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Sample records for cervical cancer patients

  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. 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 ...

  3. 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...

  4. 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

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

    Science.gov (United States)

    2016-06-24

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

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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 ...

  12. 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

  13. 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, ...

  14. 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...

  15. 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.

  16. Oxidative stress and antioxidant status in cervical cancer patients.

    Science.gov (United States)

    Naidu, M Smita K; Suryakar, A N; Swami, Sanjay C; Katkam, R V; Kumbar, K M

    2007-09-01

    Cervical cancer (CaCx) is a global public health problem as it is the second most common cancer leading to the death of women worldwide. Many references revealed that the low levels of antioxidants induce the generation of free radicals leading to DNA damage and further mutations. In the present study attempt have been made to evaluate the levels of serum Lipid peroxide, Nitric Oxide (NO(.)) Erythrocytic-Superoxide Dismutase (RBC-SOD), Vitamin-C, serum Copper (Cu) and serum Zinc (Zn). 120 patients were divided in 4 groups according to the increasing CaCx stages i.e. stage I, II, III & IV respectively. All the patients were around the age group of 25-65 years. 30 healthy women between the same age group were treated as controls. Highly significant increased values of MDA, NO(.) and Cu were observed (p<0.001) whereas the activity of RBC-SOD, levels of Vitamin-C and Zn were significantly decreased in CaCx patients as compared with healthy controls (p<0.001). Cu/Zn ratio was found to be altered in CaCx patients. From our findings it can be concluded that the oxidative stress is induced among CaCx patients, which inturn increases the risk of CaCx.

  17. No Value for Routine Chest Radiography in the Work-Up of Early Stage Cervical Cancer Patients

    NARCIS (Netherlands)

    Hoogendam, Jacob P.; Zweemer, Ronald P.; Verkooijen, Helena M.; de Jong, Pim A.; van den Bosch, Maurice A. A. J.; Verheijen, Rene H. M.; Veldhuis, WB

    2015-01-01

    Aim Evidence supporting the recommendation to include chest radiography in the work-up of all cervical cancer patients is limited. We investigated the diagnostic value of routine chest radiography in cervical cancer staging. Methods All consecutive cervical cancer patients who presented at our terti

  18. 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

  19. Human papillomavirus DNA in plasma of patients with cervical cancer

    Directory of Open Access Journals (Sweden)

    Voravud Narin

    2001-03-01

    Full Text Available Abstract Background Human papillomavirus (HPV is a crucial etiological factor for cervical cancer (CC development. From a diagnostic view-point, the consistent presence of HPV in CC allows the viral DNA to be used as a genetic marker. The aims of this study were to evaluate the presence, physical status and clinical significant of HPV DNA in circulation of CC patients. Results Whereas 6 out of 50 (12% HPV positive CC patients revealed plasma HPV DNA, it was detected in none of 20 normal controls or 13 HPV negative CC cases. The plasma DNA exhibited an HPV type identical to the HPV in the primary tumors and the DNA from both sources was integrated into host genome. Interestingly, several findings suggested an association between plasma HPV DNA and metastasis. First, three of the HPV DNA positive cases were CC patients with clinical stage IVB or recurrence with distance metastases (P = 0.001, RR = 15.67. Second, the amount of plasma HPV DNA from metastatic patients to be three times more than three other patients without metastases. Finally, the later cases had tendency to develop recurrence distant metastases within one year after complete treatment when compared with other HPV associated CC patients with the same stage but without the present of plasma HPV DNA. Conclusions The plasma HPV DNA originated from the CC, was associated with metastasis and could be used as a marker representing the circulating free CC DNA.

  20. Pretreatment plasma levels and diagnostic utility of hematopoietic cytokines in cervical cancer or cervical intraepithelial neoplasia patients.

