the others were tumor-free. Two patients experienced grade 3 acute toxicity: one had diarrhea; and another experienced thrombocytopenia. There were no grade 3 or 4 subacute toxicities. Three patients suffered from manageable rectal bleeding in

  9. Clinical outcome and dosimetric parameters of chemo-radiation including MRI guided adaptive brachytherapy with tandem-ovoid applicators for cervical cancer patients: A single institution experience.

    NARCIS (Netherlands)

    Nomden, C.N.; Leeuw, A.A. de; Roesink, J.M.; Tersteeg, R.J.; Moerland, M.A.; Witteveen, P.O.; Schreuder, H.W.B.; Dorst, E.B. van; Jurgenliemk-Schulz, I.M.

    2013-01-01

    PURPOSE: To evaluate dosimetric parameters and clinical outcome for cervical cancer patients treated with chemo-radiation and MR-image guided adaptive brachytherapy (MR-IGABT) using tandem-ovoid applicators for intracavitary or combined intracavitary/interstitial approaches. METHOD: This retrospecti

  10. Current situation of high-dose-rate brachytherapy for cervical cancer in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Rogerio Matias Vidal da; Souza, Divanizia do Nascimento, E-mail: rmv.fisica@gmail.com [Universidade Federal de Sergipe (UFS), Sao Cristovao, SE (Brazil); Pinezi, Juliana Castro Dourado [Pontificia Universidade Catolica de Goias (PUC-Goias), Goiania, GO (Brazil); Macedo, Luiz Eduardo Andrade [Hospital Chama, Arapiraca, AL (Brazil)

    2014-05-15

    To assess the current situation of high-dose-rate (HDR) brachytherapy for cancer of the cervix in Brazil, regarding apparatuses, planning methods, prescription, fractionation schedule and evaluation of dose in organs at risk. Materials and methods: in the period between March/2012 and May/2013, a multiple choice questionnaire was developed and sent to 89 Brazilian hospitals which perform HDR brachytherapy. Results: sixty-one services answered the questionnaire. All regions of the country experienced a sharp increase in the number of HDR brachytherapy services in the period from 2001 to 2013. As regards planning, although a three-dimensional planning software was available in 91% of the centers, conventional radiography was mentioned by 92% of the respondents as their routine imaging method for such a purpose. Approximately 35% of respondents said that brachytherapy sessions are performed after teletherapy. The scheme of four 7 Gy intracavitary insertions was mentioned as the most frequently practiced. Conclusion: the authors observed that professionals have difficulty accessing adjuvant three-dimensional planning tools such as computed tomography and magnetic resonance imaging. (author)

  11. Study of forty-three patients treated with HDR or LDR pre-operative brachytherapy for IIb cervical cancer

    International Nuclear Information System (INIS)

    We have studied 43 patients with IIB cervical cancer who were underwent to pre-operatory treatment. The biological effects between both modalities of treatment were analysed. All patient received EBRT to a total dose of 45Gy - fx 1,8Gy plus brachytherapy. EBRT was performed with a Linac 4MV, in box arrangement. The Brachytherapy was performed through Fletcher Colpostats in association with intrauterine tamdens, in both arms. Brachytherapy starts in HDR group after ten days of the beginning of the treatment. The scheme was the following: 1-HDR - 2 weekly insertions of 6,0Gy at point A 2-LDR - one insertiont of 15Gy at point A. Four to six weeks after the end of the irradiation course, we performed the surgical procedure with Total Hysterectomy and Salpingoforectomy (Piver second level). Results: - HDR - No residual tumor - 21/35 -60% Residual tumor - 14/35 - 40% Negative linph. - 29/35 - 83% Positive linph.- 05/35 - 14% LDR - No residual tumor - 05/08 - 62.5% Residual tumor - 03/08 - 37.5% Negative linph. - 06/08 - 75% Positive linph. - 02/08 - 25% Conclusions - This avaliation showed that local control and survival in HDR and LDR are similar. Treatment with HDR devices are safer for patients and staff, with no need of anesthesia

  12. Interfractional change of high-risk CTV D90 during image-guided brachytherapy for uterine cervical cancer.

    Science.gov (United States)

    Ohkubo, Yu; Ohno, Tatsuya; Noda, Shin-ei; Kubo, Nobuteru; Nakagawa, Akiko; Kawahara, Masahiro; Abe, Takanori; Kiyohara, Hiroki; Wakatsuki, Masaru; Nakano, Takashi

    2013-11-01

    The purpose of this study was to evaluate interfractional changes of the minimum dose delivered to 90% of the high-risk clinical target volume (HR-CTV D90) and D2cc of the bladder and rectum during brachytherapy for uterine cervical cancer patients. A total of 52 patients received external beam radiotherapy and high-dose-rate intracavitary brachytherapy (ICBT). For each of four ICBT applications, a pelvic CT scan was performed and the HR-CTV was delineated. Retrospectively, these patients were divided into two groups: (i) the standard dose group with 6 Gy to point A in each ICBT, and (ii) the adaptive dose group with a modified dose to point A to cover the HR-CTV with the 6-Gy isodose line as much as possible. The HR-CTV D90 was assessed in every session, and analyzed as interfractional changes. In the standard dose group, the interfractional changes of the HR-CTV D90 showed a linear increase from the first to the third of the four ICBT (average 6.1, 6.6, 7.0 and 7.1 Gy, respectively). In contrast, those of the adaptive dose group remained almost constant (average 7.2, 7.2, 7.3 and 7.4 Gy, respectively). Especially, in the case of a large HR-CTV volume (≥35 cm(3)) at first ICBT, the total HR-CTV D90 of the adaptive dose group with brachytherapy was significantly higher than that of the standard dose group. There were no significant differences in total D2cc in bladder and rectum between the two groups. Image-guided adaptive brachytherapy based on interfractional tumor volume change improves the dose to the HR-CTV while keeping rectal and bladder doses within acceptable levels. PMID:23732770

  13. Comparison of Dose When Prescribed to Point A and Point H for Brachytherapy in Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gang, Ji Hyeong; Gim, Il Hwan; Hwang, Seon Boong; Kim, Woong; Im, Hyeong Seo; Gang, Jin Mook; Gim, Gi Hwan; Lee, Ah Ram [Dept. of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seou (Korea, Republic of)

    2012-09-15

    The purpose of this study is to compare plans prescribed to point A with these prescribed to point H recommended by ABS (American Brachytherapy Society) in high dose rate intracavitary brachytherapy for cervical carcinoma. This study selected 103 patients who received HDR (High Dose Rate) brachytherapy using tandem and ovoids from March 2010 to January 2012. Point A, bladder point, and rectal point conform with Manchester System. Point H conforms with ABS recommendation. Also Sigmoid colon point, and vagina point were established arbitrarily. We examined distance between point A and point H. The percent dose at point A was calculated when 100% dose was prescribed to point H. Additionally, the percent dose at each reference points when dose is prescribed to point H and point A were calculated. The relative dose at point A was lower when point H was located inferior to point A. The relative doses at bladder, rectal, sigmoid colon, and vagina points were higher when point H was located superior to point A, and lower when point H was located inferior to point A. This study found out that as point H got located much superior to point A, the absorbed dose of surrounding normal organs became higher, and as point H got located much inferior to point A, the absorbed dose of surrounding normal organs became lower. This differences dose not seem to affect the treatment. However, we suggest this new point is worth being considered for the treatment of HDR if dose distribution and absorbed dose at normal organs have large differences between prescribed to point A and H.

  14. Dosimetric analysis of 3D image-guided HDR brachytherapy planning for the treatment of cervical cancer: is point A-based dose prescription still valid in image-guided brachytherapy?

    Science.gov (United States)

    Kim, Hayeon; Beriwal, Sushil; Houser, Chris; Huq, M Saiful

    2011-01-01

    The purpose of this study was to analyze the dosimetric outcome of 3D image-guided high-dose-rate (HDR) brachytherapy planning for cervical cancer treatment and compare dose coverage of high-risk clinical target volume (HRCTV) to traditional Point A dose. Thirty-two patients with stage IA2-IIIB cervical cancer were treated using computed tomography/magnetic resonance imaging-based image-guided HDR brachytherapy (IGBT). Brachytherapy dose prescription was 5.0-6.0 Gy per fraction for a total 5 fractions. The HRCTV and organs at risk (OARs) were delineated following the GYN GEC/ESTRO guidelines. Total doses for HRCTV, OARs, Point A, and Point T from external beam radiotherapy and brachytherapy were summated and normalized to a biologically equivalent dose of 2 Gy per fraction (EQD2). The total planned D90 for HRCTV was 80-85 Gy, whereas the dose to 2 mL of bladder, rectum, and sigmoid was limited to 85 Gy, 75 Gy, and 75 Gy, respectively. The mean D90 and its standard deviation for HRCTV was 83.2 ± 4.3 Gy. This is significantly higher (p IGBT in HDR cervical cancer treatment needs advanced concept of evaluation in dosimetry with clinical outcome data about whether this approach improves local control and/or decreases toxicities. PMID:20488690

  15. MRI-Guided High–Dose-Rate Intracavitary Brachytherapy for Treatment of Cervical Cancer: The University of Pittsburgh Experience

    Energy Technology Data Exchange (ETDEWEB)

    Gill, Beant S.; Kim, Hayeon; Houser, Christopher J. [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Kelley, Joseph L.; Sukumvanich, Paniti; Edwards, Robert P.; Comerci, John T.; Olawaiye, Alexander B.; Huang, Marilyn; Courtney-Brooks, Madeleine [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

    2015-03-01

    Purpose: Image-based brachytherapy is increasingly used for gynecologic malignancies. We report early outcomes of magnetic resonance imaging (MRI)-guided brachytherapy. Methods and Materials: Consecutive patient cases with FIGO stage IB1 to IVA cervical cancer treated at a single institution were retrospectively reviewed. All patients received concurrent cisplatin with external beam radiation therapy along with interdigitated high–dose-rate intracavitary brachytherapy. Computed tomography or MRI was completed after each application, the latter acquired for at least 1 fraction. High-risk clinical target volume (HRCTV) and organs at risk were identified by Groupe Européen de Curiethérapie and European SocieTy for Radiotherapy and Oncology guidelines. Doses were converted to equivalent 2-Gy doses (EQD{sub 2}) with planned HRCTV doses of 75 to 85 Gy. Results: From 2007 to 2013, 128 patients, median 52 years of age, were treated. Predominant characteristics included stage IIB disease (58.6%) with a median tumor size of 5 cm, squamous histology (82.8%), and no radiographic nodal involvement (53.1%). Most patients (67.2%) received intensity modulated radiation therapy (IMRT) at a median dose of 45 Gy, followed by a median brachytherapy dose of 27.5 Gy (range, 25-30 Gy) in 5 fractions. At a median follow up of 24.4 months (range, 2.1-77.2 months), estimated 2-year local control, disease-free survival, and cancer-specific survival rates were 91.6%, 81.8%, and 87.6%, respectively. Predictors of local failure included adenocarcinoma histology (P<.01) and clinical response at 3 months (P<.01). Among the adenocarcinoma subset, receiving HRCTV D{sub 90} EQD{sub 2} ≥84 Gy was associated with improved local control (2-year local control rate 100% vs 54.5%, P=.03). Grade 3 or greater gastrointestinal or genitourinary late toxicity occurred at a 2-year actuarial rate of 0.9%. Conclusions: This study constitutes one of the largest reported series of MRI

  16. Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Georg, P.; Georg, D.; Poetter, R.; Doerr, W. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Medical University Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology; Medical University Vienna/ AKH Wien (Austria). Comprehensive Cancer Centre; Boni, A.; Ghabuous, A. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Goldner, G.; Schmid, M.P. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Medical University Vienna/ AKH Wien (Austria). Comprehensive Cancer Centre

    2013-07-15

    Background and purpose: To analyze the time course of late rectal- and urinary bladder complications after brachytherapy for cervical cancer and to compare the incidence- and prevalence rates thereof. Patients and methods: A total of 225 patients were treated with external-beam radiotherapy (EBRT) and magnetic resonance imaging (MRI)-guided brachytherapy with or without chemotherapy. Late side effects were assessed prospectively using the Late Effects in Normal Tissue - Subjective, Objective, Management and Analytic (LENT/SOMA) scale. The parameters analyzed were time to onset, duration, actuarial incidence- (occurrence of new side effects during a defined time period) and prevalence rates (side effects existing at a defined time point). Results: Median follow-up was 44 months. Side effects (grade 1-4) in rectum and bladder were present in 31 and 49 patients, 14 and 27 months (mean time to onset) after treatment, respectively. All rectal and 76 % of bladder side effects occurred within 3 years after radiotherapy. Mean duration of rectal events was 19 months; 81 % resolved within 3 years of their initial diagnosis. Mean duration of bladder side effects was 20 months; 61 % resolved within 3 years. The 3- and 5-year actuarial complication rates were 16 and 19 % in rectum and 18 and 28 % in bladder, respectively. The corresponding prevalence rates were 9 and 2 % (rectum) and 18 and 21 % (bladder), respectively. Conclusion: Late side effects after cervical cancer radiotherapy are partially reversible, but their time course is organ-dependent. The combined presentation of incidence- and prevalence rates provides the most comprehensive information. (orig.)

  17. A questionnaire-based survey on 3D image-guided brachytherapy for cervical cancer in Japan. Advances and obstacles

    International Nuclear Information System (INIS)

    The purpose of this study is to survey the current patterns of practice, and barriers to implementation, of 3D image-guided brachytherapy (3D-IGBT) for cervical cancer in Japan. A 30-item questionnaire was sent to 171 Japanese facilities where high-dose-rate brachytherapy devices were available in 2012. In total, 135 responses were returned for analysis. Fifty-one facilities had acquired some sort of 3D imaging modality with applicator insertion, and computed tomography (CT) and magnetic resonance imaging (MRI) were used in 51 and 3 of the facilities, respectively. For actual treatment planning, X-ray films, CT and MRI were used in 113, 20 and 2 facilities, respectively. Among 43 facilities where X-ray films and CT or MRI were acquired with an applicator, 29 still used X-ray films for actual treatment planning, mainly because of limited time and/or staffing. In a follow-up survey 2.5 years later, respondents included 38 facilities that originally used X-ray films alone but had indicated plans to adopt 3D-IGBT. Of these, 21 had indeed adopted CT imaging with applicator insertion. In conclusion, 3D-IGBT (mainly CT) was implemented in 22 facilities (16%) and will be installed in 72 (53%) facilities in the future. Limited time and staffing were major impediments. (author)

  18. Dosimetric impact of applicator displacement during high dose rate (HDR) Cobalt-60 brachytherapy for cervical cancer: A planning study

    Science.gov (United States)

    Yong, J. S.; Ung, N. M.; Jamalludin, Z.; Malik, R. A.; Wong, J. H. D.; Liew, Y. M.; Ng, K. H.

    2016-02-01

    We investigated the dosimetric impact of applicator displacement on dose specification during high dose rate (HDR) Cobalt-60 (Co-60) brachytherapy for cervical cancer through a planning study. Eighteen randomly selected HDR full insertion plans were restrospectively studied. The tandem and ovoids were virtually shifted translationally and rotationally in the x-, y- and z-axis directions on the treatment planning system. Doses to reference points and volumes of interest in the plans with shifted applicators were compared with the original plans. The impact of dose displacement on 2D (point-based) and 3D (volume-based) treatment planning techniques was also assessed. A ±2 mm translational y-axis applicator shift and ±4° rotational x-axis applicator shift resulted in dosimetric changes of more than 5% to organs at risk (OAR) reference points. Changes to the maximum doses to 2 cc of the organ (D2cc) in 3D planning were statistically significant and higher than the reference points in 2D planning for both the rectum and bladder (p<0.05). Rectal D2cc was observed to be the most sensitive to applicator displacement among all dose metrics. Applicator displacement that is greater than ±2 mm translational y-axis and ±4° rotational x-axis resulted in significant dose changes to the OAR. Thus, steps must be taken to minimize the possibility of applicator displacement during brachytherapy.

  19. A questionnaire-based survey on 3D image-guided brachytherapy for cervical cancer in Japan: advances and obstacles.

    Science.gov (United States)

    Ohno, Tatsuya; Toita, Takafumi; Tsujino, Kayoko; Uchida, Nobue; Hatano, Kazuo; Nishimura, Tetsuo; Ishikura, Satoshi

    2015-11-01

    The purpose of this study is to survey the current patterns of practice, and barriers to implementation, of 3D image-guided brachytherapy (3D-IGBT) for cervical cancer in Japan. A 30-item questionnaire was sent to 171 Japanese facilities where high-dose-rate brachytherapy devices were available in 2012. In total, 135 responses were returned for analysis. Fifty-one facilities had acquired some sort of 3D imaging modality with applicator insertion, and computed tomography (CT) and magnetic resonance imaging (MRI) were used in 51 and 3 of the facilities, respectively. For actual treatment planning, X-ray films, CT and MRI were used in 113, 20 and 2 facilities, respectively. Among 43 facilities where X-ray films and CT or MRI were acquired with an applicator, 29 still used X-ray films for actual treatment planning, mainly because of limited time and/or staffing. In a follow-up survey 2.5 years later, respondents included 38 facilities that originally used X-ray films alone but had indicated plans to adopt 3D-IGBT. Of these, 21 had indeed adopted CT imaging with applicator insertion. In conclusion, 3D-IGBT (mainly CT) was implemented in 22 facilities (16%) and will be installed in 72 (53%) facilities in the future. Limited time and staffing were major impediments. PMID:26265660

  20. Posttraumatic Stress Disorder After High-Dose-Rate Brachytherapy for Cervical Cancer With 2 Fractions in 1 Application Under Spinal/Epidural Anesthesia: Incidence and Risk Factors

    International Nuclear Information System (INIS)

    Purpose: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. Methods and Materials: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale–Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. Results: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. Conclusions: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful

  1. Posttraumatic Stress Disorder After High-Dose-Rate Brachytherapy for Cervical Cancer With 2 Fractions in 1 Application Under Spinal/Epidural Anesthesia: Incidence and Risk Factors

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Czajka-Pepl, Agnieszka [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Ponocny-Seliger, Elisabeth [Department of Psychology, Sigmund Freud Private University Vienna, Vienna (Austria); Scharbert, Gisela; Wetzel, Léonore [Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Nout, Remi A. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Sturdza, Alina [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Dimopoulos, Johannes C. [Metropolitan Hospital, Athens (Greece); Dörr, Wolfgang; Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria)

    2014-06-01

    Purpose: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. Methods and Materials: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale–Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. Results: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. Conclusions: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful

  2. CT based three dimensional dose-volume evaluations for high-dose rate intracavitary brachytherapy for cervical cancer

    Science.gov (United States)

    2014-01-01

    Background In this study, high risk clinical target volumes (HR-CTVs) according to GEC-ESTRO guideline were contoured retrospectively based on CT images taken at the time of high-dose rate intracavitary brachytherapy (HDR-ICBT) and correlation between clinical outcome and dose of HR-CTV were analyzed. Methods Our study population consists of 51 patients with cervical cancer (Stages IB-IVA) treated with 50 Gy external beam radiotherapy (EBRT) using central shield combined with 2–5 times of 6 Gy HDR-ICBT with or without weekly cisplatin. Dose calculation was based on Manchester system and prescribed dose of 6 Gy were delivered for point A. CT images taken at the time of each HDR-ICBT were reviewed and HR-CTVs were contoured. Doses were converted to the equivalent dose in 2 Gy (EQD2) by applying the linear quadratic model (α/β = 10 Gy). Results Three-year overall survival, Progression-free survival, and local control rate was 82.4%, 85.3% and 91.7%, respectively. Median cumulative dose of HR-CTV D90 was 65.0 Gy (52.7-101.7 Gy). Median length from tandem to the most lateral edge of HR-CTV at the first ICBT was 29.2 mm (range, 18.0-51.9 mm). On univariate analysis, both LCR and PFS was significantly favorable in those patients D90 for HR-CTV was 60 Gy or greater (p = 0.001 and 0.03, respectively). PFS was significantly favorable in those patients maximum length from tandem to edge of HR-CTV at first ICBT was shorter than 3.5 cm (p = 0.042). Conclusion Volume-dose showed a relationship to the clinical outcome in CT based brachytherapy for cervical carcinoma. PMID:24938757

  3. [Brachytherapy].

    Science.gov (United States)

    Itami, Jun

    2014-12-01

    Brachytherapy do require a minimal expansion of CTV to obtain PTV and it is called as ultimate high precision radiation therapy. In high-dose rate brachytherapy, applicators will be placed around or into the tumor and CT or MRI will be performed with the applicators in situ. With such image-guided brachytherapy (IGBT) 3-dimensional treatment planning becomes possible and DVH of the tumor and organs at risk can be obtained. It is now even possible to make forward planning satisfying dose constraints. Traditional subjective evaluation of brachytherapy can be improved to the objective one by IGBT. Brachytherapy of the prostate cancer, cervical cancer, and breast cancer with IGBT technique was described. PMID:25596048

  4. Analysis of the Survival Rate with Cervical Cancer Using 137Cs and 192Ir Aftedoading Brachytherapy

    Institute of Scientific and Technical Information of China (English)

    GuixioZhou; GuoxiongChen; DemeiMa; JianpingSun; LinMa

    2004-01-01

    OBJECTIVE To analyze and compare the survival rate for stages Ⅱ and Ⅲ cervical cancer treated by external irradiation plus 137Cs or 192Ir. METHODS The patients with cervical cancer were treated by external irradiation plus 137Cs (group A, 427 patients) or plus 192Ir (group B, 156 patients). There were 170 stage Ⅱ cases and 413 stage Ⅲ cases. The number of cancer types were as follows: squamous cell carcinoma, 524; adenocarcinoma, 34; and adenosquamous cell carcinoma, 25. The two groups received the same external irradiation using 8 or 10 MV of X-ray. After the whole pelvis received 25-35 Gy, the focus was given a total of 45-55 Gy by four divided fields. Intracavitary irradiation was performed with one fraction of 6-7 Gy in reference dose at A point every week and a total dose of 40-60 Gy with 6-8 fractions for group A; every fraction of 5-6 Gy in reference dose of A point and total dose of 30-42 Gy with 5-7 fractions for group B.RESULTS The 5-year survival rate of stage Ⅱ and Ⅲ, and total were 82.9%, 62.2%, and 67.2% for group A respectively and 85.1%, 61.5% and 69.2% for group B respectively. There were significant differences between stage Ⅱ and Ⅲ in each group (P 0.05). The late complications of the therapy were rectitis and urocystitis and with an incidence rate of 7.3% and 6.3% for group A and 9.6% and 9.0% for group B (P> 0.05). CONCLUSION The long-term survival rate and complications of stages Ⅱ and Ⅲ cervical cancer are similar when treated with external irradiation plus 137Cs or plus 192Ir.

  5. Preliminary results of concurrent chemotherapy and radiation therapy using high-dose-rate brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ja; Lee, Ji Hye; Lee, Re Na; Suh, Hyun Suk [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2006-09-15

    To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range 34 {approx} 74) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follow: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of 45 {approx} 50.4 Gy (median: 50.4 Gy) over 5 {approx} 5.5 weeks. Ir-192 HDR intracavity brachytherapy (ICBT) was given after a total dose of 41.1 Gy. HDR-ICBT was performed twice a week, with a fraction point. A dose of 4 Gy and median dose to point A was 28 Gy (range: 16 {approx} 32 Gy) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT + ICBT) was 88 Gy{sub 10} (range:77 {approx} 94 Gy{sub 10}). The median cumulative BED at ICRU 38 reference point (EBRT + ICBT) was 131 Gy{sub 3} (range: 122 {approx} 140 Gy{sub 3}) at point A, 109 Gy{sub 3} (range:88{approx} 125 Gy{sub 3}) at the rectum and 111 Gy{sub 3} (range: 91 {approx} 123 Gy{sub 3}) at the urinary bladder. Cisplatin (60 mg/m{sup 2}) and 5-FU (1,000 mg/m{sup 2}) was administered intravenously at 2 weeks interval from the first day of radiation for median 5 (range:2 {approx} 6) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range:8{approx} 50 months). The complete response rate after concurrent chemo radiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure

  6. Implant strategies for endocervical and interstitial ultrasound hyperthermia adjunct to HDR brachytherapy for the treatment of cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wootton, Jeffery H; Prakash, Punit; Hsu, I-Chow Joe; Diederich, Chris J, E-mail: CDiederich@radonc.ucsf.edu [Department of Radiation Oncology, University of California, San Francisco, CA 94115 (United States)

    2011-07-07

    Catheter-based ultrasound devices provide a method to deliver 3D conformable heating integrated with HDR brachytherapy delivery. Theoretical characterization of heating patterns was performed to identify implant strategies for these devices which can best be used to apply hyperthermia to cervical cancer. A constrained optimization-based hyperthermia treatment planning platform was used for the analysis. The proportion of tissue {>=}41 deg. C in a hyperthermia treatment volume was maximized with constraints T{sub max} {<=} 47 deg. C, T{sub rectum} {<=} 41.5 deg. C, and T{sub bladder} {<=} 42.5 deg. C. Hyperthermia treatment was modeled for generalized implant configurations and complex configurations from a database of patients (n = 14) treated with HDR brachytherapy. Various combinations of endocervical (360{sup 0} or 2 x 180{sup 0} output; 6 mm OD) and interstitial (180{sup 0}, 270{sup 0}, or 360{sup 0} output; 2.4 mm OD) applicators within catheter locations from brachytherapy implants were modeled, with perfusion constant (1 or 3 kg m{sup -3} s{sup -1}) or varying with location or temperature. Device positioning, sectoring, active length and aiming were empirically optimized to maximize thermal coverage. Conformable heating of appreciable volumes (>200 cm{sup 3}) is possible using multiple sectored interstitial and endocervical ultrasound devices. The endocervical device can heat >41 deg. C to 4.6 cm diameter compared to 3.6 cm for the interstitial. Sectored applicators afford tight control of heating that is robust to perfusion changes in most regularly spaced configurations. T{sub 90} in example patient cases was 40.5-42.7 deg. C (1.9-39.6 EM{sub 43deg.C}) at 1 kg m{sup -3} s{sup -1} with 10/14 patients {>=}41 deg. C. Guidelines are presented for positioning of implant catheters during the initial surgery, selection of ultrasound applicator configurations, and tailored power schemes for achieving T{sub 90} {>=} 41 deg. C in clinically practical implant

  7. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  8. Intra-fraction uncertainties of MRI guided brachytherapy in patients with cervical cancer

    International Nuclear Information System (INIS)

    Dosimetric intra-fraction uncertainties in MRI-guided brachytherapy were analysed for HR-CTV and OARs. While dose differences were generally small, individual outliers occurred. In contrast to HDR, patients treated with PDR show increased mean rectal dose over time. Re-imaging prior to dose delivery helps to detect unfavorable anatomical changes, and allows for intervention

  9. Dose-volume parameters and clinical outcome of CT-guided freehand high-dose-rate interstitial brachytherapy for cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Yi Wang; Wei-Jun Ye; Le-Hui Du; Ai-Ju Li; Yu-Feng Ren; Xin-Ping Cao

    2012-01-01

    Currently,image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer.In this study,we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-doserate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach.Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer.Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied.With a median of 5 (range,4-7) implanted needles for each patient,the median dose of brachytherapy alone delivered to 90% of the target volume (D90) was 45 (range,33-54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range,20-36)Gyα/β10 for intermediate-risk clinical target volume (IR-CTV).The percentage of the CTV covered by the prescribed dose (V100) of HR-CTV with brachytherapy alone was 81.9%-99.2% (median,96.7%).With an additional dose of external beam radiotherapy (EBRT),the median D90 was 94 (range,83-104) Gyα/β10 for HR-CTV and 77 (range,70-87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100) was 75 (range,66-84) Gyα/β10 for HR-CTV and 65 (range,57-73) Gyα/β10 for IR-CTV.The minimum dose to the most irradiated 2 cc volume (D2cc) was 73-96 (median,83) Gyα/β3 for the bladder,64-98 (median,73) Gyα/β3 for the rectum,and 52-69 (median,61) Gyα/β3 for the sigmoid colon.After a median follow-up of 15 months (range,3-24 months),two patients experienced local failure,and 1 showed internal lilac nodal metastasis.Despite the relatively small number of needles used,CT-guided HDRISBT for cervical cancer showed favorable DVH parameters and clinical outcome.

  10. Radiotherapy of Cervical Cancer.

    Science.gov (United States)

    Vordermark, Dirk

    2016-01-01

    Curative-intent radical radiotherapy of cervical cancer consists of external-beam radiotherapy, brachytherapy, and concomitant chemotherapy with cisplatin. For each element, new developments aim to improve tumor control rates or treatment tolerance. Intensity-modulated radiotherapy (IMRT) has been shown to reduce gastrointestinal toxicity and can be used to selectively increase the radiotherapy dose. Individualized, image-guided brachytherapy enables better adaptation of high-dose volumes to the tumor extension. Intensification of concomitant or sequential systemic therapy is under evaluation. PMID:27614991

  11. Assessment of radiation doses to the para-aortic, pelvic, and inguinal lymph nodes delivered by image-guided adaptive brachytherapy in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Mohamed, Sandy M I; Aagaard, Torben; Fokdal, Lars U;

    2015-01-01

    PURPOSE: This study evaluated the dose delivered to lymph nodes (LNs) by brachytherapy (BT) and the effect of BT image-guided optimization on the LN dose. METHODS AND MATERIALS: Twenty-five patients with locally advanced cervical cancer were retrospectively analyzed, 16 patients of them had LN...... involvement. The patients received whole pelvis intensity-modulated radiation therapy (45-50 Gy/25-30 fx) to whole pelvis and two fractions of MRI pulsed-dose-rate BT. The delineated LN groups were para-aortic, inguinal, common iliac (CI), external iliac, internal iliac, obturator, and presacral. For each LN...

  12. Apparent diffusion coefficients in GEC ESTRO target volumes for image guided adaptive brachytherapy of locally advanced cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Haack, Soeren (Dept. of Clinical Engineering, Aarhus Univ. Hospital (Denmark)), E-mail: Soeren.haack@stab.rm.dk; Morre Pedersen, Erik (Dept. of Radiology, Aarhus Sygehus, Aarhus Univ. Hospital (Denmark)); Jespersen, Sune N. (Center of Functionally Integrative Neuroscience, Aarhus Univ. Hospital (Denmark)); Kallehauge, Jesper F. (Dept. of Medical Physics, Aarhus Univ. Hospital (Denmark)); Lindegaard, Jacob Christian; Tanderup, Kari (Dept. of Oncology Aarhus Univ. Hospital (Denmark))

    2010-10-15

    Background and purpose. T2 weighted MRI is recommended for image guided adaptive brachytherapy (IGABT) in cervical cancer. Diffusion weighted imaging (DWI) and the derived apparent diffusion coefficient (ADC) may add additional biological information on tumour cell density. The purpose of this study was to evaluate the distribution of the ADC within target volumes as recommended by GEC-ESTRO: Gross Tumour Volume at BT (GTVBT), High-Risk Clinical Tumour Volume (HR-CTV) and Intermediate-Risk Clinical Target Volume (IR-CTV) and to evaluate the change of diffusion between fractions of IGABT. Material and methods. Fifteen patients with locally advanced cervical cancer were examined by MRI before their first (BT1) and second (BT2) fraction of IGABT, resulting in a total of 30 MR examinations including both T2 weighted and DWI sequences. The Apparent Diffusion Coefficient (ADC) was calculated by use of three levels of b-values (0, 600, 1000 s/mm2). ADC maps were constructed and fused with the GEC ESTRO target contours. The mean ADC value within each target volume was calculated. Furthermore, volumes of low diffusion (ADClow) were defined based on an ADC threshold of 1.2 x 10-3 mm2/s, and overlap with target volumes was evaluated. Change of ADC level in target volumes and change of ADClow volume from BT1 to BT2 was also evaluated. Results. The mean ADC was significantly lower in GTVBT than in HR-CTV (p<0.001) which again was significantly lower than in IR-CTV (p<0.001). There was no significant change of the ADClow volume or ADC level within each target structure between BT1 and BT2 (p=0.242). All three GEC-ESTRO volumes contained volumes with low diffusion. The GTVBT contained 37.2% volume of low diffusion, HR-CTV 20.3% and IR-CTV 10.8%. Conclusion. With DWI we were able to find a significant difference in ADC-values for the three different GEC ESTRO targets. This supports the assumption that the target volumes used for dose prescription in IGABT contain tissues with

  13. Improving anatomical mapping of complexly deformed anatomy for external beam radiotherapy and brachytherapy dose accumulation in cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vásquez Osorio, Eliana M., E-mail: e.vasquezosorio@erasmusmc.nl; Kolkman-Deurloo, Inger-Karine K.; Schuring-Pereira, Monica; Zolnay, András; Heijmen, Ben J. M.; Hoogeman, Mischa S. [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam 3075 (Netherlands)

    2015-01-15

    Purpose: In the treatment of cervical cancer, large anatomical deformations, caused by, e.g., tumor shrinkage, bladder and rectum filling changes, organ sliding, and the presence of the brachytherapy (BT) applicator, prohibit the accumulation of external beam radiotherapy (EBRT) and BT dose distributions. This work proposes a structure-wise registration with vector field integration (SW+VF) to map the largely deformed anatomies between EBRT and BT, paving the way for 3D dose accumulation between EBRT and BT. Methods: T2w-MRIs acquired before EBRT and as a part of the MRI-guided BT procedure for 12 cervical cancer patients, along with the manual delineations of the bladder, cervix-uterus, and rectum-sigmoid, were used for this study. A rigid transformation was used to align the bony anatomy in the MRIs. The proposed SW+VF method starts by automatically segmenting features in the area surrounding the delineated organs. Then, each organ and feature pair is registered independently using a feature-based nonrigid registration algorithm developed in-house. Additionally, a background transformation is calculated to account for areas far from all organs and features. In order to obtain one transformation that can be used for dose accumulation, the organ-based, feature-based, and the background transformations are combined into one vector field using a weighted sum, where the contribution of each transformation can be directly controlled by its extent of influence (scope size). The optimal scope sizes for organ-based and feature-based transformations were found by an exhaustive analysis. The anatomical correctness of the mapping was independently validated by measuring the residual distances after transformation for delineated structures inside the cervix-uterus (inner anatomical correctness), and for anatomical landmarks outside the organs in the surrounding region (outer anatomical correctness). The results of the proposed method were compared with the results of the

  14. Improving anatomical mapping of complexly deformed anatomy for external beam radiotherapy and brachytherapy dose accumulation in cervical cancer

    International Nuclear Information System (INIS)

    Purpose: In the treatment of cervical cancer, large anatomical deformations, caused by, e.g., tumor shrinkage, bladder and rectum filling changes, organ sliding, and the presence of the brachytherapy (BT) applicator, prohibit the accumulation of external beam radiotherapy (EBRT) and BT dose distributions. This work proposes a structure-wise registration with vector field integration (SW+VF) to map the largely deformed anatomies between EBRT and BT, paving the way for 3D dose accumulation between EBRT and BT. Methods: T2w-MRIs acquired before EBRT and as a part of the MRI-guided BT procedure for 12 cervical cancer patients, along with the manual delineations of the bladder, cervix-uterus, and rectum-sigmoid, were used for this study. A rigid transformation was used to align the bony anatomy in the MRIs. The proposed SW+VF method starts by automatically segmenting features in the area surrounding the delineated organs. Then, each organ and feature pair is registered independently using a feature-based nonrigid registration algorithm developed in-house. Additionally, a background transformation is calculated to account for areas far from all organs and features. In order to obtain one transformation that can be used for dose accumulation, the organ-based, feature-based, and the background transformations are combined into one vector field using a weighted sum, where the contribution of each transformation can be directly controlled by its extent of influence (scope size). The optimal scope sizes for organ-based and feature-based transformations were found by an exhaustive analysis. The anatomical correctness of the mapping was independently validated by measuring the residual distances after transformation for delineated structures inside the cervix-uterus (inner anatomical correctness), and for anatomical landmarks outside the organs in the surrounding region (outer anatomical correctness). The results of the proposed method were compared with the results of the

  15. Cervical Cancer

    Science.gov (United States)

    ... Cervical cancer is caused by a virus called HPV. The virus spreads through sexual contact. Most women's bodies are able to fight HPV infection. But sometimes the virus leads to cancer. You're at higher risk ...

  16. Comparison and Consensus Guidelines for Delineation of Clinical Target Volume for CT- and MR-Based Brachytherapy in Locally Advanced Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Viswanathan, Akila N., E-mail: aviswanathan@lroc.harvard.edu [Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Erickson, Beth [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Gaffney, David K. [University of Utah Huntsman Cancer Hospital, Salt Lake City, Utah (United States); Beriwal, Sushil [University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Bhatia, Sudershan K. [University of Iowa, Iowa City, Iowa (United States); Lee Burnett, Omer [University of Alabama, Birmingham, Alabama (United States); D' Souza, David P.; Patil, Nikhilesh [London Health Sciences Centre and Western University, London, Ontario (Canada); Haddock, Michael G. [Mayo Medical Center, Rochester, Minnesota (United States); Jhingran, Anuja [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jones, Ellen L. [University of North Carolina, Chapel Hill, North Carolina (United States); Kunos, Charles A. [Case Western Reserve University, Cleveland, Ohio (United States); Lee, Larissa J. [Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Lin, Lilie L. [University of Pennsylvania, Philadelphia, Pennsylvania (United States); Mayr, Nina A. [University of Washington, Seattle, Washington (United States); Petersen, Ivy [Mayo Medical Center, Rochester, Minnesota (United States); Petric, Primoz [Division of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana (Slovenia); Department of Radiation Oncology, National Center for Cancer Care and Research, Doha (Qatar); Portelance, Lorraine [University of Miami Miller School of Medicine, Miami, Florida (United States); Small, William [Loyola University Strich School of Medicine, Chicago, Illinois (United States); Strauss, Jonathan B. [The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois (United States); and others

    2014-10-01

    Objective: To create and compare consensus clinical target volume (CTV) contours for computed tomography (CT) and 3-Tesla (3-T) magnetic resonance (MR) image-based cervical-cancer brachytherapy. Methods and Materials: Twenty-three experts in gynecologic radiation oncology contoured the same 3 cervical cancer brachytherapy cases: 1 stage IIB near-complete response (CR) case with a tandem and ovoid, 1 stage IIB partial response (PR) case with tandem and ovoid with needles, and 1 stage IB2 CR case with a tandem and ring applicator. The CT contours were completed before the MRI contours. These were analyzed for consistency and clarity of target delineation using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE), with κ statistics as a measure of agreement between participants. The conformity index was calculated for each of the 6 data sets. Dice coefficients were generated to compare the CT and MR contours of the same case. Results: For all 3 cases, the mean tumor volume was smaller on MR than on CT (P<.001). The κ and conformity index estimates were slightly higher for CT, indicating a higher level of agreement on CT. The Dice coefficients were 89% for the stage IB2 case with a CR, 74% for the stage IIB case with a PR, and 57% for the stage IIB case with a CR. Conclusion: In a comparison of MR-contoured with CT-contoured CTV volumes, the higher level of agreement on CT may be due to the more distinct contrast medium visible on the images at the time of brachytherapy. MR at the time of brachytherapy may be of greatest benefit in patients with large tumors with parametrial extension that have a partial or complete response to external beam. On the basis of these results, a 95% consensus volume was generated for CT and for MR. Online contouring atlases are available for instruction at (http://www.nrgoncology.org/Resources/ContouringAtlases/GYNCervicalBrachytherapy.aspx)

  17. Comparison and Consensus Guidelines for Delineation of Clinical Target Volume for CT- and MR-Based Brachytherapy in Locally Advanced Cervical Cancer

    International Nuclear Information System (INIS)

    Objective: To create and compare consensus clinical target volume (CTV) contours for computed tomography (CT) and 3-Tesla (3-T) magnetic resonance (MR) image-based cervical-cancer brachytherapy. Methods and Materials: Twenty-three experts in gynecologic radiation oncology contoured the same 3 cervical cancer brachytherapy cases: 1 stage IIB near-complete response (CR) case with a tandem and ovoid, 1 stage IIB partial response (PR) case with tandem and ovoid with needles, and 1 stage IB2 CR case with a tandem and ring applicator. The CT contours were completed before the MRI contours. These were analyzed for consistency and clarity of target delineation using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE), with κ statistics as a measure of agreement between participants. The conformity index was calculated for each of the 6 data sets. Dice coefficients were generated to compare the CT and MR contours of the same case. Results: For all 3 cases, the mean tumor volume was smaller on MR than on CT (P<.001). The κ and conformity index estimates were slightly higher for CT, indicating a higher level of agreement on CT. The Dice coefficients were 89% for the stage IB2 case with a CR, 74% for the stage IIB case with a PR, and 57% for the stage IIB case with a CR. Conclusion: In a comparison of MR-contoured with CT-contoured CTV volumes, the higher level of agreement on CT may be due to the more distinct contrast medium visible on the images at the time of brachytherapy. MR at the time of brachytherapy may be of greatest benefit in patients with large tumors with parametrial extension that have a partial or complete response to external beam. On the basis of these results, a 95% consensus volume was generated for CT and for MR. Online contouring atlases are available for instruction at (http://www.nrgoncology.org/Resources/ContouringAtlases/GYNCervicalBrachytherapy.aspx)

  18. Chemoradiation in cervical cancer with cisplatin and high-dose rate brachytherapy combined with external beam radiotherapy. Results of a phase-II study

    Energy Technology Data Exchange (ETDEWEB)

    Strauss, H.G.; Laban, C.; Puschmann, D.; Koelbl, H. [Dept. of Gynecology, Martin-Luther Univ. Halle-Wittenberg (Germany); Kuhnt, T.; Pigorsch, S.; Dunst, J.; Haensgen, G. [Dept. of Radiotherapy, Martin-Luther Univ. Halle-Wittenberg (Germany)

    2002-07-01

    Background: In 1999, five randomized studies demonstrated that chemoradiation with cisplatin and low-dose rate (LDR) brachytherapy has a benefit in locally advanced cervical cancer and for surgically treated patients in high-risk situations. We evaluated the safety and efficacy of concomitant chemoradiation with cisplatin and high-dose rate (HDR) brachytherapy in patients with cervical cancer. Patients and Method: 27 patients were included in our phase-II trial: 13 locally advanced cases (group A) and 14 adjuvant-therapy patients in high-risk situations (group B). A definitive radiotherapy was performed with 25 fractions of external beam therapy (1.8 Gy per fraction/middle shielded after eleven fractions). Brachytherapy was delivered at HDR schedules with 7 Gy in point A per fraction (total dose 35 Gy) in FIGO Stages IIB-IIIB. The total dose of external and brachytherapy was 70 Gy in point A and 52-54 Gy in point B. All patients in stage IVA were treated without brachytherapy. Adjuvant radiotherapy was performed with external beam radiotherapy of the pelvis with 1.8 Gy single-dose up to 50.4 Gy. Brachytherapy was delivered at HDR schedules with two fractions of 5 Gy only in patients with tumor-positive margins or tumor involvement of the upper vagina. The chemotherapeutic treatment schedule provided six courses of cisplatin 40 mg/m{sup 2} weekly recommended in the randomized studies GOG-120 and -123. Results: A total of 18/27 patients (66.7%) completed all six courses of chemotherapy. Discontinuation of radiotherapy due to therapy-related morbidity was not necessary in the whole study group. G3 leukopenia (29.6%) was the only relevant acute toxicity. There were no differences in toxicity between group A and B. Serious late morbidity occurred in 2/27 patients (7.4%). 12/13 patients (92.3%) with IIB-IVA cervical cancer showed a complete response (CR). 13/14 adjuvant cases (92.8%) are free of recurrence (median follow up: 19.1 months). Conclusion: Concomitant

  19. SU-E-I-26: The CT Compatibility of a Novel Direction Modulated Brachytherapy (DMBT) Tandem Applicator for Cervical Cancer

    International Nuclear Information System (INIS)

    Purpose: To examine CT metal image artifact from a novel direction-modulated brachytherapy (DMBT) tandem applicator (95% tungsten) for cervical cancer using a commercially available orthopedic metal artifact reduction (O-MAR) algorithm. Comparison to a conventional stainless steel applicator is also performed. Methods: Each applicator was placed in a water-filled phantom resembling the female pelvis and scanned in a Philips Brilliance 16-slice CT scanner using two pelvis protocols: a typical clinical protocol (120kVp, 16×0.75mm collimation, 0.692 pitch, 1.0s rotation, 350mm field of view (FOV), 600mAs, 1.5mm slices) and a protocol with a higher kVp and mAs setting useful for larger patients (140kVp, 16×0.75mm collimation, 0.688 pitch, 1.5s rotation, 350mm FOV, 870mAs, 1.5mm slices). Images of each tandem were acquired with and without the application of the O-MAR algorithm. Baseline scans of the phantom (no applicator) were also collected. CT numbers were quantified at distances from 5 to 30 mm away from the applicator’s edge (in increments of 5mm) using measurements at eight angles around the applicator, on three consecutive slices. Results: While the presence of both applicators degraded image quality, the DMBT applicator resulted in larger streaking artifacts and dark areas in the image compared to the stainless steel applicator. Application of the O-MAR algorithm improved all acquired images, both visually and quantitatively. The use of low and high kVp and mAs settings (120 kVp/600mAs and 140 kVp/870mAs) in conjunction with the O-MAR algorithm lead to similar CT numbers in the vicinity of the applicator and a similar reduction of the induced metal artifact. Conclusion: This work indicated that metal artifacts induced by the DMBT and the stainless steel applicator are greatly reduced when using the O-MAR algorithm, leading to better quality phantom images. The use of a high dose protocol provided similar improvements in metal artifacts compared to the

  20. SU-E-I-26: The CT Compatibility of a Novel Direction Modulated Brachytherapy (DMBT) Tandem Applicator for Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Elzibak, A; Safigholi, H; Soliman, A; Ravi, A; Song, WY [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Kager, P [The Netherlands Cancer Institute, Amsterdam (Netherlands); Han, D [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); University of California, San Diego, La Jolla, CA (United States)

    2015-06-15

    Purpose: To examine CT metal image artifact from a novel direction-modulated brachytherapy (DMBT) tandem applicator (95% tungsten) for cervical cancer using a commercially available orthopedic metal artifact reduction (O-MAR) algorithm. Comparison to a conventional stainless steel applicator is also performed. Methods: Each applicator was placed in a water-filled phantom resembling the female pelvis and scanned in a Philips Brilliance 16-slice CT scanner using two pelvis protocols: a typical clinical protocol (120kVp, 16×0.75mm collimation, 0.692 pitch, 1.0s rotation, 350mm field of view (FOV), 600mAs, 1.5mm slices) and a protocol with a higher kVp and mAs setting useful for larger patients (140kVp, 16×0.75mm collimation, 0.688 pitch, 1.5s rotation, 350mm FOV, 870mAs, 1.5mm slices). Images of each tandem were acquired with and without the application of the O-MAR algorithm. Baseline scans of the phantom (no applicator) were also collected. CT numbers were quantified at distances from 5 to 30 mm away from the applicator’s edge (in increments of 5mm) using measurements at eight angles around the applicator, on three consecutive slices. Results: While the presence of both applicators degraded image quality, the DMBT applicator resulted in larger streaking artifacts and dark areas in the image compared to the stainless steel applicator. Application of the O-MAR algorithm improved all acquired images, both visually and quantitatively. The use of low and high kVp and mAs settings (120 kVp/600mAs and 140 kVp/870mAs) in conjunction with the O-MAR algorithm lead to similar CT numbers in the vicinity of the applicator and a similar reduction of the induced metal artifact. Conclusion: This work indicated that metal artifacts induced by the DMBT and the stainless steel applicator are greatly reduced when using the O-MAR algorithm, leading to better quality phantom images. The use of a high dose protocol provided similar improvements in metal artifacts compared to the

  1. SU-E-J-226: Efficient Use of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) for Cervical-Cancer Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Damato, A; Bhagwat, M; Buzurovic, I; Cormack, R; Lee, L; Viswanathan, A [Harvard Medical School, Boston, MA (United States)

    2015-06-15

    Purpose: To investigate image modality selection in an environment with limited access to interventional MRI for image-guided high-dose-rate cervical-cancer brachytherapy. Methods: Records of all cervical-cancer patients treated with brachytherapy between 1/2013 and 8/2014 were analyzed. Insertions were performed under CT guidance (CT group) or with >1 fraction under 3T MR guidance (MRI group; subMRI includes only patients who also had a CT-guided insertion). Differences between groups in clinical target volume (CTV), disease stage (I/II or III/IV), number of patients with or without interstitial needles, and CTV D90 were investigated. Statistical significance was evaluated with the Student T test and Fisher test (p <0.05). Results: 46 cervical-cancer patients were included (16 MRI [3 subMRI], 30 CT). CTV: overall, 55±53 cm3; MRI, 81±61 cm3; CT, 42±44 cm3 (p = 0.017). Stage: overall, 24 I/II and 22 III/IV; MRI, 3 I/II and 13 III/IV; CT, 21 I/II and 9 III/IV (p = 0.002). Use of needles: overall, 26 without and 20 with; MRI, 5 without and 11 with; CT, 21 without and 9 with (p = 0.015). CTV D90: overall, 82±5 Gy; MRI, 81±6 Gy; CT, 82±5 Gy (p = 0.78). SubMRI: CTV and D90 (as % of nominal fraction dose) were 23±6 cm3 and 124±3% for MRI-guided insertions and 21±5 cm3 (p = 0.83) and 106±12% (p = 0.15) for CT-guided insertions. Conclusion: Statistically significant differences in patient population indicate preferential use of MRI for patients with high-stage disease and large residual CTVs requiring the use of interstitial needles. CTV D90 was similar between groups, despite the difference in patient selection. For patients who underwent both CT and MRI insertions, a larger MR CTV D90 and similar CTVs between insertions were observed. While MRI is generally preferable to CT, MRI selection can be optimized in environments without a dedicated MRI brachytherapy suite. This work was partially funded by the NIH R21 CA167800 (PI: Viswanathan; aviswanathan@partners.org)

  2. Cervical Cancer

    Science.gov (United States)

    ... 162 KB) This information in Spanish (en español) Female reproductive system Select image to view larger Related ... D., FACS, Captain, U.S. Public Health Service Medical Director, National Breast and Cervical Cancer Early Detection Program, ...

  3. High-dose Extended-Field Irradiation and High-Dose-Rate Brachytherapy With Concurrent Chemotherapy for Cervical Cancer With Positive Para-Aortic Lymph Nodes

    International Nuclear Information System (INIS)

    Purpose: To determine the efficacy and toxicity of extended-field radiotherapy (RT) with concurrent platinum-based chemotherapy in patients with uterine cervical carcinoma and positive para-aortic nodes. Methods and Materials: We retrospectively reviewed the results for 33 women with Stage IB-IVB cervical cancer. Each patient had received 59.4 Gy, including a three-dimensional conformal boost to the para-aortic lymph nodes and 41.4-50.4 Gy of external beam radiotherapy to the pelvis. Each patient also underwent six or seven applications of high-dose-rate brachytherapy (median, 5 Gy to point A at each session). Results: The median follow-up period of surviving patients was 39 months. The most common acute toxicity was hematologic, observed in 23 women. Severe acute and late gastrointestinal toxicity was observed in 3 and 4 patients, respectively. More than three-quarters of patients showed a complete response, encompassing the primary mass, metastatic pelvic, and para-aortic lymph nodes. Of the 33 women, 15 had no evidence of disease, 6 had persistent disease, 4 developed in-field failures, and 6 developed distant failures. The 5-year overall and disease-free survival rate was 47% and 42%, respectively. Conclusion: Concurrent chemoradiotherapy with extended-field radiotherapy is feasible in women with uterine cervical carcinoma and positive para-aortic lymph nodes, with acceptable late morbidity and a high survival rate, although it was accompanied by substantial acute toxicity.

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

    DEFF Research Database (Denmark)

    Sun, Baozhou; Yang, Deshan; Esthappan, Jackie;

    2015-01-01

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

  5. HDR brachytherapy combined with interstitial hyperthermia in locally advanced cervical cancer patients initially treated with concomitant radiochemotherapy – a phase III study

    International Nuclear Information System (INIS)

    Background and purpose: The aim of this randomised trial was to investigate whether hyperthermia (HT) combined with interstitial brachytherapy (ISBT) has any influence on local control (LC), disease-free survival (DFS), or acute and late side effects in patients with advanced cervical cancer. Materials and methods: After radiochemotherapy, consecutive patients with cervical cancer (FIGO stage II–III) were randomly assigned to two treatment groups, either ISBT alone or ISBT combined with interstitial hyperthermia (ISHT). A total of 205 patients were included in the statistical analysis. Once a week, HT, at a temperature above 42.5 °C, was administered for 45 min before and during the HDR BT. Results: The median follow-up time was 45 months (range 3–72 months). An effect of hyperthermia was not detected for disease-free survival (DFS) (log-rank test: p = 0.178) or for local control (LC) (p = 0.991). According to Cox’s analysis, HT did not significantly influence failure or interactions with potential prognostic factors for LC or DFS. Statistical differences were not observed for the distribution of early and late complications between the HT and non HT groups. Conclusions: ISHT is well-tolerated and does not affect treatment-related early or late complications. Improvements in DFS and LC were not observed following the addition of ISHT to ISBT

  6. A Prospective Cohort Study to Compare Treatment Results Between 2 Fractionation Schedules of High-Dose-Rate Intracavitary Brachytherapy (HDR-ICBT) in Patients With Cervical Cancer

    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, Taiwan (China); Sun, Li-Min [Department of Radiation Oncology, Zuoying Armed Forces General Hospital, Kaohsiung, Taiwan (China); Lin, Hao [Department of Gynecologic Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Lan, Jen-Hong [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Chanchien, Chan-Chao [Department of Gynecologic Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Huang, Yu-Jie; Wang, Chang-Yu [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China); Wang, Chong-Jong, E-mail: cjw1010@adm.cgmh.org.tw [Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (China)

    2013-01-01

    Purpose: To compare the treatment results of 2 fractionation schedules for high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer. Methods and Materials: From June 2001 through January 2008, 267 patients with stage IB-IVA cervical cancer were enrolled in the study. All patients underwent 4-field pelvic irradiation and HDR-ICBT. The median central and parametrial doses were 39.6 Gy and 45 Gy, respectively. Patient underwent either 6 Gy Multiplication-Sign 4 (HDR-4) (n=144) or 4.5 Gy Multiplication-Sign 6 (HDR-6) (n=123) to point A of ICBT using {sup 192}Ir isotope twice weekly. The rates of overall survival, locoregional failure, distant metastasis, proctitis, cystitis, and enterocolitis were compared between HDR-4 and HDR-6. Results: There were no significant differences in the demographic data between HDR-4 and HDR-6 except for total treatment time. The 5-year proctitis rates were 23.0% and 21.5% in HDR-4 and HDR-6 (P=.399), respectively. The corresponding rates of grade 2-4 proctitis were 18.7% and 9.6% (P=.060). The corresponding rates of grades 3-4 proctitis were 5.2% and 1.3% (P=.231). Subgroup analysis revealed that HDR-4 significantly increased grade 2-4 proctitis in patients aged {>=}62 years old (P=.012) but not in patients aged <62 years (P=.976). The rates of overall survival, locoregional failure, distant metastasis, cystitis, and enterocolitis were not significantly different between HDR-4 and HDR-6 schedules. Conclusion: The small fraction size of HDR-ICBT is associated with grade 2 proctitis without compromise of prognosis in elderly patients. This schedule is suggested for patients who tolerate an additional 2 applications of HDR-ICBT.