    Science.gov (United States)

    Ławicki, Sławomir; Będkowska, Grażyna E; Gacuta-Szumarska, Ewa; Knapp, Paweł; Szmitkowski, Maciej

    2012-07-04

    In this study, we compared plasma levels and the diagnostic utility of hematopoietic growth factors (HGFs) with SCC-Ag in cervical cancer patients in relation to control groups and cervical intraepithelial neoplasia (CIN) patients and healthy subjects. Pretreatment plasma levels of HGFs (SCF, GM-CSF, G-CSF and M-CSF) were determined by the use of immunoenzyme assay (ELISA), and SCC-Ag by chemiluminescent microparticle immunoassay (CMIA). Significantly different concentrations of GM-CSF, G-CSF and M-CSF were observed in the group of patients with cervical cancer and CIN compared to the healthy controls. Significant differences in plasma levels of GM-CSF and M-CSF between cervical cancer and benign lesions patients were also found. The HGFs and SCC-Ag diagnostic specificities received high values. The diagnostic sensitivity and the predictive value of a positive and negative test result were higher for M-CSF than for antigen SCC in the cancer group. The M-CSF area under the ROC curve (AUC) was the largest from hematopoietic cytokines and SCC-Ag. These results suggest the potential utility of M-CSF as a good candidate for a marker of cervical cancer as well as benign lesions of this organ (CIN).

  1. 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

  2. A panel of autoantibodies as potential early diagnostic serum biomarkers in patients with cervical cancer.

    Science.gov (United States)

    Huangfu, Mingmei; Xu, Shuang; Li, Siyao; Sun, Baosheng; Lee, Kuang-Hui; Liu, Linlin; Sun, Shilong

    2016-07-01

    The study was designed to test whether circulating autoantibodies against associated antigens (TAAs) were altered in early cervical cancer and benign cervical tumors. A total of 111 cervical cancer patients, 137 cervical benign tumor patients, and 160 healthy volunteers matched in age were recruited in this study. The expression of autoantibodies was tested using in-house developed enzyme-linked immunosorbent assay (ELISA) with linear peptide envelope antigens derived from TAAs. One-way ANOVA test showed that there was no difference in the CD25 autoantibody expression among the cervical cancer group, benign tumor group, and healthy control group (P = 0.063; P = 0.191). The expression of autoantibodies against survivin and TP53 in the cervical cancer group was significantly higher than that in the benign tumor group (P cervical cancer group than in the healthy control group (P = 0.010; P = 0.001), while autoantibodies in the cervical cancer group showed no difference in expression compared with that in the benign tumor group. The panel of five TAAs showed a sensitivity of 37.8 % and a specificity of 90 %, which was much higher than the sensitivity of the single-TAA testing group. The data from this study further support our previous hypothesis that the detection of autoantibodies for the diagnosis of a specific cancer type can be enhanced using a panel of several selected TAAs as target antigens.

  3. Increased risk of ischemic stroke in cervical cancer patients: a nationwide population-based study

    International Nuclear Information System (INIS)

    Increased risk of ischemic stroke has been validated for several cancers, but limited study evaluated this risk in cervical cancer patients. Our study aimed to evaluate the risk of ischemic stroke in cervical cancer patients. The study analyzed data from the 2003 to 2008 National Health Insurance Research Database (NHIRD) provided by the National Health Research Institutes in Taiwan. Totally, 893 cervical cancer patients after radiotherapy and 1786 appendectomy patients were eligible. The Kaplan-Meier method and the Cox proportional hazards model were used to assess the risk of ischemic stroke. The 5-year cumulative risk of ischemic stroke was significantly higher for the cervical cancer group than for the control group (7.8% vs 5.1%; p <0.005). The risk of stroke was higher in younger (age <51 years) than in older (age ≥51 years) cervical cancer patients (HR = 2.73, p = 0.04; HR = 1.37, p = 0.07) and in patients with more than two comorbid risk factors (5 years cumulative stroke rate of two comorbidities: 15% compared to no comorbidities: 4%). These study demonstrated cervical cancer patients had a higher risk of ischemic stroke than the general population, especially in younger patients. Strategies to reduce this risk should be assessed

  4. Assessment of quality of life for the patients with cervical cancer at different clinical stages

    Institute of Scientific and Technical Information of China (English)

    Yao Xie; Fang-Hui Zhao; Si-Han Lu; He Huang; Xiong-Fei Pan; Chun-Xia Yang; You-Lin Qiao

    2013-01-01

    With improved overall survival of cervical cancer patients,the importance of the quality of life (QOL)is increasingly recognized.This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment.We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information.Based on SF-36,we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011.A total of 92 patients with precancerous lesions,93 with early cancer,and 35 with advanced cancer responded to our survey.Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P < 0.05).Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P < 0.05).Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions.However,they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1and 6 months after treatment.Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer.Additionally,patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions.Thus,early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.

  5. 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

  6. Molecular tests to detect human papillomavirus infection in patients with cervical dysplasia and invasive cervical cancer in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Sait KH

    2011-07-01

    Full Text Available Khalid H Sait1, Faten S Gazzaz21Obstetrics and Gynecology Department, 2Medical Virology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaPurpose: The aim of this study was to determine the actual human papillomavirus (HPV subtype that presents in cervical dysplasia and invasive carcinoma in the Saudi population, and the feasibility of using Hybrid Capture 2 technique (HC2 on biopsy specimens to detect certain HPV subtypes.Patients and methods: A prospective study was conducted from March 2007 to December 2008. The subjects studied were women with a mean age of 48.18 years, who attended the hospital for cervical biopsy due to the suspected diagnosis of cervical dysplasia or an invasive disease, based on previous suspicious Pap smear. HPV DNA hybridization by HC2 was performed on the cervical biopsies of these patients, to detect HPV infection.Results: During the period of this study, 45 patients had cervical biopsies taken for HPV testing. Seven patients had a negative HC2 result and were found to have no cervical dysplasia on the final pathology review. Seventeen cases with cervical dysplasia and 21 patients with invasive disease were presented; the mean age was 48 years. HC2 testing for HPV were found to be positive in patients with cervical dysplasia, invasive carcinoma, and all in 5 (29.4%, 13 (61.9% and 18 (47.4%, respectively. The sensitivity of the test is 47% and specificity is 100%.Conclusion: The use of molecular detection of HPV DNA by HC2 in biopsy is feasible and effective. These results confirm the finding that HPV contributes to the etiology of cervical cancer in Muslim society.Keywords: HPV, subtyping, cervical neoplasia

  7. Human papilloma virus identification in breast cancer patients with previous cervical neoplasia

    Directory of Open Access Journals (Sweden)

    James Sutherland Lawson

    2016-01-01

    Full Text Available Purpose: Women with human papilloma virus (HPV associated cervical neoplasia have a higher risk of developing breast cancer than the general female population. The purpose of this study was to (i identify high risk for cancer HPVs in cervical neoplasia and subsequent HPV positive breast cancers which developed in the same patients and (ii determine if these HPVs were biologically active.Methods: A range of polymerase chain reaction (PCR and immunohistochemical techniques were used to conduct a retrospective cohort study of cervical precancers and subsequent breast cancers in the same patients. Results: The same high risk HPV types were identified in both the cervical and breast specimens in 13 (46% of 28 patients. HPV type 18 was the most prevalent. HPVs appeared to be biologically active as demonstrated by the expression of HPV E7 proteins and the presence of HPV associated koilocytes. The average age of these patients diagnosed with breast cancer following prior cervical precancer was 51 years, as compared to 60 years for all women with breast cancer (p for difference = 0.001. Conclusions: These findings indicate that high risk HPVs can be associated with cervical neoplasia and subsequent young age breast cancer. However these associations are unusual and are a very small proportion of breast cancers. These outcomes confirm and extend the observations of 2 similar previous studies and offer one explanation for the increased prevalence of serious invasive breast cancer among young women.

  8. 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

  9. Nomogram prediction for overall survival of patients diagnosed with cervical cancer

    OpenAIRE

    Polterauer, S; Grimm, C.; Hofstetter, G; Concin, N; Natter, C; Sturdza, A.; R. Pötter; Marth, C.; Reinthaller, A.; Heinze, G.

    2012-01-01

    Background: Nomograms are predictive tools that are widely used for estimating cancer prognosis. The aim of this study was to develop a nomogram for the prediction of overall survival (OS) in patients diagnosed with cervical cancer. Methods: Cervical cancer databases of two large institutions were analysed. Overall survival was defined as the clinical endpoint and OS probabilities were estimated using the Kaplan–Meier method. Based on the results of survival analyses and previous studies, rel...