  7. Improve definition of titanium tandems in MR-guided high dose rate brachytherapy for cervical cancer using proton density weighted MRI

    International Nuclear Information System (INIS)

    For cervical cancer patients treated with MR-guided high dose rate brachytherapy, the accuracy of radiation delivery depends on accurate localization of both tumors and the applicator, e.g. tandem and ovoid. Standard T2-weighted (T2W) MRI has good tumor-tissue contrast. However, it suffers from poor uterus-tandem contrast, which makes the tandem delineation very challenging. In this study, we evaluated the possibility of using proton density weighted (PDW) MRI to improve the definition of titanium tandems. Both T2W and PDW MRI images were obtained from each cervical cancer patient. Imaging parameters were kept the same between the T2W and PDW sequences for each patient except the echo time (90 ms for T2W and 5.5 ms for PDW) and the slice thickness (0.5 cm for T2W and 0.25 cm for PDW). Uterus-tandem contrast was calculated by the equation C = (Su-St)/Su, where Su and St represented the average signal in the uterus and the tandem, respectively. The diameter of the tandem was measured 1.5 cm away from the tip of the tandem. The tandem was segmented by the histogram thresholding technique. PDW MRI could significantly improve the uterus-tandem contrast compared to T2W MRI (0.42±0.24 for T2W MRI, 0.77±0.14 for PDW MRI, p=0.0002). The average difference between the measured and physical diameters of the tandem was reduced from 0.20±0.15 cm by using T2W MRI to 0.10±0.11 cm by using PDW MRI (p=0.0003). The tandem segmented from the PDW image looked more uniform and complete compared to that from the T2W image. Compared to the standard T2W MRI, PDW MRI has better uterus-tandem contrast. The information provided by PDW MRI is complementary to those provided by T2W MRI. Therefore, we recommend adding PDW MRI to the simulation protocol to assist tandem delineation process for cervical cancer patients

  8. 三维适形放疗配合腔内后装治疗宫颈癌的临床研究%Clinical study of three dimensional conformal radiotherapy combined with intracavitary brachytherapy in the treatment of cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Yeqin Zhou; Daiyuan Ma; Tao Ren; Xianfu Li; Jing Hu; Bangxian Tan

    2011-01-01

    Objective: The aim of our study was to evaluate the outcome and complications of cervical cancer patients undergoing conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT). Methods: Sixty cervical cancer patients were divided randomly into the conformal group and the conventional group. Thirty patients treated with 3D-conformal radiotherapy in the 3DCRT group, when the whole pelvic received DT 40 Gy, a planning CT scan of each patient was obtained and the second 3DCRT therapy plan was taken. Then, continued to irradiate to 50 Gy. At last, 3DCRT was boosted at local involved volumes to the total close of 60 Gy. When 3DCRT was combined with intracavitary brachytherapy, the dose of brachytherapy to point A was 30 Gy/5 fractions. In the conventional group, after a total tumor dose of 40 Gy was delivered by the whole pelvic irradiation, the four-field technique was used to irradiate the total pelvic and regional nodes (median close of 10 Gy), and the involved volumes were boosted to 60 Gy and the dose of brachytherapy to point A was 30 Gy-36 Gy/5-6 fractions. Moreover, both groups were combined with intracavitary brachytherapy respectively. Results: The 1, 2, 3-year survival rates for the 3DCRT group and the conventional group were 96.7%, 93.3%, 90.0% and 86.6%, 76.7%,70% respectively (P = 0.04, P = 0.02 and P = 0.02). There was a statistically significant difference between the two groups.Compared to the two groups each other in toxic effects, except for the Ⅰ-Ⅱ grade rectal and bladder reaction and pelvic fibrosis which was lower in the 3DCRT group (P = 0. 007, P = 0. 006 and P = 0. 015), the side effects were similar and well tolerated in two groups. Conclusion: The all-course 3DCRT combined with intracavitary brachytherapy can be considered as an effective and feasible approach to cervical cancer and may significantly improve the survival rate and reduce the late toxicity. This new rote for 3DCRT merits need further

  9. Commissioning of a 3D image-based treatment planning system for high-dose-rate brachytherapy of cervical cancer.

    Science.gov (United States)

    Kim, Yongbok; Modrick, Joseph M; Pennington, Edward C; Kim, Yusung

    2016-01-01

    The objective of this work is to present commissioning procedures to clinically implement a three-dimensional (3D), image-based, treatment-planning system (TPS) for high-dose-rate (HDR) brachytherapy (BT) for gynecological (GYN) cancer. The physical dimensions of the GYN applicators and their values in the virtual applicator library were varied by 0.4 mm of their nominal values. Reconstruction uncertainties of the titanium tandem and ovoids (T&O) were less than 0.4 mm on CT phantom studies and on average between 0.8-1.0 mm on MRI when compared with X-rays. In-house software, HDRCalculator, was developed to check HDR plan parameters such as independently verifying active tandem or cylinder probe length and ovoid or cylinder size, source calibration and treatment date, and differences between average Point A dose and prescription dose. Dose-volume histograms were validated using another independent TPS. Comprehensive procedures to commission volume optimization algorithms and process in 3D image-based planning were presented. For the difference between line and volume optimizations, the average absolute differences as a percentage were 1.4% for total reference air KERMA (TRAK) and 1.1% for Point A dose. Volume optimization consistency tests between versions resulted in average absolute differences in 0.2% for TRAK and 0.9 s (0.2%) for total treatment time. The data revealed that the optimizer should run for at least 1 min in order to avoid more than 0.6% dwell time changes. For clinical GYN T&O cases, three different volume optimization techniques (graphical optimization, pure inverse planning, and hybrid inverse optimization) were investigated by comparing them against a conventional Point A technique. End-to-end testing was performed using a T&O phantom to ensure no errors or inconsistencies occurred from imaging through to planning and delivery. The proposed commissioning procedures provide a clinically safe implementation technique for 3D image-based TPS for HDR

  10. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  11. Feasibility study of patient-specific quality assurance system for high-dose-rate brachytherapy in patients with cervical cancer

    Science.gov (United States)

    Lee, Boram; Ahn, Sung Hwan; Kim, Hyeyoung; Han, Youngyih; Huh, Seung Jae; Kim, Jin Sung; Kim, Dong Wook; Sim, Jina; Yoon, Myonggeun

    2016-04-01

    This study was conducted for the purpose of establishing a quality-assurance (QA) system for brachytherapy that can ensure patient-specific QA by enhancing dosimetric accuracy for the patient's therapy plan. To measure the point-absorbed dose and the 2D dose distribution for the patient's therapy plan, we fabricated a solid phantom that allowed for the insertion of an applicator for patient-specific QA and used an ion chamber and a film as measuring devices. The patient treatment plan was exported to the QA dose-calculation software, which calculated the time weight of dwell position stored in the plan DICOM (Digital Imaging and Communications in Medicine) file to obtain an overall beam quality correction factor, and that correction was applied to the dose calculations. Experiments were conducted after importing the patient's treatment planning source data for the fabricated phantom and inserting the applicator, ion chamber, and film into the phantom. On completion of dose delivery, the doses to the ion chamber and film were checked against the corresponding treatment plan to evaluate the dosimetric accuracy. For experimental purposes, five treatment plans were randomly selected. The beam quality correction factors for ovoid and tandem brachytherapy applicators were found to be 1.15 and 1.10 - 1.12, respectively. The beam quality correction factor in tandem fluctuated by approximately 2%, depending on the changes in the dwell position. The doses measured by using the ion chamber showed differences ranging from -2.4% to 0.6%, compared to the planned doses. As for the film, the passing rate was 90% or higher when assessed using a gamma value of the local dose difference of 3% and a distance to agreement of 3 mm. The results show that the self-fabricated phantom was suitable for QA in clinical settings. The proposed patient-specific QA for the treatment planning is expected to contribute to reduce dosimetric errors in brachytherapy and, thus, to enhancing treatment

  12. Preliminary experience on the implementation of computed tomography (CT)-based image guided brachytherapy (IGBT) of cervical cancer using high-dose-rate (HDR) Cobalt-60 source in University of Malaya Medical Centre (UMMC)

    Science.gov (United States)

    Jamalludin, Z.; Min, U. N.; Ishak, W. Z. Wan; Malik, R. Abdul

    2016-03-01

    This study presents our preliminary work of the computed tomography (CT) image guided brachytherapy (IGBT) implementation on cervical cancer patients. We developed a protocol in which patients undergo two Magnetic Resonance Imaging (MRI) examinations; a) prior to external beam radiotherapy (EBRT) and b) prior to intra-cavitary brachytherapy for tumour identification and delineation during IGBT planning and dosimetry. For each fraction, patients were simulated using CT simulator and images were transferred to the treatment planning system. The HR-CTV, IR-CTV, bladder and rectum were delineated on CT-based contouring for cervical cancer. Plans were optimised to achieve HR-CTV and IR-CTV dose (D90) of total EQD2 80Gy and 60Gy respectively, while limiting the minimum dose to the most irradiated 2cm3 volume (D2cc) of bladder and rectum to total EQD2 90Gy and 75Gy respectively. Data from seven insertions were analysed by comparing the volume-based with traditional point- based doses. Based on our data, there were differences between volume and point doses of HR- CTV, bladder and rectum organs. As the number of patients having the CT-based IGBT increases from day to day in our centre, it is expected that the treatment and dosimetry accuracy will be improved with the implementation.

  13. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  14. High dose rate brachytherapy for oral cancer

    International Nuclear Information System (INIS)

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer. (author)

  15. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  16. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends on ...

  17. Treatment protocols for cervical cancer

    Directory of Open Access Journals (Sweden)

    Vujkov Tamara

    2002-01-01

    Full Text Available Introduction Cervical cancer is the second most common cancer in women worldwide and the second cause of cancer death among women. About 95% (90% in developed countries of invasive carcinomas are of sqamous types, and 5% (10% in developed countries are adenocarcinomas. FIGO classification of cervical carcinomas, based on clinical staging and prognostic factor dictate therapeutic procedures and help in designing treatment protocols. Therapeutic modalities Surgical therapy includes conization, radical hysterectomy with pelvic lymphadenectomy and palliative operation urinary diversion and colostomy. Radiotherapy, brachytherapy and teletherapy are most recently combined with chemotherapy as concurrent chemoradiation. Discussion and conclusion No change in therapeutic modalities will ever decrease mortality rate of cervical carcinoma as much as education, prevention and early screening. The 5-year survival for locally advanced disease has not improved during the last 40 years as a result of failure to deliver therapy to the paraaortic region. Paraaortic lymph nodes should be evaluated before therapy planning by different imaging procedures, or more exactly by surgical staging: laparoscopy or laparotomy. Radical operations of cervical carcinoma should be performed by experienced surgeons, educated for this type of operation, with sufficient number of cases.

  18. Preventing cervical cancer globally.

    Science.gov (United States)

    Schmeler, Kathleen M

    2012-11-01

    Cervical cancer is one of the leading causes of cancer and cancer-related deaths among women worldwide. More than 85% of cases and deaths occur in the developing world where the availability of effective screening is limited. In this issue of the journal, Pierce and colleagues (beginning on page 1273) describe a novel technique using a high-resolution microendoscope (HRME) to diagnose cervical dysplasia. This perspective reviews the limitations of existing cervical cancer screening methods currently in use in low-resource settings and the potential for HRME imaging to contribute to cervical cancer prevention in the developing world.

  19. CDC's Cervical Cancer Study

    Science.gov (United States)

    ... in Cancer Moonshot Stay Informed CDC’s Cervical Cancer Study Language: English Español (Spanish) Recommend on Facebook Tweet ... year. As part of CDC’s Cervical Cancer (Cx3) Study, we surveyed a sample of both health care ...

  20. Get Tested for Cervical Cancer

    Science.gov (United States)

    ... Cervical Cancer Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview ... be cured. How often should I get screened (tested)? How often you should get screened for cervical ...

  1. [Current Status and Perspective of Chemoradiotherapy for Uterine Cervical Cancer].

    Science.gov (United States)

    Toita, Takafumi; Ariga, Takuro; Kasuya, Goro; Hashimoto, Seiji; Maemoto, Hitoshi; Heianna, Joichi; Kakinohana, Yasumasa; Murayama, Sadayuki

    2015-10-01

    Fifteen years has passed since the NCI announced the clinical importance of concurrent chemoradiotherapy (CCRT) in radiotherapy for patients with locoregionally advanced uterine cervical cancer. Numerous clinical trials have been performed to further improve the outcomes of CCRT. In addition to investigations of chemotherapeutic regimens and schedules, adaptation of novel radiotherapy methods such as image-guided brachytherapy (IGBT) and intensity-modulated radiotherapy (IMRT) is encouraged in CCRT for cervical cancer. PMID:26489545

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-06-01

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

  3. Results of concomitant chemoradiation for cervical cancer using high dose rate intracavitary brachytherapy: Study of JROSG (Japan Radiation Oncology Study Group)

    Energy Technology Data Exchange (ETDEWEB)

    Sakata, Koh-Ichi (Dept. of Radiology, Sapporo Medical Univ., School of Medicine, Sapporo (JP)); Sakurai, Hideyuki; Suzuki, Yoshiyuki (Dept. of Radiology and Radiation Oncology, Gunna Univ., School of Medicine, Gunna (JP)) (and others)

    2008-03-15

    The purpose of this study was to clarify outcome for concurrent chemoradiation (CT-RT) in locally advanced cervix cancer in Japan. This is a non-randomized retrospective analysis of 226 patients treated with definitive CT-RT or radiotherapy alone (RT alone) in nine institutions between 2001 and 2003. External irradiation consisted of whole pelvic irradiation and pelvic side wall boost irradiation, using a central shield during the latter half of the treatment with the anteroposterior parallel opposing technique. The external beam irradiation was performed with 1.8 or 2 Gy per fraction. High-dose-rate intracavitary brachytherapy (HDR) was performed in all cases. In chemotherapy, platinum based drugs were used alone or in combination with other drugs such as 5FU. Grade of late complications was scaled retrospectively with CTCv2.0. Overall survival rate at 50 months of stage Ib, II and III, IV was 82% and 66% in CR-RT and 81% and 43% in R alone, respectively. Disease-free survival rate at 50 months of stage Ib, II and III, IV was 74% and 59% in CR-RT and 76% and 52% in R alone, respectively. There was no significant difference between CT-RT and RT for overall survival and disease free survival. Univariate analysis suggested that loco-regional control was better with CT-RT, but multivariate analysis could not confirm this finding. Compared to RT alone, CT-RT caused significantly more acute and late complications. Thus, late complication (grade 3-4) free survival rate at 50 month was 69% for CT-RT and 86% for RT alone (p<0.01). The therapeutic window with concomitant radiochemotherapy and HDR brachytherapy may be narrow, necessitating a close control of dose volume parameters and adherence to systems for dose prescription

  4. Prospective Multi-Institutional Study of Definitive Radiotherapy With High-Dose-Rate Intracavitary Brachytherapy in Patients With Nonbulky (<4-cm) Stage I and II Uterine Cervical Cancer (JAROG0401/JROSG04-2)

    International Nuclear Information System (INIS)

    Purpose: To determine the efficacy of a definitive radiotherapy protocol using high-dose-rate intracavitary brachytherapy (HDR-ICBT) with a low cumulative dose schedule in nonbulky early-stage cervical cancer patients, we conducted a prospective multi-institutional study. Methods and Materials: Eligible patients had squamous cell carcinoma of the intact uterine cervix, Federation of Gynecologic Oncology and Obstetrics (FIGO) stages Ib1, IIa, and IIb, tumor size 10 (α/β = 10) at point A. The primary endpoint was the 2-year pelvic disease progression-free (PDPF) rate. All patients received a radiotherapy quality assurance review. Results: Between September 2004 and July 2007, 60 eligible patients were enrolled. Thirty-six patients were assessed with FIGO stage Ib1; 12 patients with stage IIa; and 12 patients with stage IIb. Median tumor diameter was 28 mm (range, 6–39 mm). Median overall treatment time was 43 days. Median follow-up was 49 months (range, 7–72 months). Seven patients developed recurrences: 3 patients had pelvic recurrences (2 central, 1 nodal), and 4 patients had distant metastases. The 2-year PDPF was 96% (95% confidence interval [CI], 92%–100%). The 2-year disease-free and overall survival rates were 90% (95% CI, 82%–98%) and 95% (95% CI, 89%–100%), respectively. The 2-year late complication rates (according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer of Grade ≥1) were 18% (95% CI, 8%–28%) for large intestine/rectum, 4% (95% CI, 0%–8%) for small intestine, and 0% for bladder. No Grade ≥3 cases were observed for genitourinary/gastrointestinal late complications. Conclusions: These results suggest that definitive radiotherapy using HDR-ICBT with a low cumulative dose schedule (BED, 62 Gy10 at point A) can provide excellent local control without severe toxicity in nonbulky (<4-cm) early-stage cervical cancer.

  5. Immunotherapy for Cervical Cancer

    Science.gov (United States)

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-01

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

  7. Manifestation Pattern of Early-Late Vaginal Morbidity After Definitive Radiation (Chemo)Therapy and Image-Guided Adaptive Brachytherapy for Locally Advanced Cervical Cancer: An Analysis From the EMBRACE Study

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna (Austria); Nout, Remi A. [Department of Clinical Oncology, Leiden University Medical Center (Netherlands); Tanderup, Kari; Lindegaard, Jacob C. [Department of Oncology, Aarhus University Hospital (Denmark); Westerveld, Henrike [Department of Radiotherapy, Academic Medical Centre, University of Amsterdam (Netherlands); Haie-Meder, Christine [Department of Radiotherapy, Gustave-Roussy, Villejuif (France); Petrič, Primož [Department of Radiotherapy, Institute of Oncology Ljubljana (Slovenia); Department of Radiotherapy, National Center for Cancer Care and Research, Doha (Qatar); Mahantshetty, Umesh [Department of Radiation Oncology, Tata Memorial Hospital, Mumbai (India); Dörr, Wolfgang; Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna (Austria)

    2014-05-01

    Background and Purpose: Brachytherapy in the treatment of locally advanced cervical cancer has changed substantially because of the introduction of combined intracavitary/interstitial applicators and an adaptive target concept, which is the focus of the prospective, multi-institutional EMBRACE study ( (www.embracestudy.dk)) on image-guided adaptive brachytherapy (IGABT). So far, little has been reported about the development of early to late vaginal morbidity in the frame of IGABT. Therefore, the aim of the present EMBRACE analysis was to evaluate the manifestation pattern of vaginal morbidity during the first 2 years of follow-up. Methods and Materials: In total, 588 patients with a median follow-up time of 15 months and information on vaginal morbidity were included. Morbidity was prospectively assessed at baseline, every 3 months during the first year, and every 6 months in the second year according to the Common Terminology Criteria for Adverse Events, version 3, regarding vaginal stenosis, dryness, mucositis, bleeding, fistula, and other symptoms. Crude incidence rates, actuarial probabilities, and prevalence rates were analyzed. Results: At 2 years, the actuarial probability of severe vaginal morbidity (grade ≥3) was 3.6%. However, mild and moderate vaginal symptoms were still pronounced (grade ≥1, 89%; grade ≥2, 29%), of which the majority developed within 6 months. Stenosis was most frequently observed, followed by vaginal dryness. Vaginal bleeding and mucositis were mainly mild and infrequently reported. Conclusion: Severe vaginal morbidity within the first 2 years after definitive radiation (chemo)therapy including IGABT with intracavitary/interstitial techniques for locally advanced cervical cancer is limited and is significantly less than has been reported from earlier studies. Thus, the new adaptive target concept seems to be a safe treatment with regard to the vagina being an organ at risk. However, mild to moderate vaginal morbidity

  8. Variation of treatment planning parameters (D90 HR-CTV, D2cc for OAR) for cervical cancer tandem ring brachytherapy in a multicentre setting: Comparison of standard planning and 3D image guided optimisation based on a joint protocol for dose-volume constraints

    International Nuclear Information System (INIS)

    Purpose: To perform a qualitative and quantitative comparison of different treatment planning methods used in different centres for MRI-based brachytherapy (BT) of cervical cancer. Materials and methods: Two representative patients with advanced cervical cancer (1 'limited volume case'; 1 'extensive volume case') were planned for brachytherapy (BT) with a tandem-ring applicator by six different centres. During a workshop all centres produced an institutional standard plan and an MRI-based adaptive treatment plan for each case. Optimisation was based on the fractionation schedule (HDR, PDR) and method according to the institutional protocol. Results: The loading pattern, dwell times, shape of the point A isodose varied considerably between institutional standard plans, as did dose-volume parameters for high risk CTV (HR-CTV) and also for the D2cc for OAR, violating the dose-volume constraints in many situations. During optimisation, the centres stayed as close as possible to the standard loading pattern and dwell times. The dose distributions and dose-volume parameters between the plans from the different centres became much more comparable after optimisation. The prescribed dose to the HR-CTV could be achieved in the limited volume case by all centres, in the extensive case only if additional needles were applied. Conclusion: Treatment planning for gynaecologic brachytherapy based on different traditions shows less variation in regard to target coverage and OAR dose, when 3D image-based optimisation is performed with a uniform prescription protocol.

  9. Brachytherapy in treatment of vaginal cancer

    OpenAIRE

    A. D. Kaprin; V. N. Galkin; S. A. Ivanov; V. A. Solodkiy; V. A. Titova

    2016-01-01

    Characteristics of diagnosis and treatment of different types of primary vaginal cancer are highlighted, the role and place of brachytherapy as independent method or combined treatment modality for this pathology is shown in the review. Epidemiological data on incidence of vaginal cancer in Russia are represented, presumptive mechanisms for development of the disease, risk factors, histological types, features of the course, clinical presentation, diagnostic algorithm are described. Treatment...

  10. Magnetic Resonance Imaging (MRI) Markers for MRI-Guided High-Dose-Rate Brachytherapy: Novel Marker-Flange for Cervical Cancer and Marker Catheters for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schindel, Joshua; Muruganandham, Manickam [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Pigge, F. Christopher [Department of Chemistry, University of Iowa, Iowa City, Iowa (United States); Anderson, James [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Kim, Yusung, E-mail: yusung-kim@uiowa.edu [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States)

    2013-06-01

    Purpose: To present a novel marker-flange, addressing source-reconstruction uncertainties due to the artifacts of a titanium intracavitary applicator used for magnetic resonance imaging (MRI)-guided high-dose-rate (HDR) brachytherapy (BT); and to evaluate 7 different MRI marker agents used for interstitial prostate BT and intracavitary gynecologic HDR BT when treatment plans are guided by MRI. Methods and Materials: Seven MRI marker agents were analyzed: saline solution, Conray-60, copper sulfate (CuSO{sub 4}) (1.5 g/L), liquid vitamin E, fish oil, 1% agarose gel (1 g agarose powder per 100 mL distilled water), and a cobalt–chloride complex contrast (C4) (CoCl{sub 2}/glycine = 4:1). A plastic, ring-shaped marker-flange was designed and tested on both titanium and plastic applicators. Three separate phantoms were designed to test the marker-flange, interstitial catheters for prostate BT, and intracavitary catheters for gynecologic HDR BT. T1- and T2-weighted MRI were analyzed for all markers in each phantom and quantified as percentages compared with a 3% agarose gel background. The geometric accuracy of the MR signal for the marker-flange was measured using an MRI-CT fusion. Results: The CuSO{sub 4} and C4 markers on T1-weighted MRI and saline on T2-weighted MRI showed the highest signals. The marker-flange showed hyper-signals of >500% with CuSO{sub 4} and C4 on T1-weighted MRI and of >400% with saline on T2-weighted MRI on titanium applicators. On T1-weighted MRI, the MRI signal inaccuracies of marker-flanges were measured <2 mm, regardless of marker agents, and that of CuSO{sub 4} was 0.42 ± 0.14 mm. Conclusion: The use of interstitial/intracavitary markers for MRI-guided prostate/gynecologic BT was observed to be feasible, providing accurate source pathway reconstruction. The novel marker-flange can produce extremely intense, accurate signals, demonstrating its feasibility for gynecologic HDR BT.

  11. Human Papillomavirus and Cervical Cancer

    OpenAIRE

    D. Jenkins(University of York, UK)

    2003-01-01

    Of the many types of human papillomavirus (HPV), more than 30 infect the genital tract. The association between certain oncogenic (high-risk) strains of HPV and cervical cancer is well established. Although HPV is essential to the transformation of cervical epithelial cells, it is not sufficient, and a variety of cofactors and molecular events influence whether cervical cancer will develop. Early detection and treatment of precancerous lesions can prevent progression to cervical cancer. Ident...

  12. Prospective Multi-Institutional Study of Definitive Radiotherapy With High-Dose-Rate Intracavitary Brachytherapy in Patients With Nonbulky (<4-cm) Stage I and II Uterine Cervical Cancer (JAROG0401/JROSG04-2)

    Energy Technology Data Exchange (ETDEWEB)

    Toita, Takafumi, E-mail: b983255@med.u-ryukyu.ac.jp [Department of Radiology, Graduate School of Medical Science, University of Ryukyus, Okinawa (Japan); Kato, Shingo [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Niibe, Yuzuru [Department of Radiology, School of Medicine, Kitasato University, Sagamihara (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Maebashi (Japan); Kazumoto, Tomoko [Department of Radiology, Saitama Cancer Center, Saitama (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan); Kataoka, Masaaki [Department of Radiology, National Shikoku Cancer Center, Ehime (Japan); Shikama, Naoto [Department of Radiation Oncology, Saku Central Hospital, Saku (Japan); Kenjo, Masahiro [Department of Radiation Oncology, Graduate School of Medical Science, Hiroshima University, Hiroshima (Japan); Tokumaru, Sunao [Department of Radiology, Saga University, Saga (Japan); Yamauchi, Chikako [Department of Radiation Oncology, Shiga Medical Center for Adults, Moriyama (Japan); Suzuki, Osamu [Department of Radiation Oncology, Osaka Medical Center for Cancer, Osaka (Japan); Sakurai, Hideyuki [Proton Medical Research Center and Tsukuba University, Tsukuba (Japan); Numasaki, Hodaka; Teshima, Teruki [Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Osaka (Japan); Oguchi, Masahiko [Department of Radiation Oncology, Cancer Institute Hospital, Tokyo (Japan); Kagami, Yoshikazu [Radiation Oncology Division, National Cancer Center Hospital, Tokyo (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University, Graduate School of Medicine, Maebashi (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Graduate School of Medicine, Kyoto (Japan); Mitsuhashi, Norio [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan)

    2012-01-01

    Purpose: To determine the efficacy of a definitive radiotherapy protocol using high-dose-rate intracavitary brachytherapy (HDR-ICBT) with a low cumulative dose schedule in nonbulky early-stage cervical cancer patients, we conducted a prospective multi-institutional study. Methods and Materials: Eligible patients had squamous cell carcinoma of the intact uterine cervix, Federation of Gynecologic Oncology and Obstetrics (FIGO) stages Ib1, IIa, and IIb, tumor size <40 mm in diameter (assessed by T2-weighted magnetic resonance imaging), and no pelvic/para-aortic lymphadenopathy. The treatment protocol consisted of whole-pelvis external beam radiotherapy (EBRT) of 20 Gy/10 fractions, pelvic EBRT with midline block of 30 Gy/15 fractions, and HDR-ICBT of 24 Gy/4 fractions (at point A). The cumulative biologically effective dose (BED) was 62 Gy{sub 10} ({alpha}/{beta} = 10) at point A. The primary endpoint was the 2-year pelvic disease progression-free (PDPF) rate. All patients received a radiotherapy quality assurance review. Results: Between September 2004 and July 2007, 60 eligible patients were enrolled. Thirty-six patients were assessed with FIGO stage Ib1; 12 patients with stage IIa; and 12 patients with stage IIb. Median tumor diameter was 28 mm (range, 6-39 mm). Median overall treatment time was 43 days. Median follow-up was 49 months (range, 7-72 months). Seven patients developed recurrences: 3 patients had pelvic recurrences (2 central, 1 nodal), and 4 patients had distant metastases. The 2-year PDPF was 96% (95% confidence interval [CI], 92%-100%). The 2-year disease-free and overall survival rates were 90% (95% CI, 82%-98%) and 95% (95% CI, 89%-100%), respectively. The 2-year late complication rates (according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer of Grade {>=}1) were 18% (95% CI, 8%-28%) for large intestine/rectum, 4% (95% CI, 0%-8%) for small intestine, and 0% for bladder. No Grade {>=}3 cases were

  13. Prevent Cervical Cancer

    Science.gov (United States)

    ... Risk? What Are the Symptoms? What Should I Know About Screening? Statistics Related Links Inside Knowledge Campaign What CDC Is Doing Research AMIGAS Fighting Cervical Cancer Worldwide Stay Informed Printable Versions Standard quality PDF [PDF-877KB] High-quality PDF for professional ...

  14. Prevent Cervical Cancer!

    Centers for Disease Control (CDC) Podcasts

    2015-01-08

    Cervical cancer can be prevented. Listen as two friends—one a doctor—talk about screening tests and early detection. Learn what test you might need.  Created: 1/8/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/8/2015.

  15. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  16. Future Directions - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about possible changes in cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  17. SU-E-T-525: Dose Volume Histograms (DVH) Analysis and Comparison with ICRU Point Doses in MRI Guided HDR Brachytherapy for Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Badkul, R; McClinton, C; Kumar, P; Mitchell, M [University of Kansas Medical Center, Kansas City, KS (United States)

    2014-06-01

    Purpose: Brachytherapy plays a crucial role in management of cervix cancer. MRI compatible applicators have made it possible to accurately delineate gross-target-volume(GTV) and organs-at-risk(OAR) volumes, as well as directly plan, optimize and adapt dose-distribution for each insertion. We sought to compare DVH of tumor-coverage and OARs to traditional Point-A, ICRU-38 bladder and rectum point-doses for four different planning-techniques. Methods: MRI based 3D-planning was performed on Nucletron-Oncentra-TPS for 3 selected patients with varying tumor-sizes and anatomy. GTV,high-risk-clinical-target-volume(HR-CTV), intermediate-risk-clinical-target-volume(IR-CTV) and OARs: rectum, bladder, sigmoid-colon, vaginal-mucosa were delineated. Three conventionally used techniques: mg-Radium-equivalent(RaEq),equal-dwell-weights(EDW), Medical-College-of-Wisconsin proposed points-optimization (MCWO) and a manual-graphical-optimization(MGO) volume-coverage based technique were applied for each patient. Prescription was 6Gy delivered to point-A in Conventional techniques (RaEq, EDW, MCWO). For MGO, goal was to achieve 90%-coverage (D90) to HR-CTV with prescription-dose. ICRU point doses for rectum and bladder, point-A doses, DVH-doses for HR-CTV-D90,0.1cc-volume(D0.1),1ccvolume( D1),2cc-volume(D2) were collected for all plans and analyzed . Results: Mean D90 for HR-CTV normalized to MGO were 0.89,0.84,0.9,1.0 for EDW, RaEq, MCWO, MGO respectively. Mean point-A doses were 21.7% higher for MGO. Conventional techniques with Point-A prescriptions under covered HR-CTV-D90 by average of 12% as compared to MGO. Rectum, bladder and sigmoid doses were highest in MGO-plans for ICRU points as well as D0.1,D1 and D2 doses. Among conventional-techniques, rectum and bladder ICRU and DVH doses(0.1,1,2cc) were not significantly different (within 7%).Rectum D0.1 provided good estimation of ICRU-rectum-point doses (within 3.9%),rectum D0.1 were higher from 0.8 to 3.9% while bladder D0

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

    Science.gov (United States)

    2016-06-24

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

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

    DEFF Research Database (Denmark)

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

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

  20. MRI-assisted cervix cancer brachytherapy pre-planning, based on application in paracervical anaesthesia: final report

    Directory of Open Access Journals (Sweden)

    Petric Primoz

    2014-09-01

    Full Text Available Background. Optimal applicator insertion is a precondition for the success of cervix cancer brachytherapy (BT. We aimed to assess feasibility and efficacy of MRI-assisted pre-planning, based on applicator insertion in para-cervical anaesthesia (PCA.

  1. [Preventing cervical cancer].

    Science.gov (United States)

    Simon, P; Noël, J-C

    2015-09-01

    The incidence of cervical cancer has hopefully been dropping down in our industrialized countries since the introduction of both primary and secondary prevention. Nevertheless, it is still lethal in one out of two affected women though the introduction of cytological screening has dramatically reduced the mortality. Progressive diffusion of anti-HPV vaccination, the broadening of the viral types concerned, its association with existing screening measures and finally the introduction of viral detection as a screening tool must optimize the results already obtained.

  2. 宫颈癌患者近距离放疗局部感染的临床分析%Clinical analysis of local infections in cervical cancer patients undergoing brachytherapy

    Institute of Scientific and Technical Information of China (English)

    陈建红; 汪军坚; 方静; 俞华; 屠晔强

    2015-01-01

    OBJECTIVE To explore the prevalence of local infections in cervical cancer patients undergoing brachy‐therapy and analyze the distribution and drug resistance of pathogens isolated from vaginal secretions so as to pro‐vide guidance for clinical prevention of the local infections .METHODS A total of 356 cervical cancer patients who underwent the brachytherapy from Jan 2013 to Dec 2014 were recruited as the study objects;the prevalence of lo‐cal infections and the distribution and drug resistance of the pathogens isolated from the vaginal secretions were ob‐served .RESULTS The local infections occurred in 68 of 356 patients ,with the infection rate of 19 .1% .Totally 75 strains of pathogens have been isolated ,including 50 (66 .7% ) strains of gram‐negative bacteria ,22 (29 .3% ) strains of gram‐positive bacteria ,and 3 (4 .0% ) strains of fungi;the Escherichia coli and Proteus mirabilis were dominant among the gram‐negative bacteria;the Staphylococcus spp and Enterococcus spp were the main gram‐positive bacteria;the Candida albicans was the predominant species of fungi .The E .coli strains were highly re‐sistant to cefotaxime ,cefepime ,ceftazidime ,amoxicillin ,piperacillin ,ciprofloxacin ,and gentamicin ,with the drug resistance rates varying from 62 .5% to 93 .8% ;the drug resistance rates of the P .mirabilis strains to amox‐icillin and gentamicin were 66 .7% and 55 .6% ,respectively .The Staphylococcus app was highly resistant to peni‐cillin G ,erythromycin ,ciprofloxacin ,levofloxacin ,and ampicillin ,with the drug resistance rate varying from 53 .8% to 92 .3% ;the Enterococcus sp p was highly resistant to gentamicin ,erythromycin ,and levofloxacin ,with the drug resistance rate varying from 66 .7% to 100 .0% .CONCLUSION The incidence of the complicated local in‐fections is high in the cervical cancer patients undergoing brachytherapy .It is necessary for the hospital to strengthen the detection of pathogens and master the distribution

  3. Cisplatin and Radiation Therapy Followed by Paclitaxel and Carboplatin in Treating Patients With Stage IB-IVA Cervical Cancer

    Science.gov (United States)

    2016-03-16

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  4. Drugs Approved for Cervical Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for cervical cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  5. Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

    Science.gov (United States)

    2014-12-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  6. Müllerian duct anomalies and their effect on the radiotherapeutic management of cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Madhup Rastogi; Swaroop Revannasiddaiah; Pragyat Thakur; Priyanka Thakur; Manish Gupta; Manoj K Gupta; Rajeev K Seam

    2013-01-01

    Radiotherapy plays a major role in the treatment of cervical cancer.A successful radiotherapy program integrates both external beam and brachytherapy components.The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread.However,in patients with distorted anatomy,several practical issues arise in the delivery of optimal radiotherapy,especially with brachytherapy.Müllerian duct anomalies result in congenital malformations of the female genital tract.Though being very commonly studied for their deleterious effects on fertility and pregnancy,they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer.Here,we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.

  7. Mullerian duct anomalies and their effect on the radiotherapeutic management of cervical cancer

    Directory of Open Access Journals (Sweden)

    Manoj K Gupta

    2013-08-01

    Full Text Available Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Mullerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Mullerian duct anomalies and review the very sparse amount of published literature on this topic.

  8. A practical review of magnetic resonance imaging for the evaluation and management of cervical cancer

    International Nuclear Information System (INIS)

    Cervical cancer is a leading cause of mortality in women worldwide. Staging and management of cervical cancer has for many years been based on clinical exam and basic imaging such as intravenous pyelogram and x-ray. Unfortunately, despite advances in radiotherapy and the inclusion of chemotherapy in the standard plan for locally advanced disease, local control has been unsatisfactory. This situation has changed only recently with the increasing implementation of magnetic resonance image (MRI)-guided brachytherapy. The purpose of this article is therefore to provide an overview of the benefits of MRI in the evaluation and management of cervical cancer for both external beam radiotherapy and brachytherapy and to provide a practical approach if access to MRI is limited

  9. Practice patterns of radiotherapy in cervical cancer among member groups of the Gynecologic Cancer Intergroup (GCIG)

    DEFF Research Database (Denmark)

    Gaffney, David K; Du Bois, Andreas; Narayan, Kailash;

    2007-01-01

    practice. Different scenarios were queried including advanced cervical cancer, postoperative patients, and para-aortic-positive lymph node cases. Items focused on indications for radiation therapy, radiation fields, dose, use of chemotherapy, brachytherapy and others. The cooperative groups from North......PURPOSE: The aim of this study was to describe radiotherapeutic practice of the treatment of cervical cancer in member groups of the Gynecologic Cancer Intergroup (GCIG). METHODS AND MATERIALS: A survey was developed and distributed to the members of the GCIG focusing on details of radiotherapy...... America were compared with the other groups to evaluate potential differences in radiotherapy doses. RESULTS: A total of 39 surveys were returned from 13 different cooperative groups. For the treatment of advanced cervical cancer, external beam pelvic doses and total doses to point A were 47 + 3.5 Gy...

  10. International Brachytherapy Practice Patterns: A Survey of the Gynecologic Cancer Intergroup (GCIG)

    International Nuclear Information System (INIS)

    Purpose: To determine current practice patterns with regard to gynecologic high-dose-rate (HDR) brachytherapy among international members of the Gynecologic Cancer Intergroup (GCIG) in Japan/Korea (Asia), Australia/New Zealand (ANZ), Europe (E), and North America (NAm). Methods and Materials: A 32-item survey was developed requesting information on brachytherapy practice patterns and standard management for Stage IB–IVA cervical cancer. The chair of each GCIG member cooperative group selected radiation oncology members to receive the survey. Results: A total of 72 responses were analyzed; 61 respondents (85%) used HDR. The three most common HDR brachytherapy fractionation regimens for Stage IB–IIA patients were 6 Gy for five fractions (18%), 6 Gy for four fractions (15%), and 7 Gy for three fractions (11%); for Stage IIB–IVA patients they were 6 Gy for five fractions (19%), 7 Gy for four fractions (8%), and 7 Gy for three fractions (8%). Overall, the mean combined external-beam and brachytherapy equivalent dose (EQD2) was 81.1 (standard deviation [SD] 10.16). The mean EQD2 recommended for Stage IB–IIA patients was 78.9 Gy (SD 10.7) and for Stage IIB–IVA was 83.3 Gy (SD 11.2) (p = 0.02). By region, the mean combined EQD2 was as follows: Asia, 71.2 Gy (SD 12.65); ANZ, 81.18 (SD 4.96); E, 83.24 (SD 10.75); and NAm, 81.66 (SD, 6.05; p = 0.02 for Asia vs. other regions).The ratio of brachytherapy to total prescribed dose was significantly higher for Japan (p = 0.0002). Conclusion: Although fractionation patterns may vary, the overall mean doses administered for cervical cancer are similar in Australia/New Zealand, Europe, and North America, with practitioners in Japan administering a significantly lower external-beam dose but higher brachytherapy dose to the cervix. Given common goals, standardization should be possible in future clinical trials.

  11. Prevention program of cervical cancer - Enrique Pouey

    International Nuclear Information System (INIS)

    This work is about the first basic objectives in the prevention of cervical cancer in Uruguay. The Papanicolaou test, the biopsia, and the colposcopy are important studies for the early cervical cancer detection

  12. Preventing Cervical Cancer with HPV Vaccines

    Science.gov (United States)

    Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

  13. B0-correction and k-means clustering for accurate and automatic identification of regions with reduced apparent diffusion coefficient (ADC) in adva nced cervical cancer at the time of brachytherapy

    DEFF Research Database (Denmark)

    Haack, Søren; Pedersen, Erik Morre; Vinding, Mads Sloth;

    Diffusion weighted MRI has shown great potential in diagnostic cancer imaging and may also have value for monitoring tumor response during radiotherapy. Uncertainties due to geometric distortions caused by B0-inhomogeneity and tumor delineation are major obstacles for implementing DWI for use in ...... of advanced cervical cancer.......Diffusion weighted MRI has shown great potential in diagnostic cancer imaging and may also have value for monitoring tumor response during radiotherapy. Uncertainties due to geometric distortions caused by B0-inhomogeneity and tumor delineation are major obstacles for implementing DWI for use...

  14. Cervical Cancer Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing cervical cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  15. Factors influencing outcome of I-125 prostate cancer brachytherapy

    NARCIS (Netherlands)

    Hinnen, K.A.

    2011-01-01

    Brachytherapy is becoming an increasingly popular prostate cancer treatment, probably due to the specific advantages of the procedure, such as the minimal invasiveness and the lower chance of impotence and incontinence. Nonetheless, because of the long follow-up that is required to obtain prostate c

  16. Lymphedema After Surgery in Patients With Endometrial Cancer, Cervical Cancer, or Vulvar Cancer

    Science.gov (United States)

    2014-12-23

    Lymphedema; Stage IA Cervical Cancer; Stage IA Uterine Corpus Cancer; Stage IA Vulvar Cancer; Stage IB Cervical Cancer; Stage IB Uterine Corpus Cancer; Stage IB Vulvar Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVB Vulvar Cancer

  17. Methods for Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Tatiana Vargas-Revilla

    2014-12-01

    This article is divided in three sections: the first one focuses on the general impact of cervical cancer has hadin CostaRica, these condsection gathers information about different methodologies used around the world to detect this cancer and the third one makes reference to the current development of the screening devise in Mexico that works as a monitoring system and can used by women without external assistance.

  18. HDR neutron brachytherapy for prostatic cancer in lithuania

    International Nuclear Information System (INIS)

    The purpose of this report is to analyse the physical and radiobiological background of the HDR Cf-252 Neutron brachytherapy boost in the combined radiation therapy for locally advanced prostatic cancer. The treatment schedule:two fractions of the Cf-252 brachytherapy(5Gy-eq at the dose point 2 cm from source movement trajectory) with interval 24 hours; 5-8 fractions of the photon beam external radiation therapy(5 fractions per week, 2 Gy per fraction) to the prostate, two fractions of the Cf-252 brachytherapy and after that external beam radiation therapy is continued till total dose 40-45 Gy. Six patients completed the proposed combined radiation therapy. The results of this trial will be discussed

  19. Cervical cancer screening at crossroads

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rygaard, Carsten; Baillet, Miguel Vazquez-Prada;

    2014-01-01

    ) demonstrated that HPV testing provides better protection against cervical cancer than cytology, but it requires extra repeated testing. HPV vaccination RCTs, furthermore, have proved that HPV vaccination protects against vaccine-type high-grade CIN in women vaccinated prior to sexual activity, but less so...... cancer case. The discovery of human papillomavirus (HPV) as the cause of cervical cancer dramatically changed perspectives for disease control. Screening with HPV testing was launched around 1990, and preventive HPV vaccination was licensed in 2006. Long-term randomized controlled trials (RCT...... in women vaccinated later. The challenge now is therefore to find an algorithm for screening of a heterogeneous population including non-vaccinated women; women vaccinated prior to start of sexual activity; and women vaccinated later....

  20. Cervical cancer: screening, diagnosis and staging.

    Science.gov (United States)

    Tsikouras, Panagiotis; Zervoudis, Stefanos; Manav, Bachar; Tomara, Eirini; Iatrakis, George; Romanidis, Constantinos; Bothou, Anastasia; Galazios, George

    2016-01-01

    Purpose: Despite the widespread screening programs, cervical cancer remains the third most common cancer in developing countries. Based on the implementation of cervical screening programs with the referred adoption of improved screening methods in cervical cytology with the knowledge of the important role of the human papilloma virus (HPV) it's incidence is decreased in the developed world. Even if cervical HPV infection is incredibly common, cervical cancer is relatively rare. Depending on the rarity of invasive disease and the improvement of detection of pre-cancerous lesions due to the participation in screening programs, the goal of screening is to detect the cervical lesions early in order to be treated before cancer is developed. In populations with many preventive screening programs, a decrease in cervical cancer mortality of 50-75% is mentioned over the past 50 years. The preventive examination of vagina and cervix smear, Pap test, and the HPV DNA test are remarkable diagnostic tools according to the American Cancer Association guidelines, in the investigation of asymptomatic women and in the follow up of women after the treatment of pre-invasive cervical cancer. The treatment of cervical cancer is based on the FIGO 2009 cervical cancer staging.

  1. A systematic overview of radiation therapy effects in cervical cancer (cervix uteri).

    Science.gov (United States)

    Einhorn, Nina; Tropé, Claes; Ridderheim, Mona; Boman, Karin; Sorbe, Bengt; Cavallin-Ståhl, Eva

    2003-01-01

    A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately (Acta Oncol 2003; 42: 357-365). This synthesis of the literature on radiation therapy for cervical cancer is based on data from 1 meta-analysis and 34 randomized trials. In total, 35 scientific articles are included, involving 7 952 patients. The results were compared with those of a similar overview from 1996 including 34 024 patients. The conclusions reached can be summarized in these points: There are limited scientific data supporting that postoperative pelvic radiotherapy improves disease-free survival in early cervical cancer. No firm conclusion can be drawn. There is moderate scientific evidence that external beam radiotherapy combined with brachytherapy gives a similar disease-free and overall survival rate as radical hysterectomy in early cervical cancer. There is strong scientific evidence that concomitant radiochemotherapy improves disease-free and overall survival compared to radiotherapy alone in early cervical cancer. The NCI has recently published an announcement stating that cisplatin-based chemotherapy should be used concomitantly with radiotherapy in cervical cancer. No solid documentation for this statement can be found concerning locally advanced stages ( >IIB). There is a strong scientific evidence that cisplatin-based chemotherapy given concomitantly with radiotherapy is superior to concomitant chemotherapy with hydroxyurea. There is no scientific evidence to show that neoadjuvant chemotherapy followed by radiotherapy improves disease-free or overall survival compared to radiotherapy alone in patients with localized cervical cancer. There is moderate scientific evidence that high-dose-rate brachytherapy gives the same local control rate as low-dose-rate brachytherapy but with fewer rectal complications.

  2. High-risk clinical target volume delineation in CT-guided cervical cancer brachytherapy - Impact of information from FIGO stage with or without systematic inclusion of 3D documentation of clinical gynecological examination

    Energy Technology Data Exchange (ETDEWEB)

    Hegazy, Neamat [Dept. of Radiotherapy, Comprehensive Cancer Centre Vienna, Medical Univ. of Vienna, Vienna (Austria); Dept. of Clinical Oncology, Medical Univ. of Alexandria, Alexandria (Egypt); Poetter Rickard; Kirisits, Christian [Dept. of Radiotherapy, Comprehensive Cancer Centre Vienna, Medical Univ. of Vienna, Vienna (Austria); Christian Doppler Lab. for Medical Radiation Research for Radiation Oncology, Medical Univ. Vienna (Austria); Berger, Daniel; Federico, Mario; Sturdza, Alina; Nesvacil, Nicole [Dept. of Radiotherapy, Comprehensive Cancer Centre Vienna, Medical Univ. of Vienna, Vienna (Austria)], e-mail: nicole.nesvacil@meduniwien.ac.at

    2013-10-15

    Purpose: The aim of the study was to improve computed tomography (CT)-based high-risk clinical target volume (HR CTV) delineation protocols for cervix cancer patients, in settings without any access to magnetic resonance imaging (MRI) at the time of brachytherapy. Therefore the value of a systematic integration of comprehensive three-dimensional (3D) documentation of repetitive gynecological examination for CT-based HR CTV delineation protocols, in addition to information from FIGO staging, was investigated. In addition to a comparison between reference MRI contours and two different CT-based contouring methods (using complementary information from FIGO staging with or without additional 3D clinical drawings), the use of standardized uterine heights was also investigated. Material and methods: Thirty-five cervix cancer patients with CT- and MR-images and 3D clinical drawings at time of diagnosis and brachytherapy were included. HR CTV{sub stage} was based on CT information and FIGO stage. HR CTV{sub stage} {sub +3Dclin} was contoured on CT using FIGO stage and 3D clinical drawing. Standardized HR CTV heights were: 1/1, 2/3 and 1/2 of uterine height. MRI-based HR CTV was delineated independently. Resulting widths, thicknesses, heights, and volumes of HR CTV{sub stage}, HR CTV{sub stage+3Dclin} and MRI-based HR CTV contours were compared. Results: The overall normalized volume ratios (mean{+-}SD of CT/MRI{sub ref} volume) of HR CTV{sub stage} and HR{sub stage+3Dclin} were 2.6 ({+-}0.6) and 2.1 ({+-}0.4) for 1/1 and 2.3 ({+-}0.5) and 1.8 ({+-}0.4), for 2/3, and 1.9 ({+-}0.5) and 1.5 ({+-}0.3), for 1/2 of uterine height. The mean normalized widths were 1.5{+-}0.2 and 1.2{+-}0.2 for HR CTV{sub stage} and HR CTV{sub stage+3Dclin}, respectively (p < 0.05). The mean normalized heights for HR CTV{sub stage} and HR CTV{sub stage+3Dclin} were both 1.7{+-}0.4 for 1/1 (p < 0.05.), 1.3{+-}0.3 for 2/3 (p < 0.05) and 1.1{+-}0.3 for 1/2 of uterine height. Conclusion: CT-based HR

  3. Brachytherapy in vulvar cancer: analysis of 18 patients

    International Nuclear Information System (INIS)

    INTRODUCTION: Vulvar cancer is a rather common neoplasm in elderly patients. Surgery, followed eventually by postoperative radiotherapy, is the treatment of choice. The results of exclusive radiotherapy (external beam irradiation and/or brachytherapy) are not well defined and in the recent literature only small series are reported. Radiotherapy however is the only therapeutic option in patients who are not fit for radical surgery. It is thus necessary to review its indications and its modalities. PATIENTS METHODS AND RESULTS: From 1990 to 1994 18 pts with a diagnosis of squamous cell carcinoma of the vulva have been submitted to brachytherapy. Age ranged from 60 to 92 years (mean age 76, 1 ys). 14 pts were treated at diagnosis (11 pts) or for recurrent disease after surgery (3 pts). In 8 of them brachytherapy (total dose 35-45 Gy, dose rate: 0,4-0,78 Gy/h) was preceded by external beam irradiation (Co60 or electron beam, 40-50 Gy to primary and inguinal nodes); 6 pts were treated with brachytherapy alone (58-60 Gy; dose rate 0,44-0,63 Gy/h). 4 pts underwent to brachytherapy alone for local recurrence after surgery and postoperative radiotherapy (total dose 45-60 Gy; dose rate 0,37-0,49 Gy/h). Brachytherapy was always performed with 192 Ir. Plastic tubes (2 to 5 lines) were used for single plane implantation of small exophytic lesions limited to the labia (8 cases); a perineal template (10 cases) was employed in lesions extended to the vaginal mucosa or involving the clitoris or the area of the perineum. (10(14)) pts treated at diagnosis are alive and free from local recurrence after 11-48 mos. 3 of them, treated with brachytherapy alone, have presented a nodal recurrence in the groin after 14, 15 and 27 mos. respectively. All of them are alive and free from disease after surgery and external radiotherapy. None of the pts treated for recurrent disease after surgery + external beam radiotherapy has achieved a local control. CONCLUSION: Brachytherapy alone or

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

    Science.gov (United States)

    Eich, H T; Haverkamp, U; Micke, O; Prott, F J; Müller, R P

    2000-01-01

    In vivo dosimetry in bladder and rectum as well as determining doses on suggested reference points following the ICRU report 38 contribute to quality assurance in HDR-brachytherapy of cervical carcinoma, especially to minimize side effects. In order to gain information regarding the radiation exposure at ICRU reference points in rectum, bladder, ureter and regional lymph nodes those were calculated (digitalisation) by means of orthogonal radiographs of 11 applications in patients with cervical carcinoma, who received primary radiotherapy. In addition, the doses at the ICRU rectum reference point was compared to the results of in vivo measurements in the rectum. The in vivo measurements were by factor 1.5 below the doses determined for the ICRU rectum reference point (4.05 +/- 0.68 Gy versus 6.11 +/- 1.63 Gy). Reasons for this were: calibration errors, non-orthogonal radiographs, movement of applicator and probe in the time span between X-ray and application, missing connection of probe and anterior rectal wall. The standard deviation of calculations at ICRU reference points was on average +/- 30%. Possible reasons for the relatively large standard deviation were difficulties in defining the points, identifying them on radiographs and the different locations of the applicators. Although 3 D CT, US or MR based treatment planning using dose volume histogram analysis is more and more established, this simple procedure of marking and digitising the ICRU reference points lengthened treatment planning only by 5 to 10 minutes. The advantages of in vivo dosimetry are easy practicability and the possibility to determine rectum doses during radiation. The advantages of computer-aided planning at ICRU reference points are that calculations are available before radiation and that they can still be taken into account for treatment planning. Both methods should be applied in HDR-brachytherapy of cervical carcinoma. PMID:10994367

  5. Glycoprotein and Glycan in Tissue and Blood Samples of Patients With Stage IB-IVA Cervical Cancer Undergoing Surgery to Remove Pelvic and Abdominal Lymph Nodes

    Science.gov (United States)

    2016-10-26

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  6. Simple DVH parameter addition as compared to deformable registration for bladder dose accumulation in cervix cancer brachytherapy

    DEFF Research Database (Denmark)

    Andersen, Else Stougård; Noe, Karsten Østergaaard; Sørensen, Thomas Sangild;

    2013-01-01

    Background and purpose: Variations in organ position, shape, and volume cause uncertainties in dose assessment for brachytherapy (BT) in cervix cancer. The purpose of this study was to evaluate uncertainties associated with bladder dose accumulation based on DVH parameter addition (previously...... called "the worst case assumption") in fractionated BT. Materials and methods: Forty-seven patients treated for locally advanced cervical cancer were included. All patients received EBRT combined with two individually planned 3D image-guided adaptive BT fractions. D2 and D0.1 were estimated by DVH...

  7. Preventive vaccines for cervical cancer

    Directory of Open Access Journals (Sweden)

    WHEELER COSETTE M

    1997-01-01

    Full Text Available The potential use of vaccines for the human papillomavirus (HPV in the prevention and treatment of cervical cancer is a possibility in the near future. Close to 20 genotypes of HPV, of the 75 that have been identified, infect the femine genital tract, but four subtypes (16, 18, 31 and 45 have been associated in close to 80% of cervical cancers. this article proposes that in order to design an effective prophylactic vaccine against HPV infection, an adequate immune response should be guaranteed through four goals; a activation of antigens present in the cell; b overcoming the host response and viral genetic variability in the T cell response; c generation of high levels of T and B memory cells; and d persistence of antigens.

  8. National Cancer Data Base Analysis of Radiation Therapy Consolidation Modality for Cervical Cancer: The Impact of New Technological Advancements

    Energy Technology Data Exchange (ETDEWEB)

    Gill, Beant S. [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Lin, Jeff F. [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Krivak, Thomas C. [Department of Gynecologic Oncology, Western Pennsylvania Hospital, Pittsburgh, Pennsylvania (United States); Sukumvanich, Paniti; Laskey, Robin A.; Ross, Malcolm S.; Lesnock, Jamie L. [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

    2014-12-01

    Purpose: To utilize the National Cancer Data Base to evaluate trends in brachytherapy and alternative radiation therapy utilization in the treatment of cervical cancer, to identify associations with outcomes between the various radiation therapy modalities. Methods and Materials: Patients with International Federation of Gynecology and Obstetrics stage IIB-IVA cervical cancer in the National Cancer Data Base who received treatment from January 2004 to December 2011 were analyzed. Overall survival was estimated by the Kaplan-Meier method. Univariate and multivariable analyses were performed to identify factors associated with type of boost radiation modality used and its impact on survival. Results: A total of 7654 patients had information regarding boost modality. A predominant proportion of patients were Caucasian (76.2%), had stage IIIB (48.9%) disease with squamous (82.0%) histology, were treated at academic/research centers (47.7%) in the South (34.8%), and lived 0 to 5 miles (27.9%) from the treating facility. A majority received brachytherapy (90.3%). From 2004 to 2011, brachytherapy use decreased from 96.7% to 86.1%, whereas intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT) use increased from 3.3% to 13.9% in the same period (P<.01). Factors associated with decreased brachytherapy utilization included older age, stage IVA disease, smaller tumor size, later year of diagnosis, lower-volume treatment centers, and facility type. After controlling for significant factors from survival analyses, IMRT or SBRT boost resulted in inferior overall survival (hazard ratio, 1.86; 95% confidence interval, 1.35-2.55; P<.01) as compared with brachytherapy. In fact, the survival detriment associated with IMRT or SBRT boost was stronger than that associated with excluding chemotherapy (hazard ratio, 1.61′ 95% confidence interval, 1.27-2.04′ P<.01). Conclusions: Consolidation brachytherapy is a critical treatment component for

  9. 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

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

    Science.gov (United States)

    2016-03-25

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

  11. Laparoscopic Fertility Sparing Management of Cervical Cancer

    OpenAIRE

    Chiara Facchini; Giuseppina Rapacchia; Giulia Montanari; Paolo Casadio; Gianluigi Pilu; Renato Seracchioli

    2014-01-01

    Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery ...

  12. The potential therapeutic targets for cervical cancer

    Directory of Open Access Journals (Sweden)

    L Priyanka Dwarampudi

    2013-01-01

    Full Text Available In case of invasive cervical carcinoma several molecular events were reported and these molecular events resulting in multiple genetic abnormalities. In order to control these tumors multiple molecular therapeutic targets are needed with different molecular mechanisms. Unfortunately, these molecular targets were in early stages of development. Because of less degree of success of conventional therapeutics for late stages of cervical cancer and lowering of prognosis of patients there is an increase in interest for the development of potential therapeutic targets for cervical cancer. This review article emphasizes the current molecular targeted agents; with special attention to estrogen receptors for human papilloma virus infected cervical cancer.

  13. Economic burden of cervical cancer in Malaysia

    OpenAIRE

    Sharifa E. W. Puteh; Paul Ng; Aljunid, Syed M

    2008-01-01

    Cervical cancers form the second highest number of female cancers in Malaysia, imposing a substantial amount of cost burden on its management. However, an estimation of cost burden of abnormal smears, cervical pre-invasive and invasive diseases needs to be done to show how much spending has been allocated to the problem. An expert panel committee came up with the clinical pathway and management algorithm of  cervical pre invasive and invasive diseases from July-December 2006 Malaysia. An acti...

  14. Clinical Report on Californium-252 Neutron Intraluminal Brachytherapy Combined with External Irradiation for Cervical Carcinoma Treatment

    Institute of Scientific and Technical Information of China (English)

    Huanyu Zhao; Keming Wang; Jian Sun; Xin Geng; Weiming Zhang

    2006-01-01

    OBJECTIVE To observe the curative effects and complications of californium-252 (252Cf) neutron intraluminal brachytherapy (IBT) combined with external irradiation (El) for treatment of cervical carcinoma.METHODS From December 2000 to December 2004, 128 cases of cervical carcinoma staged into ⅡA~ⅢB according to the International Federation of Gynecology and Obstetrics (FIGO) standards were treated with 252Cf neutron IBT using 8~10 Gy per fraction, once a week. The total dose at reference A point was 36~40 Gy in 4~5 fractions. From the second day after 252Cf neutron IBT treatment, the whole pelvic cavity was treated with 60Co γ-ray El, applying 2 Gy per fraction, 4 times per week. After 20~25 Gy of El, the center of the whole pelvic field was blocked with 4 cm of lead in width. The total dose of El was 45~50 Gy.RESULTS The short-term therapeutic effects were CR 95.3% and PR 4.7%. The 3 and 5-year local control rates were 93.5% and 87.9%. The overall 3-year survival rate was 87.5% and for Stages Ⅱ and Ⅲ , 90.9%and 81.5% respectively; the overall 5-year survival rate was 70% and for Stages Ⅱ and Ⅲ, 76.2% and 61% respectively. The rate of radiation complications was 4.7% for radiation cystitis, 7.8% for radiation proctitis, 6.3%for vagina contracture and adhesion and 5.5% for protracted radiation proctitis.CONCLUSION An combination of 252Cf neutron IBT with El for treatment of cervical carcinoma can be well-tolerated by cervical carcinoma patients. The rate of local tumor control is high and radiation complications are few.

  15. How Are Cervical Cancers and Pre-Cancers Diagnosed?

    Science.gov (United States)

    ... some find disturbing. Some places provide headphones with music to block this noise out. A mild sedative ... in Cervical Cancer Research? Other Resources and References Cancer Information Cancer Basics Cancer Prevention & Detection Signs & Symptoms ...

  16. Cervical cancer control, priorities and new directions.

    NARCIS (Netherlands)

    Monsonego, J; Bosch, F.X.; Coursaget, P.; Cox, JT; Franco, E; Frazer, I; Sankaranarayanan, R; Schiller, J; Singer, A; Wright, TCJr; Kinney, W; Meijer, C.J.L.M.; Linder, J

    2004-01-01

    99% of cervical cancer is initiated by HPV infection. The estimated lifetime risk of cervical cancer is nevertheless relatively low (less than 1 in 20 for most community based studies). Although sensitivity and specificity of the available diagnostic techniques are suboptimal, screening for persiste

  17. Immunosuppression and risk of cervical cancer

    DEFF Research Database (Denmark)

    Dugué, Pierre-Antoine; Rebolj, Matejka; Garred, Peter;

    2013-01-01

    A markedly increased risk of cervical cancer is known in women immunosuppressed due to AIDS or therapy following organ transplantation. The aim of this review is to determine the association between other conditions affecting the immune system and the risk of cervical cancer. Patients with end...

  18. CDC Vital Signs: Cervical Cancer is Preventable

    Science.gov (United States)

    ... prevention. No woman should die of cervical cancer. Doctors, nurses, and health systems can: Help women understand what ... Cancer Early Detection Program , Title X Family Planning Doctors, nurses, and health systems can Help women understand which ...

  19. Brachytherapy for prostate cancer: Comparative characteristics of procedures

    Directory of Open Access Journals (Sweden)

    S. V. Kanaev

    2015-01-01

    Full Text Available The introduction of interstitial radiation sources is the «youngest» of the radical method of treatment of patients with prostate cancer (PC. The high level of efficiency comparable to prostatectomy at a significantly lower rate of complications causes rapid growth of clinical use of brachytherapy (BT. Depending on the radiation source and the mode of administration into the prostate gland are two types BT – high-dose rate (temporary (HDR-BT and low-dose rate (permanent (LDR-BT brachytherapy. At the heart of these two methods are based on a single principle of direct effect of the quantum gamma radiation on the area of interest. However, the differences between the characteristics of isotopes used and technical aspects of the techniques cause the difference in performance and complication rates for expression HDR-BT and LDR-BT.

  20. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV): Basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy

    OpenAIRE

    Dimopoulos, Johannes C.A.; Petrow, Peter; Tanderup, Kari; Petric, Primoz; Berger, Daniel; Kirisits, Christian; Pedersen, Erik M; van Limbergen, Erik; Haie-Meder, Christine; Pötter, Richard

    2012-01-01

    The GYN GEC-ESTRO working group issued three parts of recommendations and highlighted the pivotal role of MRI for the successful implementation of 3D image-based cervical cancer brachytherapy (BT). The main advantage of MRI as an imaging modality is its superior soft tissue depiction quality. To exploit the full potential of MRI for the better ability of the radiation oncologist to make the appropriate choice for the BT application technique and to accurately define the target volumes and the...

  1. Economic burden of cervical cancer in Malaysia

    Directory of Open Access Journals (Sweden)

    Sharifa E.W. Puteh

    2008-12-01

    Full Text Available Cervical cancers form the second highest number of female cancers in Malaysia, imposing a substantial amount of cost burden on its management. However, an estimation of cost burden of abnormal smears, cervical pre-invasive and invasive diseases needs to be done to show how much spending has been allocated to the problem. An expert panel committee came up with the clinical pathway and management algorithm of  cervical pre invasive and invasive diseases from July-December 2006 Malaysia. An activity based costing for each clinical pathway was done. Results were converted to USD. The cost of managing pre-invasive cervical cancers stage is USD 420,150 (Range: USD 197,158-879,679. Management of invasive cancer (new cases costs USD 51,533,233.44 (Range: USD 32,405,399.69 - USD 129,014,768.40. The cost of managing existing cases is USD 17,005,966.87 (Range: USD 10,693,781.90 - USD  28,901,587.12. The total cost of managing cervical cancers by health care providers in a public setting is around USD 75,888,329.45 (Range: USD 48,083,804.60 - USD 48,083,804.60. The outcome of this study has shown that preventive modalities such as screening have only contributed to 10.3 % of the total management cost of cervical cancer. The major cost contribution (67% came from treatment of invasive cancer especially at more advanced stages of cancer, followed by treatment of existing cases (22% and lastly on pre-invasive disease (0.6%. This study revealed that proportion of preventive modality in this country was still low, and the major cost came from actual treatment cost of cervical cancer. Therefore, heightened public cervical cancer screening in the country is needed. (Med J Indones 2008; 17: 272-80Keywords: cervical cancers, pre invasive disease, HPV vaccination

  2. Cervical cancer screening in the Faroe Islands

    DEFF Research Database (Denmark)

    Hammer, Turið; Lynge, Elsebeth; Djurhuus, Gisela W;

    2015-01-01

    aim was to provide the first description of cervical cancer screening, and to determine the screening history of women diagnosed with cervical cancer in the Faroe Islands. MATERIAL AND METHODS: Screening data from 1996 to 2012 were obtained from the Diagnostic Centre at the National Hospital......BACKGROUND: The Faroe Islands have had nationally organised cervical cancer screening since 1995. Women aged 25-60 years are invited every third year. Participation is free of charge. Although several European overviews on cervical screening are available, none have included the Faroe Islands. Our...... 1999. At present, 7.0% of samples have abnormal cytology. Of all ASCUS samples, 76-95% were tested for HPV. A total of 58% of women diagnosed with cervical cancer did not participate in screening prior to their diagnosis, and 32% had normal cytology in the previous four years. CONCLUSION: Despite...

  3. Acquired vulvar lymphangioma circumscriptum after cervical cancer treatment: Case report.

    Science.gov (United States)

    Valente, Kari; Montgomery, Kathleen; Schultenover, Stephen; Desouki, Mohamed Mokhtar

    2016-04-01

    Vulvar lymphangioma circumscriptum (LC) is a rare entity which may present as a painful, warty lesion. In contrast to the congenital form, which occurs in children, the acquired form arises in older adults and may be associated with infection, Crohn's disease, or prior pelvic/regional surgery. We present a case of acquired LC of the vulva in a 55-year-old woman who presented with a 3-4 year history of vulvar pain following chemotherapy, radiation, and brachytherapy for cervical cancer. Vulvar shave biopsies followed by excision revealed a thickened dermis with epidermal hyperkeratosis, parakeratosis, elongated rete ridges and dilated lymphatic channels containing eosinophilic material and scattered thrombi. The differential diagnosis for this unusual lesion includes more common conditions such as condyloma acuminatum, fungating squamous cell carcinoma and molluscum contagiosum. It is important to recognize the clinical presentation as well as the distinct histological appearance of this rare benign entity. PMID:27331134

  4. Cervical Cancer Screening with HPV Test

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about cotesting with human papillomavirus (HPV) as part of a cervical cancer screening program.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  5. Targeted treatments for cervical cancer: a review.

    Science.gov (United States)

    Peralta-Zaragoza, Oscar; Bermúdez-Morales, Víctor Hugo; Pérez-Plasencia, Carlos; Salazar-León, Jonathan; Gómez-Cerón, Claudia; Madrid-Marina, Vicente

    2012-01-01

    Cervical cancer is the second most common cause of cancer death in women worldwide and the development of new diagnosis, prognostic, and treatment strategies merits special attention. Although surgery and chemoradiotherapy can cure 80%-95% of women with early stage cancer, the recurrent and metastatic disease remains a major cause of cancer death. Many efforts have been made to design new drugs and develop gene therapies to treat cervical cancer. In recent decades, research on treatment strategies has proposed several options, including the role of HPV E6 and E7 oncogenes, which are retained and expressed in most cervical cancers and whose respective oncoproteins are critical to the induction and maintenance of the malignant phenotype. Other efforts have been focused on antitumor immunotherapy strategies. It is known that during the development of cervical cancer, a cascade of abnormal events is induced, including disruption of cellular cycle control, perturbation of antitumor immune response, alteration of gene expression, and deregulation of microRNA expression. Thus, in this review article we discuss potential targets for the treatment of cervical cancer associated with HPV infection, with special attention to immunotherapy approaches, clinical trials, siRNA molecules, and their implications as gene therapy strategies against cervical cancer development. PMID:23144564

  6. Socioeconomic position and survival after cervical cancer

    DEFF Research Database (Denmark)

    Ibfelt, E H; Kjær, S K; Høgdall, C;

    2013-01-01

    In an attempt to decrease social disparities in cancer survival, it is important to consider the mechanisms by which socioeconomic position influences cancer prognosis. We aimed to investigate whether any associations between socioeconomic factors and survival after cervical cancer could...... be explained by socioeconomic differences in cancer stage, comorbidity, lifestyle factors or treatment....

  7. Cervical Cancer is Preventable! PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2014-11-05

    This 60 second Public Service Announcement is based on the November 2014 CDC Vital Signs report. Every visit to a doctor or nurse is an opportunity to prevent cervical cancer. Women can get a Pap test and HPV test to help prevent cervical cancer and adolescent boys and girls can get the HPV vaccination series to help prevent cervical and other cancers.  Created: 11/5/2014 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 11/5/2014.

  8. Vital Signs-Cervical Cancer is Preventable!

    Centers for Disease Control (CDC) Podcasts

    2014-11-05

    This podcast is based on the November 2014 CDC Vital Signs report. Every visit to a doctor or nurse is an opportunity to prevent cervical cancer. Women can get a Pap test and HPV test to help prevent cervical cancer and adolescent boys and girls can get the HPV vaccination series to help prevent cervical and other cancers.  Created: 11/5/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/5/2014.

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Decreased cervical cancer cell adhesion on nanotubular titanium for the treatment of cervical cancer

    OpenAIRE

    Crear J; Kummer KM; Webster TJ

    2013-01-01

    Jara Crear, Kim M Kummer, Thomas J Webster School of Engineering, Brown University, Providence, RI, USA Abstract: Cervical cancer can be treated by surgical resection, chemotherapy, and/or radiation. Titanium biomaterials have been suggested as a tool to help in the local delivery of chemotherapeutic agents and/or radiation to cervical cancer sites. However, current titanium medical devices used for treating cervical cancer do not by themselves possess any anticancer properties; such devices...

  11. Trends of cervical cancer in Greenland

    DEFF Research Database (Denmark)

    Sander, Bente B; Rebolj, Matejka; Lynge, Elsebeth

    2014-01-01

    supplemented this with data for 1980-2009 obtained from the Chief Medical Officer of Greenland. RESULTS: Incidence of cervical cancer was around 10 per 100 000 women (age-standardised, world population, ASW) in the 1950s, 30 per 100 000 in the 1960s, and in the 1980s around 60 per 100 000. From 1985 onwards......BACKGROUND: Due to its extraordinarily fast economic and social transition, virtually closed borders before 1940 and, moreover, that 85% of the population has the distinctive genetics of the Inuit, Greenland is a very interesting country to study cervical cancer from a historical perspective....... Nevertheless, little has been reported about long-term cancer trends in Greenland. Our aim was to describe and interpret the incidence of cervical cancer from 1950 to 2009. MATERIAL AND METHODS: We systematically searched PubMed for articles reporting the incidence of cervical cancer in Greenland. We...

  12. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy

    Directory of Open Access Journals (Sweden)

    Yasuhiro Yamada

    2015-01-01

    Full Text Available External beam radiotherapy (EBRT is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU] have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatment for low-risk and selected intermediate-risk prostate tumors. However, few studies have examined the use of brachytherapy to treat post-EBRT recurrent prostate cancer. The purpose of this paper is to analyze the current state of our knowledge about the effects of salvage brachytherapy in patients who develop locally recurrent prostate cancer after primary EBRT. This article also introduces our novel permanent brachytherapy salvage method.

  13. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy.

    Science.gov (United States)

    Yamada, Yasuhiro; Okihara, Koji; Iwata, Tsuyoshi; Masui, Koji; Kamoi, Kazumi; Yamada, Kei; Miki, Tsuneharu

    2015-01-01

    External beam radiotherapy (EBRT) is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU]) have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatment for low-risk and selected intermediate-risk prostate tumors. However, few studies have examined the use of brachytherapy to treat post-EBRT recurrent prostate cancer. The purpose of this paper is to analyze the current state of our knowledge about the effects of salvage brachytherapy in patients who develop locally recurrent prostate cancer after primary EBRT. This article also introduces our novel permanent brachytherapy salvage method. PMID:26112477

  14. Triapine With Chemotherapy and Radiation Therapy in Treating Patients With IB2-IVA Cervical or Vulvar Cancer

    Science.gov (United States)

    2016-10-28

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Vulvar Cancer; Stage IB2 Cervical Cancer; Stage II Vulvar Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Cervical Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vulvar Cancer; Vulvar Adenocarcinoma; Vulvar Squamous Cell Carcinoma

  15. Colposcopy and High Resolution Anoscopy in Screening For Anal Dysplasia in Patients With Cervical, Vaginal, or Vulvar Dysplasia or Cancer

    Science.gov (United States)

    2012-06-08

    Cervical Intraepithelial Neoplasia Grade 1; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage 0 Cervical Cancer; Stage 0 Vaginal Cancer; Stage 0 Vulvar Cancer; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IV Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer

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

    Science.gov (United States)

    Tewari, Krishnansu S; Monk, Bradley J

    2014-11-01

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

  17. Laparoscopic Fertility Sparing Management of Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Chiara Facchini

    2014-03-01

    Full Text Available Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women.

  18. Epidemiology of cervical cancer in Colombia

    Directory of Open Access Journals (Sweden)

    Muñoz, Nubia

    2012-12-01

    Full Text Available Worldwide, cervical cancer is the third most common cancer in women, and the first or second most common in developing countries. Cervical cancer remains in Colombia the first cause of cancer mortality and the second cause of cancer incidence among women, despite the existence of screening programs during the last 3 decades. Bucaramanga, Manizales and Cali reported rates around 20 per 100,000 and Pasto 27 per 100,000. The Cali cancer registry has reported a progressive decrease in the age standardized incidence and mortality rates of cervical cancer over the past 40 years. Reasons for the decline in incidence and mortality of cervical cancer are multiple and probably include: improvement in socio-economic conditions, decrease in parity rates and some effect of screening programs.Human papilloma Virus is the main cause of cervical cancer, HPV natural history studies have now revealed that HPVs are the commonest of the sexually transmitted infec¬tions in most populations. Most HPV exposures result in sponta¬neous clearance without clinical manifestations and only a small fraction of the infected persons, known as chronic or persistent carriers, will retain the virus and progress to precancerous and cancer. HPV 16 and 18 account for 70% of cervical cancer and the 8 most common types. (HPV 16, 18, 45, 33, 31, 52, 58 and 35 account for about 90% of cervical cancer. Case-control studies also allowed the identification of the following cofactors that acting together with HPV increase the risk of progression from HPV persistent infection to cervical cancer: tobacco, high parity, long term use of oral contraceptives and past infections with herpes simplex type 2 and Chlamydia trachomatis. The demonstration that infection with certain types of human papillomavirus (HPV is not only the main cause but also a necessary cause of cervical cancer has led to great advances in the prevention of this disease on two fronts: (i Primary prevention by the use of

  19. Targeted treatments for cervical cancer: a review

    Directory of Open Access Journals (Sweden)

    Peralta-Zaragoza O

    2012-11-01

    Full Text Available Oscar Peralta-Zaragoza,1 Víctor Hugo Bermúdez-Morales,1 Carlos Pérez-Plasencia,2,3 Jonathan Salazar-León,1 Claudia Gómez-Cerón,1 Vicente Madrid-Marina11Direction of Chronic Infections and Cancer, Research Center in Infection Diseases, National Institute of Public Health, Cuernavaca, Morelos, México; 2Oncogenomics Laboratory, National Cancer Institute of Mexico, Tlalpan, México; 3Biomedicine Unit, FES-Iztacala UNAM, México City, MéxicoAbstract: Cervical cancer is the second most common cause of cancer death in women worldwide and the development of new diagnosis, prognostic, and treatment strategies merits special attention. Although surgery and chemoradiotherapy can cure 80%–95% of women with early stage cancer, the recurrent and metastatic disease remains a major cause of cancer death. Many efforts have been made to design new drugs and develop gene therapies to treat cervical cancer. In recent decades, research on treatment strategies has proposed several options, including the role of HPV E6 and E7 oncogenes, which are retained and expressed in most cervical cancers and whose respective oncoproteins are critical to the induction and maintenance of the malignant phenotype. Other efforts have been focused on antitumor immunotherapy strategies. It is known that during the development of cervical cancer, a cascade of abnormal events is induced, including disruption of cellular cycle control, perturbation of antitumor immune response, alteration of gene expression, and deregulation of microRNA expression. Thus, in this review article we discuss potential targets for the treatment of cervical cancer associated with HPV infection, with special attention to immunotherapy approaches, clinical trials, siRNA molecules, and their implications as gene therapy strategies against cervical cancer development.Keywords: Cervical cancer, clinical trials, gene therapy, HPV E6 and E7 oncogenes, siRNAs

  20. Epidemiology and Early Detection of Cervical Cancer.

    Science.gov (United States)

    Hillemanns, Peter; Soergel, Phillip; Hertel, Hermann; Jentschke, Matthias

    2016-01-01

    The new German S3 guideline 'Prevention of Cervical Cancer' published in 2016 is based on the latest available evidence about cervical cancer screening and treatment of cervical precancer. Large randomized controlled trials indicate that human papillomavirus (HPV)-based screening may provide better protection against cervical cancer than cytology alone through improved detection of premalignant disease in the first screening round prior to progression. Therefore, women aged 30 years and older should preferably be screened with HPV testing every 3-5 years (cytology alone every 2 years is an acceptable alternative). Co-testing is not recommended. Screening should start at 25 years using cytology alone every 2 years. The preferred triage test after a positive HPV screening test is cytology. Women positive for HPV 16 and HPV 18 should receive immediate colposcopy. Another alternative triage method is p16/Ki-67 dual stain cytology. The mean yearly participation rate in Germany is between 45 and 50%. Offering devices for HPV self-sampling has the potential to increase participation rates in those women who are at higher risk of developing cervical cancer. Regarding primary prevention, the 9-valent vaccine may provide protection against up to 85% of cervical intraepithelial neoplasia (CIN) 3 and 90% of cervical cancer, and is available in Europe as a 2-dose schedule from May 2016. PMID:27614953

  1. Cervical cancer risk factors among HIV-infected Nigerian women

    OpenAIRE

    Ononogbu, Uzoma; Almujtaba, Maryam; Modibbo, Fatima; Lawal, Ishak; Offiong, Richard; Olaniyan, Olayinka; Dakum, Patrick; Spiegelman, Donna; Blattner, William; Adebamowo, Clement

    2013-01-01

    Background: Cervical cancer is the third most common cancer among women worldwide, and in Nigeria it is the second most common female cancer. Cervical cancer is an AIDS-defining cancer; however, HIV only marginally increases the risk of cervical pre-cancer and cancer. In this study, we examine the risk factors for cervical pre-cancer and cancer among HIV-positive women screened for cervical cancer at two medical institutions in Abuja, Nigeria. Methods: A total of 2,501 HIV-positive women part...

  2. Cervical Cancer - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Cervical Cancer URL of this page: https://medlineplus.gov/languages/cervicalcancer.html Other topics A-Z A B ...

  3. Extrafascial hysterectomy in IB2 cervical cancer after radio chemotherapy

    International Nuclear Information System (INIS)

    Aim: To evaluate overall and disease free survival in cervical cancer IB2 patients with concomitant chemoradiotherapy and posterior extrafascial hysterectomy treatment. Methods: Between July 2005 to December 2009, a total of 31 eligible patients with IB2 cervical cancer were treated with chemoradiotherapy and posterior hysterectomy in the Carlos Van Buren Hospital Oncology Unit. Radiotherapy consisted in external pelvic radiation and a utero-vaginal brachytherapy with low rate doses to get preoperatory doses between 70 and 75 Gy to the A point and a concomitant Cisplatin based chemotherapy. After this treatment, the patients received extrafascial hysterectomy 4 to 6 weeks completed chemoradiotherapy. Results: The mean age was 41 ± 8 years. 81% of the patients had an spinocelular carcinoma. The extrafascial hysterectomy was made between 4 to 6 weeks post-radiation in 85% of the patients. 79% and 13% of the patients received 5 and 4 chemotherapy cycles respectively. The median follow up was 38 months. The 5 years overall survival and disease free survival estimates were 86% and 79% respectively. There was a significant difference between subgroups of patients with and without macroscopic residual disease in the operatory specimen (p<0.001). Conclusion: Our survival is similar to published results with the same treatment. The presence of macroscopic residual disease in the hysterectomy specimen could be a factor of prognostic value

  4. Radiation Dose and Subsequent Risk for Stomach Cancer in Long-term Survivors of Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kleinerman, Ruth A., E-mail: kleinerr@mail.nih.gov [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Rockville, Maryland (United States); Smith, Susan A. [Department of Radiation Physics, University of Texas M D Anderson Cancer Center, Houston, Texas (United States); Holowaty, Eric [Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario (Canada); Hall, Per [Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm (Sweden); Pukkala, Eero [Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki (Finland); Vaalavirta, Leila [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland); Stovall, Marilyn; Weathers, Rita [Department of Radiation Physics, University of Texas M D Anderson Cancer Center, Houston, Texas (United States); Gilbert, Ethel [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Rockville, Maryland (United States); Aleman, Berthe M.P. [Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Kaijser, Magnus [Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm (Sweden); Andersson, Michael [Department of Oncology, Copenhagen University Hospital, Copenhagen (Denmark); Storm, Hans [Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen (Denmark); Joensuu, Heikki [Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland); Lynch, Charles F. [Department of Epidemiology, University of Iowa, Iowa City, Iowa (United States); and others

    2013-08-01

    Purpose: To assess the dose–response relationship for stomach cancer after radiation therapy for cervical cancer. Methods and Materials: We conducted a nested, matched case–control study of 201 cases and 378 controls among 53,547 5-year survivors of cervical cancer diagnosed from 1943 to 1995, from 5 international, population-based cancer registries. We estimated individual radiation doses to the site of the stomach cancer for all cases and to corresponding sites for the matched controls (overall mean stomach tumor dose, 2.56 Gy, range 0.03-46.1 and after parallel opposed pelvic fields, 1.63 Gy, range 0.12-6.3). Results: More than 90% of women received radiation therapy, mostly with external beam therapy in combination with brachytherapy. Stomach cancer risk was nonsignificantly increased (odds ratio 1.27-2.28) for women receiving between 0.5 and 4.9 Gy to the stomach cancer site and significantly increased at doses ≥5 Gy (odds ratio 4.20, 95% confidence interval 1.41-13.4, P{sub trend}=.047) compared with nonirradiated women. A highly significant radiation dose–response relationship was evident when analyses were restricted to the 131 cases (251 controls) whose stomach cancer was located in the middle and lower portions of the stomach (P{sub trend}=.003), whereas there was no indication of increasing risk with increasing dose for 30 cases (57 controls) whose cancer was located in the upper stomach (P{sub trend}=.23). Conclusions: Our findings show for the first time a significant linear dose–response relationship for risk of stomach cancer in long-term survivors of cervical cancer.

  5. Radiation Dose and Subsequent Risk for Stomach Cancer in Long-term Survivors of Cervical Cancer

    International Nuclear Information System (INIS)

    Purpose: To assess the dose–response relationship for stomach cancer after radiation therapy for cervical cancer. Methods and Materials: We conducted a nested, matched case–control study of 201 cases and 378 controls among 53,547 5-year survivors of cervical cancer diagnosed from 1943 to 1995, from 5 international, population-based cancer registries. We estimated individual radiation doses to the site of the stomach cancer for all cases and to corresponding sites for the matched controls (overall mean stomach tumor dose, 2.56 Gy, range 0.03-46.1 and after parallel opposed pelvic fields, 1.63 Gy, range 0.12-6.3). Results: More than 90% of women received radiation therapy, mostly with external beam therapy in combination with brachytherapy. Stomach cancer risk was nonsignificantly increased (odds ratio 1.27-2.28) for women receiving between 0.5 and 4.9 Gy to the stomach cancer site and significantly increased at doses ≥5 Gy (odds ratio 4.20, 95% confidence interval 1.41-13.4, Ptrend=.047) compared with nonirradiated women. A highly significant radiation dose–response relationship was evident when analyses were restricted to the 131 cases (251 controls) whose stomach cancer was located in the middle and lower portions of the stomach (Ptrend=.003), whereas there was no indication of increasing risk with increasing dose for 30 cases (57 controls) whose cancer was located in the upper stomach (Ptrend=.23). Conclusions: Our findings show for the first time a significant linear dose–response relationship for risk of stomach cancer in long-term survivors of cervical cancer

  6. CERVICAL CANCER – THE PRESENT SCENE

    Directory of Open Access Journals (Sweden)

    Singh

    2013-10-01

    Full Text Available ABSTRACT : Recent advances in cervical cancer management with well defined indications of surgery, radiotherapy and chemotherapy have resulted in significant increase in survivors with better QOL. Ongoing recent trials pertaining to further refinement of treatment protocols to make it more cure specific and less morbid will bring more changes in the present scene. This article is a concise review of salient features regarding cervical cancer screening diag nosis & management at present.

  7. Costs Associated with Cervical Cancer Screening

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Tom Cox, a practicing gynecologist and president of the American Society of Colposcopy and Cervical Pathology, provides a brief introduction to cervical cancer screening guidelines and human papillomavirus (HPV) DNA testing.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  8. Cervical cancer: A comprehensive approach towards extermination.

    Science.gov (United States)

    Bava, Smitha V; Thulasidasan, Arun Kumar T; Sreekanth, Chanickal N; Anto, Ruby John

    2016-01-01

    Human Papilloma Virus (HPV) is one of the most common sexually transmitted pathogen, globally. Oncogenic types of HPV are the causative agents of many neoplastic diseases, including cervical cancer, which ranks as the most common cancer affecting females in developing countries. HPV infection of the cervical epithelium and the subsequent integration of viral DNA into the host genome are the major risk factors for cervical cancer. The scientific discovery of HPV as the causal agent of cervical cancer has led to the development of HPV-based diagnostic tools. Prophylactic vaccines, based on the oncogenic HPV type virus-like particles have been introduced in several developed countries as a preliminary preventive approach. Nevertheless, it remains a continuous threat to women in developing countries, where the prophylactic vaccines are unaffordable and organized screening programmes are lacking. This warrants implementation of prevention strategies that will reduce cervical cancer-related mortality. In this review, we have discussed molecular pathogenesis of HPV infection and the risk factors associated with it. The diagnosis, treatment and prevention strategies of HPV-related cervical cancer have also been discussed.

  9. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Murali V

    2010-01-01

    Full Text Available Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT and intensity modulated radiotherapy (IMRT are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR, namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  10. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer.

    Science.gov (United States)

    Murali, V; Kurup, P G G; Mahadev, P; Mahalakshmi, S

    2010-04-01

    Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR) with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR), namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  11. Multidisciplinary treatment for advanced and recurrent breast cancer including brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsukiyama, Iwao; Ohno, Tatsuya (Tochigi Cancer Center, Utsunomiya (Japan). Hospital); Takizawa, Yoshikazu; Ikeda, Hiroshi; Egawa, Sunao; Ogino, Takashi

    1994-06-01

    Between 1986 and 1992, 10 patients (12 lesions) of advanced breast cancer were treated with multidisciplinary treatment including brachytherapy. The lesions treated included 5 primary breast tumors, 3 metastatic lesions in the contra lateral breast, 2 recurrences after external beam irradiation, 1 metastasis to the axillary lymph node and 1 metastasis to the upper arm skin. The interstitial irradiation techniques used were [sup 192]Ir low dose-rate irradiation for 5 lesions and high dose-rate for 7 lesions (including 3 with mould irradiation). External hyperthermia as performed for 6 lesions and interstitial hyperthermia were performed for 4 lesions. The local response was CR for 3 lesions, PRa for 8 lesions, PRb for 1 lesion with the local response rate being 100%. Excellent local control could be achieved by combination external and interstitial irradiation, indicating that radiotherapy is definitely useful for the treatment of advanced breast cancer. (author).

  12. Cervical cancer in India and HPV vaccination

    Directory of Open Access Journals (Sweden)

    K Kaarthigeyan

    2012-01-01

    Full Text Available Cervical cancer, mainly caused by Human Papillomavirus infection, is the leading cancer in Indian women and the second most common cancer in women worldwide. Though there are several methods of prevention of cervical cancer, prevention by vaccination is emerging as the most effective option, with the availability of two vaccines. Several studies have been published examining the vaccine′s efficacy, immunogenicity and safety. Questions and controversy remain regarding mandatory vaccination, need for booster doses and cost-effectiveness, particularly in the Indian context.

  13. Cervical cancer in India and HPV vaccination.

    Science.gov (United States)

    Kaarthigeyan, K

    2012-01-01

    Cervical cancer, mainly caused by Human Papillomavirus infection, is the leading cancer in Indian women and the second most common cancer in women worldwide. Though there are several methods of prevention of cervical cancer, prevention by vaccination is emerging as the most effective option, with the availability of two vaccines. Several studies have been published examining the vaccine's efficacy, immunogenicity and safety. Questions and controversy remain regarding mandatory vaccination, need for booster doses and cost-effectiveness, particularly in the Indian context. PMID:22754202

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

    Science.gov (United States)

    2016-02-09

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-02-15

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

  16. Cisplatin and Radiation Therapy With or Without Carboplatin and Paclitaxel in Patients With Locally Advanced Cervical Cancer

    Science.gov (United States)

    2016-03-17

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Chemotherapeutic Agent Toxicity; Cognitive Side Effects of Cancer Therapy; Psychological Impact of Cancer; Radiation Toxicity; Sexual Dysfunction and Infertility; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  17. Treatment of localized prostate cancer with brachytherapy: six years experience

    International Nuclear Information System (INIS)

    The usage of ultrasound scan to perform prostate biopsy punctures, the new radiation therapies and the more accurate selection of patients has allowed brachytherapy to play an important role in the treatment of the localized pathology. The objective of this paper is to review the results obtained when treating the localized prostate cancer by using brachytherapy with mud 125. Materials and methods: Between December 1999 and July 2006, 100 prostate cancer patients were treated at the Hospital Italiano de Buenos Aires, using brachytherapy with mud 125. One of the patients was treated with a combined therapy (brachytherapy + external radiotherapy). For that reason, the patient was not taken into consideration for this paper. The average age was 65.95 (52-79). The tumoral stages were T1c in 81% of the patients and T2a in 19% of them. The PSA was always below 15 ng/ml, with an average of 8.92 ng/ml; inferior to 10 ng/ml in 72 patients and between 10 and 15 ng/m ml in 28 of them. The average prostate volume was 34.68 c.c. (18.70 c.c.-58.00 c.c.). The combined Gleason score was below 6 (except for three patients with Gleason 7 who had a PSA below 10, stage T1c). The dose used was 16,000 cGy as recommended by the TG43. The energy charge of each seed was between 0.28 and 0.40 mci. Thirty days later, a prostate axial computer tomography was carried out every 3 mm. with a scanning set every 5 mm. to perform a dosimetric control of the implant. Results: The average age was 65.95 (52-79). The control computer tomography showed an adequate dosimetric coverage for the entire prostate volume, with a maximum urethral dose not above 400 Gy and a maximum rectal dose below 100 Gy. The PSA of all patients decreased to a normal level 6 months after the treatment started. The average follow-up of the 71 patients able to be tested from an oncological perspective lasted 31.15 months, with a minimum of 18 and a maximum of 72 months. Currently, seven patients of those tested (9.86%) manifest

  18. Iodine-125 interstitial brachytherapy for experimental liver cancer

    Institute of Scientific and Technical Information of China (English)

    ZHOU Fei-guo; YAN Jian-jun; HUANG Liang; LIU Cai-feng; ZHANG Xiang-hua; ZHOU Wei-ping; YAN Yi-qun

    2007-01-01

    Objective:To study the effect of iodine-125 interstitial brachytherapy on liver cancer.Methods:Animal model of human liver cancer was established by injecting SMMC-7721 cells cultivated in vitro subcutaneously into the flank of BALB/c nude mice.Nude mice with tumor of 5 mm in diameter were randomly divided into 2 groups(n=10).One iodine-125 seed of apparent activity 0.8 mCi was implanted into the center of tumor in treatment group,whereas an inactive seed was implanted in control group.The other 20 nude mice with tumor reaching 10 mm in diameter were also treated as above.The size of tumor was determined weekly after implantation,and pathological examination and blood routine were taken on the 28th day.Results:Tumor growth was obviously inhibited in treatment group of tumor of 5 mm in diameter,and there was statistically significant difference in tumor volume between treatment and control groups(P<0.01).Around iodine-125 seed,apparent necrosis of tumor was shown in treatment group,accompanied by karyopyknosis and reduced plasma in residual tumor cells microscopically.Tumor growth was not inhibited in either treatment or control group of tumor of 10 mm in diameter.There was no obvious adverse effect except for decreased white blood cells in treatment groups.Conclusion:There is certain effect of iodine-125 interstitial brachytherapy on liver cancer,which is associated with the size of tumor.

  19. Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

    Directory of Open Access Journals (Sweden)

    Kasper ME

    2015-11-01

    Full Text Available Michael E Kasper,1,2 Ahmed A Chaudhary3 1Department of Radiation Oncology, Lynn Cancer Institute at Boca Raton Regional Hospital, Boca Raton, 2Charles E. Schmidt College of Medicine, Florida Atlantic University, FL, 3North Main Radiation Oncology, Warren Alpert School of Medicine, Brown University, RI, USA Abstract: Nonmelanoma skin cancer (NMSC is an increasing health care issue in the United States, significantly affecting quality of life and impacting health care costs. Radiotherapy has a long history in the treatment of NMSC. Shortly after the discovery of X-rays and 226Radium, physicians cured patients with NMSC using these new treatments. Both X-ray therapy and brachytherapy have evolved over the years, ultimately delivering higher cure rates and lower toxicity. Electronic brachytherapy for NMSC is based on the technical and clinical data obtained from radionuclide skin surface brachytherapy and the small skin surface applicators developed over the past 25 years. The purpose of this review is to introduce electronic brachytherapy in the context of the history, data, and utilization of traditional radiotherapy and brachytherapy. Keywords: electronic brachytherapy, superficial radiotherapy, skin surface brachytherapy, electron beam therapy, nonmelanoma skin cancer, basal cell carcinoma, squamous cell carcinoma

  20. HPV genotypes in invasive cervical cancer in Danish women

    DEFF Research Database (Denmark)

    Kirschner, Benny; Junge, Jette; Holl, Katsiaryna;

    2013-01-01

    Human papillomavirus (HPV) genotype distribution in invasive cervical cancers may differ by geographic region. The primary objective of this study was to estimate HPV-genotype distribution in Danish women with a diagnosis of invasive cervical cancer....

  1. Trends in the Quality of Treatment for Patients With Intact Cervical Cancer in the United States, 1999 Through 2011

    International Nuclear Information System (INIS)

    Purpose: High-quality treatment for intact cervical cancer requires external radiation therapy, brachytherapy, and chemotherapy, carefully sequenced and completed without delays. We sought to determine how frequently current treatment meets quality benchmarks and whether new technologies have influenced patterns of care. Methods and Materials: By searching diagnosis and procedure claims in MarketScan, an employment-based health care claims database, we identified 1508 patients with nonmetastatic, intact cervical cancer treated from 1999 to 2011, who were <65 years of age and received >10 fractions of radiation. Treatments received were identified using procedure codes and compared with 3 quality benchmarks: receipt of brachytherapy, receipt of chemotherapy, and radiation treatment duration not exceeding 63 days. The Cochran-Armitage test was used to evaluate temporal trends. Results: Seventy-eight percent of patients (n=1182) received brachytherapy, with brachytherapy receipt stable over time (Cochran-Armitage Ptrend=.15). Among patients who received brachytherapy, 66% had high–dose rate and 34% had low–dose rate treatment, although use of high–dose rate brachytherapy steadily increased to 75% by 2011 (Ptrend<.001). Eighteen percent of patients (n=278) received intensity modulated radiation therapy (IMRT), and IMRT receipt increased to 37% by 2011 (Ptrend<.001). Only 2.5% of patients (n=38) received IMRT in the setting of brachytherapy omission. Overall, 79% of patients (n=1185) received chemotherapy, and chemotherapy receipt increased to 84% by 2011 (Ptrend<.001). Median radiation treatment duration was 56 days (interquartile range, 47-65 days); however, duration exceeded 63 days in 36% of patients (n=543). Although 98% of patients received at least 1 benchmark treatment, only 44% received treatment that met all 3 benchmarks. With more stringent indicators (brachytherapy, ≥4 chemotherapy cycles, and duration not exceeding 56 days), only 25% of

  2. Trends in the Quality of Treatment for Patients With Intact Cervical Cancer in the United States, 1999 Through 2011

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jiang, Jing [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Meyer, Larissa A. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Gynecologic Oncology and Reproductive Medicine (LAM), The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Eifel, Patricia J., E-mail: peifel@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-06-01

    Purpose: High-quality treatment for intact cervical cancer requires external radiation therapy, brachytherapy, and chemotherapy, carefully sequenced and completed without delays. We sought to determine how frequently current treatment meets quality benchmarks and whether new technologies have influenced patterns of care. Methods and Materials: By searching diagnosis and procedure claims in MarketScan, an employment-based health care claims database, we identified 1508 patients with nonmetastatic, intact cervical cancer treated from 1999 to 2011, who were <65 years of age and received >10 fractions of radiation. Treatments received were identified using procedure codes and compared with 3 quality benchmarks: receipt of brachytherapy, receipt of chemotherapy, and radiation treatment duration not exceeding 63 days. The Cochran-Armitage test was used to evaluate temporal trends. Results: Seventy-eight percent of patients (n=1182) received brachytherapy, with brachytherapy receipt stable over time (Cochran-Armitage P{sub trend}=.15). Among patients who received brachytherapy, 66% had high–dose rate and 34% had low–dose rate treatment, although use of high–dose rate brachytherapy steadily increased to 75% by 2011 (P{sub trend}<.001). Eighteen percent of patients (n=278) received intensity modulated radiation therapy (IMRT), and IMRT receipt increased to 37% by 2011 (P{sub trend}<.001). Only 2.5% of patients (n=38) received IMRT in the setting of brachytherapy omission. Overall, 79% of patients (n=1185) received chemotherapy, and chemotherapy receipt increased to 84% by 2011 (P{sub trend}<.001). Median radiation treatment duration was 56 days (interquartile range, 47-65 days); however, duration exceeded 63 days in 36% of patients (n=543). Although 98% of patients received at least 1 benchmark treatment, only 44% received treatment that met all 3 benchmarks. With more stringent indicators (brachytherapy, ≥4 chemotherapy cycles, and duration not exceeding 56

  3. The potential therapeutic targets for cervical cancer

    OpenAIRE

    L Priyanka Dwarampudi; Gowthamarajan, K.; Shanmugam, R; Madhuri, K.; Nilani, P.; M N Satish Kumar

    2013-01-01

    In case of invasive cervical carcinoma several molecular events were reported and these molecular events resulting in multiple genetic abnormalities. In order to control these tumors multiple molecular therapeutic targets are needed with different molecular mechanisms. Unfortunately, these molecular targets were in early stages of development. Because of less degree of success of conventional therapeutics for late stages of cervical cancer and lowering of prognosis of patients there is an inc...

  4. HDR intralumenal brachytherapy in bronchial cancer: review of our experience

    International Nuclear Information System (INIS)

    The main indications for brachytherapy in the treatment of endobronchial cancer are dyspnea. postobstructive pneumonia and atelectasis, cough and hemoptysis resulting from broncus obstruction by exophytic intralumenal tumor growth. High Dose Rate intralumenal brachytherapy (HDRBT) may be combined with external beam radiotherapy (EBRT), in particular as almost all tumors are too large for HDRBT alone. From January 1992 to September 1995 we treated 268 patients affected by bronchial cancer, with EBRT combined with HDRBT. All patients were staged as IIIa-IIIb-IV but KPS was >60 and expectancy of life > than 3 months. After bronchoscopy and Tc simulation we found that almost 10% of patients were downstaged. Treatment was always realized delivering 60 Gy to the tumour volume and 50 Gy to the mediastinal structures with EBRT. Brachytherapy was performed during the radiotherapy course. In 38 patients HDRBT was realized just one time, at the beginning of EBRT, with a dose of 10 Gy calculated at 1cm from the central axis of the catheter. In 47 HDRBT was performed twice (at the beginning and at the end of EBRT) with a dose of 7 Gy calculated at 1 cm from the central axis. From 1994 we started a 3 fractions protocol (Timing: days 1.15.30) with a dose of 5 Gy calculated at 0.5 cm from the axis. Of the 183 patients introduced in the protocol 170 received the three fractions of HDRBT and 13 were excluded from the study for personal or clinical reasons. In 97% of cases the application did not need general anesthesia; local anesthesia has been sufficient supplemented by some drug for sedation and coughing. Anyway both bronchoscopy and HDRBT (with anterior-posterior and lateral chest X-ray) are performed in the same shielded room without the necessity of displacing the patient. In almost 60% of treatments we used just one endobronchial applicator. In case of tumor involvement of the carina, two applicators were introduced. By this a larger tumor volume can be treated with adequate

  5. Urethral stricture following high dose rate brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate the incidence, timing, nature and outcome of urethral strictures following high dose rate brachytherapy (HDRB) for prostate carcinoma. Methods and materials: Data from 474 patients with clinically localised prostate cancer treated with HDRB were analysed. Ninety percent received HDRB as a boost to external beam radiotherapy (HDRBB) and the remainder as monotherapy (HDRBM). Urethral strictures were graded according to the Common Terminology Criteria for Adverse Events v3.0. Results: At a median follow-up of 41 months, 38 patients (8%) were diagnosed with a urethral stricture (6-year actuarial risk 12%). Stricture location was bulbo-membranous (BM) urethra in 92.1%. The overall actuarial rate of grade 2 or more BM urethral stricture was estimated at 10.8% (95% CI 7.0-14.9%), with a median time to diagnosis of 22 months (range 10-68 months). All strictures were initially managed with either dilatation (n = 15) or optical urethrotomy (n = 20). Second line therapy was required in 17 cases (49%), third line in three cases (9%) and 1 patient open urethroplasty (grade 3 toxicity). Predictive factors on multivariate analysis were prior trans-urethral resection of prostate (hazard ratio (HR) 2.81, 95% CI 1.15-6.85, p = 0.023); hypertension (HR 2.83, 95% CI 1.37-5.85, p = 0.005); and dose per fraction used in HDR (HR for 1 Gy increase per fraction 1.33, 95% CI 1.08-1.64, p = 0.008). Conclusions: BM urethral strictures are the most common late grade 2 or more urinary toxicity following HDR brachytherapy for prostate cancer. Most are manageable with minimally invasive procedures. Both clinical and dosimetric factors appear to influence the risk of stricture formation.

  6. Diagnosis of cervical cancer with transvaginal color Doppler sonography

    OpenAIRE

    Li-bo DENG; Wei ZHOU; Chang, Shu-Fang; Ming-jie LIN

    2011-01-01

    Objective To investigate the imaging features of cervical cancer by transvaginal color Doppler sonography(TVCS),and evaluate the diagnostic value of TVCS.Methods A hundred and thirty cases of cervical intraepithelial neoplasia(CIN) grade Ⅰ-Ⅱ and cervical cancer,diagnosed by Thinprep cytologic test(TCT),cervical biopsy and pathological examination,received TVCS examination.The image characters and color Doppler flow imaging(CDFI) were collected and analyzed.Another 41 cases with normal cervice...

  7. A non-rigid point matching method with local topology preservation for accurate bladder dose summation in high dose rate cervical brachytherapy

    Science.gov (United States)

    Chen, Haibin; Zhong, Zichun; Liao, Yuliang; Pompoš, Arnold; Hrycushko, Brian; Albuquerque, Kevin; Zhen, Xin; Zhou, Linghong; Gu, Xuejun

    2016-02-01

    GEC-ESTRO guidelines for high dose rate cervical brachytherapy advocate the reporting of the D2cc (the minimum dose received by the maximally exposed 2cc volume) to organs at risk. Due to large interfractional organ motion, reporting of accurate cumulative D2cc over a multifractional course is a non-trivial task requiring deformable image registration and deformable dose summation. To efficiently and accurately describe the point-to-point correspondence of the bladder wall over all treatment fractions while preserving local topologies, we propose a novel graphic processing unit (GPU)-based non-rigid point matching algorithm. This is achieved by introducing local anatomic information into the iterative update of correspondence matrix computation in the ‘thin plate splines-robust point matching’ (TPS-RPM) scheme. The performance of the GPU-based TPS-RPM with local topology preservation algorithm (TPS-RPM-LTP) was evaluated using four numerically simulated synthetic bladders having known deformations, a custom-made porcine bladder phantom embedded with twenty one fiducial markers, and 29 fractional computed tomography (CT) images from seven cervical cancer patients. Results show that TPS-RPM-LTP achieved excellent geometric accuracy with landmark residual distance error (RDE) of 0.7  ±  0.3 mm for the numerical synthetic data with different scales of bladder deformation and structure complexity, and 3.7  ±  1.8 mm and 1.6  ±  0.8 mm for the porcine bladder phantom with large and small deformation, respectively. The RDE accuracy of the urethral orifice landmarks in patient bladders was 3.7  ±  2.1 mm. When compared to the original TPS-RPM, the TPS-RPM-LTP improved landmark matching by reducing landmark RDE by 50  ±  19%, 37  ±  11% and 28  ±  11% for the synthetic, porcine phantom and the patient bladders, respectively. This was achieved with a computational time of less than 15 s in all cases

  8. Cervical necrosis after chemoradiation for cervical cancer: case series and literature review

    International Nuclear Information System (INIS)

    The aim of this study was to assess the management of cervical necrosis (CN) following radiotherapy (RT) and the impact of smoking status. This rare complication mimics a neoplastic recurrence, and causes concern among attending physicians. Between July 2008 and March 2013, 5 women on 285 with localized cervical cancer had a CN following RT. Patients were treated with concomitant chemoradiation. The medical records were reviewed to abstract demographic and clinical information until March 2013. 1.75% (95% confidence interval: 0.23 to 3.28%) developed CN. All patients were smokers with a mean of 19.5 pack-years (range: 7.5-45 pack-years). All patients were treated with weekly Cisplatin chemotherapy and external beam radiation to the pelvis, 45 Gy in 25 fractions. Four patients received an extra boost with a median dose of 7.2 Gy (range: 5.4-10 Gy). All patients had intracavitary brachytherapy (range: 27.9 to 30 Gy). Clinical presentation was similar for all the cases: vaginal discharge associated with pain. Mean time for time post-radiation therapy to necrosis was 9.3 months (range: 2.2-20.5 months). Standard workup was done to exclude cancer recurrence: biopsies and radiologic imaging. Conservative treatment was performed with excellent results. Resolution of the necrosis was complete after a few months (range: 1 to 4 months). Median follow-up until March 2013 was 19 months. All the patients were alive with no clinical evidence of disease. This study, the largest to date, shows that conservative management of CN after RT is effective, and should be attempted. This complication is more common in smokers, and counseling intervention should result in fewer complications of CN

  9. Diagnosis of cervical cancer with transvaginal color Doppler sonography

    Directory of Open Access Journals (Sweden)

    Li-bo DENG

    2011-09-01

    Full Text Available Objective To investigate the imaging features of cervical cancer by transvaginal color Doppler sonography(TVCS,and evaluate the diagnostic value of TVCS.Methods A hundred and thirty cases of cervical intraepithelial neoplasia(CIN grade Ⅰ-Ⅱ and cervical cancer,diagnosed by Thinprep cytologic test(TCT,cervical biopsy and pathological examination,received TVCS examination.The image characters and color Doppler flow imaging(CDFI were collected and analyzed.Another 41 cases with normal cervices as determined by inspection and cytological examination were involved as control.Results In order of normal cervix,CIN,cancer in situ and cervical cancer,the cervical diameter showed a tendency of increase,also with an increase incidence of low-level echo focus in cervix.As a specific image of cervical cancer,the low level echo focus occurred only in cervical cancer with a specificity of 100%.The absence of mucosal line in cervical canal was a specific character of stage Ⅱ cervical cancer with a specificity of 100%.CDFI and resistance index(RI revealed that the local blood flow was more abundant in invasive cancer than in CIN and cancer in situ,and significant difference was found between stage Ⅰ and stage Ⅱ cervical cancer(P < 0.05.The sensitivity and specificity of enlarged cervical diameters in diagnosis of cervical cancer were 89.1% and 82.8%.The specificity of cervical low level echo focus in diagnosis of cervical cancer and invasive cervical cancer were 100% and 94.8%,respectively.The specificity of abundant blood flow in dendritic form in diagnosis of invasive cervical cancer was 100%.Conclusions Invasive cervical cancer may present several specific features in TVCS images.TVCS examination is of high reliability in diagnosis of invasive cervical cancer,but is not so reliable in diagnosing precancerous lesion and preinvasive cancer.Combined with other auxiliary examinations,TVCS could be considered as one of the methods to diagnose cervical

  10. New molecular targets against cervical cancer

    Directory of Open Access Journals (Sweden)

    Duenas-Gonzalez A

    2014-12-01

    Full Text Available Alfonso Duenas-Gonzalez,1,2 Alberto Serrano-Olvera,3 Lucely Cetina,4 Jaime Coronel4 1Unit of Biomedical Research in Cancer, Instituto de Investigaciones Biomedicas UNAM/Instituto Nacional de Cancerologia, Mexico City, 2ISSEMyM Cancer Center, Toluca, 3Medical Oncology Service, ABC Medical Center, Mexico City, 4Division of Clinical Research, Instituto Nacional de Cancerologia, Mexico City, Mexico On behalf of the Tumor Study Group Abstract: Cervical cancer is the third most commonly diagnosed cancer worldwide and the fourth leading cause of cancer death in women. Major advances but still insufficient achievements in the treatment of locally advanced and high-risk early stage patients have occurred in the last decade with the incorporation of concurrent cisplatin with radiation and, lately, gemcitabine added to cisplatin chemoradiation. Despite a number of clinical studies incorporating molecular-targeted therapy as radiosensitizers being in progress, so far, only antiangiogenic therapy with bevacizumab added to cisplatin chemoradiation has demonstrated safety and shown encouraging results in a Phase II study. In advanced disease, cisplatin doublets do not have a great impact on the natural history of the disease with median survival rates not exceeding 13 months. The first Phase III study of bevacizumab, added to cisplatin or a non-cisplatin-containing doublet, showed significant increase in both overall survival and progression-free survival. Further studies are needed before bevacizumab plus chemotherapy can be considered the standard of care for advanced disease. Characterization of the mutational landscape of cervical cancer has already been initiated, indicating that, for now, few of these targetable alterations match with available agents. Progress in both the mutational landscape knowledge and developments of novel targeted therapies may result in more effective and individualized treatments for cervical cancer. The potential efficacy of

  11. Detecting cervical cancer by quantitative promoter hypermethylation assay on cervical scrapings : A feasibility study

    NARCIS (Netherlands)

    Reesink-Peters, N; Wisman, G.B.A.; Jeronimo, C; Tokumaru, CY; Cohen, Y; Dong, SM; Klip, HG; Buikema, HJ; Suurmeijer, AJH; Hollema, H; Boezen, HM; Sidransky, D; van der Zee, AGJ

    2004-01-01

    Current morphology-based cervical cancer screening is associated with significant false-positive and false-negative results. Tumor suppressor gene hypermethylation is frequently present in cervical cancer. It is unknown whether a cervical scraping reflects the methylation status of the underlying ep

  12. 宫颈癌3 DBT直肠实测剂量与参考剂量相关性研究%Correlation between the dose measured in the rectum and reference dose in three-dimensional brachytherapy for cervical cancer

    Institute of Scientific and Technical Information of China (English)

    刘丽琼; 赵志鹏; 程光惠; 何明远; 赵红福; 朱永刚; 施丹

    2015-01-01

    目的:探讨宫颈癌3DBT中直肠实测剂量与参考剂量的相关性,评估直肠实测剂量的意义。方法选取50例行宫颈癌根治性放疗患者,在完成全盆腔外照射后行三维近距离治疗(3DBT)。依据ICRU38号报告推荐的直肠监测方法,通过在体监测得到直肠实测剂量、参考点剂量( DICRU )及D2.0 cm3,在计划系统中得到计划剂量。应用配对t检验比较它们的差异,采用Pearson法进行相关分析。结果直肠实测剂量大于计划剂量(3.48∶3.25,P=0.000)、小于DICRU(3.48∶3.71, P=0.000)和D2.0 cm3(3.48∶3.87,P=0.002)。直肠实测剂量与计划剂量存在线性关系,二者偏差百分数为-20%~40%,偏差平均数为8.16%,其中63%宫颈癌患者偏差<±10%,最大偏差达60%。实测剂量与DICRU相关性强( r=0.722)、与D2.0 cm3相关性弱( r=0.284)。结论宫颈癌3DBT中直肠实测剂量存在一定偏差,但与计划剂量呈线性相关。实测剂量及计划剂量均会低估直肠剂量参考点剂量。直肠在体监测方法可作为有效的质量控制手段。%Objective To explore the correlation between the dose measured in the rectum and reference dose in three⁃dimensional brachytherapy ( 3DBT ) for cervical cancer, and to evaluate the significance of the dose measured in the rectum. Methods Fifty patients receiving radiotherapy for cervical cancer were selected, and 3DBT was performed after pelvic external beam radiotherapy. According to the rectal monitoring method recommended in the report ICRU38, in vivo monitoring was applied to obtain the dose measured in the rectum, reference point dose ( DICRU ) , and D2 cm3 , and the planned dose was obtained from the planning system. The differences in these values were determined by the paired t⁃test and correlation analysis was performed with Pearson test. Results The dose measured in the rectum

  13. Natural History of HPV and Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2009-10-12

    Dr. Phil Castle, an intramural research scientist at the National Institutes of Health, talks about the natural history of human papillomavirus (HPV) infections, and cervical cancer and other anogenital cancers.  Created: 10/12/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  14. Radiation dose and subsequent risk for stomach cancer in long-term survivors of cervical cancer

    DEFF Research Database (Denmark)

    Kleinerman, Ruth A; Smith, Susan A; Holowaty, Eric;

    2013-01-01

    To assess the dose-response relationship for stomach cancer after radiation therapy for cervical cancer.......To assess the dose-response relationship for stomach cancer after radiation therapy for cervical cancer....

  15. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy

    OpenAIRE

    Yasuhiro Yamada; Koji Okihara; Tsuyoshi Iwata; Koji Masui; Kazumi Kamoi; Kei Yamada; Tsuneharu Miki

    2015-01-01

    External beam radiotherapy (EBRT) is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU]) have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatm...

  16. Cyclooxygenase-2 expression in cervical cancer

    Directory of Open Access Journals (Sweden)

    Mandić Aljoša

    2014-01-01

    Full Text Available Background/Aim. Cyclooxygenase (COX or prostaglandin H2 synthase is the first enzyme that catalyzes the first two steps in the biosynthesis of prostaglandins from arachidonic acid. The aim of the study was to determine the expression level of COX-2 in patients with cervical cancer and compare it with that in the control group with no cervical pathology. Methods. The study included 76 patients divided into two groups: the control group - 30 patients without histopathological changes and the group A - 46 patients with cervical cancer, FIGO stage IB-IIA. Histopathological and immunohistochemical analyses were performed in these two groups of patients. Results. In the control group, the expression of COX-2 was not confirmed compared to the group A of 26 (56.52% patients. The expression of COX-2 showed a statistically significant difference in the presence of lymphocytic stromal infiltration (p = 0.0053. The expression of COX-2 was more pronounced in the stromal tissue without lymphocytic infiltration (80% vs 20%. Conclusion. A higher expression of COX-2 in cervical carcinoma without stromal lymphocytic infiltration suggests a possible paradoxical effect of COX-2 in immunosuppression. Frequent COX- 2 expression in the subgroup with poor prognostic histological parameters in the group A indicates the importance of COX-2 expression in the carcinogenesis of cervical cancer.

  17. Preoperative Arterial Interventional Chemotherapy on Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Hui; LING HU-Hua; TANG Liang-dan; ZHANG Xing-hua

    2008-01-01

    Objective:To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer.Methods:Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer.The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m2.Results:25 cases(including 8 cases with stage Ⅰ and 17 cases with stage Ⅱ)received one or two courses of preoperative interventional chemotherapy.The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients.All of the specimens were sent for pathological examination.Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment.As a result,relevant vaginal bleeding was stopped completely shortly after the treatment.Conclusion:Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently.The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

  18. Therapeutic Vaccination for HPV Induced Cervical Cancers

    Directory of Open Access Journals (Sweden)

    Joeli A. Brinkman

    2007-01-01

    Full Text Available Cervical Cancer is the second leading cause of cancer–related deaths in women worldwide and is associated with Human Papillomavirus (HPV infection, creating a unique opportunity to treat cervical cancer through anti-viral vaccination. Although a prophylactic vaccine may be available within a year, millions of women, already infected, will continue to suffer from HPV-related disease, emphasizing the need to develop therapeutic vaccination strategies. A majority of clinical trials examining therapeutic vaccination have shown limited efficacy due to examining patients with more advanced-stage cancer who tend to have decreased immune function. Current trends in clinical trials with therapeutic agents examine patients with pre-invasive lesions in order to prevent invasive cervical cancer. However, longer follow-up is necessary to correlate immune responses to lesion regression. Meanwhile, preclinical studies in this field include further exploration of peptide or protein vaccination, and the delivery of HPV antigens in DNA-based vaccines or in viral vectors. As long as pre-clinical studies continue to advance, the prospect of therapeutic vaccination to treat existing lesions seem good in the near future. Positive consequences of therapeutic vaccination would include less disfiguring treatment options and fewer instances of recurrent or progressive lesions leading to a reduction in cervical cancer incidence.

  19. Epidemiology and biology of cervical cancer.

    Science.gov (United States)

    Schoell, W M; Janicek, M F; Mirhashemi, R

    1999-01-01

    Worldwide, cancer of the cervix is the second leading cause of cancer death in women: each year, an estimated 500,000 cases are newly diagnosed. Among populations, there are large differences in incidence rates of invasive cervical cancer: these reflect the influence of environmental factors, screening Papanicolaou (Pap) tests, and treatment of pre-invasive lesions. The high-risk human papillomavirus (HPV) subtypes 16, 18, 31, 33, and 51 have been recovered from more than 95% of cervical cancers. We have made great strides in understanding the molecular mechanism of oncogenesis of this virus, focusing on the action of the E6 and E7 viral oncoproteins. These oncoproteins function by inactivating cell cycle regulators p53 and retinoblastoma (Rb), thus providing the initial event in progression to malignancy. Cervical cancers develop from precursor lesions, which are termed squamous intraepithelial lesions (SIL) and are graded as high or low, depending on the degree of disruption of epithelial differentiation. Viral production occurs in low-grade lesions and is restricted to basal cells. In carcinomas, viral DNA is found integrated into the host genome, but no viral production is seen. The well-defined pre-invasive stages, as well as the viral factors involved at the molecular level, make cervical carcinoma a good model for investigating immune therapeutic alternatives or adjuvants to standard treatments. PMID:10225296

  20. [Cervical cancer screening in Switzerland - current practice and future challenges].

    Science.gov (United States)

    Untiet, Sarah; Schmidt, Nicole; Low, Nicola; Petignat, Patrick

    2013-04-01

    At the beginning of the 20th Century, cervical cancer was the leading cause of death from cancer in women. A marked decline in cervical cancer has been observed since the 1960s, in parallel with the introduction of the Papanicolau (Pap) test as a cytological screening method. Today, Pap smear screening is still the most widely used tool for cervical cancer prevention. Testing for human papillomavirus (HPV) in cervical specimens or a combination of Pap and HPV testing are also now available. In this article we compare current guidelines for cervical cancer screening in Switzerland with those in other European countries. In view of the opportunities offered by HPV testing and, since 2008, HPV vaccination, current guidelines for cervical cancer screening should be updated. Both the choice of screening tests and general organization of cervical cancer screening should be reviewed.

  1. Recurrent cervical cancer : detection and prognosis

    NARCIS (Netherlands)

    Duyn, A; Van Eijkeren, M; Kenter, G; Zwinderman, K; Ansink, A

    2002-01-01

    Background. Only a small proportion of cervical cancer recurrences is detected during routine follow-up. We investigated which percentage of recurrences is detected during follow-up, which diagnostic tools are helpful to detect recurrent disease and which factors are of prognostic significance once

  2. Cervical Cancer: Reality and Paradigm Shift

    Directory of Open Access Journals (Sweden)

    Alfredo Quiñones Ceballos

    2014-09-01

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

  3. Cervical Cancer: paradigms at home and abroad

    Science.gov (United States)

    NCI funded a clinical trial that will have an impact on the treatment of late-stage cervical cancer, and also supported a screening trial in India using a network of community outreach workers offering low tech-screening by direct visualization of the cer

  4. Flexitouch® Home Maintenance Therapy or Standard Home Maintenance Therapy in Treating Patients With Lower-Extremity Lymphedema Caused by Treatment for Cervical Cancer, Vulvar Cancer, or Endometrial Cancer

    Science.gov (United States)

    2014-12-29

    Lymphedema; Stage 0 Cervical Cancer; Stage 0 Uterine Corpus Cancer; Stage 0 Vulvar Cancer; Stage I Uterine Corpus Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Vulvar Cancer; Stage IV Uterine Corpus Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer; Stage IVB Vulvar Cancer

  5. Common filaggrin gene mutations and risk of cervical cancer

    DEFF Research Database (Denmark)

    Bager, Peter; Wohlfahrt, Jan; Sørensen, Erik;

    2015-01-01

    BACKGROUND: As carriers of filaggrin gene (FLG) mutations may have a compromised cervical mucosal barrier against human papillomavirus infection, our primary objective was to study their risk of cervical cancer. METHODS: We genotyped 586 cervical cancer patients for the two most common FLG mutati...

  6. Magnetic resonance spectroscopy-guided transperineal prostate biopsy and brachytherapy for recurrent prostate cancer.

    Science.gov (United States)

    Barnes, Agnieszka Szot; Haker, Steven J; Mulkern, Robert V; So, Minna; D'Amico, Anthony V; Tempany, Clare M

    2005-12-01

    Brachytherapy targeted to the peripheral zone with magnetic resonance imaging (MRI) guidance is a prostate cancer treatment option with potentially fewer complications than other treatments. Follow-up MRI when failure is suspected is, however, difficult because of radiation-induced changes. Furthermore, MR spectroscopy (MRS) is compromised by susceptibility artifacts from radioactive seeds in the peripheral zone. We report a case in which combined MRI/MRS was useful for the detection of prostate cancer in the transitional zone in patients previously treated with MR-guided brachytherapy. We propose that MRI/MRS can help detect recurrent prostate cancer, guide prostate biopsy, and help manage salvage treatment decisions. PMID:16360468

  7. Cervical Cancer Screening in Underserved Populations

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Lisa Flowers, a specialist in human papillovarius (HPV)-related diseases and Director of Colposcopy at Emory University School of Medicine, talks about cervical cancer screening in underinsured or uninsured women.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

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

    International Nuclear Information System (INIS)

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

  9. Quantitative DNA Methylation Analysis of Candidate Genes in Cervical Cancer

    OpenAIRE

    Erin M Siegel; Riggs, Bridget M; Delmas, Amber L.; Koch, Abby; Hakam, Ardeshir; Brown, Kevin D.

    2015-01-01

    Aberrant DNA methylation has been observed in cervical cancer; however, most studies have used non-quantitative approaches to measure DNA methylation. The objective of this study was to quantify methylation within a select panel of genes previously identified as targets for epigenetic silencing in cervical cancer and to identify genes with elevated methylation that can distinguish cancer from normal cervical tissues. We identified 49 women with invasive squamous cell cancer of the cervix and ...

  10. Three-dimensional brachytherapy optimization techniques in the treatment of patients with cervix cancer; Apport des techniques de curietherapie optimisee grace a l'imagerie tridimensionnelle dans la prise en charge des patientes atteintes d'un cancer du col uterin

    Energy Technology Data Exchange (ETDEWEB)

    Haie-Meder, C.; Mazeron, R.; Verezesan, O.; Monnier, L.; Vieillot, S. [Institut Gustave-Roussy, Service de Curietherapie, 94 - Villejuif (France); Dumas, I. [Institut Gustave-Roussy, Service de Physique, 94 - Villejuif (France); Lhomme, C. [Institut Gustave-Roussy, Service d' Ooncologie Gynecologique, 94 - Villejuif (France); Morice, P. [Institut Gustave-Roussy, Service de Chirurgie Oncologique, 94 - Villejuif (France); Barillot, I. [Centre Regional Universitaire de Cancerologie Henry-S.-Kaplan, Hopital Bretonneau, CHU de Tours, 37 - Tours (France); Universite Francois-Rabelais, 37 - Tours (France)

    2009-10-15

    Traditionally, prescription and treatment planning in intracavitary brachytherapy for cervix cancer have used either reference points (mainly points A and B) or reference isodoses (60 Gy according to ICRU recommendations) to report doses to the target volume. Doses to critical organs were reported at bladder and rectum ICRU points. This practice has been supported by a long-standing clinical experience that has yielded an acceptable therapeutic ratio. The recent development of imaging has contributed to the improvement in target and organs at risk knowledge. In 2005 and 2006, the European group of brachytherapy -European Society for therapeutic radiology and oncology (GEC-E.S.T.R.O.) recommendations publications on 3-D based image brachytherapy have defined the different volumes of interest. These recommendations have been validated with intercomparison delineation studies. With the concomitant development of remote after-loading projectors, provided with miniaturized sources, it is now possible to plan radiation doses by adjusting dwell positions and relative dwell time values. These procedures allow better coverage of the targets while sparing O.A.R.. The recent literature data evidence a significant improvement in local control with no increase in complications. Further studies are needed to better define the dose recommended in both tumour and organs at risk. This is one of the goals of the European study on MRI-guided brachytherapy in locally advanced cervical cancer (E.M.B.R.A.C.E.) protocol (meaning of acronym: an international study on MRI-guided brachytherapy in locally advanced cervical cancer). (authors)

  11. Cervical cancer prevention: new tools and old barriers.

    Science.gov (United States)

    Scarinci, Isabel C; Garcia, Francisco A R; Kobetz, Erin; Partridge, Edward E; Brandt, Heather M; Bell, Maria C; Dignan, Mark; Ma, Grace X; Daye, Jane L; Castle, Philip E

    2010-06-01

    Cervical cancer is the second most common female tumor worldwide, and its incidence is disproportionately high (>80%) in the developing world. In the United States, in which Papanicolaou (Pap) tests have reduced the annual incidence to approximately 11,000 cervical cancers, >60% of cases are reported to occur in medically underserved populations as part of a complex of diseases linked to poverty, race/ethnicity, and/or health disparities. Because carcinogenic human papillomavirus (HPV) infections cause virtually all cervical cancer, 2 new approaches for cervical cancer prevention have emerged: 1) HPV vaccination to prevent infections in younger women (aged or =30 years). Together, HPV vaccination and testing, if used in an age-appropriate manner, have the potential to transform cervical cancer prevention, particularly among underserved populations. Nevertheless, significant barriers of access, acceptability, and adoption to any cervical cancer prevention strategy remain. Without understanding and addressing these obstacles, these promising new tools for cervical cancer prevention may be futile. In the current study, the delivery of cervical cancer prevention strategies to these US populations that experience a high cervical cancer burden (African-American women in South Carolina, Alabama, and Mississippi; Haitian immigrant women in Miami; Hispanic women in the US-Mexico Border; Sioux/Native American women in the Northern Plains; white women in the Appalachia; and Vietnamese-American women in Pennsylvania and New Jersey) is reviewed. The goal was to inform future research and outreach efforts to reduce the burden of cervical cancer in underserved populations.

  12. Brachytherapy in thetreatment of the oral and oropharyngeal cancer

    Directory of Open Access Journals (Sweden)

    A. M. Zhumankulov

    2015-01-01

    Full Text Available Background. One of the methods of radiotherapy of malignant tumors of oral cavity and oropharyngeal region today is interstitial radiation therapy – brachytherapy, allowing you to create the optimum dose of irradiation to the tumor, necessary for its destruction, without severe radiation reactions in the surrounding tissues unchanged. Brachytherapy has the following advantages: high precision – the ability of the local summarization of high single doses in a limited volume of tissue; good tolerability; a short time of treatment. At this time, brachytherapy is the method of choice used as palliative therapy and as a component of radical treatment.Objective: The purpose of this article is a literature review about the latest achievements of interstitial brachytherapy in malignant tumors of the oral cavity and oropharynx.

  13. Quality of life measurement in women with cervical cancer: implications for Chinese cervical cancer survivors

    Directory of Open Access Journals (Sweden)

    Ching Shirley SY

    2010-03-01

    Full Text Available Abstract Background Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of women's lives as well as the length of survival. Thus, the assessment of quality of life among cervical cancer survivors is increasingly paramount for healthcare professionals. The purposes of this review were to describe existing validated quality of life instruments used in cervical cancer survivors, and to reveal the implications of quality of life measurement for Chinese cervical cancer survivors. Methods A literature search of five electronic databases was conducted using the terms cervical/cervix cancer, quality of life, survivors, survivorship, measurement, and instruments. Articles published in either English or Chinese from January 2000 to June 2009 were searched. Only those adopting an established quality of life instrument for use in cervical cancer survivors were included. Results A total of 11 validated multidimensional quality of life instruments were identified from 41 articles. These instruments could be classified into four categories: generic, cancer-specific, cancer site-specific and cancer survivor-specific instruments. With internal consistency varying from 0.68-0.99, the test-retest reliability ranged from 0.60-0.95 based on the test of the Pearson coefficient. One or more types of validity supported the construct validity. Although all these instruments met the minimum requirements of reliability and validity, the original versions of these instruments were mainly in English. Conclusion Selection of an instrument should consider the purpose of investigation, take its psychometric properties into account, and consider the instrument's origin and comprehensiveness. As quality of life can be affected by culture, studies assessing the quality of life of cervical cancer survivors in

  14. Detection of STAT2 in early stage of cervical premalignancy and in cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Liang Zeng; Li-Hua Gao; Li-Jun Cao; De-Yun Feng; Ya Cao; Qi-Zhi Luo; Ping Yu; Ming Li

    2012-01-01

    Objective:To measure the expression pattern ofSTAT2 in cervical cancer initiation and progression in tissue sections from patients with cervicitis, dysplasia, and cervical cancer. Methods:Antibody against humanSTAT2 was confirmed by plasmids transient transfection andWestern blot.Immunohistochemistry was used to detectSTAT2 expression in the cervical biopsies by using the confirmed antibody againstSTAT2 as the primary antibody.Results:It was found that the overall rate of positiveSTAT2 expression in the cervicitis, dysplasia and cervical cancer groups were38.5%,69.4% and76.9%, respectively.TheSTAT2 levels are significantly increased in premalignant dysplasia and cervical cancer, as compared to cervicitis(P<0.05). Noticeably,STAT2 signals were mainly found in the cytoplasm, implying thatSTAT2 was not biologically active.Conclusions:These findings reveal an association between cervical cancer progression and augmentedSTAT2 expression.In conclusion,STAT2 increase appears to be an early detectable cellular event in cervical cancer development.

  15. The male role in cervical cancer

    Directory of Open Access Journals (Sweden)

    Castellsagué Xavier

    2003-01-01

    Full Text Available Experimental, clinical, and epidemiological evidence strongly suggests that genital Human Papillomaviruses (HPVs are predominantly sexually transmitted. Epidemiological studies in virginal and HPV-negative women clearly indicate that sexual intercourse is virtually a necessary step for acquiring HPV. As with any other sexually transmitted disease (STD men are implicated in the epidemiological chain of the infection. Penile HPVs are predominantly acquired through sexual contacts. Sexual contacts with women who are prostitutes play an important role in HPV transmission and in some populations sex workers may become an important reservoir of high-risk HPVs. Acting both as "carriers" and "vectors" of oncogenic HPVs male partners may markedly contribute to the risk of developing cervical cancer in their female partners. Thus, in the absence of screening programs, a woman's risk of cervical cancer may depend less on her own sexual behavior than on that of her husband or other male partners. Although more rarely than women, men may also become the "victims" of their own HPV infections as a fraction of infected men are at an increased risk of developing penile and anal cancers. Male circumcision status has been shown to reduce the risk not only of acquiring and transmitting genital HPVs but also of cervical cancer in their female partners. More research is needed to better understand the natural history and epidemiology of HPV infections in men.

  16. Correlates of Cervical Cancer Screening among Vietnamese American Women

    Directory of Open Access Journals (Sweden)

    Grace X. Ma

    2012-01-01

    Full Text Available Objective. Vietnamese American women are at the greatest risk for cervical cancer but have the lowest cervical cancer screening rates. This study was to determine whether demographic and acculturation, healthcare access, and knowledge and beliefs are associated with a prior history of cervical cancer screening among Vietnamese women. Methods. Vietnamese women (n=1450 from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey participated in the study and completed baseline assessments. Logistic regression analyses were performed. Results. Overall levels of knowledge about cervical cancer screening and human papillomavirus (HPV are low. Factors in knowledge, attitude, and beliefs domains were significantly associated with Pap test behavior. In multivariate analyses, physician recommendation for screening and having health insurance were positively associated with prior screening. Conclusion. Understanding the factors that are associated with cervical cancer screening will inform the development of culturally appropriate intervention strategies that would potentially lead to increasing cervical cancer screening rates among Vietnamese women.

  17. Low adherence to cervical cancer screening after subtotal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga Margrethe

    2015-01-01

    INTRODUCTION: A reason for not recommending subtotal hysterectomy is the risk of cervical pathology. We aimed to evaluate cervical cancer screening and to describe cervical pathology after subtotal and total hysterectomy for benign indications. METHODS: Data regarding adherence to screening.......7% were not screened. We found a minimum of one abnormal test in 28 (10.8%) after subtotal hysterectomy and one after total hysterectomy. No cervical cancers were found. CONCLUSIONS: Adherence to cervical cancer screening after subtotal hysterectomy in a Danish population is suboptimal and some patients...... have unnecessary tests performed after total hysterectomy. Clarification of the use of cervical/vaginal smears after hysterectomy is needed to identify women at risk of cervical dysplasia or cancer. FUNDING: Research Foundation of Region Zealand, University of Southern Denmark, Nykøbing Falster...

  18. A Monte Carlo dosimetry study using Henschke applicator for cervical brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Pei-Chieh [Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, 101 Sec. 2, Kung Fu Road, Hsinchu 30013, Taiwan (China); Department of Radiation Oncology, Cathay General Hospital, 280 Renai Rd. Sec.4, Taipei 106, Taiwan (China); Chao, Tsi-Chian [Department of Medical Imaging and Radiological Science, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan (China); Lee, Chung-Chi [Department of Medical Imaging and Radiological Science, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kwei-Shan, Tao-Yuan 333, Taiwan (China); Wu, Ching-Jung [Department of Radiation Oncology, Cathay General Hospital, 280 Renai Rd. Sec.4, Taipei 106, Taiwan (China); Tung, Chuan-Jong, E-mail: cjtung@mail.cgu.edu.t [Department of Medical Imaging and Radiological Science, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan (China)

    2010-07-21

    In recent years the Henschke applicator has been widely used for gynecologic patients treated by brachytherapy in Taiwan. However, the commercial brachytherapy planning system did not properly evaluate the dose perturbation caused by the Henschke applicator. Since the European Society for Therapeutic Radiology and Oncology advised that the effect of source shielding should be incorporated into the brachytherapy planning system, it required calculation and comparison of the dose distribution around the applicator. This study used the Monte Carlo MCNP code to simulate the dose distribution in a water phantom that contained the Henschke applicator with one tandem and two ovoids. Three dwell positions of a high dose rate {sup 192}Ir source were simulated by including and excluding the applicator. The mesh tally option of the MCNP was applied to facilitate the calculation of a large number of tallies in the phantom. The voxel size effect and the charge particle equilibrium were studied by comparing the results calculated with different tally options. The calculated results showed that the brachytherapy planning system overestimated the rectal dose and that the shielding material in the applicator contributed more than 40% to the rectal dose.

  19. Patterns of care for cervical cancer in Auckland, New Zealand, 2003–2007

    International Nuclear Information System (INIS)

    The purpose of this review is to document current patterns of care for the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 to IVA cervical cancer in a New Zealand cancer centre. This is a retrospective review of women with newly diagnosed FIGO Stage IB1–IVA cervical cancer in the Auckland/Northland regions between 2003 and 2007. Two hundred seven patients were identified. Fifty-three percent were stage IB, 24% stage II, 19% stage III and 3% stage IVA. Factors associated with stage ≥IIB were age >50, lack of participation in cervical screening and public first specialist assessment. Ninety percent (90/100) of stage IB1 patients and 73% (8/11) of stage IB2 patients were treated with primary surgery. Thirty-eight percent of surgically treated stage IB1 and 100% of surgically treated stage IB2 tumours had indications for adjuvant radiotherapy. Radiotherapy utilisation rates were: stage IB 49% (IB1 44%, IB2 91%); stage II 93%; stage III 90%; and stage IVA 71%. Brachytherapy utilisation rate (BTU) for stages IIB to IVA was 64% overall and 75% in definitively treated patients. Seventy-five percent of patients treated with definitive radiotherapy received concurrent cisplatin chemotherapy. Both radiotherapy and brachytherapy utilization rates were below optimal and are being addressed. No formal surgical or chemotherapy utilisation estimates exist for comparison; however, the use of concurrent cisplatin chemotherapy was similar to other groups. A high rate of adjuvant (chemo)radiotherapy was noted in surgically treated Stage IB patients, suggesting a need for an increased consideration of primary chemoradiotherapy in these patients to avoid the unnecessary toxicity of trimodality therapy. Future outcome analysis is planned.

  20. DIAGNOSTIC AND THERAPEUTIC POSSIBILITIES IN THE PROPHYLAXIS OF CERVICAL CANCER

    OpenAIRE

    Marzena Wrześniewska; Olga Adamczyk-Gruszka; Jakub Gruszka; Beata Bąk

    2013-01-01

    Poland is one of the countries with high cervical cancer morbidity and mortality. The main means to change this situation is to manage an active and modern programme of cervical cancer prophylaxis and diagnostics. To a large extent, the effectiveness of a cervical cancer prophylaxis programme is decided by the availability of modern diagnostic research. The conventional Papanicolaou test and modern LBC cytology techniques were discussed in the article, taking into consideration HPV diagno...

  1. Drug Delivery Approaches for the Treatment of Cervical Cancer

    OpenAIRE

    Farideh Ordikhani; Mustafa Erdem Arslan; Raymundo Marcelo; Ilyas Sahin; Perry Grigsby; Schwarz, Julie K.; Abdel Kareem Azab

    2016-01-01

    Cervical cancer is a highly prevalent cancer that affects women around the world. With the availability of new technologies, researchers have increased their efforts to develop new drug delivery systems in cervical cancer chemotherapy. In this review, we summarized some of the recent research in systematic and localized drug delivery systems and compared the advantages and disadvantages of these methods.

  2. Cytological diagnosis in cervical cancer

    OpenAIRE

    Mariana Bratu; Florentina Pricop; Ovidiu Toma; Dragos Crauciuc; Eduard Crauciuc

    2010-01-01

    Aim. The cytological test has multiple valences, allowing the early discovery and location of feminine genital cancer. Material and methods. In the period of time between 2001 and 2009, the study made within the Obstetrics and Gynecology Department of „Sf. Apostol Andrei” Emergency Hospital in Galaţi, revealed that from 415 cases with a changed PAP smear, the cytological diagnosis showed cancerous and pre-cancerous lesions in 53 patients (12.8%). We harvested cytological smears fo...

  3. An orthodontic device for retaining implanted radioactive sources during brachytherapy for cancer of the oral cavity

    International Nuclear Information System (INIS)

    An orthodontic retainer was devised to keeping implanted radioactive sources in position and improve the quality of life during brachytherapy for cancer of the oral cavity. The retainer was used in 3 patients with oral cancer, one with cancer of the hard palate, one with cancer of the soft palate, and one with cancer of the floor of mouth, during brachytherapy using 198Au grains and 137Cs needles. These patients could speak freely. One with cancer of the hard palate could drink water and ingest semi-liquid food during treatment instead of nasal tube feeding. The plaster dental model obtained while making the retainer proved to be useful for training radiation oncologists. (author)

  4. Cervical syphilitic lesions mimicking cervical cancer: a rare case report

    Directory of Open Access Journals (Sweden)

    Xiaoqing Zhu

    2015-02-01

    Full Text Available A woman presented to the hospital due to postcoital vaginal bleeding. The patient was initially diagnosed with cervical carcinoma by clinicians at a local hospital. However, a biopsy of the cervical lesions revealed chronic inflammation and erosion of the cervical mucosa, and the rapid plasma reagin ratio titer was 1:256. The patient was eventually diagnosed with syphilitic cervicitis and treated with minocycline 0.1 g twice a day. The patient was cured with this treatment.

  5. Radiation Therapy and Cisplatin With or Without Triapine in Treating Patients With Newly Diagnosed Stage IB2, II, or IIIB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    Science.gov (United States)

    2016-11-03

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Vaginal Cancer

  6. CT guided 125I seed brachytherapy for recurrent rectum cancer

    International Nuclear Information System (INIS)

    Objective: To investigate the technological feasibility, efficacy and morbidity of CT guided 125I seed implantation for recurrent rectum cancer. Methods: Twenty-three patients with recurrent rectum cancer were treated with CT guided interstitial 125I seed brachytherapy. In 20 patients the procedure was performed under epidural anesthesia and 3 patients under local anesthesia. Treatment planning system was used to calculate the number of seeds, the space distribution and the introduction of the seeding needles. Matched peripheral dose (MPD) of 121I seed implantation ranged from 90-120 Gy for patients who had had external radiotherapy, and 140- 160 Gy for those who had not. The planning target volume(PTV) was clinical target volume(CTV) plus 1 cm margin. The range of radioactivity of the 125I seeds was 18.5-25.9 MBq. All these 23 patients had CT scan at 5 mm intervals after implantation for quality evaluation, together with routine chest, pelvic X-ray films within 24-48 hours after seed implantation. Three patients received three-dimensional conformal radiation therapy(3DCRT) to a total dose of 45-50 Gy, with 2-3 Gy/f. Follow-up time was from 3 to 28 months. Results: All patients was able to tolerate seed implantation well. Complete pain relief was observed in 12/15, and partial relief in 2/15 and no response in 1/15, with a response rate of 93%. The local control rate was 87%. The 1- and 2-year survival rate was 93% and 50% respectively. Two of four patients have died of dissemination to the lung after 8 and 12 months. One seed has migrated into the pelvis without causing any untoward morbidity. Conclusion: CT guided 125I seed implantation for recurrent rectum cancer is safe, minimally invasive, causing only mild morbidity. It possesses a high efficacy, yet it should be given in combination with extemal beam radiation and chemotherapy, should distant metastasis be observed. (authors)

  7. Filling the gap in central shielding: three-dimensional analysis of the EQD2 dose in radiotherapy for cervical cancer with the central shielding technique

    OpenAIRE

    Tamaki, Tomoaki; Ohno, Tatsuya; NODA, SHIN-EI; Kato, Shingo; Nakano, Takashi

    2015-01-01

    This study aimed to provide accurate dose distribution profiles of radiotherapy for cervical cancer when treated with the central shielding technique by analysing the composite 3D EQD2 dose distribution of external beam radiotherapy (EBRT) plus intracavitary brachytherapy (ICBT). On a phantom, four patterns of the combinations of whole pelvis irradiation (WP) (4 fields), pelvis irradiation with central shielding technique (CS) [anterior–posterior/posterior–anterior (AP-PA fields), shielding w...

  8. A single session of intraluminal brachytherapy in palliation of oesophageal cancer

    NARCIS (Netherlands)

    Jager, J; Langendijk, H; Pannebakker, M; Rijken, J; deJong, J

    1995-01-01

    Between September 1987 and September 1993, 88 patients with oesophageal cancer were treated by a single session of intraluminal brachytherapy of 15 Gy prescribed at 1 cm distance from the central axis, using MDR Cs-137 (n = 51) during the first part of the study and HDR Ir-192 (n = 37) during the se

  9. THE TREATMENT AND EVOLUTION OF CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Dragos Crauciuc

    2011-09-01

    Full Text Available The purpose of this study is to establish the evolution of cervical cancer after applying a conventional treatment. Materials and methods. The study was performed on a number of 1249 patients who were suspected of having cervical neoplasia, and who were monitored between 2006-2010 in „Elena-Doamna” Clinical Hospital of Obstetrics and Gynecology in Ia�i, the Military Hospital Gala�i, the County Hospital Gala�i and the Emergency Hospital Buzau. Results and discussions. The study proved the effectiveness of the conservative treatment for the patients who were diagnosed using cytology, colposcopy, biopsy and histopathology, with or without HPV viral infection. Conclusions. The patients with an early diagnose have a 15% higher surviving probability. The patients who responded to the conservative preoperative treatment well are more likely to survive than the patients who did not respond favourably to the conservative preoperative treatment.

  10. Cancer risk following radiotherapy of cervical cancer: A preliminary report

    International Nuclear Information System (INIS)

    Women treated for cervical cancer were selected for study because (a) doses to body organs following radiotherapy can be accurately determined and vary sufficiently to permit dose-response evaluations, (b) organs remote from the cervix receive low-dose exposures in the range of current scientific interest, (c) treatment is relatively successful and many patients survive long enough to be at risk of late complications of radiotherapy, and (d) several nonexposed groups of women with cervical cancer are also available for comparison. In addition, population-based cancer registries provide an opportunity to inexpensively study large numbers of individuals over many decades. The careful procedures normally used by cancer registries to record second primary cancers facilitate the study of cancer incidence for which a wider view of radiation risk is expected than can be seen in investigations of mortality. Other special features of studies of cervical cancer patients include the ability to assess the effects of very large partial-body exposures, differences in organ sensitivities to radiation, interactions of radiation with biological factors such as age, and the duration of carcinogenic response

  11. Interstitial high-dose rate brachytherapy as boost for anal canal cancer

    International Nuclear Information System (INIS)

    To assess clinical outcomes of patients treated with a high-dose rate brachytherapy boost for anal canal cancer (ACC). From August 2005 to February 2013, 28 patients presenting an ACC treated by split-course external beam radiotherapy (EBRT) and HDR brachytherapy with or without chemotherapy in a French regional cancer center in Nice were retrospectively analyzed. Median age was 60.6 years [34 – 83], 25 patients presented a squamous cell carcinoma and 3 an adenocarcinoma; 21 received chemotherapy. Median dose of EBRT was 45 Gy [43.2 – 52]. Median dose of HDR brachytherapy was 12 Gy [10 - 15] with a median duration of 2 days. Median overall treatment time was 63 days and median delay between EBRT and brachytherapy was 20 days. Two-year local relapse free, metastatic free, disease free and overall survivals were 83%, 81.9%, 71.8% and 87.7% respectively. Acute toxicities were frequent but not severe with mostly grade 1 toxicities: 37% of genito-urinary, 40.7% of gastro-intestinal and 3.7% of cutaneous toxicities. Late toxicities were mainly G1 (43.1%) and G2 (22%). Two-year colostomy-free survival was 75.1%, one patient had a definitive sphincter amputation. High-dose rate brachytherapy for anal canal carcinoma as boost represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time

  12. Brachytherapy for early oral tongue cancer. Low dose rate to high dose rate

    International Nuclear Information System (INIS)

    To examine the compatibility of low dose rate (LDR) with high dose rate (HDR) brachytherapy, we reviewed 399 patients with early oral tongue cancer (T1-2N0M0) treated solely by brachytherapy at Osaka University Hospital between 1967 and 1999. For patients in the LDR group (n=341), the treatment sources consisted of Ir-192 pin for 227 patients (1973-1996; irradiated dose, 61-85 Gy; median, 70 Gy), Ra-226 needle for 113 patients (1967-1986; 55-93 Gy; median, 70 Gy). Ra-226 and Ir-192 were combined for one patient. Ir-192 HDR (microSelectron-HDR) was used for 58 patients in the HDR group (1991-present; 48-60 Gy; median, 60 Gy). LDR implantations were performed via oral and HDR via a submental/submandibular approach. The dose rates at the reference point for the LDR group were 0.30 to 0.8 Gy/h, and for the HDR group 1.0 to 3.4 Gy/min. The patients in the HDR group received a total dose of 48-60 Gy (8-10 fractions) during one week. Two fractions were administered per day (at least a 6-h interval). The 3- and 5-year local control rates for patients in the LDR group were 85% and 80%, respectively, and those in the HDR group were both 84%. HDR brachytherapy showed the same lymph-node control rate as did LDR brachytherapy (67% at 5 years). HDR brachytherapy achieved the same locoregional result as did LDR brachytherapy. A converting factor of 0.86 is applicable for HDR in the treatment of early oral tongue cancer. (author)

  13. Brachytherapy for early oral tongue cancer: low dose rate to high dose rate.

    Science.gov (United States)

    Yamazaki, Hideya; Inoue, Takehiro; Yoshida, Ken; Yoshioka, Yasuo; Furukawa, Souhei; Kakimoto, Naoya; Shimizutani, Kimishige; Inoue, Toshihiko

    2003-03-01

    To examine the compatibility of low dose rate (LDR) with high dose rate (HDR) brachytherapy, we reviewed 399 patients with early oral tongue cancer (T1-2N0M0) treated solely by brachytherapy at Osaka University Hospital between 1967 and 1999. For patients in the LDR group (n = 341), the treatment sources consisted of Ir-192 pin for 227 patients (1973-1996; irradiated dose, 61-85 Gy; median, 70 Gy), Ra-226 needle for 113 patients (1967-1986; 55-93 Gy; median, 70 Gy). Ra-226 and Ir-192 were combined for one patient. Ir-192 HDR (microSelectron-HDR) was used for 58 patients in the HDR group (1991-present; 48-60 Gy; median, 60 Gy). LDR implantations were performed via oral and HDR via a submental/submandibular approach. The dose rates at the reference point for the LDR group were 0.30 to 0.8 Gy/h, and for the HDR group 1.0 to 3.4 Gy/min. The patients in the HDR group received a total dose of 48-60 Gy (8-10 fractions) during one week. Two fractions were administered per day (at least a 6-h interval). The 3- and 5-year local control rates for patients in the LDR group were 85% and 80%, respectively, and those in the HDR group were both 84%. HDR brachytherapy showed the same lymph-node control rate as did LDR brachytherapy (67% at 5 years). HDR brachytherapy achieved the same locoregional result as did LDR brachytherapy. A converting factor of 0.86 is applicable for HDR in the treatment of early oral tongue cancer.

  14. Childhood indicators of susceptibility to subsequent cervical cancer

    OpenAIRE

    Montgomery, S M; Ehlin, A G C; Sparén, P.; Björkstén, B; Ekbom, A.

    2002-01-01

    Common warts could indicate cervical cancer susceptibility, as both are caused by human papillomavirus (HPV). Eczema was also investigated, as atopic eczema has been negatively associated with warts, but non-atopic eczema may be associated with compromised host defences, as observed in patients with HIV, suggesting increased susceptibility to HPV infection and cervical cancer. ‘Cervical cancer’ was self-reported during an interview by 87 of 7594 women members of two longitudinal British birth...

  15. Understanding cervical cancer in the context of developing countries

    Directory of Open Access Journals (Sweden)

    Farhad Ali

    2012-01-01

    Full Text Available Cancer is one of the leading causes of deaths worldwide. Among the women, gynecological cancers are most common. Cervical cancer is a main gynecological cancer of the women. The global burden of cervical cancer is disproportionately high among the developing countries where 85 per cent of the estimated 493, 000 new cases and 273, 000 deaths occur worldwide. There are several dimensions of the problem. Cervical cancer is a problem where people are poor, where the socio-economic status of the women is low and sometimes specific ethnicity also posses additional risk to the women to develop cervical cancer. Human papillomavirus infection is a main risk factor for the cervical cancer however there are some other factors which increase the risk. Among them some are number of sexual partners, age of first sexual intercourse, infection of sexually transmitted diseases, use of hormonal contraceptives, parity, age, smoking, food and diet. Apart from these factors, some other issues, such as policy on cancer, capacity of health system, socio-economic and cultural factors and awareness among the women are also associated with the cervical cancer related morbidity and mortality across the developing countries. There some interventions which give promising results in terms of reducing cervical cancer related morbidity and mortality. Among them visual inspection of cervix with acetic acid followed by treatment is one such effective method.

  16. Paclitaxel and carboplatin concurrent with radiotherapy for primary cervical cancer

    NARCIS (Netherlands)

    De Vos, FYFL; Bos, AME; Gietema, JA; Pras, E; Van Der Zee, AGJ; De Vries, EGE; Willemse, PHB

    2004-01-01

    Background: Concurrent radiochemotherapy is currently considered the new standard treatment in locally advanced cervical cancer. Patients and Methods: Eight women with cervical cancer stage IB2-IVA were treated with standard radiation therapy in combination with standard carboplatin (AUC=2, once wee

  17. European cervical cancer screening:experiences and results

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Europe has devoted great efforts to cervical cancer screening over 30 years.The mortality was generally declining although incidence rates of cervical cancer among young women have been increasing in many countries of Europe.The efficiency of screening,however,needs to be addressed by planners for an improved cost-effectiveness in the future.

  18. Are Fewer Cervical Cancer Screenings Needed After HPV Vaccine?

    Science.gov (United States)

    ... html Are Fewer Cervical Cancer Screenings Needed After HPV Vaccine? Less testing could reduce risk of false positives ... said. Women vaccinated with earlier versions of the HPV vaccine -- which protect against the two worst cancer-causing ...

  19. Constitutive STAT5 Activation Correlates With Better Survival in Cervical Cancer Patients Treated With Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: Constitutively activated signal transducers and activators of transcription (STAT) factors, in particular STAT1, STAT3, and STAT5, have been detected in a wide variety of human primary tumors and have been demonstrated to directly contribute to oncogenesis. However, the expression pattern of these STATs in cervical carcinoma is still unknown, as is whether or not they have prognostic significance. This study investigated the expression patterns of STAT1, STAT3, and STAT5 in cervical cancer and their associations with clinical outcomes in patients treated with radical radiation therapy. Methods and Materials: A total of 165 consecutive patients with International Federation of Gynecology and Obstetrics (FIGO) Stages IB to IVA cervical cancer underwent radical radiation therapy, including external beam and/or high-dose-rate brachytherapy between 1989 and 2002. Immunohistochemical studies of their formalin-fixed, paraffin-embedded tissues were performed. Univariate and multivariate analyses were performed to identify and to evaluate the effects of these factors affecting patient survival. Results: Constitutive activations of STAT1, STAT3, and STAT5 were observed in 11%, 22%, and 61% of the participants, respectively. While STAT5 activation was associated with significantly better metastasis-free survival (p < 0.01) and overall survival (p = 0.04), STAT1 and STAT3 activation were not. Multivariate analyses showed that STAT5 activation, bulky tumor (≥4 cm), advanced stage (FIGO Stages III and IV), and brachytherapy (yes vs. no) were independent prognostic factors for cause-specific overall survival. None of the STATs was associated with local relapse. STAT5 activation (odds ratio = 0.29, 95% confidence interval = 0.13–0.63) and advanced stage (odds ratio = 2.54; 95% confidence interval = 1.03–6.26) were independent predictors of distant metastasis. Conclusions: This is the first report to provide the overall expression patterns and prognostic significance

  20. Constitutive STAT5 Activation Correlates With Better Survival in Cervical Cancer Patients Treated With Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Helen H.W. [Department of Radiation Oncology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Chou, Cheng-Yang [Department of Obstetrics and Gynecology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Wu, Yuan-Hua; Hsueh, Wei-Ting; Hsu, Chiung-Hui [Department of Radiation Oncology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Guo, How-Ran [Department of Environmental and Occupational Health, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China); Lee, Wen-Ying, E-mail: 7707@so-net.net.tw [Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan (China) and Department of Pathology, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Su, Wu-Chou, E-mail: sunnysu@mail.ncku.edu.tw [Department of Internal Medicine, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan (China)

    2012-02-01

    Purpose: Constitutively activated signal transducers and activators of transcription (STAT) factors, in particular STAT1, STAT3, and STAT5, have been detected in a wide variety of human primary tumors and have been demonstrated to directly contribute to oncogenesis. However, the expression pattern of these STATs in cervical carcinoma is still unknown, as is whether or not they have prognostic significance. This study investigated the expression patterns of STAT1, STAT3, and STAT5 in cervical cancer and their associations with clinical outcomes in patients treated with radical radiation therapy. Methods and Materials: A total of 165 consecutive patients with International Federation of Gynecology and Obstetrics (FIGO) Stages IB to IVA cervical cancer underwent radical radiation therapy, including external beam and/or high-dose-rate brachytherapy between 1989 and 2002. Immunohistochemical studies of their formalin-fixed, paraffin-embedded tissues were performed. Univariate and multivariate analyses were performed to identify and to evaluate the effects of these factors affecting patient survival. Results: Constitutive activations of STAT1, STAT3, and STAT5 were observed in 11%, 22%, and 61% of the participants, respectively. While STAT5 activation was associated with significantly better metastasis-free survival (p < 0.01) and overall survival (p = 0.04), STAT1 and STAT3 activation were not. Multivariate analyses showed that STAT5 activation, bulky tumor ({>=}4 cm), advanced stage (FIGO Stages III and IV), and brachytherapy (yes vs. no) were independent prognostic factors for cause-specific overall survival. None of the STATs was associated with local relapse. STAT5 activation (odds ratio = 0.29, 95% confidence interval = 0.13-0.63) and advanced stage (odds ratio = 2.54; 95% confidence interval = 1.03-6.26) were independent predictors of distant metastasis. Conclusions: This is the first report to provide the overall expression patterns and prognostic significance of

  1. Aberrant Expression of Notch1 in Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    Li Sun; Qimin Zhan; Wenhua Zhang; Yongmei Song; Tong Tong

    2007-01-01

    OBJECTIVE To investigate the putative role of the Notch1 receptor in cervical cancer carcinogenesis and progression.METHODS The expression of the Notch1 protein was analyzed by a Western-blotting approach in 40 cervical cancer and 30 normal cervical tissues.Some tissues were examined using RT-PCR To determine Mrna levels.Celluar localization of the Notch1 protein in the paraffin-embedded cervical tissues was also analyzed by immunohistochemistry.RESULTS The Notch1 protein was detected in all 30 normal cervical tissues.In contrast.only 6 samples of 40 cervical cancer tissues showed Notch1 expression.The level of the Notch1 protein expression was significantly lower in cervical cancer tissues than that in normal tissue samples.In agreement with these observations.levels of Notch1 Mrna were found to be substantially down-regulated in cervical cancer tissues.In the immunohistochemistry staining assay,the Notch1 protein was shown to localize predominantly in the cytoplasm and nucleoli of the normal cervical squamous epithelium of the cervix,but no staining was observed in the cervical cancer cells.Notch1 expression was observed to correlate with the clinical disease stage.but there were no correlations with age,tumor size,grade or lymph node metastasis (P>0.05).The levels of Notchl protein expression were significantly higher in early stages(I~lla,66.7%) compared to those in the advanced stages (Iib~IV,12.6%)(P=0.001).CONCLUSION Notch1 may play a role as a tumor suppressor in cervical tumorigenesis.Determination of Notch1 expression may be helpful for preoperative diagnosis and accuracy of staging.But its clinical use for cervical cancer requires further investigation.

  2. Iodine-125 seed brachytherapy for early stage prostate cancer: a single-institution review

    OpenAIRE

    Zuber, Simon; Weiß, Susan; Baaske, Dieter; Schöpe, Michael; Stevens, Simon; Bodis, Stephan; Zwahlen, Daniel R.

    2015-01-01

    Purpose We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution. Material and methods Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual fu...

  3. Iodine-125 seed brachytherapy for early stage prostate cancer: a single-institution review

    OpenAIRE

    Zuber, Simon; Weiß, Susan; Baaske, Dieter; Schöpe, Michael; Stevens, Simon; Bodis, Stephan; Zwahlen, Daniel R.

    2015-01-01

    PURPOSE: We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution. MATERIAL AND METHODS: Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexu...

  4. [Gene therapy with cytokines against cervical cancer].

    Science.gov (United States)

    Bermúdez-Morales, Victor Hugo; Peralta-Zaragoza, Oscar; Madrid-Marina, Vicente

    2005-01-01

    Gene therapy is an excellent alternative for treatment of many diseases. Capacity to manipulate the DNA has allowed direct the gene therapy to correct the function of an altered gene, to increase the expression of a gene and to favour the activation of the immune response. This way, it can intend the use of the DNA like medication able to control, to correct or to cure many diseases. Gene therapy against cancer has an enormous potential, and actually the use of the DNA has increased to control diverse cancer in animal models, with very encouraging results that have allowed its applications in experimental protocols in human. This work concentrates a review of the foundations of the gene therapy and its application on cervical cancer, from the point of view of the alterations of the immune system focused on the tumour micro-environment, and the use of the cytokines as immunomodulators. PMID:16983992

  5. Cervical acid phosphatase detection: A guide to abnormal cells in cytology smear screening for cervical cancer

    OpenAIRE

    Deb Prabal; Iyer Venkateswaran; Bhatla Neerja; Markovic O; Verma Kusum

    2008-01-01

    Background: Cervical acid phosphatase-Papanicolaou (CAP-PAP) test has recently been described for detection of acid phosphatase enzyme in abnormal squamous cells, and has been proposed as a biomarker-based technology for the screening of cervical cancer. Materials and Methods: Eighty-one consecutive cervical smears were subjected to routine Papanicolaou (Pap) staining as well as CAP-PAP, which combined cytochemical staining for acid phosphatase with modified Pap stain. Statistical evaluation ...

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

    Science.gov (United States)

    2015-11-09

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

  7. Advancing cervical cancer prevention in India: implementation science priorities.

    Science.gov (United States)

    Krishnan, Suneeta; Madsen, Emily; Porterfield, Deborah; Varghese, Beena

    2013-01-01

    Cervical cancer is the leading cause of cancer mortality in India, accounting for 17% of all cancer deaths among women aged 30 to 69 years. At current incidence rates, the annual burden of new cases in India is projected to increase to 225,000 by 2025, but there are few large-scale, organized cervical cancer prevention programs in the country. We conducted a review of the cervical cancer prevention research literature and programmatic experiences in India to summarize the current state of knowledge and practices and recommend research priorities to address the gap in services. We found that research and programs in India have demonstrated the feasibility and acceptability of cervical cancer prevention efforts and that screening strategies requiring minimal additional human resources and laboratory infrastructure can reduce morbidity and mortality. However, additional evidence generated through implementation science research is needed to ensure that cervical cancer prevention efforts have the desired impact and are cost-effective. Specifically, implementation science research is needed to understand individual- and community-level barriers to screening and diagnostic and treatment services; to improve health care worker performance; to strengthen links among screening, diagnosis, and treatment; and to determine optimal program design, outcomes, and costs. With a quarter of the global burden of cervical cancer in India, there is no better time than now to translate research findings to practice. Implementation science can help ensure that investments in cervical cancer prevention and control result in the greatest impact.

  8. Changes in knowledge of cervical cancer following introduction of human papillomavirus vaccine among women at high risk for cervical cancer

    Directory of Open Access Journals (Sweden)

    L. Stewart Massad

    2015-04-01

    Conclusion: Substantial gaps in understanding of HPV and cervical cancer prevention exist despite years of health education. While more effective educational interventions may help, optimal cancer prevention may require opt-out vaccination programs that do not require nuanced understanding.

  9. On the Development of a Miniature Neutron Generator for the Brachytherapy Treatment of Cancer

    Science.gov (United States)

    Forman, L.

    2009-03-01

    Brachytherapy refers to application of an irradiation source within a tumor. 252Cf needles used in brachytherapy have been successfully applied to treatment of some of the most virulent cancers but it is doubtful that it will be widely used because of difficulty in dealing with unwanted dose (source cannot be turned off) and in adhering to stringent NRC regulations that have been exacerbated in our post 911 environment. We have been working on the development of a miniature neutron generator with the reaction target placed at the end of a needle (tube) for brachytherapy applications. Orifice geometries are most amenable, e.g. rectum and cervix, but interstitial use is possible with microsurgery. This paper dicusses the results of a 30 watt DD neutron generator SBU project that demonstrates that sufficient hydrogen isotope current can be delivered down a small diameter needle required for a DT neutron treatment device, and, will summarize the progress of building a commercial device pursued by the All Russian Institute for Automatics (VNIIA) supported by the DOE's Industrial Proliferation Prevention Program (IPP). It is known that most of the fast neutron (FN) beam cancer treatment facilities have been closed down. It appears that the major limitation in the use of FN beams has been damage to healthy tissue, which is relatively insensitive to photons, but this problem is alleviated by brachytherapy. Moreover, recent clinical results indicate that fast neutrons in the boost mode are most highly effective in treating large, hypoxic, and rapidly repopulating diseases. It appears that early boost application of FN may halt angiogenesis (development and repair of tumor vascular system) and shrink the tumor resulting in lower hypoxia. The boost brachytherapy application of a small, low cost neutron generator holds promise of significant contribution to the treatment of cancer.

  10. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik;

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  11. Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES

    Energy Technology Data Exchange (ETDEWEB)

    Park, Su Gyong; Chang, Hye Sook; Choi, Eun Kyong; Yi, Byong Yong [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    1992-12-15

    Remote afterloading high dose rate brachytherapy(HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures performed at Asan Medical Center for 3 years. From Sep. 1985 to Aug 1992, 471 procedures of intracavitary radiation in 55 patients of cervical cancer and 26 of nasopharyngeal cancer, 79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range 1-31 months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, 80% achieves palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

  12. 75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2010-02-18

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... Force guidelines for breast and cervical cancer screening; Impact of the revised clinical screening recommendations for both breast and cervical cancer on the National Breast and Cervical Cancer Early...

  13. Neoadjuvant chemotherapy in cervical cancer in pregnancy.

    Science.gov (United States)

    Ilancheran, Arunachalam

    2016-05-01

    Cervical cancer is the most common gynecological cancer encountered in pregnancy. The standard treatment of early cervical cancer is usually surgical removal of the cervix (in selected cases) or, more commonly, the uterus. However, when cervical cancer develops during pregnancy, definitive surgical treatment often needs to be postponed until the fetus reaches maturity. Neoadjuvant chemotherapy (NACT) is an innovative approach in the management of these patients. It helps in controlling the disease and delaying delivery. The paper presents a literature review of the history of NACT, as well as practice points and agenda for further research. PMID:26536815

  14. Simultaneous radiochemotherapy and endoluminal HDR brachytherapy in esophageal cancer; Simultane Radiochemotherapie mit intraluminaler HDR-Brachytherapie des Oesophaguskarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Patonay, P.; Naszaly, A.; Mayer, A. [Hauptstaedtisches Zentrum fuer Radioonkologie und Strahlentherapie, Budapest (Hungary)

    2007-02-15

    Purpose: to study efficacy and toxicity of radiochemotherapy in esophageal cancer including initial endoluminal high-dose-rate brachytherapy (HDR-BT). Patients and methods: between 01/1995 and 06/2005, 61 patients with esophageal cancer were treated preoperatively with definitive and palliative intent. Treatment started with intraluminal HDR-BT for recanalization of the esophagus (single fraction size of 8 Gy in 0.5 cm depth, three times, q7d) followed by external-beam radiation therapy (50 Gy total dose, 5 x 2 Gy/week, 25 fractions in 5 weeks). Chemotherapy was started simultaneously with external irradiation (three courses of cisplatin and 5-fluorouracil, q21d). Results: swallowing function improved in 55/61 patients (dysphagia classification according to the RTOG), and worsened in 6/61 patients, respectively. Median duration of symptomatic improvement was 11 months, median follow-up 12 months (range 3-68 months). Following simultaneous radiochemotherapy, tumor resectability was achieved in 7/25 patients of the neoadjuvant group, and the histological specimen showed complete remission in 6/7 patients. Conclusion: these results indicate a favorable effect of simultaneous radiochemotherapy starting with endoluminal HDR-after-loading-(AL-)BT in esophageal cancer. (orig.)

  15. DIAGNOSTIC AND THERAPEUTIC POSSIBILITIES IN THE PROPHYLAXIS OF CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Marzena Wrześniewska

    2013-11-01

    Full Text Available Poland is one of the countries with high cervical cancer morbidity and mortality. The main means to change this situation is to manage an active and modern programme of cervical cancer prophylaxis and diagnostics. To a large extent, the effectiveness of a cervical cancer prophylaxis programme is decided by the availability of modern diagnostic research. The conventional Papanicolaou test and modern LBC cytology techniques were discussed in the article, taking into consideration HPV diagnostics in the procedures for carefully selected cytological diagnosis, in the so called in-depth stage of preventive screening tests and the role of the p16 biomarker in predicting the development of a higher degree of epithelial-cell pathologies of the cervix. Colposcopy as a diagnostic method for the verification of cytological and virological abnormalities. The modern LEEP/LLETZ procedure used in diagnosis and treatment of cervical changes is used to realise the in-depth stage of cervical cancer prophylaxis programmes.

  16. Women's perspectives on illness in being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which...... if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. Objective To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide...... whether to participate in cervical cancer screening. Study design The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels...

  17. LOSS OF HETEROZYGOSITY ON CHROMOSOME 17p13.3 IN OVARIAN CANCER AND CERVICAL CANCER

    Institute of Scientific and Technical Information of China (English)

    Zhang Guoling; Yang Huijian; Xu Kaili; Zhou Jin; Qin Ruidi; Lu Minghua

    1998-01-01

    Objective:To identify the loss of heterozygosity (LOH) on chromosome 17p13.3 in ovarian cancer and cervical cancer. Methods: The frequency of LOH on chromosome 17p13.3 in DNA samples from 24 ovarian cancers, 9 cervical cancers, and 13 non-malignant gynecological diseases were determined respectively, using Southern blot method with probe PYNZ.22. Results:LOH on 17p13.3 was found in 12 of 24 (50.0%) ovarian cancers (including a borderline mucinous cystadenoma), 4of 9 (44.4%) cervical carcinomas, and 1 of 13 (7.7%) nonmalignant gynecological diseases, which was cervical intraepithelial neoplasm HI (CIN Ⅲ) (P<0.01).Conclusion: These results show that LOH on 17p13.3 is associated with ovarian cancer and cervical cancer,suggesting that detection of LOH on 17p13.3 may be helpful to understand the molecular pathogenesis of ovarian cancer and cervical cancer.

  18. Patient, Physician, and Nurse Factors Associated With Entry Onto Clinical Trials and Finishing Treatment in Patients With Primary or Recurrent Uterine, Endometrial, or Cervical Cancer

    Science.gov (United States)

    2016-10-26

    Recurrent Cervical Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Uterine Corpus Cancer; Stage I Uterine Sarcoma; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Uterine Sarcoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Uterine Sarcoma; Stage IV Uterine Corpus Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  19. Impact of comorbidity in elderly prostate cancer patients treated with brachytherapy

    Institute of Scientific and Technical Information of China (English)

    Costanza Chiumento; Alba Fiorentino; Mariella Cozzolino; Rocchina Caivano; Stefania Clemente; Piernicola Pedicini; Vincenzo Fusco

    2013-01-01

    Objective:To analyze the correlations among comorbidity and overall survival (OS),biochemical progression-free survival (b-PFS) and toxicity in elderly patents with localized prostate cancer treated with 125I brachytherapy.Methods:Elderly men,aged ≥65 years,with low-intermediate risk prostate cancer,were treated with permanent 125I brachytherapy as monotherapy.Comorbidity data were obtained from medical reports using age-adjusted Charlson comorbidity index (a-CCI).The patients were categorized into two age groups (<75and ≥75 years old),and two comorbidity score groups (a-CCI ≤3 and >3).Toxicity was scored with Radiation Therapy Oncology Group (RTOG) scale.Results:From June 2003 to October 2009,a total of 92 elderly patients underwent prostate brachytherapy,including 57 men (62%) with low-risk prostate cancer,and 35 men (38%) with intermediate-risk prostate cancer.The median age of patients was 75 years (range,65-87 years).Forty-seven patients (51%) had a-CCI ≤3 and 45 patients (49%) a-CCI >3.With a median follow-up period of 56 months (range,24-103 months),the 5-year actuarial OS and b-PFS were 91.3% and 92.4% respectively,without statistical significance between two Charlson score groups.Toxicity was mild.None of the patients experienced gastrointestinal (GI) toxicity,and only 4 patiens (4%) experienced late genitourinary (GU) grade-3 (G3) toxicity.No correlation between acute GU and GI toxicity and comorbidity was showed (P=0.50 and P=0.70,respectively).Conclusions:Our data suggest that elderly men with low-intermediate risk prostate cancer and comorbidity can be considered for a radical treatment as 125I low-dose rate brachytherapy.

  20. Screening for cervical cancer: when theory meets reality

    Directory of Open Access Journals (Sweden)

    Nygård Mari

    2011-06-01

    Full Text Available Abstract Cervical cancer screening reduces morbidity and mortality due to cervical cancer. However, there are many factors that determine the success of any cervical cancer prevention effort: the prevalence of human papillomavirus infection in general population, the existence of an organized screening program and the corresponding coverage, the existence and quality of the field and laboratory facilities for screening and diagnostic follow-up, and the facilities available for treating diagnosed lesions. Monitoring the patient path or "chain of action" for each patient with an abnormal screening result is of crucial importance. Cost-effectiveness models are widely used by decision-makers to determine which cervical cancer screening program would maximize health benefits within a given, usually limited, set of resources. Regardless of their level of sophistication, however, these models cannot replace empirical evaluations of the effectiveness of screening programs. Cervical cancer prevention activities need to be monitored and evaluated in each country where they are introduced to see that they meet performance standards. Policy-makers responsible for allocating resources for cervical cancer prevention have a duty to allocate resources not only for cervical cancer screening, but also for screening program surveillance.

  1. Chlamydia Trachomatis Infection-Associated Risk of Cervical Cancer

    Science.gov (United States)

    Zhu, Haiyan; Shen, Zhaojun; Luo, Hui; Zhang, Wenwen; Zhu, Xueqiong

    2016-01-01

    Abstract As whether Chlamydia trachomatis infection increases the risk of cervical cancer is controversial in the literature, we performed a meta-analysis. Based on a comprehensive search of publications in the Medline, Cochrane, and EMBASE databases, we identified and extracted data from all relevant articles examining C. trachomatis infection and the risk of cervical cancer. The quality of each included study was assessed according to the 9-star Newcastle–Ottawa scale. The strength of association between the C. trachomatis and risk of cervical cancer was estimated by odds ratio (OR) and 95% confidence intervals (CIs). This review was registered at PROSPERO with registration No. CRD42014015672. A total of 22 studies with 4291 cervical cancer cases and 7628 controls were identified. Overall, C. trachomatis was significantly linked to increased cervical cancer risk in prospective studies (OR = 2.21, 95% CI: 1.88–2.61, P papilloma virus and C. trachomatis has a higher risk of cervical cancer (OR = 4.03, 95% CI: 3.15–5.16, P papilloma virus infections. This approach will not only protect against pelvic inflammatory disease and infertility, but may also prevent cervical cancer. PMID:27043670

  2. STUDY OF DEPRESSION IN WOMEN WITH CERVICAL AND BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Nimisha

    2015-02-01

    Full Text Available BACKGROUND : There is considerable lack of scientific estimate of depressive disorder among cancer patients in India. OBJECTIVES : (1 To associate the depressive disorders between the cervical cancer and breast cancer patients and (2 to compare the level of depressi on score among cervical and breast cancer patients , and with medically ill inpatient population with some other medical illnesses. SETTING AND DESIGN: A cross - sectional study at inpatient Department of Bharath Cancer Hospital and JSS Medical College Hospit al , Mysore. MATERIAL AND METHOD: The study was conducted on admitted thirty breast and thirty cervical cancer inpatients in medical ward of JSS Hospital and Bharath Cancer Hospital , Mysore from D ecember 2007 to august 2009. Data analysis was done for the both groups of cancer and with thirty control group of medically ill inpatient population with some other medical illnesses. Detailed psychological , sociodemographic characteristics were recorded in proforma specially designed for the study. Depression was assessed using MINI plus , HAMD scale and scoring was done. STATISTICAL ANALYSIS : Descriptive statistics , Cross tabs procedure , r epeated measure ANOVA statistical methods were carried out through the SPSS for Windows (version 16.0. RESULTS: Major depressi ve disorder was present in 16.7% of breast cancer and 23.3% of cervical cancer patients. . There was no significant asso ciation between type of cancer (B reast cancer and cervical cancer and depressive disorder. Depression score was found high in cervical c ancer cases compare to breast cancer cases though difference in these scores were not statistically significant in between two cancer groups. Depression score was high and significant in both cancer groups as compare to control group. CONCLUSION : Depressio n is more prevalent in cancer patients than in other several medical illneses and adequate knowledge is required for psychosocial interventions and designing

  3. Consecutive magnetic resonance imaging during brachytherapy for cervical carcinoma: predictive value of volume measurements with respect to persistent disease and prognosis

    International Nuclear Information System (INIS)

    Cervical cancer is associated with a high yearly mortality. The presence of persistent disease after radiotherapy is a significant predictor of patient survival. The aim of our study was to assess if tumor volume regression measured with MR imaging at the time of brachytherapy can discriminate between patients who eventually will achieve a complete response to radiotherapy from those who will not. The second objective was to evaluate whether tumor volume regression predicts overall treatment failure. MRI was evaluated quantitatively in 35 patients; by means of tumor volumetry on T2-weighted MR images before treatment, at the first BCT application, and at the final BCT. The MR images were independently analyzed by two investigators. As a reference standard histopathologic confirmation of residual tumor and/or clinical exam during follow-up > 1 year were used. Area under the curve were compared, P-values <0.05 were considered significant. There was a good correlation between volume measurements made by the two observers. A residual tumor volume >9.4 cm3 at final BCT and tumor volume regression < 77 % of the pre-treatment volume were significantly associated with local residual tumor after completion of therapy (p < 0.02) (AUC, 0.98-1.00). A volume >2.8 cm3 at final BCT was associated with overall treatment failure (p < 0.03). Our study shows that volume analysis during BCT is a predictive tool for local tumor response and overall treatment outcome. The potential of local response assessment to identify patients at high risk of overall treatment failure is promising

  4. Clinical study on radiotherapy combined with surgical treatment of 162 patients with cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Xiaopeng Zhong; Xukun Tong; Lingfang Yang; Donglin Yuan; Huigao Cai

    2008-01-01

    Objective: To compare the 5-year survival rates and complications of internal and external irradiation therapy combined with operation in patients with Ⅱ-Ⅲ period of cervical cancer.Methods: 162 cervical cancer patients after the whole palace resection pelvic lymphadenectomy were divided into three groups, and then accepted radiotherapy.The first group with 91 cases was accepted internal and external irradiation therapy before operation; the second group with 37 cases was given internal irradiation therapy before operation; the third group with 34 cases was given routine postoperative radiotherapy.External irradiation used 60Co irradiation or a linear accelerator, to the whole basin, and the irradiation dose of "B" point in preoperative radiotherapy was 26-30 Gy, in postoperative radiotherapy was 46-50 Gy; intraluminal brachytherapy used 192lr,the dose of "A" point was 5-15 Gy.Results: The 5-year survival rate of preoperative combined radiotherapy group was 78.0%(71/91), preoperative intracavitary radiotherapy group 64.9% (24/37), and postoperative radiotherapy group 35.3% (12/34).Comparing the 5-year survival rates of the preoperative combined and postoperative irradiation groups, there was significant difference (P<0.05).The major complications were radioactive proctitis and cystitis, the complication incidences of three groups were 35.2% (32/91), 32.4% (12/37), 38.2% (13/34), respectively, and the differences were not statistically significant (P>0.05).Conclusion: The intraluminal brachytherapy plus external irradiation can significantly increase the 5-year survival rate of patients with Ⅱa-Ⅲa stages, and the incidence of complications was not significant difference.

  5. Youtube as a source of information on cervical cancer

    Directory of Open Access Journals (Sweden)

    Janak Adhikari

    2016-01-01

    Full Text Available Background: Cervical cancer is the third most common cancer worldwide. Accurate information about cervical cancer to general public can lower the burden of the disease including its mortality. Aims: We aimed to look at the quality of information available in YouTube for cervical cancer. Materials and Methods: We searched YouTube (http://www.youtube.com for videos using the keyword "Cervical cancer" on November 12, 2015. Videos were then analyzed for their source and content of information. Results: We studied 172 videos using the keyword "Cervical cancer" on November 12, 2015. We found that there were videos describing the personal stories, risk factors, and the importance of screening. However, videos discussing all the aspects of cancers were lacking. Likewise, videos from the reputed organization were also lacking. Conclusion: Although there were numerous videos available in cervical cancer, videos from reputed organizations including Center for Disease Control and Prevention, American Cancer Society, and World Health Organization were lacking. We strongly believe that quality videos from such organizations via YouTube can help lower the burden of disease.

  6. Health-Related Quality of Life up to Six Years After 125I Brachytherapy for Early-Stage Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose: Health-related quality of life (HRQOL) after prostate brachytherapy has been extensively described in published reports but hardly any long-term data are available. The aim of the present study was to prospectively assess long-term HRQOL 6 years after 125I prostate brachytherapy. Methods and Materials: A total of 127 patients treated with 125I brachytherapy for early-stage prostate cancer between December 2000 and June 2003 completed a HRQOL questionnaire at five time-points: before treatment and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTCQLQ-C30), and the tumor-specific EORTC prostate cancer module (EORTC-PR25). A change in a score of ≥10 points was considered clinically relevant. Results: Overall, the HRQOL at 6 years after 125I prostate brachytherapy did not significantly differ from baseline. Although a statistically significant deterioration in HRQOL at 6 years was seen for urinary symptoms, bowel symptoms, pain, physical functioning, and sexual activity (p 125I prostate brachytherapy. HRQOL scores returned to approximately baseline values at 1 year and remained stable up to 6 years after treatment. 125I prostate brachytherapy did not adversely affect patients' long-term HRQOL.

  7. Cervical cytology in serous and endometrioid endometrial cancer.

    Science.gov (United States)

    Roelofsen, Thijs; Geels, Yvette P; Pijnenborg, Johanna M A; van Ham, Maaike A P C; Zomer, Saskia F; van Tilburg, Johanna M Wiersma; Snijders, Marc P M L; Siebers, Albert G; Bulten, Johan; Massuger, Leon F A G

    2013-07-01

    The aim of this study was to determine the frequency of abnormal cervical cytology in preoperative cervical cytology of patients diagnosed with uterine papillary serous carcinoma (UPSC) and endometrioid endometrial carcinoma (EEC). In addition, associations between abnormal cervical cytology and clinicopathologic factors were evaluated. In this multicentre study, EEC patients diagnosed at two hospitals from 1999 to 2009 and UPSC patients diagnosed at five hospitals from 1992 to 2009, were included. Revision of the histologic slides was performed systematically and independently by 3 gynecopathologists. Cervical cytology within six months before histopathologic diagnosis of endometrial carcinoma was available for 267 EEC and 80 UPSC patients. Cervical cytology with atypical, malignant, or normal endometrial cells in postmenopausal women was considered as abnormal cytology, specific for endometrial pathology. Abnormal cervical cytology was found in 87.5% of UPSC patients, compared with 37.8% in EEC patients. In UPSC, abnormal cytology was associated with extrauterine spread of disease (P=0.043). In EEC, abnormal cytology was associated with cervical involvement (P=0.034). In both EEC and UPSC patients, abnormal cervical cytology was not associated with survival. In conclusion, abnormal cervical cytology was more frequently found in UPSC patients. It was associated with extrauterine disease in UPSC patients, and with cervical involvement in EEC patients. More prospective research should be performed to assess the true clinical value of preoperative cervical cytology in endometrial cancer patients. PMID:23722512

  8. Women's perspectives on illness in being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which if untrea......Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which...... of analysis: naive reading, structural analysis and critical interpretation. Results These revealed that women were unprepared for screening results showing cervical cell changes, since they had no symptoms. When diagnosed, participants believed that they had early-stage cancer, leading to feelings...

  9. GENERAL AWARNANCE OF HUMAN PAPILLOMA VIRUS VACCINE AGAINST CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    SAFILA NAVEED

    2014-01-01

    Full Text Available We have conducted a survey program on the awarnance of HPV vaccine of cervical cancer in common people. Methods: For this survey we perform 2 steps. First we made a questionnaires in which we ask to female of different belongs to different education field either they are married or not. Secondly we gone in the different hospitals of Karachi and observe treatment, diagnosis, vaccination availability and frequency of cervical cancer. Results:From questionnaire we observed that only 1 % female are aware about cervical cancer and its vaccine i.e. HPV, even female belongs medical field are not aware about it. Form hospital survey we observed that frequency of cervical cancer is very less but in Shaukat Khanum hospital 90 cases reported out of 1803 cancer. The given treatment is radiology, chemotherapy and surgery.

  10. Evaluation of functioning of high dose rate brachytherapy at the Instituto Nacional do Cancer

    International Nuclear Information System (INIS)

    Quality control tests are very useful tools to assure the quality of patient's treatment. A daily control of the high dose rate micro selectron was performed based on the security parameters of the equipment and on the quickness of performance. The purpose of this report is to evaluate and to discuss the errors found during the first three years with the high dose rate brachytherapy, at the Instituto Nacional de Cancer. (author)

  11. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer*

    Science.gov (United States)

    Pellizzon, Antônio Cássio Assis

    2016-01-01

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy.

  12. Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer

    International Nuclear Information System (INIS)

    Locoregional recurrence is the typical pattern of recurrence in gastric cancer, and cannot be removed by surgery in most of the patients. We aimed to evaluate the feasibility and efficacy of computed tomography (CT)-guided brachytherapy for patients with locoregional recurrent gastric cancer. We reviewed the case histories of 28 patients with locoregional recurrent gastric cancer that were selected for CT- guided brachytherapy by a multidisciplinary team. The clinical data of the patients including patient characteristics, treatment parameters, short-term effects, and survival data were collected and analyzed. 15-75 125I seeds were implanted into each patient to produce a minimal peripheral dose (MPD) 100-160 Gy. Median day 0 dosimetry was significant for the following: V100 (the volume treated with the prescription dose) 95.8% (90.2-120.5%) and D90 (prescription dose received by at least 90% of the volume) 105.2% (98.0-124.6%) of prescription dose. No serious complications occurred during the study. Two months after brachytherapy, complete response, partial response and progressive disease were observed in 50.0%, 28.6% and 21.4% of patients, respectively. The median survival time was 22.0 ± 5.2 months, and the 1, 2,and 3-year survival rate was 89 ± 6%, 52 ± 10% and 11 ± 7%, respectively. A univariate analysis showed that the tumor size was a significant predictor of overall survival (P = 0.034). Patients with tumors <3 cm had relatively higher complete response rate (66.7%), compared to those with tumors >3 cm (30.8%). The PTV (planning target volume) smaller than 45 cm3 was significantly correlated with achieving complete tumor eradication in the treated region (P = 0.020). For selected patients with limited locoregional recurrent gastric cancer, CT-guided brachytherapy using 125I seeds implantation can provide a high local control rate, with minimal trauma

  13. Brachytherapy in non melanoma skin cancer of eyelid: a systematic review

    OpenAIRE

    Frakulli, Rezarta; Galuppi, Andrea; Cammelli, Silvia; MACCHIA, GABRIELLA; Cima, Simona; Gambacorta, Maria A.; Cafaro, Ines; Tagliaferri, Luca; Perrucci, Elisabetta; Buwenge, Milly; Frezza, Giovanni; Valentini, Vincenzo; Morganti, Alessio G.

    2015-01-01

    Purpose Non melanoma skin cancers (NMSC) of eyelid are uncommon. Many treatments approach are available with surgery being considered as the gold standard. Radiotherapy is an effective alternative in patients unfit for surgery. Brachytherapy (BT) might be a better therapeutic option due high radiation dose concentration to the tumor and rapid dose fall-off resulting in normal tissues sparing. The aim of this review is to evaluate local control, toxicity, and functional cosmetic outcome of BT ...

  14. High-dose rate brachytherapy in the treatment of cancer of the cervix uteri

    Directory of Open Access Journals (Sweden)

    D. A. Aliyev

    2011-01-01

    Full Text Available Analysis of the results of examining and treating 246 patients with Stages IIA-IIIB cancer of the cervix uteri (CCU, receiving specific chemoradiotherapy (CRT at the Department of Radiotherapy, National Oncology Center (Baku, has ascertained that CRT using two high-dose (9 Gy rate brachytherapy fractions and competitive cisplatin chemotherapy is an effective, reasonably safe, and economically sound treatment method for locally advanced CCU. The method shows acceptable toxicity and may be used in routine clinical practice.

  15. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer*

    Science.gov (United States)

    Pellizzon, Antônio Cássio Assis

    2016-01-01

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. PMID:27403021

  16. Preparation and characterization of composite microspheres for brachytherapy and hyperthermia treatment of cancer

    International Nuclear Information System (INIS)

    Composite microspheres were prepared by coating yttrium–aluminum–silicate (YAS) glass microspheres (20–30 μm) with a layer of Fe3O4 nanoparticles and evaluated for potential use in brachytherapy and hyperthermia treatment of cancer. After neutron activation to form the β-emitting 90Y radionuclide, the composite microspheres can be injected into a patient to destroy cancerous tumors; at the same time, the composite microspheres can generate heat upon application of a magnetic field to also destroy the tumors. The results showed that the composite microspheres were chemically durable when immersed in a simulated body fluid (SBF), with ∼ 0.25% weight loss and ∼ 3.2% yttrium dissolved into the SBF after 30 days at 37 °C. The composite microspheres also showed ferromagnetic properties as a result of the Fe3O4 coating; when immersed in water at 20 °C (20 mg in 1 mL of water), the application of an alternating magnetic field produced a temperature increase from 20 °C to 38−46 °C depending on the thickness of the Fe3O4 coating. The results indicate that these composite microspheres have promising potential in combined brachytherapy and hyperthermia treatment of cancerous tumors. - Highlights: ► Composite microspheres for brachytherapy and hyperthermia treatment of cancer. ► Fe3O4 nanoparticles coated on the yttrium–aluminum–silicate glass microspheres. ► Microspheres are chemically stable in SBF. ► Microspheres can generate heat for hyperthermia under an alternating magnetic field. ► Microspheres can emit β-rays for brachytherapy after neutron activation.

  17. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pellizzon, Antonio Cassio Assis, E-mail: acapellizzon@hcancer.org.br [A.C. Camargo Cancer Center, Sao Paulo, SP (Brazil). Departamento de Radioterapia

    2016-05-15

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. (author)

  18. Prevalence and risk factors for cervical cancer and pre-cancerous lesions in Rwanda

    OpenAIRE

    Makuza, Jean Damascène; Nsanzimana, Sabin; Muhimpundu, Marie Aimee; Pace, Lydia Eleanor; Ntaganira, Joseph; Riedel, David James

    2015-01-01

    Introduction Cervical cancer prevalence in Rwanda has not been well-described. Visual inspection with acetic acid or Lugol solution has been shown to be effective for cervical cancer screening in low resource settings. The aim of the study is to understand the prevalence and risk factors for cervical cancer and pre- cancerous lesions among Rwandan women between 30 and 50 old undergoing screening. Methods This cross-sectional analytical study was done in 3 districts of Rwanda from October 2010...

  19. Cervical cancer screening policies and coverage in Europe

    DEFF Research Database (Denmark)

    Anttila, Ahti; von Karsa, Lawrence; Aasmaa, Auni;

    2009-01-01

    The aim of the study was to compare current policy, organisation and coverage of cervical cancer screening programmes in the European Union (EU) member states with European and other international recommendations. According to the questionnaire-based survey, there are large variations in cervical...

  20. Women's perspectives on illness when being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    BACKGROUND: In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30-40. Systematic screening can identify women with cervical cell changes, which if untre...

  1. High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis

    OpenAIRE

    Fouad Aoun; Ksenija Limani; Alexandre Peltier; Quentin Marcelis; Marc Zanaty; Alexandre Chamoun; Marc Vanden Bossche; Thierry Roumeguère; Roland van Velthoven

    2015-01-01

    Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU) compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon's rank-sum or χ 2 test. Kaplan-Meier curves, log-rank tests, and Cox regression mod...

  2. Preparation and deployment of indigenous 125I- seeds for the treatment of prostate cancer: dawn of prostate brachytherapy in India

    International Nuclear Information System (INIS)

    'Permanent seed implantation' using 125I- seeds represents an effective treatment modality for prostate cancer. An innovative strategy to prepare and deploy 125I- seeds for treatment of prostate cancer has been evolved. Seeds prepared by chemisorptions of 125I on palladium coated silver wires were characterized and encased in titanium tubes by ND:YAG laser. Several batches of critically evaluated seeds exhibiting release of 125I were supplied to P.D. Hinduja Hospital, Mumbai for treatment of prostate cancer patients. Successful deployment of indigenous seeds in prostate brachytherapy has opened a new window for making prostate brachytherapy affordable to needy cancer patients. (author)

  3. Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

    International Nuclear Information System (INIS)

    A modified form of high dose rate (HDR) brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT). EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer. A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation. The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities. EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer

  4. Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Uk; Cho, Kwan Ho; Moon, Sung Ho; Choi, Sung Weon; Park, Joo Yong; Yun, Tak; Lee, Sang Hyun; Lim, Young Kyung; Jeong, Chi Young [National Cancer Center, Goyang (Korea, Republic of)

    2014-12-15

    To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

  5. Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

    International Nuclear Information System (INIS)

    To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

  6. Recovery of hormone sensitivity after salvage brachytherapy for hormone refractory localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Dan Smith

    2010-06-01

    Full Text Available PURPOSE: Recent work has demonstrated the return of hormone sensitivity after palliative chemotherapy in androgen independent prostate cancer. We wished to establish whether a similar phenomenon existed in patients with no exposure to chemotherapy. MATERIALS AND METHODS: A review of “hormone resistant” patients who had received salvage brachytherapy for localized prostate cancer after previous external beam radiotherapy was undertaken. Three patients with subsequent biochemical relapse responded to the rechallenge with hormonal treatment. RESULTS: The series of patients presented here demonstrates this phenomenon occurs after salvage brachytherapy with no exposure to chemotherapy. Recovery of sensitivity is demonstrated both to androgen deprivation and to androgen receptor antagonism. The recovery of hormone sensitivity was surprisingly durable, ranging from eight months to over twenty-one months. CONCLUSIONS: Hormone sensitivity may be recovered after salvage brachytherapy. Potential mechanisms underlying these observations are discussed and the likely central role of the activity of the androgen receptor highlighted. The relevance of these findings to the management of advanced prostate cancer is considered including thoughts on the practice of intermittent anti-androgen therapy.

  7. Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Thropay John P

    2010-07-01

    Full Text Available Abstract Background A modified form of high dose rate (HDR brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT. EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer. Methods A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation. Results The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities. Conclusions EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer.

  8. High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon’s rank-sum or χ2 test. Kaplan-Meier curves, log-rank tests, and Cox regression models were constructed to assess differences in survival rates between the two groups. Results. Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p<0.05. Median oncologic follow-up was 83 months (13–123 months in the HIFU cohort and 44 months (13–89 months in the brachytherapy cohort. Median time to achieve PSA nadir was statistically shorter in the HIFU. Biochemical recurrence-free survival rate was significantly higher in the brachytherapy cohort compared to HIFU cohort (68.5% versus 53%, p<0.05. No statistically significant difference in metastasis-free, cancer specific, and overall survivals was observed between the two groups. Conclusion. HIFU and brachytherapy are safe with no significant difference in cancer specific survival on long term oncologic follow-up. Nonetheless, a randomized controlled trial is needed to confirm these results.

  9. High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis.

    Science.gov (United States)

    Aoun, Fouad; Limani, Ksenija; Peltier, Alexandre; Marcelis, Quentin; Zanaty, Marc; Chamoun, Alexandre; Vanden Bossche, Marc; Roumeguère, Thierry; van Velthoven, Roland

    2015-01-01

    Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU) compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon's rank-sum or χ (2) test. Kaplan-Meier curves, log-rank tests, and Cox regression models were constructed to assess differences in survival rates between the two groups. Results. Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p HIFU cohort and 44 months (13-89 months) in the brachytherapy cohort. Median time to achieve PSA nadir was statistically shorter in the HIFU. Biochemical recurrence-free survival rate was significantly higher in the brachytherapy cohort compared to HIFU cohort (68.5% versus 53%, p cancer specific, and overall survivals was observed between the two groups. Conclusion. HIFU and brachytherapy are safe with no significant difference in cancer specific survival on long term oncologic follow-up. Nonetheless, a randomized controlled trial is needed to confirm these results. PMID:26357511

  10. MRI assessment of cervical cancer for adaptive radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dimopoulos, Johannes C.A.; Schirl, Gertrude; Baldinger, Anja; Poetter, Richard [Medical Univ. of Vienna (Austria). Dept. of Radiotherapy; Helbich, Thomas H. [Medical Univ. of Vienna (Austria). Dept of Radiology

    2009-05-15

    Purpose: To assess the importance of the information obtained from MRI for adaptive cervix cancer radiotherapy. Patients and methods: 49 patients with cervix cancer, treated by external-beam radiotherapy (EBRT) and MRI-assisted high-dose-rate brachytherapy {+-} concomitant cisplatin, underwent MRI at diagnosis and at the time of brachytherapy fractions. 190 MRI examinations were performed. Pretreatment scans were correlated with clinical examination (CE) findings. Measurements in 3-D of the tumor extension and also of the distance from the tumor to the pelvic side wall were performed using both MRI and CE. The tumor volume regression induced initially by EBRT and the subsequent regression after each brachytherapy fraction were assessed. Results: MRI and CE showed 92% agreement in overall parametrial staging and 73% agreement in terms of vaginal involvement. There was, however, disagreement in parametrial side (right/left) classification in 25% of the parametria examined. These were patients with unilateral displacement of the cervix and contralateral invasion of the parametrium. The mean tumor volume on the pretreatment MRI scan (GTVD) was 61 cm{sup 3}. At the time of the four brachytherapy fractions the mean was 16 cm{sup 3}, 10 cm{sup 3}, 9 cm{sup 3}, and 8 cm{sup 3}, defined as the GTVBT plus the gray zones in the parametria. Conclusion: CE and MRI findings agree well in terms of overall staging. The clinical assessment of side-specific parametrial invasion improved when having access to the additional knowledge obtained from MRI. The greatest decrease in tumor volume occurs during EBRT, whereas tumor regression between the first and subsequent brachytherapy fractions is minor. (orig.)

  11. Prognostic significance of annexin A2 and annexin A4 expression in patients with cervical cancer

    OpenAIRE

    Choi, Chel Hun; Chung, Joon-Yong; Chung, Eun Joo; Sears, John D.; Lee, Jeong-Won; Bae, Duk-Soo; Hewitt, Stephen M.

    2016-01-01

    Background The annexins (ANXs) have diverse roles in tumor development and progression, however, their clinical significance in cervical cancer has not been elucidated. The present study was to investigate the clinical significance of annexin A2 (ANXA2) and annexin A4 (ANXA4) expression in cervical cancer. Methods ANXA2 and ANXA4 immunohistochemical staining were performed on a cervical cancer tissue microarray consisting of 46 normal cervical epithelium samples and 336 cervical cancer cases ...

  12. A risk evaluation model of cervical cancer based on etiology and human leukocyte antigen allele susceptibility

    OpenAIRE

    Bicheng Hu; Ning Tao; Fanyu Zeng; Min Zhao; Lixin Qiu; Wen Chen; Yun Tan; Yun Wei; Xufeng Wu; Xinxing Wu

    2014-01-01

    Background: There are no reliable risk factors to accurately predict progression to cervical cancer in patients with chronic cervicitis infected with human papillomavirus (HPV). The aim of this study was to create a validated predictive model based on the risk factors for cervical cancer. A model to estimate the risk of cervical cancer may help select patients for intervention therapy in order to reduce the occurrence of cervical cancer after HPV infection. Methods: This retrospective anal...

  13. Cervical cancer: The preventive role of HPV vaccine (review article

    Directory of Open Access Journals (Sweden)

    N. Behtash

    2007-05-01

    Full Text Available Cervical cancer is the second most common gynecologic cancer. A steady 70% annual decline in mortality from cervical cancers has been observed since the mid 20th century after the introduction of widespread papanicolaou cytological screening. But also cervical cancer continues to be an important world health problem for women. Cervical cancer is one of the best- understood neoplasm given its well known viral cause of persistent infection with high risk human papillomavirus (HPV. To date, two manufacturers have developed HPV vaccines composed of noninfectious, recombinant HPV viral-like particles (VLPs. This article presents current advances and perspectives on HPV vaccines.The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13--26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.

  14. A review of cervical cancer research in malaysia.

    Science.gov (United States)

    Zaridah, S

    2014-08-01

    Despite cervical cancer being potentially preventable, it is the second most common cancer among women in Malaysia. One hundred and five articles related to Cervical Cancer were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Fifty seven articles were selected and reviewed for the articles' clinical relevance and future research implications. This article reviews the various aspects of cervical cancer in Malaysia, mainly persistent infection of high risk human papillomavirus (HPV), primary prevention (HPV vaccination), screening method (Pap smear issues), and the attitude and knowledge of various groups of Malaysian women that contributed to the failure to reduce the incidence and mortality of cervical cancer. Most of the studies focused on prevention, Pap smear issues, HPV DNA testing, HPV vaccination and various recommendations for prevention of cervical cancer. Secondary prevention by screening is still an important aspect because even with HPV vaccination, screening still plays an important role as vaccination does not cover all high risk HPVs. There is a need to seriously consider a properly organised screening programme, taking into consideration what we already know about the attitude and knowledge of Malaysian women, economic factors and psychosocial issues of the screening method. There is also a large gap in clinical studies on the outcome, management and survival of cervical cancer patients in Malaysia. PMID:25417949

  15. Survival analysis of cervical cancer using stratified Cox regression

    Science.gov (United States)

    Purnami, S. W.; Inayati, K. D.; Sari, N. W. Wulan; Chosuvivatwong, V.; Sriplung, H.

    2016-04-01

    Cervical cancer is one of the mostly widely cancer cause of the women death in the world including Indonesia. Most cervical cancer patients come to the hospital already in an advanced stadium. As a result, the treatment of cervical cancer becomes more difficult and even can increase the death's risk. One of parameter that can be used to assess successfully of treatment is the probability of survival. This study raises the issue of cervical cancer survival patients at Dr. Soetomo Hospital using stratified Cox regression based on six factors such as age, stadium, treatment initiation, companion disease, complication, and anemia. Stratified Cox model is used because there is one independent variable that does not satisfy the proportional hazards assumption that is stadium. The results of the stratified Cox model show that the complication variable is significant factor which influent survival probability of cervical cancer patient. The obtained hazard ratio is 7.35. It means that cervical cancer patient who has complication is at risk of dying 7.35 times greater than patient who did not has complication. While the adjusted survival curves showed that stadium IV had the lowest probability of survival.

  16. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  17. The case for focal brachytherapy for the management of low grade prostate cancer

    International Nuclear Information System (INIS)

    Full text: Radical therapy of low to intermediate prostate cancer patients can cause substantial adverse events relating to genitourinary and rectal toxicity. Yet there is little evidence that such treatment results in increased life expectancy. On the other hand, watchful waiting is associated with active surveillance and the patient must accept that the cancer remains untreated and has a risk of progression. Focal therapy of low grade prostate cancer provides an intermediate approach to the management of this cancer. The approach is to treat only those positive segments on biopsy and so reduce the likelihood of adverse events. However, continued surveillance is required because of the increased risk of disease progression. Focal therapy needs to be evaluated using available ablative therapies. Recent studies of focal HIFU for 20 patients showed PSA reduced from 7.3 to 1.5 ng/mL at 12 months. 1/20 patients had inadequate erections and 2120 required pads. 17/19 had no histological evidence of cancer and none had evidence of high volume or Gleason = 7 cancer in the treated lobe. Seed brachytherapy is commonly used for radical prostate treatment of low volume disease. As the same template can be used for seed therapy as is used for biopsy, the technique is ideally suited for focal brachytherapy. As any treatment involving less than the entire gland involves the risk of leaving viable cancer cells outside the treatment zone, a phase 3 randomised clinical trial between radical and focal brachytherapy is advocated to demonstrate the efficacy and safety of the latter relative to radical therapy.

  18. Intestinal obstructions following the cervical cancer treatment

    International Nuclear Information System (INIS)

    Sixty-six intestinal obstructions occured among 2149 patients of cervical cancer treated during period 1961 - 1975. They are divided into four groups, that is, 1.29 cases living with no signs of recurrence after the treatment for obstructions, 2.7 cases that died of obstructions or of complications from its treatment, 3.6 cases that once cured from the obstructions but died from the cancer more than one year after the treatment, 4.24 cases that died from the cancer within one year after the treatment for obstructions. With significantly high incidence, intestinal obstructions are observed with the post-operatory irradiation over 5,000 rads to the whole pelvis or post operatory irradiation using combined telecobalt and small sources. The common sites of obstructions are small intestine to the operated group and sigmoid colon or rectum to the radiotherapy group. Twenty-nine of the patients were treated conservatively and of them 15 are living, intestinal resections and end to end anastomoses were performed to 8 patients, 5 of them are living, but 7 of them suffered from wound disruptions, so the indication for this operation should be carefully decided. (auth.)

  19. Virus and Cervical Cancer: Role and implication: A Review

    Directory of Open Access Journals (Sweden)

    Kalyani Raju

    2015-03-01

    Full Text Available Cervical cancer is one of the leading cancers in women worldwide especially in developing countries. Various etiological factors are described, of which Human papiloma virus (HPV is proved by various molecular epidemiological studies to play a major role. However many co-factors are required and thought to facilitate the action of HPV in cervical carcinogenesis. Here the role of various viruses in cervical cancer and its implication in screening and diagnosis of cervical cancer is highlighted. In-depth knowledge of role of different viruses helps in better screening methods and probably in target therapy / development of an appropriate vaccine. [Biomed Res Ther 2015; 2(3.000: 220-30

  20. Grantee Spotlight: Dr. Kolawole Okuyemi - Improving Cervical Cancer Screening Attitudes

    Science.gov (United States)

    Dr. Kolawole Okuyumi is studying cervical cancer screening attitudes and behaviors of African immigrants and refugees in Minnesota, and introducing “cancer” and “cervix” to their everyday vocabulary.

  1. Bevacizumab improves survival for patients with advanced cervical cancer

    Science.gov (United States)

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

  2. Is neo-adjuvant chemotherapy a better option for management of cervical cancer patients of rural India?

    Directory of Open Access Journals (Sweden)

    G A Dastidar

    2016-01-01

    Full Text Available Objectives: To explore alternate modality of treatment in patients of advanced cancer cervix by neo-adjuvant chemotherapy (NACT followed by External Beam Radiotherapy (ERT and Brachytherapy (BT. Short- (6 months and long- (12 months term follow-up data from these patients were compared with the retrospective data from an urban cancer centre, where standard protocol of concurrent chemo-radiotherapy is practiced. Materials and Methods: Two hundred patients of advanced cervical cancer, treated at our rural cancer centre between January 2007 and December 2007, were included in the study arm (Group A. These patients received three cycles of neo-adjuvant chemotherapy with Cisplatin, Bleomycin, and Vincristine before External-Beam Radiotherapy (EBT followed by brachytherapy. Patients in the control arm (Group B of an urban cancer centre, received EBT with weekly concomitant Cisplatin, followed by brachytherapy. Short- (6 months and long- (12 months term follow-up data from our patients were compared with the retrospective data from the urban cancer centre. Results and Analysis: Complete response rate was comparatively higher among patients of Group A, also correspondingly proportion of patients showing progressive disease and stable disease was lower among them. Local treatment failure was 87.5% among patients from Group A and 94.4% in Group B patients. Concomitant chemoradiation (CRT was associated with more GI toxicities. Conclusion: Our result suggests NACT arm is as effective as CRT arm in respect of complete response with less pelvic failure and G.I toxicities. Further follow-up data are needed before arriving at a definite conclusion.

  3. Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren;

    2014-01-01

    INTRODUCTION: Women living with HIV (WLWH) are reportedly at increased risk of invasive cervical cancer (ICC). WLWH in Denmark attend the National ICC screening program less often than women in the general population. We aimed to estimate the incidence of cervical dysplasia and ICC in WLWH...... and hazard ratios (HRs) for time from inclusion to first cervical intraepithelial neoplasia (CIN)/ICC and time from first normal cervical cytology to first CIN/ICC were estimated. Sensitivity analyses were performed to include prior screening outcome, screening intensity and treatment of CIN...... with normal baseline cytology, incidences of CIN1+ and CIN2+ were higher in WLWH. However, incidences were comparable between WLWH and controls adherent to the National ICC screening program. CONCLUSIONS: Overall, WLWH develop more cervical disease than controls. However, incidences of CIN are comparable...

  4. American Brachytherapy Society survey regarding practice patterns of postoperative irradiation for endometrial cancer: Current status of vaginal brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To survey the current postoperative recommendations for radiotherapy (RT) in patients with endometrial cancer, with an emphasis on vaginal brachytherapy (VBT). Methods and Materials: In August 2003, a 32-item questionnaire was mailed to a random sample of 2396 members of the American Society for Therapeutic Radiology and Oncology and the American Brachytherapy Society. The sample excluded members-in-training, physicists, and non-U.S. members. A follow-up mailing was conducted in November 2003. Those who had not treated any patient in the previous year for endometrial carcinoma were instructed to indicate so at the beginning of the questionnaire and return it without responding to any other item. Responses were tabulated to determine the relative frequency distribution. Results: of the 2396 surveys sent out, 757 were returned, for a response rate of 31.6%. Of those who responded, 551 (72.8%) had performed postoperative irradiation for endometrial cancer and were included in this study. Of the 551 respondents, 99.8% had delivered external beam RT to some endometrial cancer patients. An increasing trend was found toward referrals for VBT; 91.5% of those who treated endometrial cancer performed VBT. The vaginal target most often irradiated was the upper vagina in 40.7%, upper 4-5 cm in 54.5%, and the entire vagina in 4.9%; 21.3% placed clips at the vaginal apex for applicator verification. The maximal dose to the bladder and rectum was recorded in 78.3% and 80.2% of patients, respectively. Of the respondents, 40% did not use low-dose-rate (LDR) VBT. The two most common LDR applicators were Delclos cylinders (29.7%) and Fletcher colpostats (29.3%). The mean boost dose delivered with LDR VBT when prescribed to the surface was 29.9 Gy and when prescribed to 0.5 cm was 23.8 Gy. When LDR therapy was used without external beam RT, the mean dose when prescribed to the surface was 56.8 Gy and when prescribed to 0.5 cm was 47.9 Gy. In 2002, 69.1% of respondents treated

  5. Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy

    Directory of Open Access Journals (Sweden)

    Valle Sabrina

    2009-02-01

    Full Text Available Abstract Background We estimated the number of women undergoing cervical cancer screening annually in Italy, the rates of cervical abnormalities detected, and the costs of screening and management of abnormalities. Methods The annual number of screened women was estimated from National Health Interview data. Data from the Italian Group for Cervical Cancer Screening were used to estimate the number of positive, negative and unsatisfactory Pap smears. The incidence of CIN (cervical intra-epithelial neoplasia was estimated from the Emilia Romagna Cancer Registry. Patterns of follow-up and treatment costs were estimated using a typical disease management approach based on national guidelines and data from the Italian Group for Cervical Cancer Screening. Treatment unit costs were obtained from Italian National Health Service and Hospital Information System of the Lazio Region. Results An estimated 6.4 million women aged 25–69 years undergo screening annually in Italy (1.2 million and 5.2 million through organized and opportunistic screening programs, respectively. Approximately 2.4% of tests have positive findings. There are approximately 21,000 cases of CIN1 and 7,000–17,000 cases of CIN2/3. Estimated costs to the healthcare service amount to €158.5 million for screening and €22.9 million for the management of cervical abnormalities. Conclusion Although some cervical abnormalities might have been underestimated, the total annual cost of cervical cancer prevention in Italy is approximately €181.5 million, of which 87% is attributable to screening.

  6. New Molecular Tools for Efficient Screening of Cervical Cancer

    OpenAIRE

    Magnus von Knebel Doeberitz

    2001-01-01

    Cytological screening using the Pap-smear led to a remarkable reduction of the mortality of cervical cancer. However, due to subjective test criteria it is hampered by poor inter- and intra-observer agreement. More reproducible assays are expected to improve the current screening and avoid unnecessary medical intervention and psychological distress for the affected women. Cervical cancer arises as consequence of persistent high risk papillomavirus (HR-HPV) infections. Expression of two viral ...

  7. Molecular mechanisms of cisplatin resistance in cervical cancer

    OpenAIRE

    Zhu, Xueqiong

    2016-01-01

    Haiyan Zhu, Hui Luo, Wenwen Zhang, Zhaojun Shen, Xiaoli Hu, Xueqiong Zhu Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China Abstract: Patients with advanced or recurrent cervical cancer have poor prognosis, and their 1-year survival is only 10%–20%. Chemotherapy is considered as the standard treatment for patients with advanced or recurrent cervical cancer, and cisplatin appears to tr...

  8. Molecular mechanisms of cisplatin resistance in cervical cancer

    OpenAIRE

    Zhu H; Luo H; Zhang W; Shen Z; Hu X; Zhu X

    2016-01-01

    Haiyan Zhu, Hui Luo, Wenwen Zhang, Zhaojun Shen, Xiaoli Hu, Xueqiong Zhu Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China Abstract: Patients with advanced or recurrent cervical cancer have poor prognosis, and their 1-year survival is only 10%–20%. Chemotherapy is considered as the standard treatment for patients with advanced or recurrent cervical cancer, and cisplatin appears to treat the ...

  9. Quality of Care in Women With Stage I Cervical Cancer

    OpenAIRE

    Chu, Joseph; Polissar, Lincoln; Tamimi, Hisham K.

    1982-01-01

    A study was done to assess the quality of care received by women with stage I cervical cancer. Through a population-based registry serving 13 counties of western Washington, including Seattle, we identified all women residents in whom local-stage cervical cancer developed between January 1974 and December 1978 (N=369). The cases were subdivided into stage IA (microinvasive) and stage IB (frankly invasive). Quality of care was defined as optimal or suboptimal at the outset of the study; this d...

  10. Screening and cervical cancer cure: population based cohort study

    OpenAIRE

    Andrae, B.; Andersson, T. M.-L.; Lambert, P C; Kemetli, L.; Silfverdal, L.; Strander, B.; Ryd, W.; Dillner, J.; Tornberg, S.; Sparen, P.

    2012-01-01

    Objective To determine whether detection of invasive cervical cancer by screening results in better prognosis or merely increases the lead time until death. Design Nationwide population based cohort study. Setting Sweden. Participants All 1230 women with cervical cancer diagnosed during 1999-2001 in Sweden prospectively followed up for an average of 8.5 years. Main outcome measures Cure proportions and five year relative survival ratios, stratified by screening history, mode of detection, age...

  11. A lectin-based diagnostic system using circulating antibodies to detect cervical intraepithelial neoplasia and cervical cancer.

    Science.gov (United States)

    Jin, Yingji; Kim, Seung Cheol; Kim, Hyoung Jin; Ju, Woong; Kim, Yun Hwan; Kim, Hong-Jin

    2016-01-01

    In the present study, we developed serological strategies using immunoglobulin fractions obtained by protein A chromatography to screen for cervical cancer and cervical intraepithelial neoplasia I (CIN I). The reactivities of the immunoglobulins purified from sera of women with normal cytology, CIN I and cervical cancer were compared in enzyme-linked immunosorbent assays (ELISA) and enzyme-linked lectin assays (ELLAs). To capture the immunoglobulins, ELISAs and ELLAs were performed in protein A immobilized microplates. The reactivity of immunoglobulin in ELISA was in the increasing order normal cytology, CIN I and cervical cancer, while that in ELLAs for detecting fucosylation was in the decreasing order normal cytology, CIN I and cervical cancer. It was confirmed that women with CIN I were distinguishable from women with normal cytology or women with cervical cancer in the ELISA or the ELLA for detecting fucosylation with considerable sensitivity and specificity. Women with cervical cancer were also distinguishable from women with normal cytology with high sensitivity (ELISA: 97%, ELLA: 87%) and specificity (ELISA: 69%, ELLA: 72%). Moreover, the logistic regression model of the ELISA and the ELLA discriminated cervical cancer from normal cytology with 93% sensitivity and 93% specificity. These results indicate that the ELISAs and the ELLAs have great potential as strategies for primary screening of cervical cancer and CIN. It is expected that the ELISA and the ELLA can provide new insights to understand systemic changes of serum immunoglobulins during cervical cancer progression.

  12. Complications associated with brachytherapy alone or with laser in lung cancer

    International Nuclear Information System (INIS)

    Relatively little has been reported about destruction through brachytherapy of mucosa-perforating and extraluminary tumors with probable large vessel involvement causing major hemorrhagic or fistular complications. We report 12 patients subjected to laser and brachytherapy for centrally occluding lung cancer, whom we have periodically followed up from June 1986 until they died. Although all laser procedures were free from complications, necrotic cavitation in five cases, two of which were accompanied by large bronchoesophageal fistulas, and massive fatal hemoptysis occurred in six. Minor complications included radiation mucositis (two), noncritical mucosal scarring (two), and cough (four). Characteristics that will identify patients at risk of developing fatal hemoptysis and fistulas should be better defined by imaging and endoscopic techniques. In such cases, modifying the protocol or using alternative procedures should be considered. Minor complications, such as cough, can be avoided by using topical steroid therapy (eg, beclomethasone dipropionate)

  13. Pulsed dose rate (PDR) brachytherapy as salvage treatment of locally advanced or recurrent gynecologic cancer

    DEFF Research Database (Denmark)

    Jensen, P T; Roed, H; Engelholm, S A;

    1998-01-01

    presents the first clinical results from The Finsen Center with PDR-brachytherapy in patients with locally advanced or recurrent gynecologic cancer. METHODS AND MATERIALS: Between June 1993 and August 1996, 34 patients with gynecologic malignancies (22 pelvic recurrences, 12 primary locally advanced) have....... There was no difference in survival probability when stratifying the patients by primary diagnosis (recurrent vs. primary advanced), relapse locations (central vs. central + pelvic wall mass) or treatment volume. Seventeen chronic grade III complications were observed in 10 patients. Large treatment volumes significantly...... correlated to severe gastrointestinal complications. Fifteen of 17 chronic grade III complications were observed in patients treated for recurrent disease. CONCLUSION: PDR-brachytherapy in combination with external irradiation is an effective treatment option for patients with locally advanced or recurrent...

  14. Impact of concurrent chemotherapy on definitive radiotherapy for women with FIGO IIIb cervical cancer

    International Nuclear Information System (INIS)

    The purpose of this retrospective study is to investigate the impact of concurrent chemotherapy on definitive radiotherapy for the International Federation of Gynecology and Obstetrics (FIGO) IIIb cervical cancer. Between 2000 and 2009, 131 women with FIGO IIIb cervical cancer were treated by definitive radiotherapy (id est (i.e.) whole pelvic external beam radiotherapy for 40-60 Gy in 20-30 fractions with or without center shielding and concomitant high-dose rate intracavitary brachytherapy with 192-iridium remote after loading system for 6 Gy to point A of the Manchester method). The concurrent chemotherapy regimen was cisplatin (40 mg/m2/week). After a median follow-up period of 44.0 months (range 4.2-114.9 months) and 62.1 months for live patients, the five-year overall survival (OS), loco-regional control (LRC) and distant metastasis-free survival (DMFS) rates were 52.4, 80.1 and 59.9%, respectively. Univariate and multivariate analyses revealed that lack of concurrent chemotherapy was the most significant factor leading to poor prognosis for OS (HR=2.53; 95% CI 1.44-4.47; P=0.001) and DMFS (HR=2.53; 95% CI 1.39-4.61; P=0.002), but not for LRC (HR=1.57; 95% CI 0.64-3.88; P=0.322). The cumulative incidence rates of late rectal complications after definitive radiotherapy were not significantly different with or without concurrent chemotherapy (any grade at five years 23.9 vs 21.7%; P=0.669). In conclusion, concurrent chemotherapy is valuable in definitive radiotherapy for Japanese women with FIGO IIIb cervical cancer. (author)

  15. High-dose-rate intraluminal brachytherapy during preoperative chemoradiation for locally advanced rectal cancers

    Institute of Scientific and Technical Information of China (English)

    Mutahir; Ali; Tunio; Mansoor; Rafi; Altaf; Hashmi; Rehan; Mohsin; Abdul; Qayyum; Mujahid; Hasan; Amjad; Sattar; Muhammad; Mubarak

    2010-01-01

    AIM:To determine the feasibility and safety of high dose rate intraluminal brachytherapy(HDR-ILBT) boost during preoperative chemoradiation for rectal cancer.METHODS:Between 2008 and 2009,thirty-six patients with locally advanced rectal cancer(≥ T3 or N+),were treated initially with concurrent capecitabine(825 mg/m2 oral twice daily) and pelvic external beam radiotherapy(EBRT)(45 Gy in 25 fractions),then were randomized to group A;HDR-ILBT group(n = 17) to receive 5.5-7 Gy×2 to gross tumor volume(GTV) and g...

  16. Pathways of cervical cancer screening among Chinese women

    Directory of Open Access Journals (Sweden)

    Ma GX

    2013-06-01

    Full Text Available Grace X Ma,1 Min Qi Wang,2 Xiang S Ma,3 Steven E Shive,4 Yin Tan,5 Jamil I Toubbeh51Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, 2Department of Public and Community Health, University of Maryland, College Park, MD, 3College of Health Professions and School of Medicine, Temple University, Philadelphia, PA, 4Center for Asian Health, Temple University, and Department of Health, East Stroudsburg University, East Stroudsburg, PA, 5Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, USABackground: The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancer screening among Chinese American women.Methods: A cross-sectional design included a sample of 573 Chinese American women aged 18 years and older. The initial step involved use of confirmatory factor analysis, that included the following variables: access to and satisfaction with health care, and enabling and predisposing cultural and health beliefs. Structural equation model analyses were conducted on factors related to cervical cancer screening.Results: Age, marital status, employment, household income, and having health insurance, but not educational level, were significantly related to cervical screening status. Predisposing and enabling factors were positively associated with cervical cancer screening. The cultural factor was significantly related to the enabling factor or the satisfaction with health care factor.Conclusion: This model highlights the significance of sociocultural factors in relation to cervical cancer screening. These factors were significant, with cultural, predisposing, enabling, and health belief factors and access to and satisfaction with health care reinforcing the need to assist Chinese American women with poor English fluency in translation and awareness of the importance of cervical

  17. Long-term disease control with triapine-based radiochemotherapy for patients with stage IB2-IIIB cervical cancer

    Directory of Open Access Journals (Sweden)

    Charles A Kunos

    2014-07-01

    Full Text Available Background: National Cancer Institute phase I #7336 and phase II #8327 clinical trials explored the safety and efficacy of triapine (NSC #663249 added to cisplatin radiochemotherapy in untreated patients with advanced-stage cervical cancer. Triapine inhibits ribonucleotide reductase, the rate-limiting enzyme responsible for DNA-building deoxyribonucleotides, and thereby, enhances radiochemosensitivity by prolonging DNA repair time. Here we report 3-year efficacy endpoints of pelvic locoregional relapse rate, disease-free and overall survivals. Methods: Eligible patients with bulky IB-IIIB cervical cancer underwent three-times weekly triapine (25 or 50 mg/m2, once-weekly cisplatin (40mg/m2, and conventional daily pelvic radiation followed by brachytherapy. A cumulative incidence method estimated pelvic locoregional relapse rates. Disease-free survival was measured from radiochemotherapy start date to the date of first relapse or cancer-related death. Overall survival was measured from radiochemotherapy start date to the date of any-cause death. The Kaplan-Meier method estimated survivals. Findings: Between 2006 and 2011, 24 untreated patients with cervical cancer met criteria for reporting in this study. A median 3.4 years of follow-up time (range, 0.3-7.6 years has been observed. All had squamous cancers and the majority had either node-positive stage IB-IIA (33% or stage IIIB (42% disease. The 3-year pelvic locoregional relapse rate, disease-free survival, and overall survival were 4% (95% confidence interval [CI], 0-20%, 80% (95% CI: 71-89%, and 82% (95% CI: 74%-90%, respectively. Interpretation: Triapine radiochemotherapy was safe, active, and effective in patients with untreated advanced-stage cervical cancer, worthy of randomized clinical trial study.Funding: National Institutes of Health grants U01 CA62502 and P30 CA43703-17

  18. Surface activity, lipid profiles and their implications in cervical cancer.

    Directory of Open Access Journals (Sweden)

    Preetha A

    2005-01-01

    Full Text Available Background: The profiles of lipids in normal and cancerous tissues may differ revealing information about cancer development and progression. Lipids being surface active, changes in lipid profiles can manifest as altered surface activity profiles. Langmuir monolayers offer a convenient model for evaluating surface activity of biological membranes. Aims: The aims of this study were to quantify phospholipids and their effects on surface activity of normal and cancerous human cervical tissues as well as to evaluate the role of phosphatidylcholine (PC and sphingomyelin (SM in cervical cancer using Langmuir monolayers. Methods and Materials: Lipid quantification was done using thin layer chromatography and phosphorus assay. Surface activity was evaluated using Langmuir monolayers. Monolayers were formed on the surface of deionized water by spreading tissue organic phase corresponding to 1 mg of tissue and studying their surface pressure-area isotherms at body temperature. The PC and SM contents of cancerous human cervical tissues were higher than those of the normal human cervical tissues. Role of PC and SM were evaluated by adding varying amounts of these lipids to normal cervical pooled organic phase. Statistical analysis: Student′s t-test (p < 0.05 and one-way analysis of variance (ANOVA was used. Results: Our results reveals that the phosphatidylglycerol level in cancerous cervical tissue was nearly five folds higher than that in normal cervical tissue. Also PC and sphingomyelin SM were found to be the major phospholipid components in cancerous and normal cervical tissues respectively. The addition of either 1.5 µg DPPC or 0.5 µg SM /mg of tissue to the normal organic phase changed its surface activity profile to that of the cancerous tissues. Statistically significant surface activity parameters showed that PC and SM have remarkable roles in shifting the normal cervical lipophilic surface activity towards that of cancerous lipophilic

  19. Improved internal iliac artery chemotherapy combined with radiotherapy for the treatment of stage Ⅲ-Ⅳa cervical cancers

    International Nuclear Information System (INIS)

    Objective: To investigate the efficacy of modified internal iliac artery chemotherapy combined with radiotherapy for the treatment of stage Ⅲ-Ⅳa cervical cancers. Methods: A total of 70 patients with stage Ⅲ-Ⅳa cervical cancer, who were admitted to the authors' hospital (Department of Obstetric and Gynecology, Oncology) during the period from May 2005 to August 2009, were enrolled in this study. The clinical data were retrospectively analyzed. Modified internal iliac artery chemotherapy combined with radiotherapy was carried out in 32 patients (study group), and simple radiotherapy was adopted in 38 patients (control group). For patients in study group, puncturing of right femoral artery using Seldinger's technique was performed, which was followed by right uterine artery chemoembolization and subsequent super-selective left iliac artery chemotherapy, which lasted for three days. The chemotherapeutic drugs included cisplatin and fluorouracil. Distance external beam linear accelerator was used for radiotherapy together with 192 Ir high dose rate brachytherapy. For patients in control group, only distance external beam linear accelerator radiotherapy with 192 Ir high dose rate brachytherapy was employed, with the radioactive dose being a little bit smaller than that used in the study group. Results: The one-year survival rate for the study group and the control group was 78.1% and 55.3%, respectively (P0.05). The difference in the occurrence of radiotherapy-related complications was not significant between the two groups (P>0.05). Conclusion: For the treatment of stage Ⅲ-Ⅳa cervical cancers, modified internal iliac artery chemotherapy combined with radiotherapy is more effective than that of simple radiotherapy for a short-term period. The living quality of the patients can be markedly improved. Nevertheless, the five-year survival rate of chemotherapy combined with radiotherapy is not statistically difference from that of simple radiotherapy. (authors)

  20. Small cell cervical cancer: an unusual finding at cholecystectomy.

    LENUS (Irish Health Repository)

    Boyle, Emily

    2012-02-01

    BACKGROUND: Small cell carcinoma of the cervix is a rare cancer, comprising less than 3% of all cervical neoplasms. It uniformly has a poor prognosis, and has a high mortality even with early stage disease. It can metastasise rapidly and metastatic sites include lung, liver, brain, bone, pancreas and lymph nodes. CASE: Here, we report the case of a 60-year-old woman with no symptoms of cervical pathology who developed post-renal failure following a laparoscopic cholecystectomy. The cause was bilateral ureteric obstruction from metastatic small cell cervical cancer and metastases were subsequently found on her gallbladder specimen. CONCLUSION: This is an unusual presentation of small cell cervical cancer and demonstrates the aggressive nature of this disease.

  1. New Molecular Tools for Efficient Screening of Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Magnus von Knebel Doeberitz

    2001-01-01

    Full Text Available Cytological screening using the Pap-smear led to a remarkable reduction of the mortality of cervical cancer. However, due to subjective test criteria it is hampered by poor inter- and intra-observer agreement. More reproducible assays are expected to improve the current screening and avoid unnecessary medical intervention and psychological distress for the affected women. Cervical cancer arises as consequence of persistent high risk papillomavirus (HR-HPV infections. Expression of two viral oncogenes, E6 and E7, in epithelial stem cells is required to initiate and maintain cervical carcinogenesis and results in significant overexpression of the cellular p16INK4a protein. Since this protein is not expressed in normal cervical squamous epithelia, screening for p16INK4a over-expressing cells allows to specifically identify dysplastic lesions, and significantly reduces the inter-observer disagreement of the conventional cytological or histological tests. Progression of preneoplastic lesions to invasive cancers is associated with extensive recombination of viral and cellular genomes which can be monitored by detection of papillomavirus oncogene transcripts (APOT assay derived from integrated viral genome copies. Detection of integrated type oncogene transcripts points to far advanced dysplasia or invasive cancers and thus represents a progression marker for cervical lesions. These new assays discussed here will help to improve current limitations in cervical cancer screening, diagnosis, and therapy control.

  2. Benefit of Adjuvant Brachytherapy Versus External Beam Radiation for Early Breast Cancer: Impact of Patient Stratification on Breast Preservation

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jiang, Jing [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Xu, Ying [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hoffman, Karen E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-02-01

    Purpose: Brachytherapy after lumpectomy is an increasingly popular breast cancer treatment, but data concerning its effectiveness are conflicting. Recently proposed “suitability” criteria guiding patient selection for brachytherapy have never been empirically validated. Methods: Using the Surveillance, Epidemiology, and End Results–Medicare linked database, we compared women aged 66 years or older with invasive breast cancer (n=28,718) or ductal carcinoma in situ (n=7229) diagnosed from 2002 to 2007, treated with lumpectomy alone, brachytherapy, or external beam radiation therapy (EBRT). The likelihood of breast preservation, measured by subsequent mastectomy risk, was compared by use of multivariate proportional hazards, further stratified by American Society for Radiation Oncology (ASTRO) brachytherapy suitability groups. We compared 1-year postoperative complications using the χ{sup 2} test and 5-year local toxicities using the log-rank test. Results: For patients with invasive cancer, the 5-year subsequent mastectomy risk was 4.7% after lumpectomy alone (95% confidence interval [CI], 4.1%-5.4%), 2.8% after brachytherapy (95% CI, 1.8%-4.3%), and 1.3% after EBRT (95% CI, 1.1%-1.5%) (P<.001). Compared with lumpectomy alone, brachytherapy achieved a more modest reduction in adjusted risk (hazard ratio [HR], 0.61; 95% CI, 0.40-0.94) than achieved with EBRT (HR, 0.22; 95% CI, 0.18-0.28). Relative risks did not differ when stratified by ASTRO suitability group (P=.84 for interaction), although ASTRO “suitable” patients did show a low absolute subsequent mastectomy risk, with a minimal absolute difference in risk after brachytherapy (1.6%; 95% CI, 0.7%-3.5%) versus EBRT (0.8%; 95% CI, 0.6%-1.1%). For patients with ductal carcinoma in situ, EBRT maintained a reduced risk of subsequent mastectomy (HR, 0.40; 95% CI, 0.28-0.55; P<.001), whereas the small number of patients treated with brachytherapy (n=179) precluded definitive comparison with lumpectomy alone

  3. Human Papillomavirus Research on the Prevention, Diagnosis, and Prognosis of Cervical Cancer in Taiwan

    OpenAIRE

    Chyong-Huey Lai; Angel Chao; Huei-Jean Huang

    2012-01-01

    Cervical cancer is third in incidence and fourth in mortality among cancers of women worldwide. Epidemiological studies have shown that human papillomavirus (HPV) is necessary, if not sufficient, to cause nearly 100% of cervical cancers. HPV testing is useful in primary screening for cervical neoplasms. The value of HPV detection or genotyping is potentially useful in triage of borderline or low-grade abnormal cervical cytology, follow-up after treatment of cervical intraepithelial neoplasia,...

  4. An overview on applications of optical spectroscopy in cervical cancers

    Directory of Open Access Journals (Sweden)

    Chilakapati Murali

    2008-01-01

    Full Text Available Despite advances in the treatment modalities, cervical cancers are one of the leading causes of cancer death among women. Pap smear and colposcopy are the existing screening methods and histopathology is the gold standard for diagnosis. However, these methods have been shown to be prone to reporting errors, which could be due to their subjective interpretation. Radiotherapy is the mainstay of treatment for the locally advanced stages of cervical cancers. The typical treatment regimen spans over 4 months, from the first fraction of radiation to clinical assessment of tumor response to radiotherapy. It is often noticed that due to intrinsic properties of tumors, patients with the same clinical stage and histological type respond differently to radiotherapy. Hence, there exists a need for the development of new methods for early diagnosis as well as for early prediction of tumor radioresponse. Optical spectroscopic methods have been shown to be potential alternatives for use in cancer diagnosis. In this review, we provide a brief background on the anatomy and histology of the uterine cervix and the etiology of cervical cancers; we briefly discuss the optical spectroscopic approach to cervical cancer diagnosis. A very brief discussion on radiation therapy and radiation resistance is also provided. We also share our experiences with the Raman spectroscopic methodologies in cervical cancer diagnosis as well as in the prediction of tumor radioresponse.

  5. Priority Setting for Improvement of Cervical Cancer Prevention in Iran

    Directory of Open Access Journals (Sweden)

    Azam Majidi

    2016-04-01

    Full Text Available Background Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV have been successful interventions for prevention of invasive cervical cancer (ICC. Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. Methods We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. Results From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. Conclusion A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran.

  6. The Effects of New Screening Tests in the Dutch Cervical Cancer Screening Programme

    NARCIS (Netherlands)

    K. Rozemeijer (Kirsten)

    2016-01-01

    markdownabstractCervical cancer is the fourth most common cancer in women all over the world, mainly affecting young women. As cervical cancer is easy to prevent by early detection and treatment of the disease, screening was introduced in the Netherlands in the 1970s. The number of cervical cancer c

  7. Potential opportunities to reduce cervical cancer by addressing risk factors other than HPV

    OpenAIRE

    Kumar, Ramaiah Vinay; Bhasker, Suman

    2013-01-01

    Cervical cancer is the most common cancer in developing world and 80% of global burden is reported from these nations. Human papillomavirus along with poverty, illiteracy/lower education level and standards, multi-parity, tobacco, malnutrition and poor genital hygiene may act synergistically to cause cervical cancer. Risk factor of cervical cancer may in itself be the reason for non-viability of cervical cancer vaccine program in this part of the world. Interventions to address these risk fac...

  8. Combined transperineal radiofrequency (RF) interstitial hyperthermia and brachytherapy for localized prostate cancer (PC)

    Energy Technology Data Exchange (ETDEWEB)

    Urakami, Shinji; Gonda, Nobuko; Kikuno, Nobuyuki [Shimane Medical Univ., Izumo (Japan)] (and others)

    2001-05-01

    Hyperthermia has been used effectively as a radiation sensitizer. Interstitial hyperthermoradiotherapy has been therefore utilized as a minimal invasive therapy in attempts to improve local tumor control for various cancers, but not for urological cancer. The purpose of this study was to investigate the safety and feasibility of transperineal hyperthermoradiotherapy for localized PC. Based on our basic study of hyperthermoradiotherapy, we devised the procedure of combined transperineal RF interstitial hyperthermia and brachytherapy for localized prostate cancer. Two patients with localized PC underwent transperineal RF interstitial hyperthermia combined with brachytherapy operation the 192-Ir remote after-loading system (RALS). Under transrectal ultrasound guidance, a total number of 12-18 stainless steel needles for 192-Ir RALS were implanted into the prostatic gland and seminal vesicles (SV) in an optimized pattern. Eight of the needles were used as electrodes for hyperthermia, and were electrically insultated using the vinyl catheter along the length of the subdermal fatty tissue to protect from overheating. Three other needles were utilized for continuous temperature mapping in the prostate. Rectal temperature was also monitored. Total radiation doses of 70 Gy to the prostate and SV were planned as a combination of brachytherapy (24 Gy/4 fraction) and external irradiation using a four-field box technique (46 Gy/23 fraction). Hyperthermic treatment (goal of 42 to 43 deg C for 60 minutes) was performed twice following the 1st and 4th brachytherapy at an interval of more than 48 hours for the recovery of cancer cells from thermotolerance. Both patients reached the treatment goal of all intraprostatic temperatures >43.0 deg C, which was considered favorable for hyperthermia, and the rectal temperatures of both patients remained <38 deg C during hyperthermia. In serial PSA measurements of both patients, serum PSA was less than 1.0 ng/ml within 3 months and has since

  9. 125I brachytherapy combined with chemotherapy of advanced non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    林元强; 孙昱; 王任婕; 高识; 陈滨; 孙步彤; 马庆杰; 纪铁凤; 张海山

    2015-01-01

    This study was to evaluate effect of 125I brachytherapy combined with chemotherapy on advanced non-small cell lung cancer (NSCLC). Patients with NSCLC in stages III to IV were divided into two groups: Group A (n = 27) received 125I brachytherapy combined with gemcitabine and cisplatin (GP) chemotherapy, and Group B (n = 27) received GP chemotherapy only. The results showed that the overall response rate and median progression-free survival time were 78%and 11.5 months in Group A, 41%and 8 months in Group B, respectively (P 0.05). The interventional complications in Group A included 5 patients with postoperative pneumothorax and 4 patients with hemoptysis. No patients had radiation pneumonia, radiation esophagitis or esophagotracheal fistula. Chemotherapy treatment-related toxicities were not significantly different between the two groups. The relief of tumor-associated symptoms including cough, hemoptysis, chest pain, and short breath was found in both groups, without statistical difference in remission rates between Groups A and B (P >0.05). In conclusion, 125I brachytherapy combined with chemotherapy proved to be safe and effective for treating advanced NSCLC with few complications. It improves local control rate and prolongs the progression-free survival time.

  10. Quality control of the breast cancer treatments on Hdr brachytherapy with TLD-100

    Energy Technology Data Exchange (ETDEWEB)

    Torres H, F. [Universidad de Cordoba, Materials and Applied Physics Group, 230002 Monteria, Cordoba (Colombia); De la Espriella V, N. [Universidad de Cordoba, Grupo Avanzado de Materiales y Sistemas Complejos, 230002 Monteria, Cordoba (Colombia); Sanchez C, A., E-mail: franciscotorreshoyos@yahoo.com [Universidad de Cordoba, Departamento de Enfermeria, 230002 Monteria, Cordoba (Colombia)

    2014-07-01

    An anthropomorphic Phantom, a female trunk, was built with a natural bone structure and experimental material coated, glycerin and water-based material called JJT to build soft tissue equivalent to the muscle of human tissue, and a polymer (styrofoam) to build the lung as critical organ to simulate the treatment of breast cancer, with high dose rate brachytherapy (Hdr) and sources of Ir-192. The treatments were planned and calculated for the critical organ: Lung, and injury of 2 cm in diameter in breast with Micro Selectron Hdr system and the software Plato Brachytherapy V 14.1 of the Nucletron (Netherlands) which uses the standard protocol of radiotherapy for brachytherapy treatments. The dose experimentally measured with dosimeters TLD-100 LiF: Mg; Ti, which were previously calibrated, were placed in the same positions and bodies mentioned above, with less than 5% uncertainty. The reading dosimeters was carried out in a Harshaw TLD 4500. The results obtained for calculated treatments, using the standard simulator, and the experimental with TLD-100, show a high concordance, as they are on average a ± 1.1% making process becomes in a quality control of this type of treatments. (Author)

  11. Cervical cancer screening in Belgium and overscreening of adolescents.

    Science.gov (United States)

    Van Kerrebroeck, Helena; Makar, Amin

    2016-03-01

    There has been a marked decrease in the incidence of cervical cancer thanks to cytological screening with the Pap smear test. In Belgium, this screening is rather opportunistic. Over 39% of Belgian women between 25 and 64 years of age are never or only rarely screened by cytological tests. Moreover, there is an excess use of Pap smears because of women who rely on their yearly cervical smear and because many Pap smears are obtained from women beyond the target age range of 25 to 64 years. Sexually active adolescents are increasingly being recognized as a population distinct from adult women. They are at a high risk of acquiring the human papillomavirus (HPV), but most infections and cervical intraepithelial lesions caused by HPV are efficiently cleared by the immune system. We present a description of cervical cancer screening in Belgium using the database of the National Health Insurance Institute (RIZIV/INAMI) and the Belgian Health Care Knowledge Centre (KCE). We describe why elimination of Pap testing in the adolescent population reduces costs and harms without increasing cervical cancer rates. Expectant management, education on the risk factors for cervical cancer and HPV persistence, and HPV vaccination are very important in adolescents and young adults. PMID:25812038

  12. Current imaging strategies for the evaluation of uterine cervical cancer.

    Science.gov (United States)

    Bourgioti, Charis; Chatoupis, Konstantinos; Moulopoulos, Lia Angela

    2016-04-28

    Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age. Prognosis is highly depended on extent of the disease at diagnosis and, therefore, accurate staging is crucial for optimal management. Cervical cancer is clinically staged, according to International Federation of Gynecology and Obstetrics guidelines, but, currently, there is increased use of cross sectional imaging modalities [computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-CT (PET-CT)] for the study of important prognostic factors like tumor size, parametrial invasion, endocervical extension, pelvic side wall or adjacent/distal organs involvement and lymph node status. Imaging indications also include cervical cancer follow-up, evaluation of tumor response to treatment and selection of suitable candidates for less radical surgeries like radical trachelectomy for fertility preservation. The preferred imaging method for local cervical cancer evaluation is MRI; CT is equally effective for evaluation of extrauterine spread of the disease. PET-CT shows high diagnostic performance for the detection of tumor relapse and metastatic lymph nodes. The aim of this review is to familiarize radiologists with the MRI appearance of cervical carcinoma and to discuss the indications of cross sectional imaging during the course of the disease in patients with cervical carcinoma.

  13. Zoledronic acid induces apoptosis and autophagy in cervical cancer cells.

    Science.gov (United States)

    Wang, I-Te; Chou, Shou-Chu; Lin, Ying-Chin

    2014-12-01

    Cervical cancer is one of the most common gynecological cancers in association with high mortality and morbidity. The present study was aimed to investigate the in vitro effects of zoledronic acid (ZA) on viability and induction of apoptosis and autophagy as well as inflammatory effects in three human cervical cancer cell lines (HeLa, SiHa, and CaSki). Cell viability was measured by 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay. Induction of apoptosis was determined by quantitation of expression level of B cell lymphoma 2 (Bcl-2) and Bax messenger RNA (mRNA) and identification of the proteolytic cleavage of poly (ADP)-ribose polymerase (PARP) and caspase-3. Autophagic effects were examined by quantitation of mRNA expression of autophagy protein 5 (ATG5) and beclin1 and identifying accumulation of microtubule-associated protein 1 light chain 3 (LC3)-II. Inflammatory effect was determined by measuring expression and production of IL-6 and cyclooxygenase-2 (Cox-2). The results showed ZA significantly inhibited cell viability of cervical cancer cells. ZA-induced cell death displayed features characteristic to both apoptosis and autophagy and was associated with different changes in the levels of Bcl-2 and Bax in the various cervical cancer lines. Expression of metastatic cytokines, IL-6 and Cox-2, was upregulated in the presence of ZA at low concentration. Our data revealed that ZA inhibits cervical cancer cells through the synergistic effect of apoptosis induction and autophagy activation.

  14. Cosmetic results in early stage breast cancer patients with high-dose brachytherapy after conservative surgery

    International Nuclear Information System (INIS)

    Purpose: to reveal cosmetic results in patients at early stages of low risk breast cancer treated with partial accelerated radiotherapy using high dose rate brachytherapy. Methods and materials: from March 2001 to July 2003,14 stages l and ll breast cancer patients were treated at the Colombian national cancer institute in Bogota with conservative surgery and radiotherapy upon the tumor bed (partial accelerated radiotherapy), using interstitial implants with iridium 192 (high dose rate brachytherapy) with a dose of 32 Gys, over 4 days, at 8 fractions twice a day. Results: with an average follow up of 17.7 months, good cosmetic results were found among 71.4 % of patients and excellent results among 14.3% of patients, furthermore none of the patients neither local nor regional or distant relapses. Conclusion: among patients who suffer from breast cancer at early stages, it showed is possible to apply partial accelerated radiotherapy upon the tumor bed with high doses over 4 days with good to excellent cosmetic results

  15. Nominated Texture Based Cervical Cancer Classification

    Directory of Open Access Journals (Sweden)

    Edwin Jayasingh Mariarputham

    2015-01-01

    Full Text Available Accurate classification of Pap smear images becomes the challenging task in medical image processing. This can be improved in two ways. One way is by selecting suitable well defined specific features and the other is by selecting the best classifier. This paper presents a nominated texture based cervical cancer (NTCC classification system which classifies the Pap smear images into any one of the seven classes. This can be achieved by extracting well defined texture features and selecting best classifier. Seven sets of texture features (24 features are extracted which include relative size of nucleus and cytoplasm, dynamic range and first four moments of intensities of nucleus and cytoplasm, relative displacement of nucleus within the cytoplasm, gray level cooccurrence matrix, local binary pattern histogram, tamura features, and edge orientation histogram. Few types of support vector machine (SVM and neural network (NN classifiers are used for the classification. The performance of the NTCC algorithm is tested and compared to other algorithms on public image database of Herlev University Hospital, Denmark, with 917 Pap smear images. The output of SVM is found to be best for the most of the classes and better results for the remaining classes.

  16. Prospective Phase I-II Trial of Helical Tomotherapy With or Without Chemotherapy for Postoperative Cervical Cancer Patients

    International Nuclear Information System (INIS)

    Purpose: To investigate, in a prospective trial, the acute and chronic toxicity of patients with cervical cancer treated with surgery and postoperative intensity-modulated radiotherapy (RT) delivered using helical tomotherapy, with or without the administration of concurrent chemotherapy. Patients and Methods: A total of 24 evaluable patients entered the study between March 2006 and August 2009. The indications for postoperative RT were tumor size, lymphovascular space invasion, and the depth of cervical stromal invasion in 15 patients; 9 patients underwent postoperative RT because of surgically positive lymph nodes. All patients underwent pelvic RT delivered with helical tomotherapy and intracavitary high-dose-rate brachytherapy. Treatment consisted of concurrent weekly platinum in 17, sequential carboplatin/Taxol in 1, and RT alone in 6. The patients were monitored for acute and chronic toxicity using the Common Toxicity Criteria, version 3.0. Results: The median follow-up was 24 months (range, 4–49). At the last follow-up visit, 23 patients were alive and disease free. Of the 24 patients, 12 (50%) experienced acute Grade 3 gastrointestinal toxicity (anorexia in 5, diarrhea in 4, and nausea in 3). One patient developed acute Grade 4 genitourinary toxicity (vesicovaginal fistula). For patients treated with concurrent chemotherapy, the incidence of acute Grade 3 and 4 hematologic toxicity was 71% and 24%, respectively. For patients treated without concurrent chemotherapy, the incidence of acute Grade 3 and 4 hematologic toxicity was 29% and 14%, respectively. Two long-term toxicities occurred (vesicovaginal fistula at 25 months and small bowel obstruction at 30 months). The overall and progression-free survival rate at 3 years for all patients was 100% and 89%, respectively. Conclusion: The results of our study have shown that postoperative external RT for cervical cancer delivered with helical tomotherapy and high-dose-rate brachytherapy and with or without

  17. Prospective Phase I-II Trial of Helical Tomotherapy With or Without Chemotherapy for Postoperative Cervical Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, Julie K., E-mail: jschwarz@radonc.wustl.edu [Department of Radiation Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Cell Biology and Physiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Wahab, Sasa [Cobb Center for Radiation Oncology Center, Austell, GA (United States); Grigsby, Perry W. [Department of Radiation Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States)

    2011-12-01

    Purpose: To investigate, in a prospective trial, the acute and chronic toxicity of patients with cervical cancer treated with surgery and postoperative intensity-modulated radiotherapy (RT) delivered using helical tomotherapy, with or without the administration of concurrent chemotherapy. Patients and Methods: A total of 24 evaluable patients entered the study between March 2006 and August 2009. The indications for postoperative RT were tumor size, lymphovascular space invasion, and the depth of cervical stromal invasion in 15 patients; 9 patients underwent postoperative RT because of surgically positive lymph nodes. All patients underwent pelvic RT delivered with helical tomotherapy and intracavitary high-dose-rate brachytherapy. Treatment consisted of concurrent weekly platinum in 17, sequential carboplatin/Taxol in 1, and RT alone in 6. The patients were monitored for acute and chronic toxicity using the Common Toxicity Criteria, version 3.0. Results: The median follow-up was 24 months (range, 4-49). At the last follow-up visit, 23 patients were alive and disease free. Of the 24 patients, 12 (50%) experienced acute Grade 3 gastrointestinal toxicity (anorexia in 5, diarrhea in 4, and nausea in 3). One patient developed acute Grade 4 genitourinary toxicity (vesicovaginal fistula). For patients treated with concurrent chemotherapy, the incidence of acute Grade 3 and 4 hematologic toxicity was 71% and 24%, respectively. For patients treated without concurrent chemotherapy, the incidence of acute Grade 3 and 4 hematologic toxicity was 29% and 14%, respectively. Two long-term toxicities occurred (vesicovaginal fistula at 25 months and small bowel obstruction at 30 months). The overall and progression-free survival rate at 3 years for all patients was 100% and 89%, respectively. Conclusion: The results of our study have shown that postoperative external RT for cervical cancer delivered with helical tomotherapy and high-dose-rate brachytherapy and with or without

  18. Needs and priorities of women with endometrial and cervical cancer

    DEFF Research Database (Denmark)

    Jeppesen, Mette Moustgaard; Mogensen, Ole; Dehn, Pernille;

    2015-01-01

    -recorded, transcribed verbatim and analyzed thematically. RESULTS: Forty-four of the included women were diagnosed with cervical cancer (median age 45 years). Of these, 22 had FIGO-stage 1 disease (50%) and 23 received radiation therapy (52.3%). The remaining 52 women (median age 66.5 years) were diagnosed...... problems were of specific concern for cervical cancer patients (p = 0.029). However, in both cancer groups, the mean problem intensity scores were comparable to normative data, suggesting that the majority of patients will not require extensive rehabilitation. Qualitative analysis indicated that treatment...

  19. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    OpenAIRE

    Lopamudra Das; Soumen Das; Jyotirmoy Chatterjee

    2015-01-01

    Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cy...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  1. Inadequate cervical cancer screening among mid-aged Australian women who have experienced partner violence

    NARCIS (Netherlands)

    Loxton, Deborah; Powers, Jennifer; Schofield, Margot; Hussain, Rafat; Hosking, Stacey

    2009-01-01

    Objectives. Partner violence is linked to cervical cancer and other gynaecological conditions. However, results of current research into associations between partner violence and cervical cancer screening have been inconclusive. Therefore, the current research investigates the association between pa

  2. Breast and cervical cancer screening programme implementation in 16 countries

    DEFF Research Database (Denmark)

    Dowling, Emily C; Klabunde, Carrie; Patnick, Julietta;

    2010-01-01

    There is a continuing need to monitor and evaluate the impact of organized screening programmes on cancer incidence and mortality. We report results from a programme assessment conducted within the International Cancer Screening Network (ICSN) to understand the characteristics of cervical screeni...

  3. Improvements in the Dutch Cervical Cancer Screening Programme since 1995

    NARCIS (Netherlands)

    A.B Bos (A.)

    2006-01-01

    markdownabstract__Abstract__ Worldwide, cervical cancer is the second most common cancer in women, and therefore an important public health problem (1 ). In developing countries, the age standardised incidence rate varies between 16 - 40 per 100,000 women in 1988- 1992 (2). In the same period, in d

  4. Cervical Microbiome and Cytokine Profile at Various Stages of Cervical Cancer: A Pilot Study

    Science.gov (United States)

    Bahena-Román, Margarita; Téllez-Sosa, Juan; Martínez-Barnetche, Jesús; Cortina-Ceballos, Bernardo; López-Estrada, Guillermina; Delgado-Romero, Karina; Burguete-García, Ana I.; Cantú, David; García-Carrancá, Alejandro; Madrid-Marina, Vicente

    2016-01-01

    Cervical cancer (CC) is caused by high-risk human papillomavirus persistence due to the immunosuppressive tumor microenvironment mediated by cytokines. Vaginal microbiota determines the presence of certain cytokines locally. We assessed the association between cervical microbiota diversity and the histopathological diagnosis of each stage of CC, and we evaluated mRNA cervical expression levels of IL-4, IL-6, IL-10, TGF-β1, TNF-α and IFN-γ across the histopathological diagnosis and specific bacterial clusters. We determined the cervical microbiota by high throughput sequencing of 16S rDNA amplicons and classified it in community state types (CST). Mean difference analyses between alpha-diversity and histopathological diagnosis were carried out, as well as a β-diversity analysis within the histological diagnosis. Cervical cytokine mRNA expression was analyzed across the CSTs and the histopathological diagnoses. We found a significant difference in microbiota's diversity in NCL-HPV negative women vs those with squamous intraepithelial lesions (SIL) and CC(p = 0.006, p = 0.036).When β-diversity was evaluated, the CC samples showed the highest variation within groups (p<0.0006) and the largest distance compared to NCL-HPV negative ones (p<0.00001). The predominant bacteria in women with normal cytology were L. crispatus and L. iners, whereas for SIL, it was Sneathia spp. and for CC, Fusobacterium spp. We found higher median cervical levels of IL-4 and TGF-β1 mRNA in the CST dominated by Fusobacterium spp. These results suggest that the cervical microbiota may be implicated in cervical cancer pathology. Further cohort studies are needed to validate these findings. PMID:27115350

  5. Tc17 Cells in Patients with Uterine Cervical Cancer

    OpenAIRE

    Yan Zhang; Fei Hou; Xin Liu; Daoxin Ma; Youzhong Zhang; Beihua Kong; Baoxia Cui

    2014-01-01

    BACKGROUND: The existence of Tc17 cells was recently shown in several types of infectious and autoimmune diseases, but their distribution and functions in uterine cervical cancer (UCC) have not been fully elucidated. METHODS: The frequency of Tc17 cells in peripheral blood samples obtained from UCC patients, cervical intraepithelial neoplasia (CIN) patients and healthy controls was determined by flow cytometry. Besides, the prevalence of Tc17 cells and their relationships to Th17 cells and Fo...

  6. Endometrial and cervical cancer: incidence and mortality among women in the Lodz region

    OpenAIRE

    Beata Leśniczak; Grzegorz Krasomski; Przemysław Oszukowski; Tomasz Stetkiewicz; Piotr Woźniak

    2015-01-01

    Introduction: By the early 21st century the most common cancer of female genitals in Poland was cervical cancer. Now endometrial cancer ranks first. The aim of this study was to analyse the incidence and mortality of endometrial and cervical cancer among women in the Lodz region. Material and methods: Data on the incidence and mortality of endometrial and cervical cancer among inhabitants of the Lodz region were obtained from the National Cancer Registry and Bulletin of Cancer Cases...

  7. Preventing cervical cancer : overviews of the National Breast and Cervical Cancer Early Detection Program and 2 US immunization programs.

    Science.gov (United States)

    Khan, Kris; Curtis, C Robinette; Ekwueme, Donatus U; Stokley, Shannon; Walker, Chastity; Roland, Katherine; Benard, Vicki; Saraiya, Mona

    2008-11-15

    Three federal programs with the potential to reduce cervical cancer incidence, morbidity, and mortality, especially among underserved populations, are administered by the Centers for Disease Control and Prevention (CDC): the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), the Vaccines for Children (VFC) Program, and the Section 317 immunization grant program. The NBCCEDP provides breast and cervical cancer screening and diagnostic services to uninsured and underinsured women. The VFC program and the Section 317 immunization grant program provide vaccines, including human papillomavirus (HPV) vaccine, to targeted populations at no cost for these vaccines. This article describes the programs, their histories, populations served, services offered, and roles in preventing cervical cancer through HPV vaccination and cervical cancer screening. Potential long-term reduction in healthcare costs resulting from HPV vaccination is also discussed. As an example of an initiative to vaccinate uninsured women aged 19-26 years through a cancer services program, a state-based effort that was recently launched in New York, is highlighted.

  8. Analysis of clinical characteristics of 950 cases of cervical cancer

    Directory of Open Access Journals (Sweden)

    Shu-li ZHU

    2015-04-01

    Full Text Available Objective To discuss the clinical features of the patients suffering from cervical cancer who visited Daping Hospital affiliated to Third Military Medical University in recent 10 years. Methods The clinical data of the patients who were pathologically diagnosed as invasive cervical cancer in Daping Hospital of TMMU from Jan. 2004 to Dec. 2013 were retrospectively analyzed. They were divided into different age groups and analyzed according to age, clinical features, pathological type, and surgical approach. Results Clinical data of 950 patients with invasive cervical cancer were reviewed in this study. The mean age of the patients was 46.9 years. The clinical features, pathological type, and surgical approaches were different in different age groups. Analysis of the age structure of the patients, the onset age of cervical cancer seemed to increase year by year. Conclusion The clinical features of cervical cancer are diversity in different age, and the strategy for controlling its development should be varied according to age. DOI: 10.11855/j.issn.0577-7402.2015.03.09

  9. Results of the European research project 'Improving the effectiveness of cancer treatment with 3D Brachytherapy'

    International Nuclear Information System (INIS)

    The project iMERA + T2.J06 'Improving the effectiveness of cancer treatment using 3D brachytherapy' was solved in the period 2008-2011 in collaboration of metrology institutes from 10 European Union countries, including participation of the Czech Republic. Its main objective was to create a means to ensure metrological quantity absorbed dose in water from brachyterapeutical (BT) sources enabling more accurate assessment of therapeutic benefit than using existing dosimetry protocols that are based on the quantity kerma in the air. This project is discussed.

  10. High-dose rate iridium-192 brachytherapy combined with external beam radiotherapy for localized prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kasahara, Kotaro; Inoue, Keiji; Karashima, Takashi; Inoue, Yuichiro; Kariya, Shinji; Inomata, Taisuke; Yoshida, Shoji; Shuin, Taro [Kochi Medical School, Nankoku (Japan)

    2001-07-01

    We report our technique and also preliminary results in the cases with localized prostate cancer treated by the combination of high-dose rate Iridium-192 (HDR-Ir 192) brachytherapy and external irradiation. From June 1999 to August 2000, 17 patients were treated by the combination of HDR-Ir 192 and external beam. The mean age of patients was 72 years (range, 48-81 years). The clinical stage was B1 in 5, B2 in 7 and C (no cancer with seminal vesicle) in 5 cases. Of 10 patients without neoadjuvant hormonal therapy, the median initial pretreatment PSA was 15.3 ng/ml (6.93-222.32 ng/ml). The treatment was given by HDR-Ir 192 brachytherapy (6 Gy x 3 times/2 days) and external beam irradiation (40 or 45 Gy). The brachytherapy was given using TRUS guided percutaneously inserted temporary needles with a high dose rate remote afterloading control. Local control was evaluated by digital rectal examination, TRUS-guided biopsies and serum PSA evaluations. Follow-up ranged from 2 to 14 months, with a median of 8 months. In 4 (40.0%) of 10 patients without neoadjuvant hormonal therapy the level of serum PSA was decreased to less than 4.0 ng/ml within 3 months after the therapy. The effective grade in the biopsy specimens of 8 patients without neoadjuvant hormonal therapy was Grade 0b in 4, Grade 1 in 1, Grade 3 in 3 cases at 3 months after the therapy. No severe intra-or peri-operative complications occurred. The combined radiotherapy treatment is safe and effective for use in the patients with localized prostate cancer. However, more comprehensive studies involving long-term follow-up and great numbers of the cases with localized prostate cancer treated by the combination of HDR-Ir 192 brachytherapy and external irradiation will be necessary to determine whether this therapy contributes to better prognosis. (author)

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

    OpenAIRE

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

    2011-01-01

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

  12. Endocavitary Ultrasound Applicator for Hyperthermia Treatment of Cervical Cancer

    Science.gov (United States)

    Wootton, Jeffery; Chen, Xin; Juang, Titania; Rieke, Viola; Hsu, I.-Chow Joe; Diederich, Chris

    2009-04-01

    An endocavitary ultrasound applicator has been developed for targeted heat delivery to the cervix. The device has multiple sectored tubular transducers for truly 3-D heating control (angular and along the length) and is integrated with an intracavitary HDR brachytherapy applicator for sequential administration of conformal heat and radiation. Brachytherapy treatment planning data are inspected to determine target thermal treatment volumes. Heat treatments are simulated with an acoustic and biothermal model of cervical tissue. Power control to individual elements and sectors is implemented for global maximum and pilot point control to limit rectum and bladder temperature. A parametric analysis of device parameters, tissue properties, and catheter materials is conducted to assess their effects on heating patterns and inform device development. Acoustic output of all devices was characterized. MR thermal imaging is used to analyze 3-D conformal heating capabilities in ex vivo tissue and compare to theoretical predictions. Devices were fabricated with 1-3 transducers at 6.5-8 MHz with sectors from 90-180° and heating length from 15-35 mm housed within a 6 mm diameter water-cooled PET catheter. Directional heating from sectored transducers can extend lateral penetration of therapeutic heating (41° C)>2 cm while maintaining rectum and bladder temperatures within 12 mm below thermal damage thresholds. MR artifacts extended <2 mm beyond the device and real time thermal imaging was used to guide power selection to shape heating profiles in axial and coronal slices. Endocavitary delivery of ultrasound thermal therapy is feasible and 3-D conformal capabilities will benefit targeted cervical hyperthermia.

  13. 125I seed implant brachytherapy for the treatment of parotid gland cancers in children and adolescents

    International Nuclear Information System (INIS)

    Background and purpose: There is a lack of optimal treatment strategies for managing salivary gland cancers in children and adolescents. This study is aimed at assessing the effect of 125I seed implantation for the treatment of parotid cancers in children and adolescents. Patients and methods: A total of 12 patients younger than 16 years with parotid gland malignant tumors underwent 125I seed implant brachytherapy between October 2003 and November 2008. All patients were assessed after treatment and at the local tumor control appointments. Facial nerve function, maxillofacial development, and radioactive side-effects were assessed. Results: The follow-up period ranged from 41-104 months. One patient with T4b died of pulmonary metastasis. The other patients were alive during the follow-up period. There were no serious radiation-related complications. The treatment did not affect facial nerve function and dentofacial growth in any of the children. Conclusion: For parotid gland cancers in children, 125I seed implant brachytherapy may be an acceptable treatment without serious complications and with satisfactory short-term effects. (orig.)

  14. Quantitative DNA methylation analysis of candidate genes in cervical cancer.

    Science.gov (United States)

    Siegel, Erin M; Riggs, Bridget M; Delmas, Amber L; Koch, Abby; Hakam, Ardeshir; Brown, Kevin D

    2015-01-01

    Aberrant DNA methylation has been observed in cervical cancer; however, most studies have used non-quantitative approaches to measure DNA methylation. The objective of this study was to quantify methylation within a select panel of genes previously identified as targets for epigenetic silencing in cervical cancer and to identify genes with elevated methylation that can distinguish cancer from normal cervical tissues. We identified 49 women with invasive squamous cell cancer of the cervix and 22 women with normal cytology specimens. Bisulfite-modified genomic DNA was amplified and quantitative pyrosequencing completed for 10 genes (APC, CCNA, CDH1, CDH13, WIF1, TIMP3, DAPK1, RARB, FHIT, and SLIT2). A Methylation Index was calculated as the mean percent methylation across all CpG sites analyzed per gene (~4-9 CpG site) per sequence. A binary cut-point was defined at >15% methylation. Sensitivity, specificity and area under ROC curve (AUC) of methylation in individual genes or a panel was examined. The median methylation index was significantly higher in cases compared to controls in 8 genes, whereas there was no difference in median methylation for 2 genes. Compared to HPV and age, the combination of DNA methylation level of DAPK1, SLIT2, WIF1 and RARB with HPV and age significantly improved the AUC from 0.79 to 0.99 (95% CI: 0.97-1.00, p-value = 0.003). Pyrosequencing analysis confirmed that several genes are common targets for aberrant methylation in cervical cancer and DNA methylation level of four genes appears to increase specificity to identify cancer compared to HPV detection alone. Alterations in DNA methylation of specific genes in cervical cancers, such as DAPK1, RARB, WIF1, and SLIT2, may also occur early in cervical carcinogenesis and should be evaluated. PMID:25826459

  15. Quantitative DNA methylation analysis of candidate genes in cervical cancer.

    Science.gov (United States)

    Siegel, Erin M; Riggs, Bridget M; Delmas, Amber L; Koch, Abby; Hakam, Ardeshir; Brown, Kevin D

    2015-01-01

    Aberrant DNA methylation has been observed in cervical cancer; however, most studies have used non-quantitative approaches to measure DNA methylation. The objective of this study was to quantify methylation within a select panel of genes previously identified as targets for epigenetic silencing in cervical cancer and to identify genes with elevated methylation that can distinguish cancer from normal cervical tissues. We identified 49 women with invasive squamous cell cancer of the cervix and 22 women with normal cytology specimens. Bisulfite-modified genomic DNA was amplified and quantitative pyrosequencing completed for 10 genes (APC, CCNA, CDH1, CDH13, WIF1, TIMP3, DAPK1, RARB, FHIT, and SLIT2). A Methylation Index was calculated as the mean percent methylation across all CpG sites analyzed per gene (~4-9 CpG site) per sequence. A binary cut-point was defined at >15% methylation. Sensitivity, specificity and area under ROC curve (AUC) of methylation in individual genes or a panel was examined. The median methylation index was significantly higher in cases compared to controls in 8 genes, whereas there was no difference in median methylation for 2 genes. Compared to HPV and age, the combination of DNA methylation level of DAPK1, SLIT2, WIF1 and RARB with HPV and age significantly improved the AUC from 0.79 to 0.99 (95% CI: 0.97-1.00, p-value = 0.003). Pyrosequencing analysis confirmed that several genes are common targets for aberrant methylation in cervical cancer and DNA methylation level of four genes appears to increase specificity to identify cancer compared to HPV detection alone. Alterations in DNA methylation of specific genes in cervical cancers, such as DAPK1, RARB, WIF1, and SLIT2, may also occur early in cervical carcinogenesis and should be evaluated.

  16. Quantitative DNA methylation analysis of candidate genes in cervical cancer.

    Directory of Open Access Journals (Sweden)

    Erin M Siegel

    Full Text Available Aberrant DNA methylation has been observed in cervical cancer; however, most studies have used non-quantitative approaches to measure DNA methylation. The objective of this study was to quantify methylation within a select panel of genes previously identified as targets for epigenetic silencing in cervical cancer and to identify genes with elevated methylation that can distinguish cancer from normal cervical tissues. We identified 49 women with invasive squamous cell cancer of the cervix and 22 women with normal cytology specimens. Bisulfite-modified genomic DNA was amplified and quantitative pyrosequencing completed for 10 genes (APC, CCNA, CDH1, CDH13, WIF1, TIMP3, DAPK1, RARB, FHIT, and SLIT2. A Methylation Index was calculated as the mean percent methylation across all CpG sites analyzed per gene (~4-9 CpG site per sequence. A binary cut-point was defined at >15% methylation. Sensitivity, specificity and area under ROC curve (AUC of methylation in individual genes or a panel was examined. The median methylation index was significantly higher in cases compared to controls in 8 genes, whereas there was no difference in median methylation for 2 genes. Compared to HPV and age, the combination of DNA methylation level of DAPK1, SLIT2, WIF1 and RARB with HPV and age significantly improved the AUC from 0.79 to 0.99 (95% CI: 0.97-1.00, p-value = 0.003. Pyrosequencing analysis confirmed that several genes are common targets for aberrant methylation in cervical cancer and DNA methylation level of four genes appears to increase specificity to identify cancer compared to HPV detection alone. Alterations in DNA methylation of specific genes in cervical cancers, such as DAPK1, RARB, WIF1, and SLIT2, may also occur early in cervical carcinogenesis and should be evaluated.

  17. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV): Basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy.

    Science.gov (United States)

    Dimopoulos, Johannes C A; Petrow, Peter; Tanderup, Kari; Petric, Primoz; Berger, Daniel; Kirisits, Christian; Pedersen, Erik M; van Limbergen, Erik; Haie-Meder, Christine; Pötter, Richard

    2012-04-01

    The GYN GEC-ESTRO working group issued three parts of recommendations and highlighted the pivotal role of MRI for the successful implementation of 3D image-based cervical cancer brachytherapy (BT). The main advantage of MRI as an imaging modality is its superior soft tissue depiction quality. To exploit the full potential of MRI for the better ability of the radiation oncologist to make the appropriate choice for the BT application technique and to accurately define the target volumes and the organs at risk, certain MR imaging criteria have to be fulfilled. Technical requirements, patient preparation, as well as image acquisition protocols have to be tailored to the needs of 3D image-based BT. The present recommendation is focused on the general principles of MR imaging for 3D image-based BT. Methods and parameters have been developed and progressively validated from clinical experience from different institutions (IGR, Universities of Vienna, Leuven, Aarhus and Ljubljana) and successfully applied during expert meetings, contouring workshops, as well as within clinical and interobserver studies. It is useful to perform pelvic MRI scanning prior to radiotherapy ("Pre-RT-MRI examination") and at the time of BT ("BT MRI examination") with one MR imager. Both low and high-field imagers, as well as both open and close magnet configurations conform to the requirements of 3D image-based cervical cancer BT. Multiplanar (transversal, sagittal, coronal and oblique image orientation) T2-weighted images obtained with pelvic surface coils are considered as the golden standard for visualisation of the tumour and the critical organs. The use of complementary MRI sequences (e.g. contrast-enhanced T1-weighted or 3D isotropic MRI sequences) is optional. Patient preparation has to be adapted to the needs of BT intervention and MR imaging. It is recommended to visualise and interpret the MR images on dedicated DICOM-viewer workstations, which should also assist the contouring

  18. Cervical Cancer Screening Interventions for U.S. Latinas: A Systematic Review

    Science.gov (United States)

    Corcoran, Jacqueline; Dattalo, Patrick; Crowley, Meghan

    2012-01-01

    The high cervical cancer mortality rate among Latinas compared with other ethnic groups in the United States is of major concern. Latina women are almost twice as likely to die from cervical cancer as non-Hispanic white women. To improve Latina cervical cancer screening rates, interventions have been developed and tested. This systematic review…

  19. 77 FR 66469 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2012-11-05

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... meeting of the aforementioned committee: Name: Breast and Cervical Cancer Early Detection and Control..., regarding the early detection and control of breast and cervical cancer. The committee makes...

  20. 76 FR 30723 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2011-05-26

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... for breast and cervical cancer screening; updates on the National Breast and Cervical Cancer Early... Health and Human Services, and the Director, CDC, regarding the early detection and control of breast...

  1. Residual tumour volumes and grey zones after external beam radiotherapy (with or without chemotherapy) in cervical cancer patients. A low-field MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, M.P.; Mansmann, B.; Federico, M.; Georg, P.; Fidarova, E. [General Hospital of Vienna (Austria). Dept. of Radiotherapy; Dimopoulous, J.C.A. [Metropolitan Hospital, Athens (Greece). Dept. of Radiation Oncology; Doerr, W. [General Hospital of Vienna (Austria). Dept. of Radiotherapy; Technische Univ. Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology; Medical University of Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology; Poetter, R. [General Hospital of Vienna (Austria). Dept. of Radiotherapy; Medical University of Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology

    2013-03-15

    Background: Grey zones, which are defined as tissue with intermediate signal intensity in the area of primary hyperintense tumour extension, can be seen during radiation with or without chemotherapy on the T2-weighted MRI in patients with cervical cancer. The purpose of this study was to systematically measure the tumour volume at the time of diagnosis and the residual tumour volume at the time of brachytherapy without and with consideration of the grey zones and to estimate tumour regression during external beam radiotherapy (EBRT). Material and methods: T2-weighted MRI datasets of 175 patients with locally advanced cervical cancer (FIGO stage IB-IVA), who underwent combined external beam radiotherapy and brachytherapy with or without concomitant chemotherapy were available for this study. The gross tumour volume at the time of diagnosis (GTV{sub init}) and at the time of first brachytherapy without (GTV{sub res}) and with (GTV{sub res} + GZ) consideration of grey zones were measured for each patient. A descriptive statistical analysis was performed and tumour regression rates without (R) and with consideration of grey zones (R{sub GZ}) were calculated. Further, the role of prognostic factors on GTV{sub init}, GTV{sub res}, GTV{sub res} + GZ and tumour regression rates was investigated. Results: The median GTV{sub init}, GTV{sub res}, GTV{sub res} + GZ in all patients were 44.4 cm{sup 3}, 8.2 cm{sup 3}, 20.3 cm{sup 3}, respectively. The median R was 78.5% and the median R{sub GZ} was 50.1%. The histology and FIGO staging showed a significant impact on GTV{sub init}, GTV{sub res} and GTV{sub res} + GZ. Conclusion: Grey zones represent a substantial proportion of the residual tumour volume at the time of brachytherapy. Differentiation of high signal intensity mass and surrounding intermediate signal intensity grey zones may be reasonable. (orig.)

  2. Residual tumour volumes and grey zones after external beam radiotherapy (with or without chemotherapy) in cervical cancer patients. A low-field MRI study

    International Nuclear Information System (INIS)

    Background: Grey zones, which are defined as tissue with intermediate signal intensity in the area of primary hyperintense tumour extension, can be seen during radiation with or without chemotherapy on the T2-weighted MRI in patients with cervical cancer. The purpose of this study was to systematically measure the tumour volume at the time of diagnosis and the residual tumour volume at the time of brachytherapy without and with consideration of the grey zones and to estimate tumour regression during external beam radiotherapy (EBRT). Material and methods: T2-weighted MRI datasets of 175 patients with locally advanced cervical cancer (FIGO stage IB-IVA), who underwent combined external beam radiotherapy and brachytherapy with or without concomitant chemotherapy were available for this study. The gross tumour volume at the time of diagnosis (GTVinit) and at the time of first brachytherapy without (GTVres) and with (GTVres + GZ) consideration of grey zones were measured for each patient. A descriptive statistical analysis was performed and tumour regression rates without (R) and with consideration of grey zones (RGZ) were calculated. Further, the role of prognostic factors on GTVinit, GTVres, GTVres + GZ and tumour regression rates was investigated. Results: The median GTVinit, GTVres, GTVres + GZ in all patients were 44.4 cm3, 8.2 cm3, 20.3 cm3, respectively. The median R was 78.5% and the median RGZ was 50.1%. The histology and FIGO staging showed a significant impact on GTVinit, GTVres and GTVres + GZ. Conclusion: Grey zones represent a substantial proportion of the residual tumour volume at the time of brachytherapy. Differentiation of high signal intensity mass and surrounding intermediate signal intensity grey zones may be reasonable. (orig.)

  3. Retrospective feasibility study of simultaneous integrated boost in cervical cancer using tomotherapy: the impact of organ motion and tumor regression

    Directory of Open Access Journals (Sweden)

    Herrera Fernanda G

    2013-01-01

    Full Text Available Abstract Background Whole pelvis intensity modulated radiotherapy (IMRT is increasingly being used to treat cervical cancer aiming to reduce side effects. Encouraged by this, some groups have proposed the use of simultaneous integrated boost (SIB to target the tumor, either to get a higher tumoricidal effect or to replace brachytherapy. Nevertheless, physiological organ movement and rapid tumor regression throughout treatment might substantially reduce any benefit of this approach. Purpose To evaluate the clinical target volume - simultaneous integrated boost (CTV-SIB regression and motion during chemo-radiotherapy (CRT for cervical cancer, and to monitor treatment progress dosimetrically and volumetrically to ensure treatment goals are met. Methods and materials Ten patients treated with standard doses of CRT and brachytherapy were retrospectively re-planned using a helical Tomotherapy - SIB technique for the hypothetical scenario of this feasibility study. Target and organs at risk (OAR were contoured on deformable fused planning-computed tomography and megavoltage computed tomography images. The CTV-SIB volume regression was determined. The center of mass (CM was used to evaluate the degree of motion. The Dice’s similarity coefficient (DSC was used to assess the spatial overlap of CTV-SIBs between scans. A cumulative dose-volume histogram modeled estimated delivered doses. Results The CTV-SIB relative reduction was between 31 and 70%. The mean maximum CM change was 12.5, 9, and 3 mm in the superior-inferior, antero-posterior, and right-left dimensions, respectively. The CTV-SIB-DSC approached 1 in the first week of treatment, indicating almost perfect overlap. CTV-SIB-DSC regressed linearly during therapy, and by the end of treatment was 0.5, indicating 50% discordance. Two patients received less than 95% of the prescribed dose. Much higher doses to the OAR were observed. A multiple regression analysis showed a significant interaction

  4. Retrospective feasibility study of simultaneous integrated boost in cervical cancer using tomotherapy: the impact of organ motion and tumor regression

    International Nuclear Information System (INIS)

    Whole pelvis intensity modulated radiotherapy (IMRT) is increasingly being used to treat cervical cancer aiming to reduce side effects. Encouraged by this, some groups have proposed the use of simultaneous integrated boost (SIB) to target the tumor, either to get a higher tumoricidal effect or to replace brachytherapy. Nevertheless, physiological organ movement and rapid tumor regression throughout treatment might substantially reduce any benefit of this approach. To evaluate the clinical target volume - simultaneous integrated boost (CTV-SIB) regression and motion during chemo-radiotherapy (CRT) for cervical cancer, and to monitor treatment progress dosimetrically and volumetrically to ensure treatment goals are met. Ten patients treated with standard doses of CRT and brachytherapy were retrospectively re-planned using a helical Tomotherapy - SIB technique for the hypothetical scenario of this feasibility study. Target and organs at risk (OAR) were contoured on deformable fused planning-computed tomography and megavoltage computed tomography images. The CTV-SIB volume regression was determined. The center of mass (CM) was used to evaluate the degree of motion. The Dice’s similarity coefficient (DSC) was used to assess the spatial overlap of CTV-SIBs between scans. A cumulative dose-volume histogram modeled estimated delivered doses. The CTV-SIB relative reduction was between 31 and 70%. The mean maximum CM change was 12.5, 9, and 3 mm in the superior-inferior, antero-posterior, and right-left dimensions, respectively. The CTV-SIB-DSC approached 1 in the first week of treatment, indicating almost perfect overlap. CTV-SIB-DSC regressed linearly during therapy, and by the end of treatment was 0.5, indicating 50% discordance. Two patients received less than 95% of the prescribed dose. Much higher doses to the OAR were observed. A multiple regression analysis showed a significant interaction between CTV-SIB reduction and OAR dose increase. The CTV-SIB had important

  5. Predictive Factors and Management of Rectal Bleeding Side Effects Following Prostate Cancer Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Price, Jeremy G. [Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York (United States); Stone, Nelson N. [Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York (United States); Stock, Richard G., E-mail: Richard.Stock@mountsinai.org [Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York (United States)

    2013-08-01

    Purpose: To report on the incidence, nature, and management of rectal toxicities following individual or combination brachytherapy following treatment for prostate cancer over a 17-year period. We also report the patient and treatment factors predisposing to acute ≥grade 2 proctitis. Methods and Materials: A total of 2752 patients were treated for prostate cancer between October 1990 and April 2007 with either low-dose-rate brachytherapy alone or in combination with androgen depletion therapy (ADT) or external beam radiation therapy (EBRT) and were followed for a median of 5.86 years (minimum 1.0 years; maximum 19.19 years). We investigated the 10-year incidence, nature, and treatment of acute and chronic rectal toxicities following BT. Using univariate, and multivariate analyses, we determined the treatment and comorbidity factors predisposing to rectal toxicities. We also outline the most common and effective management for these toxicities. Results: Actuarial risk of ≥grade 2 rectal bleeding was 6.4%, though notably only 0.9% of all patients required medical intervention to manage this toxicity. The majority of rectal bleeding episodes (72%) occurred within the first 3 years following placement of BT seeds. Of the 27 patients requiring management for their rectal bleeding, 18 underwent formalin treatment and nine underwent cauterization. Post-hoc univariate statistical analysis revealed that coronary artery disease (CAD), biologically effective dose, rectal volume receiving 100% of the prescription dose (RV100), and treatment modality predict the likelihood of grade ≥2 rectal bleeding. Only CAD, treatment type, and RV100 fit a Cox regression multivariate model. Conclusions: Low-dose-rate prostate brachytherapy is very well tolerated and rectal bleeding toxicities are either self-resolving or effectively managed by medical intervention. Treatment planning incorporating adjuvant ADT while minimizing RV100 has yielded the best toxicity-free survival following

  6. Single fraction multimodal image guided focal salvage high-dose-rate brachytherapy for recurrent prostate cancer

    Science.gov (United States)

    Rischke, Hans-Christian; Meyer, Philipp Tobias; Knobe, Sven; Volgeova-Neher, Natalja; Kollefrath, Michael; Jilg, Cordula Annette; Grosu, Anca Ligia; Baltas, Dimos; Kroenig, Malte

    2016-01-01

    Purpose We present a novel method for treatment of locally recurrent prostate cancer (PCa) following radiation therapy: focal, multimodal image guided high-dose-rate (HDR) brachytherapy. Material and methods We treated two patients with recurrent PCa after primary (#1) or adjuvant (#2) external beam radiation therapy. Multiparametric magnetic resonance imaging (mpMRI), choline, positron emission tomography combined with computed tomography (PET/CT), or prostate-specific membrane antigen (PSMA)-PET combined with CT identified a single intraprostatic lesion. Positron emission tomography or magnetic resonance imaging – transrectal ultrasound (MRI-TRUS) fusion guided transperineal biopsy confirmed PCa within each target lesion. We defined a PET and mpMRI based gross tumor volume (GTV). A 5 mm isotropic margin was applied additionally to each lesion to generate a planning target volume (PTV), which accounts for technical fusion inaccuracies. A D90 of 18 Gy was intended in one fraction to each PTV using ultrasound guided HDR brachytherapy. Results Six month follow-up showed adequate prostate specific antygen (PSA) decline in both patients (ΔPSA 83% in patient 1 and ΔPSA 59.3% in patient 2). Follow-up 3-tesla MRI revealed regressive disease in both patients and PSMA-PET/CT showed no evidence of active disease in patient #1. No acute or late toxicities occurred. Conclusions Single fraction, focal, multimodal image guided salvage HDR brachytherapy for recurrent prostate cancer is a feasible therapy for selected patients with single lesions. This approach has to be evaluated in larger clinical trials. PMID:27504134

  7. Can radical parametrectomy be omitted inoccult cervical cancer afterextrafascial hysterectomy?

    Institute of Scientific and Technical Information of China (English)

    Huai-WuLu,; JingLi,; Yun-YunLiu,; Chang-HaoLiu,; Guo-CaiXu,; Ling-LingXie,; Miao-FangWu; Zhong-QiuLin

    2015-01-01

    Background:Occult invasive cervical cancer discovered after simple hysterectomy is not common, radical parame‑trectomy (RP) is a preferred option for young women. However, the morbidity of RP was high. The aim of our study is to assess the incidence of parametrial involvement in patients who underwent radical parametrectomy for occult cervical cancer or radical hysterectomy for early‑stage cervical cancer and to suggest an algorithm for the triage of patients with occult cervical cancer to avoid RP. Methods:A total of 13 patients with occult cervical cancer who had undergone RP with an upper vaginectomy and pelvic lymphadenectomy were included in this retrospective study. Data on the clinicopathologic characteristics of the cases were collected. The published literature was also reviewed, and low risk factors for parametrial involvement in early‑stage cervical cancer were analyzed. Results:Of the 13 patients, 9 had a stage IB1 lesion, and 4 had a stage IA2 lesion. There were four patients with grade 1 disease, seven with grade 2 disease, and two with grade 3 disease. The median age of the entire patients was 41years. The most common indication for extrafascial hysterectomy was cervical intraepithelial neoplasia 3. Three patients had visible lesions measuring 10–30mm, in diameter and ten patients had cervical stromal invasions with depths ranging from 4 to 9mm; only one patient had more than 50% stromal invasion, and four patients had lymph‑vascular space invasion (LVSI). Perioperative complications included intraoperative bowel injury, blood transfusion, vesico‑vaginal ifstula, and ileus (1 case for each). Postoperative pathologic examination results did not show residual disease or parametrial involvement. One patient with positive lymph nodes received concurrent radiation therapy. Only one patient experienced recurrence. Conclusions:Perioperative complications following RP were common, whereas the incidence of parametrial involve‑ment was very low

  8. The epidemiology of hypopharynx and cervical esophagus cancer.

    Science.gov (United States)

    Popescu, C R; Bertesteanu, S V G; Mirea, D; Grigore, Raluca; lonescu, Diana; Popescu, B

    2010-01-01

    At the beginning of the 21st century the hypopharynx and the cervical esophagus cancer represents a major issue for all countries of the world. The epidemiology of the hypopharynx and cervical esophagus cancer deals with the spread of the disease in the human population with regard to sex, age, profession, time and space, as well as risk factors that contribute to these phenomena. The main goal is to investigate the causes and the factors involved in the development of the tumors at the pharyngoesophageal junction, knowledge that contributes to the latest therapeutic assessment through interdisciplinary collaboration (E.N.T. surgeon, general surgeon, radiation oncologist, chemotherapist, and nutritionist). The epidemiology of the hypopharynx and cervical esophagus cancer includes three major areas of interest: descriptive (the study of the spread in mass population), analytical (the study of causal risk factors on the disease) and experimental (that verifies by experiments on animals the prior identified hypothesis). PMID:21254737

  9. DETECTION OF SENTINEL LYMPH NODE IN EARLY CERVICAL CANCER

    Institute of Scientific and Technical Information of China (English)

    刘琳; 李斌; 章文华

    2004-01-01

    Objective: To assess the value of sentinel lymph node (SLN) localization by lymphoscintigraphy and gamma probe detection in early cervical cancer. Methods: A total of 27 patients with operable invasive early cervical cancer and clinically proved negative pelvic lymph nodes were included in this study. The 99Tcm-dextran of 74 MBq (2 mCi) was injected around the cervix at 2( and 10(. Lymphoscintigraphy and gamma probe detection were used to find the SLN. Results: The SLN was identified in 27 patients. The sensitivity and specificity of the SLN detection to predict the metastasis of the pelvic lymph node were 100% and 100% respectively. Conclusion: Identification of the SLN using radionuclide is feasible and possible in women with early cervical cancer.

  10. Preprocessing: A Step in Automating Early Detection of Cervical Cancer

    CERN Document Server

    Das, Abhishek; Bhattacharyya, Debasis

    2011-01-01

    Uterine Cervical Cancer is one of the most common forms of cancer in women worldwide. Most cases of cervical cancer can be prevented through screening programs aimed at detecting precancerous lesions. During Digital Colposcopy, colposcopic images or cervigrams are acquired in raw form. They contain specular reflections which appear as bright spots heavily saturated with white light and occur due to the presence of moisture on the uneven cervix surface and. The cervix region occupies about half of the raw cervigram image. Other parts of the image contain irrelevant information, such as equipment, frames, text and non-cervix tissues. This irrelevant information can confuse automatic identification of the tissues within the cervix. Therefore we focus on the cervical borders, so that we have a geometric boundary on the relevant image area. Our novel technique eliminates the SR, identifies the region of interest and makes the cervigram ready for segmentation algorithms.

  11. Preprocessing for Automating Early Detection of Cervical Cancer

    CERN Document Server

    Das, Abhishek; Bhattacharyya, Debasis

    2011-01-01

    Uterine Cervical Cancer is one of the most common forms of cancer in women worldwide. Most cases of cervical cancer can be prevented through screening programs aimed at detecting precancerous lesions. During Digital Colposcopy, colposcopic images or cervigrams are acquired in raw form. They contain specular reflections which appear as bright spots heavily saturated with white light and occur due to the presence of moisture on the uneven cervix surface and. The cervix region occupies about half of the raw cervigram image. Other parts of the image contain irrelevant information, such as equipment, frames, text and non-cervix tissues. This irrelevant information can confuse automatic identification of the tissues within the cervix. Therefore we focus on the cervical borders, so that we have a geometric boundary on the relevant image area. Our novel technique eliminates the SR, identifies the region of interest and makes the cervigram ready for segmentation algorithms.

  12. HPV与宫颈癌%Hunum papillomavirus and cervical cancer

    Institute of Scientific and Technical Information of China (English)

    祁玉兰; 梁新芳

    2008-01-01

    It has been approved that the genital human papillomavirus(HPV) infection is one of the leading causes of cervical cancer.Over two-thirds of cervical cancer cases are associated with infection of either HPV16 or HPV18.The success of HPV prophylactic vaccine development is the milestone of cervical cancer prevention of humankind.%人乳头瘤病毒(HPV)的感染已被证实与宫颈癌的发生有密切关系.超过2/3的宫颈癌与HPV16或HPV18感染有关.HPV预防性疫苗研制的成功则是子宫颈癌预防研究的里程碑.

  13. Breaking the DNA damage response to improve cervical cancer treatment.

    Science.gov (United States)

    Wieringa, Hylke W; van der Zee, Ate G J; de Vries, Elisabeth G E; van Vugt, Marcel A T M

    2016-01-01

    Every year, cervical cancer affects ∼500,000 women worldwide, and ∼275,000 patients die of this disease. The addition of platin-based chemotherapy to primary radiotherapy has increased 5-year survival of advanced-stage cervical cancer patients, which is, however, still only 66%. One of the factors thought to contribute to treatment failure is the ability of tumor cells to repair chemoradiotherapy-induced DNA damage. Therefore, sensitization of tumor cells for chemoradiotherapy via inhibition of the DNA damage response (DDR) as a novel strategy to improve therapy effect, is currently studied pre-clinically as well as in the clinic. Almost invariably, cervical carcinogenesis involves infection with the human papillomavirus (HPV), which inactivates part of the DNA damage response. This HPV-mediated partial inactivation of the DDR presents therapeutic targeting of the residual DDR as an interesting approach to achieve chemoradio-sensitization for cervical cancer. How the DDR can be most efficiently targeted, however, remains unclear. The fact that cisplatin and radiotherapy activate multiple signaling axes within the DDR further complicates a rational choice of therapeutic targets within the DDR. In this review, we provide an overview of the current preclinical and clinical knowledge about targeting the DDR in cervical cancer. PMID:26643553

  14. The Epidemiology of Human Papillomavirus Infection and Cervical Cancer

    Directory of Open Access Journals (Sweden)

    F. Xavier Bosch

    2007-01-01

    Full Text Available Cervical cancer has been recognized as a rare outcome of a common Sexually Transmitted Infection (STI. The etiologic association is restricted to a limited number of viral types of the family of the Human Papillomaviruses (HPVs. The association is causal in nature and under optimal testing systems, HPV DNA can be identified in all specimens of invasive cervical cancer. As a consequence, it has been claimed that HPV infection is a necessary cause of cervical cancer. The evidence is consistent worldwide and implies both the Squamous Cell Carcinomas (SCC, the adenocarcinomas and the vast majority (i.e. > 95% of the immediate precursors, namely High Grade Squamous Intraepithelial Lesions (HSIL/Cervical Intraepithelial Neoplasia 3 (CIN3/Carcinoma in situ. Co-factors that modify the risk among HPV DNA positive women include the use of oral contraceptives (OC for five or more years, smoking, high parity (five or more full term pregnancies and previous exposure to other sexually transmitted diseases such as Chlamydia Trachomatis (CT and Herpes Simplex Virus type 2 (HSV-2. Women exposed to the Human Immunodeficiency Virus (HIV are at high risk for HPV infection, HPV DNA persistency and progression of HPV lesions to cervical cancer.

  15. Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: importance of positive or close parametrial resection margin

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yi Jun; Lee, Kyung Ja; Park, Kyung Ran [Dept. of Radiation Oncology, (Korea, Republic of); and others

    2015-06-15

    To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute. Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors. The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS. PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

  16. Progress in Treatment of Cervical Cancer%宫颈癌的治疗进展

    Institute of Scientific and Technical Information of China (English)

    侯彩英; 宫荣杰; 姚元庆

    2011-01-01

    Cervical carcinoma is the second most common cancer in women and is the most prevalent female malignancy in Africa, Asia and South America. Its morbidity and mortality are only less than breast cancer. Radical surgery (hysterectomy plus pelvic lymph node dissection) and radiotherapy are the traditional treatment while chemotherapy is used for advanced stage and recurrent or metastatic patients. Following the development of science technical, it has progress in method of surgical and radiotherapy and chemotherapy. At the same time, some new therapies have adopted in clinics, including targeted therapy, gene therapy and vaccine prevention. The standard therapy for the locally advanced cervical cancer has been a combination of external pelvic radiation and brachytherapy.%宫颈癌是全世界妇女中第二常见的恶性肿瘤,在非洲、亚洲以及南美洲,是妇女最常见的恶性肿瘤.其发病率和死亡率仅次于乳腺癌.宫颈癌的传统治疗是根治性手术(包括广泛全子宫切除+盆腔淋巴结清扫术)和放疗,化疗主要用于晚期或复发转移的患者.近些年,随着科学技术的发展,其手术方式及放化疗方式都有了新的进展,同时,还出现了靶向治疗、基因治疗及疫苗预防等综合防治体系.

  17. Human Papillomavirus 16E6 Oncogene Mutation in Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    Feng Sun; Xiao-qin Ha; Tong-de Lv; Chuan-ping Xing; Bin Liu; Xiao-zhe Cao

    2009-01-01

    Objective: Cervical cancer (CC) is the second most common type of cancer in women worldwide, after breast cancer. High-risk human papillomaviruses (HR-HPVs) are considered to be the major causes of cervical cancer. HPV16 is the most common type of HR-HPVs and HPV16 E6 gene is one of the major oncogenes. Specific mutations are considered as dangerous factors causing CC. This study was designed to find mutations of HPV16 E6 and the relationship between the mutations and the happening of CC.Methods: The tissue DNA was extracted from 15 biopsies of CC. Part of HPV16 E6 gene (nucleotide 201-523) was amplified by polymerase chain reaction (PCR) from the CC tissue DNA. The PCR fragments were sequenced and analyzed.Results: The result of PCR showed that the positive rate of HPV16 E6 was 93.33% (14/15). After sequencing and analyzing, in the 13 out of 14 PCR fragments, 4 maintained prototype (30.77%), 8 had a same 350G mutation (61.54%), and 1 had a 249G mutation (7.69%).Conclusion: This study suggest that there is a high infection rate of HPV in cervical cancer and most of the HPV16 E6 gene has mutations. Those mutations may have an association with the development of cervical cancer.

  18. Twist and YB-1 gene expression in cervical cancer and cervical intraepithelial neoplasia tissue as well as its correlation with epithelial-mesenchymal transition

    Institute of Scientific and Technical Information of China (English)

    Qin Liu; Hong Li; Yu Zhang

    2016-01-01

    Objective:To study the Twist and YB-1 gene expression in cervical cancer and cervical intraepithelial neoplasia tissue as well as its correlation with epithelial-mesenchymal transition. Methods:Normal cervical tissue, cervical intraepithelial neoplasia tissue and cervical cancer tissue were collected for study. ELISA kits were used to detect Twist, YB-1, E-cadherin,β-catenin, N-cadherin and Vimentin contents in cervical tissue, and immunohistochemistry was used to detect Twist and YB-1 expression levels in cervical tissue.Results:Twist and YB-1 contents, cell positive rate and immunohistochemical scores as well as N-cadherin and Vimentin contents in cervical cancer tissue and cervical intraepithelial neoplasia tissue were significantly higher than those in normal cervical tissue while E-cadherin andβ-catenin contents were lower than those in normal cervical tissue; Twist and YB-1 contents, cell positive rate and immunohistochemical scores as well as N-cadherin and Vimentin contents in cervical cancer tissue were significantly higher than those in cervical intraepithelial neoplasia tissue while E-cadherin andβ-catenin contents were lower than those in cervical intraepithelial neoplasia tissue; the higher the Twist and YB-1 expression levels in cervical cancer tissue, the lower the E-cadherin andβ-catenin contents, and the higher the N-cadherin and Vimentin contents.Conclusions: Twist and YB-1 gene overexpression can promote epithelial-mesenchymal transition to be involved in the occurrence of cervical cancer and cervical intraepithelial neoplasia.

  19. Endoluminal brachytherapy in the treatment of oesophageal cancer: technique description, case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Luisa Castilla

    2015-07-01

    Full Text Available Endoesophageal brachytherapy is a useful technique for the palliative treatment of dysphagia in advanced oesophageal cancer. This technique offers good results on dysphagia control and quality of life. We report the case of a patient treated with this technique presenting complete response to the dysphagia. We describe endoesophageal brachyterapy technique and we comment on the literature.

  20. A Gompertzian model with random effects to cervical cancer growth

    Energy Technology Data Exchange (ETDEWEB)

    Mazlan, Mazma Syahidatul Ayuni; Rosli, Norhayati [Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang, Lebuhraya Tun Razak, 26300 Gambang, Pahang (Malaysia)

    2015-05-15

    In this paper, a Gompertzian model with random effects is introduced to describe the cervical cancer growth. The parameters values of the mathematical model are estimated via maximum likehood estimation. We apply 4-stage Runge-Kutta (SRK4) for solving the stochastic model numerically. The efficiency of mathematical model is measured by comparing the simulated result and the clinical data of the cervical cancer growth. Low values of root mean-square error (RMSE) of Gompertzian model with random effect indicate good fits.

  1. The epidemiology of hypopharynx and cervical esophagus cancer

    OpenAIRE

    Popescu, CR; Bertesteanu, SVG; Mirea, D; Grigore, R; Ionescu, D.; Popescu, B

    2010-01-01

    At the beginning of the 21st century hypopharynx and cervical esophagus cancer represents a major issue for all countries of the world. The epidemiology of the hypopharynx and cervical esophagus cancer deals with the spread of the disease in human population in regards to sex, age, profession, time and space, as well as risk factors that contribute to these phenomena. The main goal is to investigate the causes and the factors involved in the development of the tumors at the pharyngo–esophagea...

  2. Disease-related needs of black patients with cervical cancer

    Directory of Open Access Journals (Sweden)

    I. Treadwell

    1992-09-01

    Full Text Available The high incidence of cervical cancer amongst South African black women is complicated by late presentation for treatment as well as by misconceptions and ignorance which adversely affect the quality of their lives. The aim of the research was to determine the disease-related needs of patients suffering from cervical cancer which would serve as a basis for planning on providing for these needs. Needs for the following were identified: • Education on early detection in the community. • Education on nutrition and hygiene. • Information on and assistance in obtaining financial relief by means of subsidised transport and disability pensions.

  3. Gompertzian stochastic model with delay effect to cervical cancer growth

    Energy Technology Data Exchange (ETDEWEB)

    Mazlan, Mazma Syahidatul Ayuni binti; Rosli, Norhayati binti [Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang, Lebuhraya Tun Razak, 26300 Gambang, Pahang (Malaysia); Bahar, Arifah [Department of Mathematical Sciences, Faculty of Science, Universiti Teknologi Malaysia, 81310 Johor Bahru, Johor and UTM Centre for Industrial and Applied Mathematics (UTM-CIAM), Universiti Teknologi Malaysia, 81310 Johor Bahru, Johor (Malaysia)

    2015-02-03

    In this paper, a Gompertzian stochastic model with time delay is introduced to describe the cervical cancer growth. The parameters values of the mathematical model are estimated via Levenberg-Marquardt optimization method of non-linear least squares. We apply Milstein scheme for solving the stochastic model numerically. The efficiency of mathematical model is measured by comparing the simulated result and the clinical data of cervical cancer growth. Low values of Mean-Square Error (MSE) of Gompertzian stochastic model with delay effect indicate good fits.

  4. Surgical Treatment of Early-Stage Cervical Cancer.

    Science.gov (United States)

    Brucker, Sara Y; Ulrich, Uwe A

    2016-01-01

    Surgical treatment of cervical cancer has been a cornerstone in the management of this malignancy for more than 100 years. Today, for early-stage and low-risk cervical cancer, surgery is still considered the gold standard. If the preoperative assessment of the tumor reveals a situation prompting postoperative adjuvant radiochemotherapy, the latter should be planned as the primary treatment option, being preceded by staging laparoscopy including pelvic and paraaortic lymph node dissection. As an alternative to the open approach, the definitive surgical treatment should be either performed laparoscopically, or be laparoscopic-assisted, or laparoscopically robotic-assisted. PMID:27614875

  5. Cervical screening and cervical cancer death among older women: a population-based, case-control study.

    Science.gov (United States)

    Rustagi, Alison S; Kamineni, Aruna; Weinmann, Sheila; Reed, Susan D; Newcomb, Polly; Weiss, Noel S

    2014-05-01

    Recent research suggests that cervical screening of older women is associated with a considerable decrease in cervical cancer incidence. We sought to quantify the efficacy of cervical cytology screening to reduce death from this disease. Among enrollees of 2 US health plans, we compared Papanicolaou smear screening histories of women aged 55-79 years who died of cervical cancer during 1980-2010 (cases) to those of women at risk of cervical cancer (controls). Controls were matched 2:1 to cases on health plan, age, and enrollment duration. Cytology screening during the detectable preclinical phase, estimated as the 5-7 years before diagnosis during which cervical neoplasia is asymptomatic but cytologically detectable, was ascertained from medical records. A total of 39 cases and 80 controls were eligible. The odds ratio of cervical cancer death associated with screening during the presumed detectable preclinical phase was 0.26 (95% confidence interval: 0.10, 0.63) after adjustment for matching characteristics, smoking, marital status, and race/ethnicity using logistic regression. We estimate that cervical cytology screening of all women aged 55-79 years in the United States could avert 630 deaths annually. These results provide a minimum estimate of the efficacy of human papillomavirus DNA screening-a more sensitive test-to reduce cervical cancer death among older women.

  6. [Historical overview and the current practice of intracavitary treatment of cervical and endometrial cancer in the Oncoradiology Center of Budapest].

    Science.gov (United States)

    Sinkó, Dániel; Nemeskéri, Csaba; Pallinger, Ágnes; Weisz, Csaba; Naszály, Attila; Landherr, László

    2015-06-01

    The aims of our study were to describe the history and development of intracavitary brachytherapy in the treatment of gynecological tumors, to introduce our current practice for intracavitary brachytherapy treatments based on CT planning. Gynecological intracavitary brachytherapy has been applied in our department since the early 1930s. After a long development it has been completely renewed by 2014. In our center definitive and/or preoperative gynecological HDR-AL brachytherapy treatments were given to 25 patients (13 corpus uterine cancer patients and 12 cervical cancer patients) during the period of 01. 01. 2014-31. 01. 2015. In each case, target volumes were planned by CT images, DVH (dose volume histogram) analysis was performed in order to calculate the radiation tolerance dose of rectum and urinary bladder. Evaluation was performed by the EclipseTM 11.0.47. brachytherapy treatment planning system. During the definitive treatments of the 13 uterine cancer patients the D2cc value related to rectum tolerance was 66.3 GyEQD2 (46-91 Gy). The average D2cc value of urinary bladder tolerance was 76.5 GyEQD2 (30-112 Gy). CI was 0.72 (0.6-0.95). Average value of COIN was 0.57 (0.35-0.78). Compared to the prescribed dose D100 and D90 values were given in ratios. Compared to the volume which receives 100% of reference dose V150 and V200 values were also given in ratios. D100 and D90 were calculated to be 0.66 (0.47-0.97) and 0.91 (0.8-1.25). V150 and V200 volumes were 0.11 (0.04-0.18) and 0.06 (0.02-0.1). During the definitive treatments of 12 cervical cancer patients the D2cc value related to rectum tolerance calculated by DVH was 75.2 GyEQD2 (60-82 Gy). The average D2cc value of urinary bladder tolerance was 85 GyEQD2 based on DVH. CI was 0.66 (0.42-0.76). Average value of COIN was 0.52 (0.32-0.78). Mean value of DHI was 0.46 (0.27-0.54). D100 and D90 were calculated to be 0.72 (0.57-0.89) and 0.91 (0.84-1.11). V150 and V200 volumes were 0.057 (0.02-0.13) and 0.02 (0

  7. Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

    DEFF Research Database (Denmark)

    Obel, J; McKenzie, J; Buenconsejo-Lum, L E;

    2015-01-01

    OBJECTIVE: To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination...... insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted...... population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear...

  8. Predictors of Toxicity After Image-guided High-dose-rate Interstitial Brachytherapy for Gynecologic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Larissa J. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Viswanathan, Akila N., E-mail: aviswanathan@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States)

    2012-12-01

    Purpose: To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Methods and Materials: Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adverse Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. Results: At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Discussion: Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure

  9. Cervical cancer : incidence, screening and prognosis among immigrant women in Sweden

    OpenAIRE

    Azerkan, Fatima

    2013-01-01

    Immigrant studies may help further our understanding of the aetiology of cervical cancer and improve its prevention. The overall aim of this thesis is to study the risk of cervical cancer among immigrant women in Sweden, their cervical screening attendance and their prognosis after cervical cancer diagnosis. Quantitative cohort study designs using data from population-based registers were carried out and analysed using Poisson regression and Cox proportional hazard models. A quantitative expl...

  10. Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi

    Directory of Open Access Journals (Sweden)

    Melanie Y. Hami

    2014-10-01

    Full Text Available Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services. Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi. Results: A statistically-significant association existed between women’s intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003 and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041 at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages. Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi’s women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women

  11. Relationship between two year PSA nadir and biochemical recurrence in prostate cancer patients treated with iodine-125 brachytherapy

    Directory of Open Access Journals (Sweden)

    Carlos Antônio da Silva Franca

    2014-04-01

    Full Text Available Objective To evaluate the relationship between two year PSA nadir (PSAn after brachytherapy and biochemical recurrence rates in prostate cancer patients. Materials and Methods In the period from January 1998 to August 2007, 120 patients were treated with iodine-125 brachytherapy alone. The results analysis was based on the definition of biochemical recurrence according to the Phoenix Consensus. Results Biochemical control was observed in 86 patients (71.7%, and biochemical recurrence, in 34 (28.3%. Mean PSAn was 0.53 ng/ml. The mean follow-up was 98 months. The patients were divided into two groups: group 1, with two year PSAn < 0.5 ng/ml after brachytherapy (74 patients; 61.7%, and group 2, with two year PSAn ≥ 0.5 ng/ml after brachytherapy (46 patients; 38.3%. Group 1 presented biochemical recurrence in 15 patients (20.3%, and group 2, in 19 patients (43.2% (p < 0.02. The analysis of biochemical disease-free survival at seven years, stratified by the two groups, showed values of 80% and 64% (p < 0.02, respectively. Conclusion Levels of two year PSAn ≥ 0.5 ng/ml after brachytherapy are strongly correlated with a poor prognosis. This fact may help to identify patients at risk for disease recurrence.

  12. Illness Perception, Knowledge and Self-Care about Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Elisa Kern de Castro

    2015-09-01

    Full Text Available Prevention plays a central role in early detection of cervical cancer. Common Sense Model proposes that the nature and organization of illness representations can guide actions related to health and how self-care is exercised. The aim of this study was to describe and compare illness perception, knowledge and self-care in women with and without cancer precursor lesions. Participants were 92 women (aged 18-59 from primary care unity divided into two groups: women with and without premalignant lesion. Measures for illness perception, knowledge and self-care were used. There was no statistically significant difference (t test e chi-square test between groups in the variables analyzed. Despite the risk for cervical cancer, women with precursor lesions do not adjust their illness perceptions, knowledge and self-care to the situation. These data show the need to warn women against the cervical cancer risks, because their distorted perceptions and lack of knowledge about the disease may hamper the screening and control of cervical cancer.

  13. Cervical cancer in north-eastern Libya: 2000-2008.

    Science.gov (United States)

    Ben Khaial, F; Bodalal, Z; Elramli, A; Elkhwsky, F; Eltaguri, A; Bendardaf, R

    2014-08-01

    Libya is a country with a low population, listed under the EMRO. Using registers and patient records from a major primary oncology clinic, data was gathered from Libyan cervical cancer patients and various parameters were studied across 9 years. Out of 4,090 female cancer cases during the study period, 1.8% were cervical cancer (n = 74). The average age of presentation was 53 years, with most of the cases (60%, n = 44) being premenopausal. Approximately 65% (n = 48) of cervical cancer patients are diagnosed at later stages (i.e. stages III and IV). The majority of these cases are squamous cell carcinoma (83.8%, n = 62), while 16.2% (n = 12) were found to be adenocarcinoma. Patients with squamous cell carcinoma presented at later stages more often than those with adenocarcinoma. Human papilloma virus was strongly implicated in cervical cancer, with 94% (n = 63) of those who were tested being positive for HPV-16 (82.5%, n = 52) and HPV-18 (12.7%, n = 8). Diagnosis was most frequently made through biopsy (97.3%, n = 72) as opposed to Pap smears (2.7%, n = 2). Most Libyan patients were put through chemotherapy (75%, n = 55) and triple therapy (surgery with combined chemotherapy and radiotherapy) was the most common (38%, n = 28) modality of treatment. Comparisons were made between Libya and other nations, either in the developed world or neighbouring countries. The major problem of cervical cancer in Libya is delayed presentation and hence, all the recommendations focus on increased awareness for the populace, implementation of a national cancer control plan and a national screening programme.

  14. Are 20 human papillomavirus types causing cervical cancer?

    Science.gov (United States)

    Arbyn, Marc; Tommasino, Massimo; Depuydt, Christophe; Dillner, Joakim

    2014-12-01

    In 2012, the International Agency for Research on Cancer concluded that there was consistent and sufficient epidemiological, experimental and mechanistic evidence of carcinogenicity to humans for 12 HPV types (HPV16, HPV18, HPV31, HPV33, HPV35, HPV39, HPV45, HPV51, HPV52, HPV56, HPV58 and HPV59) for cervical cancer. Therefore, these types were considered as 1A carcinogens. They all belong to the family of the α-Papillomaviridae, in particular to the species α5 (HPV51), α6 (HPV56), α7 (HPV18, HPV39, HPV45, HPV59) and α9 (HPV16, HPV31, HPV33, HPV35, HPV52, HPV58). Less evidence is available for a thirteenth type (HPV68, α7), which is classified as a 2A carcinogen (probably carcinogenic). Moreover, seven other phylogenetically related types (HPV26, HPV53, HPV66, HPV67, HPV68, HPV70 and HPV73) were identified as single HPV infections in certain rare cases of cervical cancer and were considered possibly carcinogenic (2B carcinogens). Recently, Halec et al [7] demonstrated that the molecular signature of HPV-induced carcinogenesis (presence of type-specific spliced E6*| mRNA; increased expression of p16; and decreased expression of cyclin D1, p53 and Rb) was similar in cervical cancers containing single infections with one of the eight afore-mentioned 2A or 2B carcinogens to those in cancers with single infections with group 1 carcinogens. Ninety six percent of cervical cancers are attributable to one of the 13 most common HPV types (groups 1 and 2A). Including the additional seven HPV types (group 2B) added 2.6%, to reach a total of 98.7% of all HPV-positive cervical cancers. From recently updated meta-analyses, it was shown that HPV68, HPV26, HPV66, HPV67, HPV73 and HPV82 were significantly more common in cancer cases than in women with normal cervical cytology, suggesting that for these HPV types, an upgrading of the carcinogen classification could be considered. However, there is no need to include them in HPV screening tests or vaccines, given their rarity in

  15. Reirradiation for recurrent head and neck cancer with salvage interstitial pulsed-dose-rate brachytherapy. Long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Strnad, Vratislav; Lotter, Michael; Kreppner, Stephan; Fietkau, Rainer [University Hospital Erlangen, Dept. of Radiation Oncology, Erlangen (Germany)

    2015-01-10

    To assess the long-term results of protocol-based interstitial pulsed-dose-rate (PDR) brachytherapy as reirradiation combined with simultaneous chemotherapy and interstitial hyperthermia in selected patients with recurrent head and neck tumors. A total of 104 patients with biopsy-proven recurrent head and neck cancer were treated with interstitial PDR brachytherapy. Salvage surgery had also been undergone by 53/104 (51 %) patients (R1 or R2 resection in > 80 % of patients). Salvage brachytherapy alone was administered in 81 patients (78 %), with a median total dose of 56.7 Gy. Salvage brachytherapy in combination with external beam radiotherapy (EBRT) was performed in 23/104 patients (32 %), using a median total dose of D{sub REF} = 24 Gy. Simultaneously to PDR brachytherapy, concomitant chemotherapy was administered in 58/104 (55.8 %) patients. A single session of interstitial hyperthermia was also used to treat 33/104 (31.7 %) patients. The analysis was performed after a median follow-up of 60 months. Calculated according to Kaplan-Meier, local tumor control rates after 2, 5, and 10 years were 92.5, 82.4, and 58.9 %, respectively. Comparing results of salvage PDR brachytherapy with or without simultaneous chemotherapy, the 10-year local control rates were 76 vs. 39 % (p= 0014), respectively. No other patient- or treatment-related parameters had a significant influence on treatment results. Soft tissue necrosis or bone necrosis developed in 18/104 (17.3 %) and 11/104 (9.6 %) patients, respectively, but only 3 % of patients required surgical treatment. PDR interstitial brachytherapy with simultaneous chemotherapy is a very effective and, in experienced hands, also a safe treatment modality in selected patients with head and neck cancer in previously irradiated areas. (orig.) [German] Es erfolgte die Analyse der Langzeitergebnisse einer protokollbasierten interstitiellen Brachytherapie (Re-Bestrahlung) mit simultaner Chemotherapie und interstitieller Hyperthermie

  16. Folate receptor and Ki-67 nucleoprotein expressions in cervical cancer tissue and their correlation

    Institute of Scientific and Technical Information of China (English)

    Ran Yan; Feng Li

    2016-01-01

    Objective:To detect the expression of both FR-α protein and ki-67 in cervical cancer tissues, and discuss the relationship between them and clinical significance.Methods:Using immunohistochemical method test normal cervical tissue and cervical cancer tissue before FR-α protein expression and the expression of Ki-67.Results:FR- protein expression in normal cervical tissues was positive for 7.0% while in cervical cancer tissue the positive rate was 82.1%. The difference was statistically significant. Ki-67 protein expression in normal cervical tissues was 0% while in cervical cancer tissue the positive rate was 80.2%. The difference was statistically significant. The two protein expression in cervical cancer stageⅠ,Ⅱ and stageⅢ were different, but the difference was not statistically significant. In cervical cancer tissues, both the two protein were positively correlated. There are correlations between them. Difference was statistically significant.Conclusion:FR-α elevated protein expression is involved in the pathogenesis of cervical cancer. FR-α protein expression in cervical cancer and precancerous tissue has correlation with Ki-67, FR-α protein maybe participate in the occurrence and development of the cell proliferation in cervical cancer.

  17. Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Thorsteinsson, K; Ladelund, S; Jensen-Fangel, S;

    2016-01-01

    OBJECTIVES: Women living with HIV (WLWH) are reportedly at increased risk of invasive cervical cancer (ICC). A recent publication found that WLWH in Denmark attend the national ICC screening programme less often than women in the general population. We aimed to estimate the incidence of cervical...... performed to include prior screening outcome, screening intensity and treatment of CIN/ICC in the interpretation of results. RESULTS: We followed 1140 WLWH and 17 046 controls with no prior history of ICC or hysterectomy for 9491 and 156 865 person-years, respectively. Compared with controls, the overall...... in both groups were adherent to the national ICC screening programme and had a normal baseline cytology, incidences of CIN and ICC were comparable. CONCLUSIONS: Overall, WLWH developed more cervical disease than controls. Yet, in WLWH and controls adherent to the national ICC screening programme...

  18. Two cytological methods for screening for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, B.; Simonsen, K.; Junge, J.

    2008-01-01

    INTRODUCTION: Denmark has had an organized screening programme for cervical cancer since the 1960s. In spite of this, almost 150 Danish women die from the disease each year. There are currently two different methods for preparation of cervical samples: conventional Papanicolaou smear and liquid......-based cytology. MATERIALS AND METHODS: In 2002, the Department of Pathology, Hvidovre Hospital changed over from the conventional Papanicolaou smear screening method to SurePath liquid-based cytology. This article is based on a retrospective comparison on data from the population screening programme for cervical...... cancer in the Municipality of Copenhagen. RESULTS: The number of tests with the diagnosis of "normal cells" decreased 1% after the conversion to liquid-based cytology, whilst the number of tests with "atypical cells" and "cells suspicious for malignancy" increased by 64.3% and 41.2% respectively...

  19. Low-dose-rate brachytherapy for patients with transurethral resection before implantation in prostate cancer: long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Prada, Pedro J.; Anchuelo, Javier; Blanco, Ana Garcia; Paya, Gema; Cardenal, Juan; Acuña, Enrique; Ferri, Maria [Department of Radiation Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain); Vazquez, Andres; Pacheco, Maite; Sanchez, Jesica [Department of Radiation Physics, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain)

    2016-01-15

    Objectives: We analyzed the long-term oncologic outcome for patients with prostate cancer and transurethral resection who were treated using low-dose-rate (LDR) prostate brachytherapy. Methods and Materials: From January 2001 to December 2005, 57 consecutive patients were treated with clinically localized prostate cancer. No patients received external beam radiation. All of them underwent LDR prostate brachytherapy. Biochemical failure was defined according to the 'Phoenix consensus'. Patients were stratified as low and intermediate risk based on The Memorial Sloan Kettering group definition. Results: The median follow-up time for these 57 patients was 104 months. The overall survival according to Kaplan-Meier estimates was 88% (±6%) at 5 years and 77% (±6%) at 12 years. The 5 and 10 years for failure in tumour-free survival (TFS) was 96% and respectively (±2%), whereas for biochemical control was 94% and respectively (±3%) at 5 and 10 years, 98% (±1%) of patients being free of local recurrence. A patient reported incontinence after treatment (1.7%). The chronic genitourinary complains grade I were 7% and grade II, 10%. At six months 94% of patients reported no change in bowel function. Conclusions: The excellent long-term results and low morbidity presented, as well as the many advantages of prostate brachytherapy over other treatments, demonstrates that brachytherapy is an effective treatment for patients with transurethral resection and clinical organ-confined prostate cancer. (author)

  20. Cervical Cancer Knowledge, Perceptions and Screening Behaviour Among Female University Students in Ghana.

    Science.gov (United States)

    Binka, Charity; Nyarko, Samuel H; Doku, David T

    2016-06-01

    Cervical cancer is becoming a leading cause of death among women in developing countries. Nevertheless, little is known regarding knowledge and perception of cervical cancer and screening behaviour particularly among female tertiary students in Ghana. This study sought to examine the knowledge and perceptions of cervical cancer and screening behaviour among female students in the University of Cape Coast and Ghana Institute of Management and Public Administration in Ghana. A cross-sectional survey design was adopted for the study. Systematic and stratified random sampling techniques were used to select 410 participants for the study. The study found that the participants lacked knowledge on specific risk factors and symptoms of cervical cancer. Also, even though the participants had a fair perception of cervical cancer, they had a poor cervical cancer screening behaviour. Awareness of cervical cancer was significantly influenced by religious affiliation while cervical cancer screening was significantly determined by the working status of the participants. Specific knowledge on cervical cancer and its risk factors as well as regular screening behaviour is paramount to the prevention of cervical cancer. Consequently, the University Health Services should focus on promoting regular cervical cancer awareness campaigns and screening among the students particularly, females. PMID:25957285

  1. Lumbosacral plexus delineation, dose distribution, and its correlation with radiation-induced lumbosacral plexopathy in cervical cancer patients

    Directory of Open Access Journals (Sweden)

    Tunio M

    2014-12-01

    Full Text Available Mutahir Tunio,1 Mushabbab Al Asiri,1 Yasser Bayoumi,2 Ali Abdullah O Balbaid,1 Majed AlHameed,3 Stanciu Laura Gabriela,1 Ahmad Amir O Ali1 1Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia; 2National Cancer Institute, Cairo University, Cairo, Egypt; 3Neurology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia Background: To evaluate the dose distribution to the lumbosacral plexus (LSP and its correlation with radiation-induced lumbosacral plexopathy (RILSP in patients with cervical cancer treated with intensity-modulated radiotherapy (IMRT and high-dose-rate brachytherapy.Materials and methods: After meeting eligibility criteria, 50 patients with cervical cancer were selected who were treated with IMRT and high-dose-rate brachytherapy, and the LSP was contoured. Mean volume; percentages of LSP volume absorbing 40, 50, 55, and 60 Gy (V30, V40, V50, V55, and V60 and point doses (P1, P2, P3, P4, P5, P6, P7, P8, P9, and P10; and RILSP incidence were calculated.Results: At 60 months of follow-up, four patients (8% were found to have grade 2/3 RILSP. The mean maximal LSP dose in patients with RILSP was 59.6 Gy compared with 53.9 Gy in patients without RILSP (control; P=0.04. The mean values of V40, V50, V55, and V60 in patients with RILSP versus control were 61.8% versus 52.8%, 44.4% versus 27.7%, 8.0% versus 0.3% and 1.8% versus 0%, respectively (P=0.01, 0.001, 0.001, and 0.001, respectively.Conclusion: The delineation of the LSP during IMRT planning may reduce the risk for RILSP. The mean values of V40, V50, V55, and V60 for LSP should be less than 55%, 30%, 5%, and 0.5%, respectively; however, further studies are warranted.Keywords: cervical cancer, intensity-modulated radiation therapy, lumbosacral plexus delineation, radiation-induced lumbosacral plexopathy, dosimetric analysis

  2. Human papillomavirus prevalence in paired urine and cervical samples in women invited for cervical cancer screening.

    Science.gov (United States)

    Burroni, Elena; Bonanni, Paolo; Sani, Cristina; Lastrucci, Vieri; Carozzi, Francesca; Iossa, Anna; Andersson, Karin Louise; Brandigi, Livia; Di Pierro, Carmelina; Confortini, Massimo; Levi, Miriam; Boccalini, Sara; Indiani, Laura; Sala, Antonino; Tanini, Tommaso; Bechini, Angela; Azzari, Chiara

    2015-03-01

    With the introduction of Human papillomavirus (HPV) vaccination in young girls in 2007, it is important to monitor HPV infections and epidemiological changes in this target population. The present study has evaluated the detection of human papillomavirus DNA in paired cervical and urine samples to understand if HPV testing in urine could be used as non-invasive method to monitor HPV status in young women. The study enrolled 216 twenty five-year-old women, resident in Florence and invited for the first time to the cervical cancer Screening Program within a project evaluating the impact of HPV vaccination. HPV genotyping was performed on 216 paired urine and cervical samples. The overall concordance between cervix and urine samples, investigated by HPV genotyping (INNO-LiPA HPV Genotyping Extra), was: 85.6% (184/215), 84.6% (182/215), 80% (172/215) when the same HPV, at least the same HR HPV and all HR HPV, respectively, were detected. HPV type specific concordance in paired urine and cervical samples was observed in 85.8% (175/204) of women with normal cytology and in seven out of nine women with abnormal cytology. Urine seems to be a suitable and reliable biological material for HPV DNA detection as evidenced by the high concordance with HPV detected in cervical samples. These results suggest that urine could be a good noninvasive tool to monitor HPV infection in vaccinated women.

  3. Clinical outcomes of adjuvant radiation therapy and prognostic factors in early stage uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Ju; Rhee, Woo Joong; Choi, Seo Hee; Kim, Gwi Eon; Kim, Yong Bae [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Nam, EunJi; Kim, Sang Wun; Kim, Sung Hoon [Dept. of Radiation Oncology, Obstetrics and Gynecology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic

  4. Quality of life characteristics inpatients with cervical cancer

    DEFF Research Database (Denmark)

    Bjelic-Radisic, Vesna; Jensen, Pernille T; Vlasic, Karin Kuljanic;

    2012-01-01

    Annually about 500,000 women worldwide are diagnosed with cervical cancer. For many patients, young age at the time of diagnosis and a good prognosis regarding the disease imply a long life with the side-effects and sequels of various treatment options. The present study investigated the extent t...

  5. Cervical cancer, quality issues in early detection and prognostic factors

    NARCIS (Netherlands)

    Zaal, A.

    2014-01-01

    It is expected that cervical cancer incidence will reduce in The Netherlands over the next decades, as a result of hrHPV vaccination and hrHPV-based screening. Untill then, quality of care could need some improvements as suggested by the work described in this thesis. Novel tools are being indicated

  6. Diagnostic and treatment procedures induced by cervical cancer screening

    NARCIS (Netherlands)

    M. van Ballegooijen (Marjolein); M.A. Koopmanschap (Marc); G.J. van Oortmarssen (Gerrit); J.D.F. Habbema (Dik); N. van der Lubbe (Nils); H.M.A. van Agt (H. M A)

    1990-01-01

    markdownabstractAbstract The amount of diagnostic and treatment procedures induced by cervical cancer screening has been assessed prospectively and related to mortality reduction. Assumptions are based on data from Dutch screening programmes and on a scenario for future developments. With 5 invita

  7. Cytokine expression & TGF-beta signaling in cervical cancer

    NARCIS (Netherlands)

    Kloth, Judith Nathalie

    2009-01-01

    Immune surveillance is of utmost importance in preventing cervical carcinogenesis. Cytokines play a central role in directing and fine tuning the immune response. In cancer, cytokines can either be involved in stimulating the anti-tumor immune response or in tumor growth and progression. The studies

  8. Improving cervical cancer screening rates in an urban HIV clinic.

    Science.gov (United States)

    Cross, Sara L; Suharwardy, Sanaa H; Bodavula, Phani; Schechtman, Kenneth; Overton, E Turner; Onen, Nur F; Lane, Michael A

    2014-01-01

    Human immunodeficiency virus (HIV)-infected women are at increased risk of invasive cervical cancer; however, screening rates remain low. The objectives of this study were to analyze a quality improvement intervention to increase cervical cancer screening rates in an urban academic HIV clinic and to identify factors associated with inadequate screening. Barriers to screening were identified by a multidisciplinary quality improvement committee at the Washington University Infectious Diseases clinic. Several strategies were developed to address these barriers. The years pre- and post-implementation were analyzed to examine the clinical impact of the intervention. A total of 422 women were seen in both the pre-implementation and post-implementation periods. In the pre-implementation period, 222 women (53%) underwent cervical cancer screening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancer screening (p screening included fewer visits attended (pre: 4.2 ± 1.5; post: 3.4 ± 1.4; p screening rates in an urban academic HIV clinic.

  9. [Use of oral contraceptives and increased risk of cervical cancer

    NARCIS (Netherlands)

    Schmeink, C.E.; Lenselink, C.H.; Bekkers, R.L.M.

    2008-01-01

    A recently published meta-analysis and a large cohort study showed independently that use of oral contraceptives (OC) leads to an increased relative risk (RR) of cervical cancer. This RR increased with the duration of OC use and was 1.90 after 5 years or more (95% CI: 1.69-2.13). The increased RR de

  10. Early cervical cancer coexistent with idiopathic inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, M.; Kalter, C.; Roberts, W.S.; Cavanagh, D.

    1989-07-01

    Early invasive carcinoma of the cervix may be treated by surgery or radiation therapy. Two patients with early cervical cancer are presented whose concomitant inflammatory bowel disease figured significantly in the selection of surgery as treatment. The use of radiotherapy in the face of inflammatory bowel disease, however, is not clearly addressed in the literature.

  11. Treatment Extends Survival for Women with Cervical Cancer

    Science.gov (United States)

    Patients with locally advanced cervical cancer who received gemcitabine (Gemzar®) both as part of initial treatment and as part of therapy following primary treatment had improved survival compared with patients whose treatment did not include gemcitabine, according to findings presented at the 2009 ASCO meeting in Orlando.

  12. Evolution of the health economics of cervical cancer vaccination

    NARCIS (Netherlands)

    Ferko, Nicole; Postma, Maarten; Gallivan, Steve; Kruzikas, Denise; Drummond, Michael

    2008-01-01

    This paper reviews the history of modelling for cervical cancer vaccination. We provide an interpretation and summary of conclusions pertaining to the usefulness of different models, the predicted epidemiological impact of vaccination and the cost-effectiveness of adolescent, catch-up and sex-specif

  13. Highlights on recurrence after surgery for cervical cancer

    DEFF Research Database (Denmark)

    Fuglsang, Katrine; Petersen, Lone Kjeld; Blaakær, Jan

    Objective After surgery due to cervical cancer women are offered to attend a follow-up program 10 times during five years with the purpose for early diagnosis of recurrence. The aim of this study is to evaluate the follow-up program, which has remained unchanged for 20 years even though reminding...

  14. Cervical Cancer: A Review of the Psychosocial Factors Following Treatment.

    Science.gov (United States)

    Gilliland, Kevin Clark

    Cervical cancer is a diagnosis that has a profound psychosocial impact, constituting a physical and emotional crisis for patients as well as family. In general, research indicates that the choice of treatment and the stage of the disease are instrumental in determining the psychosocial adjustment. Disruptions are likely to occur in self-esteem,…

  15. Patients with cervical cancer: why did screening not prevent these cases?

    NARCIS (Netherlands)

    Bie, R.P. de; Vergers-Spooren, H.C.; Massuger, L.F.A.G.; Siebers, A.G.; Salet-van der Pol, M.R.; Vedder, J.E.M.; Melchers, W.J.G.; Bulten, J.; Bekkers, R.L.M.

    2011-01-01

    OBJECTIVE: The objective of the study was to assess the screening history of women with cervical cancer and review normal cervical smears 5 years preceding the diagnosis. STUDY DESIGN: Cytological and histological results of 401 women treated for invasive cervical cancer between 1991 and 2008 at the

  16. Challenges in Prevention and Care Delivery for Women with Cervical Cancer in Sub-Saharan Africa.

    Science.gov (United States)

    Randall, Thomas C; Ghebre, Rahel

    2016-01-01

    Virtually all cases of invasive cervical cancer are associated with infection by high-risk strains of human papilloma virus. Effective primary and secondary prevention programs, as well as effective treatment for early-stage invasive cancer have dramatically reduced the burden of cervical cancer in high-income countries; 85% of the mortality from cervical cancer now occurs in low- and middle-income countries. This article provides an overview of challenges to cervical cancer care in sub-Saharan Africa (SSA) and identifies areas for programmatic development to meet the global development goal to reduce cancer-related mortality. Advanced stage at presentation and gaps in prevention, screening, diagnostic, and treatment capacities contribute to reduced cervical cancer survival. Cost-effective cervical cancer screening strategies implemented in low resource settings can reduce cervical cancer mortality. Patient- and system-based barriers need to be addressed as part of any cervical cancer control program. Limited human capacity and infrastructure in SSA are major barriers to comprehensive cervical cancer care. Management of early-stage, locally advanced or metastatic cervical cancer involves multispecialty care, including gynecology oncology, medical oncology, radiology, pathology, radiation oncology, and palliative care. Investment in cervical cancer care programs in low- and middle-income countries will need to include effective recruitment programs to engage women in the community to access cancer screening and diagnosis services. Though cervical cancer is a preventable and treatable cancer, the challenges to cervical control in SSA are great and will require a broadly integrated and sustained effort by multiple stakeholders before meaningful progress can be achieved.

  17. Challenges in Prevention and Care Delivery for Women with Cervical Cancer in Sub-Saharan Africa

    Science.gov (United States)

    Randall, Thomas C.; Ghebre, Rahel

    2016-01-01

    Virtually all cases of invasive cervical cancer are associated with infection by high-risk strains of human papilloma virus. Effective primary and secondary prevention programs, as well as effective treatment for early-stage invasive cancer have dramatically reduced the burden of cervical cancer in high-income countries; 85% of the mortality from cervical cancer now occurs in low- and middle-income countries. This article provides an overview of challenges to cervical cancer care in sub-Saharan Africa (SSA) and identifies areas for programmatic development to meet the global development goal to reduce cancer-related mortality. Advanced stage at presentation and gaps in prevention, screening, diagnostic, and treatment capacities contribute to reduced cervical cancer survival. Cost-effective cervical cancer screening strategies implemented in low resource settings can reduce cervical cancer mortality. Patient- and system-based barriers need to be addressed as part of any cervical cancer control program. Limited human capacity and infrastructure in SSA are major barriers to comprehensive cervical cancer care. Management of early-stage, locally advanced or metastatic cervical cancer involves multispecialty care, including gynecology oncology, medical oncology, radiology, pathology, radiation oncology, and palliative care. Investment in cervical cancer care programs in low- and middle-income countries will need to include effective recruitment programs to engage women in the community to access cancer screening and diagnosis services. Though cervical cancer is a preventable and treatable cancer, the challenges to cervical control in SSA are great and will require a broadly integrated and sustained effort by multiple stakeholders before meaningful progress can be achieved. PMID:27446806

  18. Challenges in Prevention and Care Delivery for Women with Cervical Cancer in Sub-Saharan Africa.

    Science.gov (United States)

    Randall, Thomas C; Ghebre, Rahel

    2016-01-01

    Virtually all cases of invasive cervical cancer are associated with infection by high-risk strains of human papilloma virus. Effective primary and secondary prevention programs, as well as effective treatment for early-stage invasive cancer have dramatically reduced the burden of cervical cancer in high-income countries; 85% of the mortality from cervical cancer now occurs in low- and middle-income countries. This article provides an overview of challenges to cervical cancer care in sub-Saharan Africa (SSA) and identifies areas for programmatic development to meet the global development goal to reduce cancer-related mortality. Advanced stage at presentation and gaps in prevention, screening, diagnostic, and treatment capacities contribute to reduced cervical cancer survival. Cost-effective cervical cancer screening strategies implemented in low resource settings can reduce cervical cancer mortality. Patient- and system-based barriers need to be addressed as part of any cervical cancer control program. Limited human capacity and infrastructure in SSA are major barriers to comprehensive cervical cancer care. Management of early-stage, locally advanced or metastatic cervical cancer involves multispecialty care, including gynecology oncology, medical oncology, radiology, pathology, radiation oncology, and palliative care. Investment in cervical cancer care programs in low- and middle-income countries will need to include effective recruitment programs to engage women in the community to access cancer screening and diagnosis services. Though cervical cancer is a preventable and treatable cancer, the challenges to cervical control in SSA are great and will require a broadly integrated and sustained effort by multiple stakeholders before meaningful progress can be achieved. PMID:27446806

  19. The evaluation of older patients with cervical cancer

    Directory of Open Access Journals (Sweden)

    Gao Y

    2013-06-01

    Full Text Available Ying Gao,1 Jin-lu Ma,1,* Fei Gao,2,* Li-ping Song11Department of Radiotherapy Oncology, First Affiliated Hospital of Xi'an Jiaotong University, 2Department of Neurology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China *These authors contributed equally to this workObjective: The number of elderly patients being diagnosed with cervical cancer is increasing, and the outcome of cervical cancer related to age is controversial. We conducted a retrospective analysis in patients treated for advanced cervical cancer in order to investigate patient characteristics and prognosis of older patients.Methods: Medical records were collected of 159 patients with cervical cancer who had been treated with radiotherapy or combined radiotherapy and chemotherapy from January 2007 to January 2009. The patients were divided into two age groups: (1 patients ≥65 years old, and (2 patients 0.05. Seventy-six patients had human papillomavirus (HPV at diagnosis (twelve women ≥65 years, 64 women ≤65 years; P = 0.000. Forty-two women tested positive for HPV 16, while 32 women tested positive for HPV 18 respectively. Pelvic and/or paraaortic lymph-node metastasis was found in 25 patients (eight in group 1, 17 in group 2; P = 0.960 on computed tomography scan. Of the 159 patients analyzed, sixteen patients (16/52 in group 1 received concurrent chemotherapy, while 96 (96/107 in group 2 completed that treatment.Conclusions: Cervical cancer has the same prognosis in old and young women. Age may not be an independent increased risk of death in women with cervical cancer, and the age-group is at lower risk for virulent HPV strands (HPV 16/18 compared to younger patients. Treatment recommendations were implemented less often for older patients. Radiotherapy remained the most common treatment chosen for elderly patients. This confirms that there is a stronger need to pay attention to the elderly patient.Keywords: cervical cancer, older

  20. Optoelectronic method for detection of cervical intraepithelial neoplasia and cervical cancer

    Science.gov (United States)

    Pruski, D.; Przybylski, M.; Kędzia, W.; Kędzia, H.; Jagielska-Pruska, J.; Spaczyński, M.

    2011-12-01

    The optoelectronic method is one of the most promising concepts of biophysical program of the diagnostics of CIN and cervical cancer. Objectives of the work are evaluation of sensitivity and specificity of the optoelectronic method in the detection of CIN and cervical cancer. The paper shows correlation between the pNOR number and sensitivity/specificity of the optoelectronic method. The study included 293 patients with abnormal cervical cytology result and the following examinations: examination with the use of the optoelectronic method — Truscreen, colposcopic examination, and histopathologic biopsy. Specificity of the optoelectronic method for LGSIL was estimated at 65.70%, for HGSIL and squamous cell carcinoma of cervix amounted to 90.38%. Specificity of the optoelectronic method used to confirm lack of cervical pathology was estimated at 78.89%. The field under the ROC curve for the optoelectronic method was estimated at 0.88 (95% CI, 0.84-0.92) which shows high diagnostic value of the test in the detection of HGSIL and squamous cell carcinoma. The optoelectronic method is characterised by high usefulness in the detection of CIN, present in the squamous epithelium and squamous cell carcinoma of cervix.

  1. ACOG Recommendations and Guidelines for Cervical Cancer Screening and Management

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about ACOG's recommendations for cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  2. Continuous 7-Days-A-Week External Beam Irradiation in Locally Advanced Cervical Cancer: Final Results of the Phase I/II Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the feasibility and efficacy of definitive continuous 7-days-a-week pelvic irradiation without breaks between external beam radiotherapy and brachytherapy in locally advanced cervical cancer. Methods and Materials: Between November 1998 and December 1999, 30 patients with International Federation of Obstetrics and Gynecology Stage IIB or IIIB cervical cancer were included in a prospective Phase I/II study of continuous 7-days-a-week pelvic irradiation, to the total Manchester point B dose of 40.0–57.6 Gy. The first 13 patients (Group A) were given a daily tumor dose of 1.6 Gy, and the remaining 17 patients (Group B) were given 1.8 Gy. One or two immediate brachytherapy applications (point A dose 10–20 Gy, each) were performed in 28 cases. Results: Two patients did not complete the irradiation because of apparent early progression of disease during the irradiation. Eleven of the 28 evaluable patients (39%; 45% and 35% in Groups A and B, respectively) completed their treatment within the prescribed overall treatment time. Acute toxicity (including severe European Organisation for Research and Treatment of Cancer/Radiation Therapy Oncology Group Grade 3 and 4 effects in 40%) was experienced by 83% of patients and resulted in unplanned treatment interruptions in 40% of all patients (31% and 47% of patients in Groups A and B, respectively). Severe intestinal side effects occurred in 31% and 41% of Patients in Groups A and B, respectively (p = 0.71). The 5-year overall survival probability was 33%. Cancer recurrence occurred in 63% of patients: 20% inside and 57% outside the pelvis. Cumulative incidence of late severe bowel and urinary bladder toxicity at 24 months was 15%. Conclusion: Continuous irradiation in locally advanced cervical cancer is associated with a high incidence of severe acute toxicity, resulting in unplanned treatment interruptions. Late severe effects and survival after continuous radiotherapy do not substantially differ from

  3. Prolactin and prolactin receptor expression in cervical intraepithelial neoplasia and cancer.

    Science.gov (United States)

    Ascencio-Cedillo, Rafael; López-Pulido, Edgar Ivan; Muñoz-Valle, José Francisco; Villegas-Sepúlveda, Nicolás; Del Toro-Arreola, Susana; Estrada-Chávez, Ciro; Daneri-Navarro, Adrian; Franco-Topete, Ramón; Pérez-Montiel, Delia; García-Carrancá, Alejandro; Pereira-Suárez, Ana Laura

    2015-04-01

    Prolactin receptor (PRLR) overexpression could play a role in tumorigenesis. The aim of this study was to determine prolactin (PRL) and PRLR expression in biopsies from patients with precursor lesions and uterine cervical cancer. PRLR expression was analyzed in 63 paraffin-embedded biopsies of uterine cervical tissue. In total, eleven low-grade squamous intraepithelial lesions (LSIL), 23 high-grade squamous intraepithelial lesions (HSIL), 21 uterine cervical cancers (UCC) and 8 normal epithelium (NE) were examined using immunoperoxidase staining and Western blot analysis. Additionally, PRL expression was identified in human cervical cancer serum and tissues. The PRLR expression was found to be significantly increased in cervical cancer in comparison with normal tissue and precursor lesions (P prolactin expression was similar in precursor lesions and cervical cancer by Western blot analysis. Our data suggest a possible role for PRLR in the progression of cervical cancer.

  4. Implementation of image-guided brachytherapy (IGBT) for patients with uterine cervix cancer: a tumor volume kinetics approach

    Science.gov (United States)

    Mendez, Lucas Castro; Stuart, Silvia Radwanski; Guimarães, Roger Guilherme Rodrigues; Ramos, Clarissa Cerchi Angotti; de Paula, Lucas Assad; de Sales, Camila Pessoa; Chen, André Tsin Chih; Blasbalg, Roberto; Baroni, Ronaldo Hueb

    2016-01-01

    Purpose To evaluate tumor shrinking kinetics in order to implement image-guided brachytherapy (IGBT) for the treatment of patients with cervix cancer. Material and methods This study has prospectively evaluated tumor shrinking kinetics of thirteen patients with uterine cervix cancer treated with combined chemoradiation. Four high dose rate brachytherapy fractions were delivered during the course of pelvic external beam radiation therapy (EBRT). Magnetic resonance imaging (MRI) exams were acquired at diagnosis (D), first (B1), and third (B3) brachytherapy fractions. Target volumes (GTV and HR-CTV) were calculated by both the ellipsoid formula (VE) and MRI contouring (VC), which were defined by a consensus between at least two radiation oncologists and a pelvic expert radiologist. Results Most enrolled patients had squamous cell carcinoma and FIGO stage IIB disease, and initiated brachytherapy after the third week of pelvic external beam radiation. Gross tumor volume volume reduction from diagnostic MRI to B1 represented 61.9% and 75.2% of the initial volume, when measured by VE and VC, respectively. Only a modest volume reduction (15-20%) was observed from B1 to B3. Conclusions The most expressive tumor shrinking occurred in the first three weeks of oncological treatment and was in accordance with gynecological examination. These findings may help in IGBT implementation. PMID:27648083

  5. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

  6. WE-F-BRD-01: HDR Brachytherapy II: Integrating Imaging with HDR

    Energy Technology Data Exchange (ETDEWEB)

    Craciunescu, O [Duke University Medical Center, Durham, NC (United States); Todor, D [Virginia Commonwealth University, Richmond, VA (United States); Leeuw, A de

    2014-06-15

    In recent years, with the advent of high/pulsed dose rate afterloading technology, advanced treatment planning systems, CT/MRI compatible applicators, and advanced imaging platforms, image-guided adaptive brachytherapy treatments (IGABT) have started to play an ever increasing role in modern radiation therapy. The most accurate way to approach IGABT treatment is to provide the infrastructure that combines in a single setting an appropriate imaging device, a treatment planning system, and a treatment unit. The Brachytherapy Suite is not a new concept, yet the modern suites are incorporating state-of-the-art imaging (MRI, CBCT equipped simulators, CT, and /or US) that require correct integration with each other and with the treatment planning and delivery systems. Arguably, an MRI-equipped Brachytherapy Suite is the ideal setup for real-time adaptive brachytherapy treatments. The main impediment to MRI-IGABT adoption is access to MRI scanners. Very few radiation oncology departments currently house MRI scanners, and even fewer in a dedicated Brachytherapy Suite. CBCT equipped simulators are increasingly offered by manufacturers as part of a Brachytherapy Suite installation. If optimized, images acquired can be used for treatment planning, or can be registered with other imaging modalities. This infrastructure is relevant for all forms of brachytherapy, especially those utilizing multi-fractionated courses of treatment such as prostate and cervix. Moreover, for prostate brachytherapy, US imaging systems can be part of the suite to allow for real-time HDR/LDR treatments. Learning Objectives: Understand the adaptive workflow of MR-based IGBT for cervical cancer. Familiarize with commissioning aspects of a CBCT equipped simulator with emphasis on brachytherapy applications Learn about the current status and future developments in US-based prostate brachytherapy.

  7. Tc17 cells in patients with uterine cervical cancer.

    Directory of Open Access Journals (Sweden)

    Yan Zhang

    Full Text Available BACKGROUND: The existence of Tc17 cells was recently shown in several types of infectious and autoimmune diseases, but their distribution and functions in uterine cervical cancer (UCC have not been fully elucidated. METHODS: The frequency of Tc17 cells in peripheral blood samples obtained from UCC patients, cervical intraepithelial neoplasia (CIN patients and healthy controls was determined by flow cytometry. Besides, the prevalence of Tc17 cells and their relationships to Th17 cells and Foxp3-expressing T cells as well as microvessels in tissue samples of the patients were assessed by immunohistochemistry staining. RESULTS: Compared to controls, patients with UCC or CIN had a higher proportion of Tc17 cells in both peripheral blood and cervical tissues, but the level of Tc17 cells in UCC tissues was significantly higher than that in CIN tissues. Besides, the increased level of Tc17 in UCC patients was associated with the status of pelvic lymph node metastases and increased microvessel density. Finally, significant correlations of infiltration between Tc17 cells and Th17 cells or Foxp3-expressing T cells were observed in UCC and CIN tissues. CONCLUSIONS: This study indicates that Tc17 cell infiltration in cervical cancers is associated with cancer progression accompanied by increased infiltrations of Th17 cells and regulatory T cells as well as promoted tumor vasculogenesis.

  8. Radiochemotherapy plus 3-aminopyridine-2-carboxaldehyde thiosemicarbazone (3-AP, NSC #663249) in Advanced-Stage Cervical and Vaginal Cancers

    Science.gov (United States)

    Kunos, Charles A.; Radivoyevitch, Tomas; Waggoner, Steven; Debernardo, Robert; Zanotti, Kristine; Resnick, Kimberly; Fusco, Nancy; Adams, Ramon; Redline, Raymond; Faulhaber, Peter; Dowlati, Afshin

    2013-01-01

    Objective Cervical and vaginal cancers have virally-mediated or mutated defects in DNA damage repair responses, making these cancers sensible targets for ribonucleotide reductase inhibition during radiochemotherapy. Methods We conducted a phase II study evaluating 3x weekly 2-hour intravenous 3-aminopyridine-2-carboxaldehyde thiosemicarbazone (3-AP, 25 mg/m2) co-administered with 1x weekly intravenous cisplatin (40 mg/m2) and daily pelvic radiation (45 Gy) in women with stage IB2-IVB cervical (n = 22) or stage II-IV vaginal (n = 3) cancers. Brachytherapy followed (40 Gy). Toxicity was monitored by common terminology criteria for adverse events (version 3.0). The primary end point of response was assessed by 3-month posttherapy 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography (PET/CT) and clinical examination. Results 3-AP radiochemotherapy achieved clinical responses in 24 (96% [95% confidence interval: 80-99%]) of 25 patients (median follow-up 20 months, range 2-35 months). 23 (96% [95% confidence interval: 80-99%]) of 24 patients had 3-month posttherapy PET/CT scans that recorded metabolic activity in the cervix or vagina equal or less than that of the cardiac blood pool, suggesting complete metabolic responses. The most frequent 3-AP radiochemotherapy-related adverse events included fatigue, nausea, diarrhea, and reversible hematological and electrolyte abnormalities. Conclusions The addition of 3-AP to cisplatin radiochemotherapy was tolerable and produced high rates of clinical and metabolic responses in women with cervical and vaginal cancers. Future randomized phase II and III clinical trials of 3-AP radiochemotherapy are warranted. PMID:23603372

  9. Knowledge of medical school students on breast cancer and cervical cancer, and their prevention

    OpenAIRE

    Anna Liszcz; Badowska-Kozakiewicz, Anna M.

    2016-01-01

    Introduction: Breast cancer and cervical cancer are the most common cancers in women. Early diagnosis of the disease can reduce mortality, so it plays an important role in the field of prevention measures. An important aspect is education, the aim of which is to provide information on the risk factors for cervical cancer and breast cancer, as well as the possibility of eliminating them from the life of women, but also shaping women’s need to perform regular diagnostics. Aim of the resea...

  10. Selective tumor irradiation by infusional brachytherapy in nonresectable pancreatic cancer: a phase I study

    International Nuclear Information System (INIS)

    Purpose: Selective high-dose radiation of solid tumors has been a goal of radiation oncology. The physiological barriers of solid tumors (high interstitial tumor pressure, reduced tumor vascularity, and poor perfusion) have been major barriers in achieving significant tumor dose of systemically infused radioconjugates. Direct tumor infusional brachytherapy overcomes these barriers and leads to selective high tumor doses. Methods and Materials: The development of interstitial tumor infusion of macroaggregated albumin (MAA) followed by colloidal chromic phosphate 32P has overcome solid tumor obstacles in 47 patients with nonresectable pancreatic cancer in a Phase I dose escalation study. The colloidal 32P infusion was followed by external radiation and five fluorouracil. Results: Of the 28 patients with cancer limited to the pancreas, 15 of 16 patients retained 86-100% (mean 96%) of the infused colloidal 32P isotope. While the other 12 patients had partial shunting to the liver, shunting to the liver was due to high interstitial resistance with tumor dose deposition of 17-88% (mean 52%). Of the 19 patients with metastatic pancreas cancer, colloidal 32P tumor deposition ranged from 22 to 100% of the infused dose (mean 79%). The less than optimal tumor deposition led to our increasing the MAA from 600,000 to 1.5-2.5 million particles. Interstitial dexamethasone 2 mg and later 4 mg was infused first and prevented liver shunting by somehow reducing tumor resistance. The median survival in 28 Phase I patients with nonresectable pancreas cancer without metastasis, was 12 months. No significant toxicity occurred when treatment was limited to two infusions with as much as 30 mCi each. The maximum tumor dose was 17,000 Gy (1.700,000 cGy). In 19 non-resectable pancreatic cancer patients with metastasis, a 6.9 months median survival was observed. Conclusions: Infusional brachytherapy is an outpatient procedure that delivers high-dose radiation selectively to pancreatic cancer

  11. Knowledge, Attitudes, and Practices for Cervical Cancer Screening Among the Bhutanese Refugee Community in Omaha, Nebraska

    OpenAIRE

    Haworth, Rebecca J.; Margalit, Ruth; Ross, Christine; Nepal, Tikka; Soliman, Amr S.

    2014-01-01

    Cervical cancer is the second most common cause of cancer mortality among women with the vast majority of patients in developing countries. Bhutanese refugees in the United States are from South Central Asia, the 4th leading region of the world for cervical cancer incidence. Over the past few years, Bhutanese refugees have increased significantly in Nebraska. This study evaluates current knowledge of cervical cancer and screening practices among the Bhutanese refugee women in Omaha, Nebraska....

  12. Quality of life of women undergoing treatment for cervical cancer

    Directory of Open Access Journals (Sweden)

    Francieli Ana Dallabrida

    2014-04-01

    Full Text Available This study aimed to evaluate the quality of life of women with cervical cancer. This is a cross-sectional, descriptive study developed with 43 women undergoing oncological treatment assisted at an Oncology High Complexity Center, in the Southern region of Brazil. The instrument used was the European Organization for Research and Treatment of Cancer – Quality of Life Questionnaire Core-30, and the data were analyzed through descriptive statistics. The average age was 54.6 years old. Married women prevailed (53.4%, with incomplete elementary education (72.1% and income from one to two minimum wages (62.8%. Quality of Life was considered very satisfactory. According to the development scales and emotional functioning, the result was from regular to satisfactory. The most frequent symptoms were fatigue, lack of appetite and pain. There is a need of structure of public health policies, for preventing cervical cancer in the most vulnerable population.

  13. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Lopamudra Das

    2015-01-01

    Full Text Available Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cytosensors over a frequency range offers instantaneous and quantitative means to monitor cellular events and is an upcoming technique in real time to classify cells as normal and abnormal ones. This technology is exploited for label-free detection of diseases by identifying and measuring nonbiological parameters of the cell which may carry the disease signature.

  14. Magnetic resonance imaging in the staging of cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Camisao, Claudia C. [Hospital Sao Lucas, Rio de Janeiro, RJ (Brazil)]. E-mail: ccamisao@inca.gov.br; Brenna, Sylvia M.F. [Hospital Maternidade Leonor Mendes de Barros, Sao Paulo, SP (Brazil); Lombardelli, Karen V.P. [Hospital do Cancer (HCII), Rio de Janeiro, RJ (Brazil); Djahjah, Maria Celia R. [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Zeferino, Luiz Carlos [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Ginecologia

    2007-05-15

    Cervical cancer is the worldwide leading cause of cancer-related death of women, especially in developing countries. The International Federation of Gynecology and Obstetrics recommends staging during surgery, however, surgical-pathologic staging would not be feasible in cases of more advanced cancers. Generally, in these cases, the staging is performed by means of clinical and gynecological examination and basic imaging studies. However, such an approach fails to demonstrate the actual extent of the disease, and does not include significant prognostic factors such as tumor volume, stromal invasion and lymph node involvement. Magnetic resonance imaging has increasingly been utilized in cervical cancer staging, since at early stages of the disease its performance may be compared to intraoperative findings and, at advanced stages, it shows to be superior to the clinical evaluation. Additionally, magnetic resonance imaging presents an excellent imaging resolution for the different densities of pelvic structures, does not require ionizing radiation, is comfortable for the patient, improves de staging, allowing the early detection of recurrence and the identification of reliable prognostic factors which contribute to the therapeutic decision making process and results prediction with an excellent cost-effectiveness. The present article is aimed at reviewing the most significant aspects of magnetic resonance imaging in the cervical cancer staging. (author)

  15. A new afterloading-applicator for primary brachytherapy of endometrial cancer

    International Nuclear Information System (INIS)

    Presented is a new afterloading applicator used for primary brachytherapy of endometrial cancer. The advantages: The afterloading applicator holds six afterloading tubes which bundled together in a cover. After the cover is pulled back, the individual tubes expand as a result of the sleeve shape and of the inherent stress of the plastic material used and make direct contact with the endometrium and with the tumor. The applicator is 8 mm in diameter which means that the cervix has to be dilated to Hegar 8 or 9. Radiation planning is done on the basis of orthogonal localisation X-rays or MR. The newly designed applicator can be used for both HDR and LDR afterloading procedures. We have clinical experiences in 42 applications. (orig.)

  16. Evaluation of organ doses in brachytherapy treatment of uterus cancer using mathematical reference Indian adult phantom

    International Nuclear Information System (INIS)

    Quantifying organ dose to healthy organs during radiotherapy is essential to estimate the radiation risk. Dose factors are generated by simulating radiation transport through an anthropomorphic mathematical phantom representing a reference Indian adult using the Monte Carlo method. The mean organ dose factors (in mGy min-1 GBq-1) are obtained considering the Micro Selectron 192Ir source and BEBIG 60Co sources in the uterus of a reference Indian adult female phantom. The present study provides the factors for mean absorbed dose to organs applicable to the Indian female patient population undergoing brachytherapy treatment of uterus cancer. This study also includes a comparison of the dimension of organs in the phantom model with measured values of organs in the various investigated patients. (author)

  17. Equivalence of Gyn GEC-ESTRO guidelines for image guided cervical brachytherapy with EUD-based dose prescription

    OpenAIRE

    Shaw, William; Rae, William ID; Alber, Markus L

    2013-01-01

    Background To establish a generalized equivalent uniform dose (gEUD) -based prescription method for Image Guided Brachytherapy (IGBT) that reproduces the Gyn GEC-ESTRO WG (GGE) prescription for cervix carcinoma patients on CT images with limited soft tissue resolution. Methods The equivalence of two IGBT planning approaches was investigated in 20 patients who received external beam radiotherapy (EBT) and 5 concomitant high dose rate IGBT treatments. The GGE planning strategy based on dose to ...

  18. Biologia molecular do câncer cervical Molecular biology of cervical cancer

    Directory of Open Access Journals (Sweden)

    Waldemar Augusto Rivoire

    2006-01-01

    Full Text Available A carcinogênese é um processo de múltiplas etapas. Alterações no equilíbrio citogenético ocorrem na transformação do epitélio normal a câncer cervical. Numerosos estudos apoiam a hipótese de que a infecção por HPV está associada com o desenvolvimento de alterações malignas e pré-malignas do trato genital inferior. Neste trabalho são apresentadas as bases para a compreensão da oncogênese cervical. O ciclo celular é controlado por proto-oncogenes e genes supressores. Quando ocorrem mutações, proto-oncogenes tornam-se oncogenes, que são carcinogênicos e causam multiplicação celular excessiva. A perda da ação de genes supressores funcionais pode levar a célula ao crescimento inadequado. O ciclo celular também pode ser alterado pela ação de vírus, entre eles o HPV (Human Papiloma Virus, de especial interesse na oncogênese cervical. Os tipos de HPV 16 e 18 são os de maior interesse, freqüentemente associados a câncer cervical e anal. O conhecimento das bases moleculares que estão envolvidas na oncogênese cervical tem sido possível devido a utilização de técnicas avançadas de biologia molecular. A associação destas técnicas aos métodos diagnósticos clássicos, poderão levar a uma melhor avaliação das neoplasias cervicais e auxiliar no desenvolvimento de novas terapias, talvez menos invasivas e mais efetivas.Carcinogenesis involves several steps. Disorders of the cytogenetic balance occur during the evolution from normal epithelium to cervical cancer. Several studies support the hypothesis that the Human Papiloma Virus (HPV infection is associated to development of premalignant and malignant lesions of cervical cancer. In this review we show the basis to understand cervical oncogenesis. The cell cycle is controlled by protooncogenes and supressive genes. This orchestrated cell cycle can be affected by virus such as HPV. Of special interest in the cervical carcinogenesis are the HPV subtypes 16 and 18

  19. High-Dose-Rate Brachytherapy Boost for Prostate Cancer: Comparison of Two Different Fractionation Schemes

    International Nuclear Information System (INIS)

    Purpose: This is a retrospective study comparing our experience with high-dose-rate (HDR) brachytherapy boost for prostate cancer, using two different fractionation schemes, 600 cGy × 3 fractions (patient group 1) and 950 cGy × 2 fractions (patient group 2). Methods and Materials: A total of 165 patients were treated for prostate cancer using external beam radiation therapy up to a dose of 45 Gy, followed by an HDR brachytherapy prostate radiation boost. Between July 1997 and Nov 1999, 64 patients were treated with an HDR boost of 600 cGy × 3 fractions; and between June 2000 and Nov 2005, 101 patients were treated with an HDR boost of 950 cGy × 2 fractions. All but 9 patients had at least one of the following risk features: pretreatment prostate-specific antigen (PSA) level >10, a Gleason score ≥7, and/or clinical stage T3 disease. Results: Median follow-up was 105 months for group 1 and 43 months for group 2. Patients in group 2 had a greater number of high-risk features than group 1 (p = 0.02). Adjusted for comparable follow-up, there was no difference in biochemical no-evidence-of-disease (bNED) rate between the two fractionation scheme approaches, with 5-year Kaplan-Meier estimates of 93.5% in group 1 and 87.3% in group 2 (p = 0.19). The 5-year estimates of progression-free survival were 86% for group 1 and 83% for group 2 (p = 0.53). Among high-risk patients, there were no differences in bNED or PFS rate due to fractionation. Conclusions: Results were excellent for both groups. Adjusted for comparable follow-up, no differences were found between groups.

  20. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    Energy Technology Data Exchange (ETDEWEB)

    Gruen, Arne; Musik, Thabea; Stromberger, Carmen; Budach, Volker; Marnitz, Simone [Charite Univ. Medicine Berlin, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiooncology; Koehler, Christhardt; Schneider, Achim [Charite Univ. Medicine Berlin, Campus Mitte- und Benjamim Franklin, Berlin (Germany). Dept. of Gynaecology; Fueller, Juergen; Wendt, Thomas [Jena Univ. Hospital (Germany). Dept. of Radiooncology

    2011-06-15

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  1. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    International Nuclear Information System (INIS)

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  2. Percutaneous interstitial brachytherapy for adrenal metastasis. Technical report

    International Nuclear Information System (INIS)

    We developed and evaluated the feasibility of a brachytherapy technique as a safe and effective treatment for adrenal metastasis. Adapting a paravertebral insertion technique in radiofrequency ablation of adrenal tumors, we developed an interstitial brachytherapy for adrenal metastasis achievable on an outpatient basis. Under local anesthesia and under X-ray CT guidance, brachytherapy applicator needles were percutaneously inserted into the target. A treatment plan was created to eradicate the tumor while preserving normal organs including the spinal cord and kidney. We applied this interstitial brachytherapy technique to two patients: one who developed adrenal metastasis as the third recurrence of uterine cervical cancer after reirradiation, and one who developed metachronous multiple metastases from malignant melanoma. The whole procedure was completed in 2.5 hours. There were no procedure-related or radiation-related early/late complications. 18F-fluorodeoxyglucose positron emission tomography (FDG PET)-CT images at two and three months after treatment showed absence of FDG uptake, and no recurrence of the adrenal tumor was observed for over seven months until expiration, and for six months until the present, respectively. This interventional interstitial brachytherapy procedure may be useful as a safe and eradicative treatment for adrenal metastasis. (author)

  3. Incidence of Secondary Cancer Development After High-Dose Intensity-Modulated Radiotherapy and Image-Guided Brachytherapy for the Treatment of Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zelefsky, Michael J., E-mail: Zelefskm@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Housman, Douglas M.; Pei Xin; Alicikus, Zumre; Magsanoc, Juan Martin [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Dauer, Lawrence T.; St Germain, Jean [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Yamada, Yoshiya; Kollmeier, Marisa; Cox, Brett [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Zhang Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2012-07-01

    Purpose: To report the incidence and excess risk of second malignancy (SM) development compared with the general population after external beam radiotherapy (EBRT) and brachytherapy to treat prostate cancer. Methods and Materials: Between 1998 and 2001, 1,310 patients with localized prostate cancer were treated with EBRT (n = 897) or brachytherapy (n = 413). We compared the incidence of SMs in our patients with that of the general population extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results data set combined with the 2000 census data. Results: The 10-year likelihood of SM development was 25% after EBRT and 15% after brachytherapy (p = .02). The corresponding 10-year likelihood for in-field SM development in these groups was 4.9% and 1.6% (p = .24). Multivariate analysis showed that EBRT vs. brachytherapy and older age were the only significant predictors for the development of all SMs (p = .037 and p = .030), with a trend for older patients to develop a SM. The increased incidence of SM for EBRT patients was explained by the greater incidence of skin cancer outside the radiation field compared with that after brachytherapy (10.6% and 3.3%, respectively, p = .004). For the EBRT group, the 5- and 10-year mortality rate was 1.96% and 5.1% from out-of field cancer, respectively; for in-field SM, the corresponding mortality rates were 0.1% and 0.7%. Among the brachytherapy group, the 5- and 10-year mortality rate related to out-of field SM was 0.8% and 2.7%, respectively. Our observed SM rates after prostate RT were not significantly different from the cancer incidence rates in the general population. Conclusions: Using modern sophisticated treatment techniques, we report low rates of in-field bladder and rectal SM risks after prostate cancer RT. Furthermore, the likelihood of mortality secondary to a SM was unusual. The greater rate of SM observed with EBRT vs. brachytherapy was related to a small, but significantly

  4. Incidence of Secondary Cancer Development After High-Dose Intensity-Modulated Radiotherapy and Image-Guided Brachytherapy for the Treatment of Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose: To report the incidence and excess risk of second malignancy (SM) development compared with the general population after external beam radiotherapy (EBRT) and brachytherapy to treat prostate cancer. Methods and Materials: Between 1998 and 2001, 1,310 patients with localized prostate cancer were treated with EBRT (n = 897) or brachytherapy (n = 413). We compared the incidence of SMs in our patients with that of the general population extracted from the National Cancer Institute’s Surveillance, Epidemiology, and End Results data set combined with the 2000 census data. Results: The 10-year likelihood of SM development was 25% after EBRT and 15% after brachytherapy (p = .02). The corresponding 10-year likelihood for in-field SM development in these groups was 4.9% and 1.6% (p = .24). Multivariate analysis showed that EBRT vs. brachytherapy and older age were the only significant predictors for the development of all SMs (p = .037 and p = .030), with a trend for older patients to develop a SM. The increased incidence of SM for EBRT patients was explained by the greater incidence of skin cancer outside the radiation field compared with that after brachytherapy (10.6% and 3.3%, respectively, p = .004). For the EBRT group, the 5- and 10-year mortality rate was 1.96% and 5.1% from out-of field cancer, respectively; for in-field SM, the corresponding mortality rates were 0.1% and 0.7%. Among the brachytherapy group, the 5- and 10-year mortality rate related to out-of field SM was 0.8% and 2.7%, respectively. Our observed SM rates after prostate RT were not significantly different from the cancer incidence rates in the general population. Conclusions: Using modern sophisticated treatment techniques, we report low rates of in-field bladder and rectal SM risks after prostate cancer RT. Furthermore, the likelihood of mortality secondary to a SM was unusual. The greater rate of SM observed with EBRT vs. brachytherapy was related to a small, but significantly increased

  5. Computer aided decision support system for cervical cancer classification

    Science.gov (United States)

    Rahmadwati, Rahmadwati; Naghdy, Golshah; Ros, Montserrat; Todd, Catherine

    2012-10-01

    Conventional analysis of a cervical histology image, such a pap smear or a biopsy sample, is performed by an expert pathologist manually. This involves inspecting the sample for cellular level abnormalities and determining the spread of the abnormalities. Cancer is graded based on the spread of the abnormal cells. This is a tedious, subjective and time-consuming process with considerable variations in diagnosis between the experts. This paper presents a computer aided decision support system (CADSS) tool to help the pathologists in their examination of the cervical cancer biopsies. The main aim of the proposed CADSS system is to identify abnormalities and quantify cancer grading in a systematic and repeatable manner. The paper proposes three different methods which presents and compares the results using 475 images of cervical biopsies which include normal, three stages of pre cancer, and malignant cases. This paper will explore various components of an effective CADSS; image acquisition, pre-processing, segmentation, feature extraction, classification, grading and disease identification. Cervical histological images are captured using a digital microscope. The images are captured in sufficient resolution to retain enough information for effective classification. Histology images of cervical biopsies consist of three major sections; background, stroma and squamous epithelium. Most diagnostic information are contained within the epithelium region. This paper will present two levels of segmentations; global (macro) and local (micro). At the global level the squamous epithelium is separated from the background and stroma. At the local or cellular level, the nuclei and cytoplasm are segmented for further analysis. Image features that influence the pathologists' decision during the analysis and classification of a cervical biopsy are the nuclei's shape and spread; the ratio of the areas of nuclei and cytoplasm as well as the texture and spread of the abnormalities

  6. Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe

    DEFF Research Database (Denmark)

    Tjalma, Wiebren A; Fiander, Alison; Reich, Olaf;

    2013-01-01

    Knowledge of differences in human papillomavirus (HPV)-type prevalence between high-grade cervical intraepithelial neoplasia (HG-CIN) and invasive cervical cancer (ICC) is crucial for understanding the natural history of HPV-infected cervical lesions and the potential impact of HPV vaccination...... on cervical cancer prevention. More than 6,000 women diagnosed with HG-CIN or ICC from 17 European countries were enrolled in two parallel cross-sectional studies (108288/108290). Centralised histopathology review and standardised HPV-DNA typing were applied to formalin-fixed paraffin-embedded cervical...... specimens dated 2001-2008. The pooled prevalence of individual HPV types was estimated using meta-analytic methods. A total of 3,103 women were diagnosed with HG-CIN and a total of 3,162 with ICC (median ages: 34 and 49 years, respectively), of which 98.5 and 91.8% were HPV-positive, respectively. The most...

  7. Behaviour among women in the scope of cervical cancer prevention

    Directory of Open Access Journals (Sweden)

    Aleksandra Słopiecka

    2013-12-01

    Full Text Available Introduction: Cytological examination is a simple and inexpensive method used in the prevention of cervical cancer. In Poland, too low proportions of women still have the test. Aim of the research : To analyse the attitudes towards cervical cancer prevention. Material and methods : Two hundred and ten hospitalized women were invited to take part in the investigation. The research used the diagnostic poll method, using the author’s original questionnaire form. The research was carried out in four gynaecological wards. Results : Of the women who participated in the research, 16.2% by the time of diagnosis had never received a Pap test. In the analysed group, 88.2% of women were not referred to a specialist for a Pap test. Among all respondents, only 35.7% underwent cervix cytology regularly, i.e. once a year or once every 2 years. Conclusions : The effort made by the women towards the attitudes of cervical cancer prevention was insufficient; still too many women had not reported to the specialist for taking material from the cervix, or did not do so regularly. A significant relation in the behaviour of women was found depending on their level of education and place of residence. Greater activity of nurses, midwives and family physicians in stimulating Polish women to participate in prevention programmes for cervical cancer is advisable. To increase the health awareness of girls and women, it is important to include in the curriculum, especially in secondary schools, the issues of prevention of female reproductive system cancer.

  8. Metabolic Response on Post-therapy FDG-PET Predicts Patterns of Failure After Radiotherapy for Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, Julie K., E-mail: jschwarz@radonc.wustl.edu [Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Siegel, Barry A.; Dehdashti, Farrokh [Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Grigsby, Perry W. [Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States)

    2012-05-01

    Purpose: To determine the patterns of failure in patients with cervical cancer treated with definitive radiotherapy and evaluated for metabolic response with early posttherapy {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET). Methods and Materials: The records of 238 patients with cervical cancer were reviewed. All patients were treated with a combination of external radiotherapy and intracavitary brachytherapy. Two hundred and nineteen patients (92%) received concurrent chemotherapy. All patients underwent pretreatment FDG-PET, and posttherapy FDG-PET was performed within 8-16 weeks of the completion of radiotherapy. Posttherapy FDG-PET results were categorized as complete metabolic response (CMR), partial metabolic response (PMR), and progressive disease (PD). Failure patterns were categorized as none, isolated local failure (central pelvis {+-} pelvic lymph nodes), distant failure, or combined local plus distant failure. Results: Of the 91 patients (38%) who had a recurrence, 22 had isolated local failures, and 69 had distant failures (49 distant failures and 20 combined local plus distant failures). Of the 173 patients with a CMR, 40 (23%) experienced treatment failure. All 25 patients with PD experienced treatment failure, which was distant in 24 patients (96%). Among the 40 patients with PMR, no failure has been observed for 14 patients (35%). Of the 26 failures within the PMR group, 15 (58%) were limited to the pelvis. Differences in the patterns of failure between the three groups (CMR, PMR, PD) were statistically significant (chi-square test; p < 0.0001). Conclusions: The majority of failures after definitive radiotherapy for cervical cancer include distant failures, even in the setting of concurrent chemotherapy. PMR within the cervix or lymph nodes is more commonly associated with isolated local recurrence.

  9. Impact of treatment time-related factors on prognoses and radiation proctitis after definitive chemoradiotherapy for cervical cancer.

    Science.gov (United States)

    Huang, Eng-Yen; Lin, Hao; Wang, Chong-Jong; Chanchien, Chan-Chao; Ou, Yu-Che

    2016-09-01

    This study aimed to investigate the impact of treatment time-related factors on outcomes and radiation proctitis in patients undergoing concurrent chemoradiotherapy (CCRT) for cervical cancer. From September 2001 to December 2012, 146 patients with stage IIB cervical squamous cell carcinoma treated with CCRT were reviewed from a prospective cohort. Patients who received the same dose (45 Gy) of external beam radiation therapy (EBRT) were included in the analysis (n = 125). The same equivalent dose of 2 Gy (EQD2) of high-dose-rate intracavitary brachytherapy (HDR-ICBT) was delivered at either 4 fractions of 6 Gy or 6 fractions of 4.5 Gy. The effects of the overall treatment time (OTT) and interval between EBRT and HDR-ICBT on the cancer-specific survival (CSS), local recurrence (LR), and incidence of proctitis were compared. The treatment time-related factors did not adversely affect the CSS and LR rates. The multivariate analyses did not identify the OTT as an independent factor of CSS (P = 0.839) and LR (P = 0.856). However, OTT ≤56 days (P = 0.026) was identified as the only independent factor of overall proctitis. The 5-year Grade 2 or greater proctitis rates were 14.9% and 0% (P = 0.001) in patients with the EBRT to ICBT interval ≤5 days and >5 days, respectively. To reduce rectal damage without compromising prognosis, the gap between EBRT and HDR-ICBT should exceed 5 days in cervical cancer patients undergoing CCRT. Strictly limiting the OTT to 56 days may result in radiation proctitis without improvements in prognosis.

  10. Intelligent Screening Systems for Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Yessi Jusman

    2014-01-01

    Full Text Available Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data.

  11. Hysterectomy and its impact on the calculated incidence of cervical cancer and screening coverage in Denmark

    DEFF Research Database (Denmark)

    Lam, Janni Uyen Hoa; Lynge, Elsebeth; Njor, Sisse Helle;

    2015-01-01

    BACKGROUND: The incidence rates of cervical cancer and the coverage in cervical cancer screening are usually reported by including in the denominator all women from the general population. However, after hysterectomy women are not at risk anymore of developing cervical cancer. Therefore, it makes...... sense to determine the indicators also for the true at-risk populations. We described the frequency of total hysterectomy in Denmark and its impact on the calculated incidence of cervical cancer and the screening coverage. MATERIAL AND METHODS: With data from five Danish population-based registries......, the incidence rate of cervical cancer and the screening coverage for women aged 23-64 years on 31 December 2010 were calculated with and without adjustments for hysterectomies undertaken for reasons other than cervical cancer. They were calculated as the number of cases divided by 1) the total number of woman...

  12. Cervical cancer screening in primary health care setting in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Aro, Arja R.; Rasch, Vibeke;

    2012-01-01

    of this study showed that VIA has higher sensitivity and lower specificity compared to Pap smear, but a combination of both tests has greater sensitivity and specificity than each test independently. It indicates that VIA is useful for screening of cervical cancer in the primary health care setting in Sudan......OBJECTIVE: To determine the feasibility of visual inspection with the use of acetic acid (VIA) as a screening method for cervical cancer, an alternative to the Pap smear used in primary health care setting in Sudan, and to compare sensitivity, specificity, positive and negative predictive values......, and histological diagnosis of positive cases of both tests. METHODS: A cross-sectional study of 934 asymptomatic women living in Khartoum, Sudan, was conducted during 2009-2010. A semi-structured questionnaire containing socio-economic and reproductive variables was used to collect data from each participant...

  13. Patient age, tumor appearance and tumor size are risk factors for early recurrence of cervical cancer

    OpenAIRE

    WANG, Juan; WANG, Tao; YANG, YUN-YI; CHAI, YAN-LAN; Shi, Fan; Liu, Zi

    2014-01-01

    The recurrence and metastasis of cervical cancer contribute to a poor prognosis. The aim of this study was to investigate the risk factors for cervical cancer progression. A total of 284 patients with recurrent cervical cancer were retrospectively recruited to evaluate the association of disease recurrence with clinicopathological data. The univariate analysis demonstrated that patient age, tumor appearance and tumor size were significantly associated with early recurrence and metastasis of t...

  14. The initial experience of electronic brachytherapy for the treatment of non-melanoma skin cancer

    Directory of Open Access Journals (Sweden)

    Bhatnagar Ajay

    2010-09-01

    Full Text Available Abstract Background Millions of people are diagnosed with non-melanoma skin cancers (NMSC worldwide each year. While surgical approaches are the standard treatment, some patients are appropriate candidates for radiation therapy for NMSC. High dose rate (HDR brachytherapy using surface applicators has shown efficacy in the treatment of NMSC and shortens the radiation treatment schedule by using a condensed hypofractionated approach. An electronic brachytherapy (EBT system permits treatment of NMSC without the use of a radioactive isotope. Methods Data were collected retrospectively from patients treated from July 2009 through March 2010. Pre-treatment biopsy was performed to confirm a malignant cutaneous diagnosis. A CT scan was performed to assess lesion depth for treatment planning, and an appropriate size of surface applicator was selected to provide an acceptable margin. An HDR EBT system delivered a dose of 40.0 Gy in eight fractions twice weekly with 48 hours between fractions, prescribed to a depth of 3-7 mm. Treatment feasibility, acute safety, efficacy outcomes, and cosmetic results were assessed. Results Thirty-seven patients (mean age 72.5 years with 44 cutaneous malignancies were treated. Of 44 lesions treated, 39 (89% were T1, 1 (2% Tis, 1 (2% T2, and 3 (7% lesions were recurrent. Lesion locations included the nose for 16 lesions (36.4%, ear 5 (11%, scalp 5 (11%, face 14 (32%, and an extremity for 4 (9%. Median follow-up was 4.1 months. No severe toxicities occurred. Cosmesis ratings were good to excellent for 100% of the lesions at follow-up. Conclusions The early outcomes of EBT for the treatment of NMSC appear to show acceptable acute safety and favorable cosmetic outcomes. Using a hypofractionated approach, EBT provides a convenient treatment schedule.

  15. Reporting small bowel dose in cervix cancer high-dose-rate brachytherapy.

    Science.gov (United States)

    Liao, Yixiang; Dandekar, Virag; Chu, James C H; Turian, Julius; Bernard, Damian; Kiel, Krystyna

    2016-01-01

    Small bowel (SB) is an organ at risk (OAR) that may potentially develop toxicity after radiotherapy for cervix cancer. However, its dose from brachytherapy (BT) is not systematically reported as in other OARs, even with image-guided brachytherapy (IGBT). This study aims to introduce consideration of quantified objectives for SB in BT plan optimization and to evaluate the feasibility of sparing SB while maintaining adequate target coverage. In all, 13 patients were included in this retrospective study. All patients were treated with external beam radiotherapy (EBRT) 45Gy in 25 fractions followed by high dose rate (HDR)-BT boost of 28Gy in 4 fractions using tandem/ring applicator. Magnetic resonance imaging (MRI) and computed tomographic (CT) images were obtained to define the gross tumor volume (GTV), high-risk clinical target volume (HR-CTV) and OARs (rectum, bladder, sigmoid colon, and SB). Treatment plans were generated for each patient using GEC-ESTRO recommendations based on the first CT/MRI. Treatment plans were revised to reduce SB dose when the [Formula: see text] dose to SB was > 5Gy, while maintaining other OAR constraints. For the 7 patients with 2 sets of CT and MRI studies, the interfraction variation of the most exposed SB was analyzed. Plan revisions were done in 6 of 13 cases owing to high [Formula: see text] of SB. An average reduction of 19% in [Formula: see text] was achieved. Meeting SB and other OAR constraints resulted in less than optimal target coverage in 2 patients (D90 of HR-CTV < 77Gyαβ10). The highest interfraction variation was observed for SB at 16 ± 59%, as opposed to 28 ± 27% for rectum and 21 ± 16% for bladder. Prospective reporting of SB dose could provide data required to establish a potential correlation with radiation-induced late complication for SB. PMID:26235549

  16. Preventive vaccines for cervical cancer Vacunas para prevenir el cáncer cervical

    Directory of Open Access Journals (Sweden)

    COSETTE M WHEELER

    1997-07-01

    Full Text Available The potential use of vaccines for the human papillomavirus (HPV in the prevention and treatment of cervical cancer is a possibility in the near future. Close to 20 genotypes of HPV, of the 75 that have been identified, infect the femine genital tract, but four subtypes (16, 18, 31 and 45 have been associated in close to 80% of cervical cancers. this article proposes that in order to design an effective prophylactic vaccine against HPV infection, an adequate immune response should be guaranteed through four goals; a activation of antigens present in the cell; b overcoming the host response and viral genetic variability in the T cell response; c generation of high levels of T and B memory cells; and d persistence of antigens.El potencial uso de vacunas de virus del papiloma humano (VPH en la prevención y tratamiento del cáncer cervical posiblemente será implementado durante los próximos años. Cerca de los 20 genotipos de VPH de los 75 que se encuentran identificados infectan el tracto genital femenino, pero son cuatro subtipos: 16, 18, 31 y 45 los que se han asociado en cerca de 80% a cáncer cervical. En este ensayo se plantea que para poder diseñar una vacuna profiláctica contra la infección de VPH, efectiva, se debe garantizar una adecuada respuesta inmune a través de cuatro metas: a activación de antígenos presentes en la célula; b superar la respuesta del huésped y la variabilidad genética viral en la respuesta de células T; c generación de altos niveles de células T y B de memoria, y d persistencia de antígenos.

  17. Treatment of cervical cancer in the Republic of Srpska

    Directory of Open Access Journals (Sweden)

    Draganović Dragica

    2011-01-01

    Full Text Available Introduction. Since 1897, when the first radical hysterectomy with lymphadenectomy was done by Wertheim in Vienna, this operation has had the central role in the surgical treatment of invasive cervical tumors. Material and methods. In the period from 1997 to 2010, 177 patients diagnosed with invasive cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO stage IB1 - II were operated at the Department of Obstetrics and Gynecology in Banja Luka. All patients underwent radical hysterectomy by Wertheim - Meigs. The aim of this study is to present the technique of this operation, as well as its effectiveness in the treatment of cervical cancer. Results. The distribution of the patients having invasive cervical cancer according to the International Federation of Gynecology and Obstetrics classification was as follows: I B1 - 35.67%, I B2 - 23.17%, II A - 15.48%, II B - 25.68% on average is 21.3 removed lymph glands. The rate of intraoperative and postoperative complications was 8 (4.51% and 17 (9.60%, respectively. Of the 26 patients who were operated in the period from 2005 - 2010, 13 had stage II B according to the International Federation of Gynecology and Obstetrics; there were 6 lethal outcomes (23.08 and the five-year survival rate was 76.92%. Discussion and conclusion. By applying the proper surgical technique and early prevention of immediate complications, we achieved satisfactory results in operative morbity and mortality, intraoperative and postoperative complications of the lesion for radical surgery by the Wertheim- Meigs-in the treatment of cancer of the uterus in the I B - II B stage according to the International Federation of Gynecology and Obstetrics classification.

  18. Cervical cancer screening coverage in a high-incidence region

    Directory of Open Access Journals (Sweden)

    Cibelli Navarro

    2015-01-01

    Full Text Available OBJECTIVE To analyze the coverage of a cervical cancer screening program in a city with a high incidence of the disease in addition to the factors associated with non-adherence to the current preventive program. METHODS A cross-sectional study based on household surveys was conducted. The sample was composed of women between 25 and 59 years of age of the city of Boa Vista, RR, Northern Brazil who were covered by the cervical cancer screening program. The cluster sampling method was used. The dependent variable was participation in a women’s health program, defined as undergoing at least one Pap smear in the 36 months prior to the interview; the explanatory variables were extracted from individual data. A generalized linear model was used. RESULTS 603 women were analyzed, with an mean age of 38.2 years (SD = 10.2. Five hundred and seventeen women underwent the screening test, and the prevalence of adherence in the last three years was up to 85.7% (95%CI 82.5;88.5. A high per capita household income and recent medical consultation were associated with the lower rate of not being tested in multivariate analysis. Disease ignorance, causes, and prevention methods were correlated with chances of non-adherence to the screening system; 20.0% of the women were reported to have undergone opportunistic and non-routine screening. CONCLUSIONS The informed level of coverage is high, exceeding the level recommended for the control of cervical cancer. The preventive program appears to be opportunistic in nature, particularly for the most vulnerable women (with low income and little information on the disease. Studies on the diagnostic quality of cervicovaginal cytology and therapeutic schedules for positive cases are necessary for understanding the barriers to the control of cervical cancer.

  19. Combined clinical and genetic testing algorithm for cervical cancer diagnosis

    OpenAIRE

    Liou, Yu-Ligh; Zhang, Tao-Lan; Yan, Tian; Yeh, Ching-Tung; Kang, Ya-Nan; Cao, Lanqin; Wu, Nayiyuan; Chang, Chi-Feng; Wang, Huei-Jen; Yen, Carolyn; Chu, Tang-Yuan; Zhang, Yi; Zhang, Yu; Zhou, Honghao

    2016-01-01

    Background Opportunistic screening in hospitals is widely used to effectively reduce the incidence rate of cervical cancer in China and other developing countries. This study aimed to identify clinical risk factor algorithms that combine gynecologic examination and molecular testing (paired box gene 1 (PAX1) or zinc finger protein 582 (ZNF582) methylation or HPV16/18) results to improve diagnostic accuracy. Methods The delta Cp of methylated PAX1 and ZNF582 was obtained via quantitative methy...

  20. The results of combination therapy for local cervical cancer

    International Nuclear Information System (INIS)

    Administration of the developed technique os combination treatment based on split course of combination radiotherapy against a background of neoadjuvant chemotherapy to 275 patients with stage II-III cervical cancer allowed to transfer an immobile tumor process to the respectable in 46.0% og cases, which was followed by the uterus and appendages removal, while with traditional course of radiotherapy operability index was only 6.9%

  1. Overcoming Barriers to Cervical Cancer Screening Among Asian American Women

    OpenAIRE

    Fang, Carolyn Y.; Ma, Grace X.; Tan, Yin

    2011-01-01

    Significant disparities in cervical cancer incidence and mortality exist among ethnic minority women, and in particular, among Asian American women. These disparities have been attributed primarily to differences in screening rates across ethnic/racial groups. Asian American women have one of the lowest rates of screening compared to other ethnic/racial groups. Yet Asian Americans, who comprise one of the fastest growing populations in the United States, have received the least attention in c...

  2. Epidemiologic studies of cervical cancer in Costa Rica

    OpenAIRE

    Herrero, Rolando

    1996-01-01

    A case-control study of cervical cancer was conducted in Costa Rica, Co- lombia, Mexico and Panama from 1986 to 1987, to determine risk factors operating in these traditionally high-incidence areas. The study included 759 cases and 1,430 hospital and community controls, and accomplished more than 95% participation rates for both types of participants. The ma- jor risk factors identified were: detection of human papillomavirus (HPV) types 16 or 18, increasing number of livebi...

  3. Changes in knowledge of cervical cancer following introduction of human papillomavirus vaccine among women at high risk for cervical cancer

    Science.gov (United States)

    Stewart Massad, L.; Evans, Charlesnika T.; Weber, Kathleen M.; D'Souza, Gypsyamber; Hessol, Nancy A.; Wright, Rodney L.; Colie, Christine; Strickler, Howard D.; Wilson, Tracey E.

    2015-01-01

    Purpose To describe changes in knowledge of cervical cancer prevention, human papillomavirus (HPV), and HPV vaccination among women at high risk for cervical cancer in the first five years after introduction of HPV vaccination. Methods In 2007, 2008–9, and 2011, women in a multicenter U.S. cohort study completed 44-item self-report questionnaires assessing knowledge of cervical cancer prevention, HPV, and HPV vaccination. Results across time were assessed for individuals, and three study enrollment cohorts were compared. Knowledge scores were correlated with demographic variables, measures of education and attention, and medical factors. Associations were assessed in multivariable models. Results In all, 974 women completed three serial questionnaires; most were minority, low income, and current or former smokers. The group included 652 (67%) HIV infected and 322 (33%) uninfected. Summary knowledge scores (possible range 0–24) increased from 2007 (12.8, S.D. 5.8) to 2008–9 (13.9, S.D. 5.3, P < 0.001) and to 2011 (14.3, S.D. 5.2, P < 0.0001 vs 2007 and < 0.04 vs 2008–9). Higher knowledge scores at first and follow-up administration of questionnaires, higher income, and higher education level were associated with improved knowledge score at third administration. Women not previously surveyed had scores similar to those of the longitudinal group at baseline. Conclusion Substantial gaps in understanding of HPV and cervical cancer prevention exist despite years of health education. While more effective educational interventions may help, optimal cancer prevention may require opt-out vaccination programs that do not require nuanced understanding. PMID:25870859

  4. Positive diagnostic values and histological detection ratios from the Rotterdam cervical cancer screening programme

    NARCIS (Netherlands)

    F.A. Kreuger; H. Beerman (Henk); H.G. Nijs (Huub); M. van Ballegooijen (Marjolein)

    1998-01-01

    textabstractBACKGROUND: In organized screening programmes for cervical cancer, pre-cancerous lesions are detected by cervical smears. However, during follow-up after a positive smear these pre-cancerous lesions are not always found. The purpose of the study is to analys

  5. A Proof of Concept Imaging System for Automated Cervical Cancer Screening in Peru

    Science.gov (United States)

    Raza Garcia, Mabel Karel

    2013-01-01

    Cervical cancer is the second most frequent cancer in women around the world and affects half a million women per year. The World Health Organization (WHO) estimates that 275,000 women die every year, and 80% to 85% of these deaths occur in low-resource countries in Africa and South America. In Peru, cervical cancer has the highest incidence and…

  6. Challenges in breast and cervical cancer control in Japan.

    Science.gov (United States)

    Sauvaget, Catherine; Nishino, Yoshikazu; Konno, Ryo; Tase, Toru; Morimoto, Tadaoki; Hisamichi, Shigeru

    2016-07-01

    Since the mid-1990s, there has been an increasing incidence of, and mortality from, cervical and breast cancers in Japan. Such an increase has raised concerns over the efficiency of Japan's screening programmes for these cancers. Although citizens benefit from universal health coverage, the Japanese health insurance system mostly focuses on tertiary prevention and disease treatment, while secondary prevention (screening) is low priority. Citizens have multiple opportunities to be screened for cancer-either through programmes organised by municipalities, or individual or collective, opportunistic and comprehensive health check-ups on a voluntary basis. Despite this, however, participation is as low as 35% of the target population for both cancers. In this Policy Review, we discuss the challenges in the prevention of breast and cervical cancers in Japan, particularly focusing on the structure of the National Health Insurance system and the National Cancer Control Plan, reasons for low participation as a result of social and political attitudes, as well as providing recommendations to overcome these challenges. Japanese women would benefit from new measures to increase participation, a national data surveillance programme to monitor screening activities, and the implementation of a quality assurance system among all providers. PMID:27396648

  7. Therapeutic vaccines against human papillomavirus and cervical cancer.

    Science.gov (United States)

    Cid-Arregui, Angel

    2009-01-01

    Cervical cancer and its precursor intra-epithelial lesions are linked to infection by a subset of so-called "highrisk" human papillomavirus types, which are estimated to infect nearly four hundred million women worldwide. Two prophylactic vaccines have been commercialized recently targeting HPV16 and 18, the most prevalent viral types found in cervical cancer, which operate through induction of capsid-specific neutralizing antibodies. However, in patients with persistent infection these vaccines have not been found to protect against progression to neoplasia. Attempts are being made to develop therapeutic vaccines targeting nonstructural early viral proteins. Among these, E6 and E7 are the preferred targets, since they are essential for induction and maintenance of the malignant phenotype and are constitutively expressed by the transformed epithelial cells. Here are reviewed the most relevant potential vaccines based on HPV early antigens that have shown efficacy in preclinical models and that are being tested in clinical studies, which should determine their therapeutic capacity for eradicating HPV-induced premalignant and malignant lesions and cure cervical cancer. PMID:19915722

  8. Chemotherapy and radiotherapy in locally advanced cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-31

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

  9. Preoperative transarterial chemoembolization for cervical cancer: analysis of efficacy

    International Nuclear Information System (INIS)

    Objective: To evaluate preoperative transarterial chemoembolization in treating locally advanced cervical cancer and to observe the pathological changes. Methods: Forty-three patients with pathologically proved cervical cancer were enrolled in this study. All patients were treated with transarterial chemoembolization before radical hysterectomy. Bleomycin and cisplantin were infused via bilateral uterine arteries, followed by arterial embolization with gelfoam particles as embolic agent. Radical hysterectomy was performed 20-87 days (mean 38.3 days) after chemoembolization, and the specimen was taken for pathologic examination. Results: (1) complete response (CR) was seen in 4 cases and partial response (PR) in 29 cases, with a total effective rate of 76.7%. (2) The interval between chemoembolization and hysterectomy was a risk factor related to the effect of chemoembolization, i.e. the longer the interval was, the poorer the effect of chemoembolization would be. (3) Pathologically, the tumoral parauterine infiltration was not so severe as estimated before surgery. Conclusion: Preoperative chemoembolization is a safe and effective adjunctive means for the treatment of cervical cancer, which is very helpful for the subsequent radical hysterectomy. (authors)

  10. Combined modality therapy for stage ⅠB cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Yang Qiuan; Qian Shao; Yang Xingsheng

    2009-01-01

    Objective:To evaluate the current approaches for multimodality therapy for stage ⅠB cervical cancer. Methods:The relevant literature has served as a source for identified high or intermediate risks and management of stage ⅠB cervical cancer. Result:The high risks include pelvic lymph node metastasis (PLNM), positive resection margin (PRM), and the in-volvement of parametrium (IPM). The intermediate risks include deep stromal invasion (DSI), bulky tumor size ( BTS), lymphovascular space invasion (LVSI). Adeno-carcinomatous histo-type is the new risk feature relevant to poor prognoses. Both radical hysterectomy plus bilateral pelvic lymph node dissection(PLND) and radical radiotherapy have proven to be equally effec-tive. Surgery is more performed for stage ⅠB1 disease;radiotherapy or chemoradiotherapy is preferable for stage ⅠB2 disease. For patients with one high risk or two of intermediate risks, radical hysterectomy plus PLND followed by concurrent chemoradiotherapy can improve overall survival(OS) and disease-free survival (DFS). Conclusion:The management should be indi-vidualized for stage ⅠB cervical cancer. The optimized multidisciplinary therapy can benefit pa-tients with the best cure and minimum morbidity and complications.

  11. [Consensus for the prevention of cervical cancer in Mexico].

    Science.gov (United States)

    Kably Ambe, Alberto; Ruiz Moreno, José Antonio; Ponce, Eduardo Lazcano; Vargas Hernández, Victor Manuel; Aguado Pérez, Rogelio A; Alonso de Ruiz, Patricia

    2011-12-01

    Cervical cancer remains a serious public health problem in the world; that is why the Mexican Federation of Schools of Obstetrics and Gynecology convened the elaboration of a consensus that is devoted this number of Ginecologia y Obstetricia de Mexico. In recent years has strengthened perceptions (public and private) in the need for preventive strategies in the medium and long terms. The development of effective vaccines against the human papilloma virus and the application of new methods of detection from viral DNA (completely automated for personal application) allow some degree of optimism. It is proposed a consensus with general recommendations in two consecutive stages: (a) primary prevention consisting of education for the prevention of cervical cancer and universal immunization and (b) secondary prevention by early detection of infections or injuries that could favor carcinogenesis. The consensus reviewed characteristics of available vaccines in detail and proposes strategies for implementation in Mexican population. Also, check out main methods of early detection of infection (or predisposing lesions) and suggests public and private strategies for implementation. Consensus places particular emphasis on early immunization for female population and correct use of methods for detection of infections or injuries that might cause cervical cancer.

  12. Screening history in women with cervical cancer in a Danish population-based screening program

    DEFF Research Database (Denmark)

    Kirschner, Benny; Poll, Susanne; Junge, Jette;

    2011-01-01

    The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer.......The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer....

  13. Inhibiting CD146 by its Monoclonal Antibody AA98 Improves Radiosensitivity of Cervical Cancer Cells.

    Science.gov (United States)

    Cheng, Huawen

    2016-01-01

    BACKGROUND Cervical cancer is one of the major causes of cancer death of females worldwide. Radiotherapy is considered effective for cervical cancer treatment, but the low radiosensitivity found in some cases severely affects therapeutic outcomes. This study aimed to reveal the role of CD146, an important adhesion molecule facilitating tumor angiogenesis, in regulating radiosensitivity of cervical cancer cells. MATERIAL AND METHODS CD146 protein expression was compared in normal cells, cervical cancer cells with lower radiosensitivity, and cervical cancer cells with higher sensitivity from cervical squamous cell carcinoma patients. Anti-CD146 monoclonal antibody AA98 was used to inhibit CD146 in human cervical cancer SiHa cells with relatively low radiosensitivity, and then the cell survival and apoptosis changes after radiation were detected by colony formation assay and flow cytometry. RESULTS CD146 protein was significantly up-regulated in cervical cancer cells (Pcancer cells with lower radiosensitivity. The SiHa cells treated with AA98 showed more obvious inhibition in cell survival (Papoptosis (Pcancer cells, which might allow improvement in treatment outcome in cervical cancer. Further studies are necessary for understanding the detailed mechanism of CD146 in regulating radiosensitivity. PMID:27647179

  14. Evaluation of role of radical radiotherapy and chemotherapy in cervical cancer patients- A preliminary report

    Directory of Open Access Journals (Sweden)

    Sanjay Singh Chandel

    2016-01-01

    Full Text Available Background: Carcinoma of uterine cervix is the commonest cancer affecting females in developing countries. Concurrent chemoradiation has remained the sole definitive treatment available in the advanced stages. The study was planned to take the advantage of radiosensitisation accruing due to chemotherapy at the time of brachytherapy, when approximately 40% of total tumor dose is applied. Subjects and Methods: Sixty-four patients were enrolled who had locally advanced uterine cervix carcinoma (Federation of Gynecology and Obstetrics Stage IIB–IVA from July 2011 to May 2013 for concurrent chemotherapy and intracavitory brachytherapy after completion of concurrent chemotherapy and external beam radiotherapy followed by three insertion of brachytherapy separated by a week by flexitron brachytherapy unit to Point A, for each application was 6 Gy by high dose rate. Cisplatin was given (35 mg/m2 1 day before brachytherapy in each application. Results: At medium follow-up of 19 months (range 8–30 months clinical complete response rate was found to be 89% at 3 months of follow-up. Acute side effect as nausea and vomiting Grades I and II were recorded as 55% and 28% respectively, no renal dysfunction and no thrombocytopenia were encountered. No patients had Grade IV or life threatening toxicity. Overall survival and disease free survival after 30 months of follow-up is 88% and 75% respectively. Conclusion: Use of concurrent chemotherapy with brachytherapy is effective and feasible with acceptable toxicity for locally advanced carcinoma of the uterine cervix.

  15. A1E reduces stemness and self-renewal in HPV 16-positive cervical cancer stem cells

    OpenAIRE

    Kwon, Taeho; Bak, Yesol; Ham, Sun-Young; Yu, Dae-Yeul; Yoon, Do-Young

    2016-01-01

    Background Cervical cancer is the second most common cancer in females. Recent reports have revealed the critical role of cervical cancer stem cells (CSCs) in tumorigenicity and metastasis. Previously we demonstrated that A1E exerts an anti-proliferative action, which inhibits the growth of cervical cancer cells. Methods A1E is composed of 11 oriental medicinal herbs. Cervical cancer cell culture, wund healing and invasion assay, flow cytometry, sheroid formation assay, and wstern blot assays...

  16. Endometrial and cervical cancer: incidence and mortality among women in the Lodz region

    Directory of Open Access Journals (Sweden)

    Beata Leśniczak

    2015-09-01

    Full Text Available Introduction: By the early 21st century the most common cancer of female genitals in Poland was cervical cancer. Now endometrial cancer ranks first. The aim of this study was to analyse the incidence and mortality of endometrial and cervical cancer among women in the Lodz region. Material and methods: Data on the incidence and mortality of endometrial and cervical cancer among inhabitants of the Lodz region were obtained from the National Cancer Registry and Bulletin of Cancer Cases in the Lodz region. The analysis covered ten consecutive years beginning in 2001. Results : The number of new cases reported in 2010 exceeded that observed in 2001 by 181. The standardized incidence rate of endometrial cancer increased by 6.3, while the standardized incidence rate of cervical cancer decreased by 1.4. Conclusions : In the years 2001-2010, the incidence of endometrial cancer increased by 88.3% and that of cervical cancer decreased by 6.5% among inhabitants of the Lodz region. In the years 2001-2010, mortality of endometrial cancer increased by 24.5% and that of cervical cancer decreased by 12.6%. In 2010, the highest crude incidence rates in the Lodz region of both endometrial and cervical cancer at 39.1 were recorded in the district town of Piotrków.

  17. Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

    DEFF Research Database (Denmark)

    Rebolj, Matejka; van Ballegooijen, Marjolein; Lynge, Elsebeth;

    2009-01-01

    OBJECTIVE: To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. DESIGN: Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry...... of histopathology and cytopathology (PALGA). SETTING: Netherlands, national data. Population 218,847 women aged 45-54 and 445,382 aged 30-44 at the time of the third negative smear test. MAIN OUTCOME MEASURES: 10 year cumulative incidence of interval cervical cancer. RESULTS: 105 women developed cervical cancer...... within 2 595,964 woman years at risk after the third negative result at age 30-44 and 42 within 1,278,532 woman years at risk after age 45-54. During follow-up, both age groups had similar levels of screening. After 10 years of follow-up, the cumulative incidence rate of cervical cancer was similar: 41...

  18. Are 20 human papillomavirus types causing cervical cancer?

    OpenAIRE

    Arbyn, Marc; Tommasino, Massimo; Depuydt, Christophe; Dillner, Joakim

    2014-01-01

    Abstract: In 2012, the International Agency for Research on Cancer concluded that there was consistent and sufficient epidemiological, experimental and mechanistic evidence of carcinogenicity to humans for 12 HPV types (HPV16, HPV18, HPV31, HPV33, HPV35, HPV39, HPV45, HPV51, HPV52, HPV56, HPV58 and HPV59) for cervical cancer. Therefore, these types were considered as 1A carcinogens. They all belong to the family of the -Papillomaviridae, in particular to the species 5 (HPV51), 6 (HPV56), 7 (H...

  19. Human papillomavirus research on the prevention, diagnosis, and prognosis of cervical cancer in Taiwan.

    Science.gov (United States)

    Chao, Angel; Huang, Huei-Jean; Lai, Chyong-Huey

    2012-01-01

    Cervical cancer is third in incidence and fourth in mortality among cancers of women worldwide. Epidemiological studies have shown that human papillomavirus (HPV) is necessary, if not sufficient, to cause nearly 100% of cervical cancers. HPV testing is useful in primary screening for cervical neoplasms. The value of HPV detection or genotyping is potentially useful in triage of borderline or low-grade abnormal cervical cytology, follow-up after treatment of cervical intraepithelial neoplasia, assessment of prognosis and treatment planning for invasive cervical cancer. Studies from Chang Gung Memorial Hospital have defined the genotype distribution of cervical cancer in Taiwan and confirmed the independent prognostic value of the HPV genotype in cervical cancer. The cost-effectiveness of using HPV testing in prevention and management of cervical neoplasms depends on the medical and public health infrastructure of the individual country. The population-based HPV prevalence and genotype distribution as well as longitudinal follow-up studies have established strong support for incorporating HPV testing with cervical cytology and for future comparisons of HPV epidemiology before and after implementation of HPV prophylactic vaccines in Taiwan. Future directions in HPV research are discussed. PMID:22913856

  20. Expression and Effects of High-Mobility Group Box 1 in Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Xiaoao Pang

    2014-05-01

    Full Text Available We investigated the significance of high- mobility group box1 (HMGB1 and T-cell-mediated immunity and prognostic value in cervical cancer. HMGB1, forkhead/winged helix transcription factor p3 (Foxp3, IL-2, and IL-10 protein expression was analyzed in 100 cervical tissue samples including cervical cancer, cervical intraepithelial neoplasia (CIN, and healthy control samples using immunohistochemistry. Serum squamous cell carcinoma antigen (SCC-Ag was immunoradiometrically measured in 32 serum samples from 37 cases of squamous cervical cancer. HMGB1 and SCC-Ag were then correlated to clinicopathological characteristics. HMGB1 expression tends to increase as cervical cancer progresses and it was found to be significantly correlated to FIGO stage and lymph node metastasis. These findings suggest that HMGB1 may be a useful prognostic indicator of cervical carcinoma. In addition, there were significant positive relationships between HMGB1 and FOXP3 or IL-10 expression (both p < 0.05. In contrast, HMGB1 and IL-2 expression was negatively correlated (p < 0.05. HMGB1 expression may activate Tregs or facilitate Th2 polarization to promote immune evasion of cervical cancer. Elevated HMGB1 protein in cervical carcinoma samples was associated with a high recurrence of HPV infection in univariate analysis (p < 0.05. HMGB1 expression and levels of SCC-Ag were directly correlated in SCC (p < 0.05. Thus, HMGB1 may be a useful biomarker for patient prognosis and cervical cancer prediction and treatment.

  1. MicroRNA-373 functions as an oncogene and targets YOD1 gene in cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Luo-Qiao; Zhang, Yue; Yan, Huan; Liu, Kai-Jiang, E-mail: liukaijiang@126.com; Zhang, Shu, E-mail: drzhangshu@126.com

    2015-04-10

    miR-373 was reported to be elevated in several tumors; however, the role of miR-373 in cervical cancer has not been investigated. In this study we aimed to investigate the role of miR-373 in tumorigenicity of cervical cancer cells in vivo and in vitro. The expression of miR-373 was investigated using real-time reverse transcription-polymerase chain reaction assay in 45 cervical specimens and cervical cancer cell lines. The role of miR-373 in tumorigenicity of cervical cancer cells was assessed by cell proliferation, colony formation in vitro as well as tumor growth assays in vivo with the overexpression of miR-373 or gene silencing. The functional target gene of miR-373 in cervical cancer cells was identified using integrated bioinformatics analysis, gene expression arrays, and luciferase assay. We founded that the expression of miR-373 is upregulated in human cervical cancer tissues and cervical carcinoma cell lines when compared to the corresponding noncancerous tissues. Ectopic overexpression of miR-373 in human cervical cancer cells promoted cell growth in vitro and tumorigenicity in vivo, whereas silencing the expression of miR-373 decreased the rate of cell growth. YOD1 was identified as a direct and functional target of miR-373 in cervical cancer cells. Expression levels of miR-373 were inversely correlated with YOD1 levels in human cervical cancer tissues. RNAi-mediated knockdown of YOD1 phenocopied the proliferation-promoting effect of miR-373. Moreover, overexpression of YOD1 abrogated miR-373-induced proliferation of cervical cancer cells. These results demonstrate that miR-373 increases proliferation by directly targeting YOD1, a new potential therapeutic target in cervical cancer. - Highlights: • The expression of miR-373 is upregulated in human cervical cancer tissues. • miR-373 effects as oncogenic miRNA in cervical cancer in vitro and in vivo. • miR-373 increases proliferation of cervical cancer cells by directly targeting YOD1.

  2. MicroRNA-373 functions as an oncogene and targets YOD1 gene in cervical cancer

    International Nuclear Information System (INIS)

    miR-373 was reported to be elevated in several tumors; however, the role of miR-373 in cervical cancer has not been investigated. In this study we aimed to investigate the role of miR-373 in tumorigenicity of cervical cancer cells in vivo and in vitro. The expression of miR-373 was investigated using real-time reverse transcription-polymerase chain reaction assay in 45 cervical specimens and cervical cancer cell lines. The role of miR-373 in tumorigenicity of cervical cancer cells was assessed by cell proliferation, colony formation in vitro as well as tumor growth assays in vivo with the overexpression of miR-373 or gene silencing. The functional target gene of miR-373 in cervical cancer cells was identified using integrated bioinformatics analysis, gene expression arrays, and luciferase assay. We founded that the expression of miR-373 is upregulated in human cervical cancer tissues and cervical carcinoma cell lines when compared to the corresponding noncancerous tissues. Ectopic overexpression of miR-373 in human cervical cancer cells promoted cell growth in vitro and tumorigenicity in vivo, whereas silencing the expression of miR-373 decreased the rate of cell growth. YOD1 was identified as a direct and functional target of miR-373 in cervical cancer cells. Expression levels of miR-373 were inversely correlated with YOD1 levels in human cervical cancer tissues. RNAi-mediated knockdown of YOD1 phenocopied the proliferation-promoting effect of miR-373. Moreover, overexpression of YOD1 abrogated miR-373-induced proliferation of cervical cancer cells. These results demonstrate that miR-373 increases proliferation by directly targeting YOD1, a new potential therapeutic target in cervical cancer. - Highlights: • The expression of miR-373 is upregulated in human cervical cancer tissues. • miR-373 effects as oncogenic miRNA in cervical cancer in vitro and in vivo. • miR-373 increases proliferation of cervical cancer cells by directly targeting YOD1

  3. NIH Research Leads to Cervical Cancer Vaccine

    Science.gov (United States)

    ... NIH researchers Drs. Douglas Lowy (left) and John Schiller developed the vaccine to prevent HPV infection in ... But thanks to Drs. Douglas Lowy and John Schiller, senior research scientists at NIH's National Cancer Institute, ...

  4. Early stage cervical cancer : quality of cancer care and quality of life

    NARCIS (Netherlands)

    Pieterse, Quirine Dionne

    2007-01-01

    To improve quality of cancer care treatment-related information is needed. This could be acquired by registries. Since January 1984, the Leiden University Medical Center (LUMC) collects prospectively more than 200 relevant clinical and pathological parameters of women with cervical cancer treated in

  5. Targeted treatments for cervical cancer: a review

    OpenAIRE

    Peralta-Zaragoza O; Bermúdez-Morales VH; Pérez-Plasencia C; Salazar-León J; Gómez-Cerón C; Madrid-Marina V

    2012-01-01

    Oscar Peralta-Zaragoza,1 Víctor Hugo Bermúdez-Morales,1 Carlos Pérez-Plasencia,2,3 Jonathan Salazar-León,1 Claudia Gómez-Cerón,1 Vicente Madrid-Marina11Direction of Chronic Infections and Cancer, Research Center in Infection Diseases, National Institute of Public Health, Cuernavaca, Morelos, México; 2Oncogenomics Laboratory, National Cancer Institute of Mexico, Tlalpan, México; 3Biomedicine Unit, FES-Iztac...

  6. Comprehensive knowledge about cervical cancer is low among women in Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Getahun Frehiwot

    2013-01-01

    Full Text Available Abstract Background Cervical cancer is the first most common cancer in women in sub-Saharan Africa followed by breast cancer. In Ethiopia, the incidence of cervical cancer is high i.e. 35.9 per 100,000 women. Low level of awareness, lack of effective screening programs, overshadowed by other health priorities (such as acquired immune deficiency syndrome, tuberculosis and malaria and insufficient attention to women’s health are the possible factors for the observed higher incidence rate of cervical cancers in the country. Data on knowledge of Ethiopian women regarding cervical cancer is lacking. The aim of this study was to assess the knowledge of women about cervical cancer and associated factors. Methods A community based cross-sectional survey was conducted from April 4-16, 2010 in Gondar town, Northwest Ethiopia. A total of 633 women aged 15 years and above were interviewed using semi-structured questionnaire by 8 trained data collectors and 2 supervisors. SPSS Windows version 15.0 was employed for data entry and analysis. Result Of all the respondents, 495 (78.7% of them had heard about cervical cancer and only 195 (31% of them were knowledgeable about the disease. Conclusion The knowledge of women on cervical cancer was found to be poor. Education about the disease must include information on risk factors, sign and symptoms of cervical cancer.

  7. Development of a community cancer education program: the Forsyth County, NC cervical cancer prevention project.

    OpenAIRE

    Michielutte, R; Dignan, M B; Wells, H B; Young, L. D.; Jackson, D S; Sharp, P C

    1989-01-01

    The authors outline the development and implementation of a public health education program for cervical cancer screening among black women in Forsyth County, NC. The educational program includes distributing electronic and printed information media messages, a program of direct education for women, and providing information on current issues in cervical screening to primary-care physicians. Program development was based on social marketing principles, the PRECEDE model, and the communication...

  8. Waiting time for radiotherapy in women with cervical cancer

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2015-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe the waiting time for radiotherapy for patients with cervical cancer. METHODS This descriptive study was conducted with 342 cervical cancer cases that were referred to primary radiotherapy, in the Baixada Fluminense region, RJ, Southeastern Brazil, from October 1995 to August 2010. The waiting time was calculated using the recommended 60-day deadline as a parameter to obtaining the first cancer treatment and considering the date at which the diagnosis was confirmed, the date of first oncological consultation and date when the radiotherapy began. Median and proportional comparisons were made using the Kruskal Wallis and Chi-square tests. RESULTS Most of the women (72.2% began their radiotherapy within 60 days from the diagnostic confirmation date. The median of this total waiting time was 41 days. This median worsened over the time period, going from 11 days (1995-1996 to 64 days (2009-2010. The median interval between the diagnostic confirmation and the first oncological consultation was 33 days, and between the first oncological consultation and the first radiotherapy session was four days. The median waiting time differed significantly (p = 0.003 according to different stages of the tumor, reaching 56 days, 35 days and 30 days for women whose cancers were classified up to IIA; from IIB to IIIB, and IVA-IVB, respectively. CONCLUSIONS Despite most of the women having had access to radiotherapy within the recommended 60 days, the implementation of procedures to define the stage of the tumor and to reestablish clinical conditions took a large part of this time, showing that at least one of these intervals needs to be improved. Even though the waiting times were ideal for all patients, the most advanced cases were quickly treated, which suggests that access to radiotherapy by women with cervical cancer has been reached with equity.

  9. Propensity-Weighted Comparison of Long-Term Risk of Urinary Adverse Events in Elderly Women Treated For Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, Sean P., E-mail: selliott@umn.edu [Department of Urology, University of Minnesota, Minneapolis, Minnesota (United States); Fan, Yunhua; Jarosek, Stephanie [Department of Urology, University of Minnesota, Minneapolis, Minnesota (United States); Chu, Haitao [Department of Biostatistics, University of Minnesota, Minneapolis, Minnesota (United States); Downs, Levi [Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota (United States); Dusenbery, Kathryn [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Geller, Melissa A. [Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota (United States); Virnig, Beth A. [Department of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota (United States)

    2015-07-01

    Purpose: Cervical cancer treatment is associated with a risk of urinary adverse events (UAEs) such as ureteral stricture and vesicovaginal fistula. We sought to measure the long-term UAE risk after surgery and radiation therapy (RT), with confounding controlled through propensity-weighted models. Methods and Materials: From the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified women ≥66 years old with nonmetastatic cervical cancer treated with simple surgery (SS), radical hysterectomy (RH), external beam RT plus brachytherapy (EBRT+BT), or RT+surgery. We matched them to noncancer controls 1:3. Differences in demographic and cancer characteristics were balanced by propensity weighting. Grade 3 to 4 UAEs were identified by diagnosis codes plus treatment codes. Cumulative incidence was measured using Kaplan-Meier methods. The hazard associated with different cancer treatments was compared using Cox models. Results: UAEs occurred in 272 of 1808 cases (17%) and 222 of 5424 (4%) controls; most (62%) were ureteral strictures. The raw cumulative incidence of UAEs was highest in advanced cancers. UAEs occurred in 31% of patients after EBRT+BT, 25% of patients after RT+surgery, and 15% of patients after RH; however, after propensity weighting, the incidence was similar. In adjusted Cox models (reference = controls), the UAE risk was highest after RT+surgery (hazard ratio [HR], 5.07; 95% confidence interval [CI], 2.32-11.07), followed by EBRT+BT (HR, 3.33; 95% CI, 1.45-7.65), RH (HR, 3.65; 95% CI, 1.41-9.46) and SS (HR, 0.99; 95% CI, 0.32-3.01). The higher risk after RT+surgery versus EBRT+BT was statistically significant, whereas, EBRT+BT and RH were not significantly different from each other. Conclusions: UAEs are common after cervical cancer treatment, particularly in patients with advanced cancers. UAEs are more common after RT, but these women tend to have the advanced cancers. After propensity weighting, the risk after RT was similar

  10. Combined treatment of localized prostata cancer with HDR-Iridium 192 remote brachytherapy and external beam irradiation

    International Nuclear Information System (INIS)

    Background: The localized prostate cancer can be treated curatively by radiation therapy. The combined treatment of external beam irradiation and HDR-Iridium 192 remote brachytherapy allows higher radiation doses within the tumor without increasing radiation sequelae. Patients and Methods: Patients of our clinic have been treated with this combined procedure since 1991. Between 1991 and 1994 15 patients received 2x9 Gy of high-dose-rate brachytherapy, followed by 36 Gy external beam irradiation (group A). Because of the frequent local failures in group A, the reference dose of external beam irradiation was increased to 50.4 Gy after brachytherapy between 1994 and 1996. Results: Seven of 15 patients (47%) in group A developed a local recurrence after a median of 17 (13 to 30) months. In group B (20 patients) local failure occurred in 3 patients (15%) after 11, 16 and 32 months. Conclusion: The combined radiation therapy of localized prostate cancer cannot substitute radical prostatectomy completely, but it is a promising alternative in the curative treatment in selected patients. (orig.)