  10. Matrix metalloproteinase-9 is a prognostic marker for patients with cervical cancer.

    Science.gov (United States)

    Li, Yi; Wu, Tao; Zhang, Beilei; Yao, Yuanqing; Yin, Guowu

    2012-12-01

    Cervical cancer remains one of the most common malignancies in women. Previous study proved MMP-9 might be prognostic marker for multiple human malignancies. The present study was to investigate the protein expression of MMP-9 in cervical cancer and its association with clinicopathological characteristics as well as prognosis of patients. Cervical cancer specimens from 225 cases who had not received chemotherapy or radiotherapy prior to surgery were collected. Immunochemistry assays were utilized to investigate MMP-9 protein expression. Results showed that MMP-9 expression was increased in cervical cancer and associated with stromal invasion, FIGO stage, lymph node metastasis, and vascular invasion. Kaplan-Meier analysis showed that patients with cervical cancer of positive MMP-9 staining tend to have worse overall survival. In multivariate analysis stratified for known prognostic variables, MMP-9 was proved to be an independent prognostic factor. The present study confirmed that MMP-9 expression in cervical cancer was an independent prognostic factor of patients, which might be a potential diagnostic and even therapeutic target of cervical cancer.

  11. The clinical-immunological analysis of a specific and combined immunotherapy of patients with cervical cancer

    OpenAIRE

    D. K. Kenbayeva; A. F. Lazarev

    2012-01-01

    Research objective is the comparative assessment of efficiency of two various ways of an immunotherapy of patients with cervical cancer. 57 patients with cervical cancer, the III stages, distributed on 3 groups – combined radiotherapy, a combination of a radiotherapy and specific immunotherapy, and also a radiotherapy, specific and adaptive immunotherapy are surveyed. Clinical efficiency of treatment was estimated by means of primary tumor regression and 3-year survival rate. The scheme of co...

  12. The diagnostic value of PET/CT scanning in patients with cervical cancer

    DEFF Research Database (Denmark)

    Loft, Annika; Berthelsen, Anne Kiil; Roed, Henrik;

    2007-01-01

    OBJECTIVE: To investigate the clinical value of PET/CT as a supplement to FIGO staging in patients with cervical cancer stage >or=1B. METHODS: This prospective study included 120 consecutive patients. After staging, a whole-body PET/CT scan was performed and these examinations were divided into two....../CT scanning for newly diagnosed cervical cancer FIGO stage >or=1B has a high sensitivity and specificity, and can be a valuable supplement to the FIGO staging procedure....

  13. Laparoscopic Indocyanine Green Sentinel Lymph Node Mapping in Pregnant Cervical Cancer Patients.

    Science.gov (United States)

    Papadia, Andrea; Mohr, Stefan; Imboden, Sara; Lanz, Susanne; Bolla, Daniele; Mueller, Michael D

    2016-02-01

    We present cases of 2 pregnant patients with early-stage cervical cancer who have undergone indocyanine green (ICG) sentinel lymph node (SLN) mapping followed by laparoscopic SLN biopsy, pelvic lymphadenectomy, and cervical conization. Eight milliliters of ICG were injected in the 4 quadrants of the cervix after having obtained an adequate pneumoperitoneum and having inspected the abdominal cavity. SLNs were identified in both hemipelvises in both patients. In the final pathologic analysis, both SLNs and non-SLNs were negative for metastatic disease. No adverse events from ICG injection were recorded. ICG SLN mapping seems to be feasible in pregnant cervical cancer patients.

  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. 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

  16. Serum copper and zinc levels in patients with cervical cancer.

    Science.gov (United States)

    Chen, C A; Hwang, J L; Kuo, T L; Hsieh, C Y; Huang, S C

    1990-08-01

    The serum copper (SCL) and zinc (SZL) levels were measured in 99 patients with cervical cancer and 50 patients with uterine myoma as controls. The mean SCL in the control group was 109.4 +/- 17.4 micrograms/ml as compared to 117.1 +/- 14.6 micrograms/dl and was not significant (NS) in 17 carcinoma in situ (CIS) patients, 142.3 +/- 14.2 micrograms/dl in 30 stage I patients (p less than 0.001), 159.0 +/- 16.6 micrograms/dl in 22 stage II patients (p less than 0.001), 171.6 +/- 25.7 micrograms/dl in 10 stage III or IV patients (p less than 0.001), and 166.2 +/- 32.2 micrograms/dl in 20 recurrent patients (p less than 0.001). The SCL returned to control level 2 weeks after surgical treatment for the stage I and II patients (mean 110.6 +/- 19.6 and 108.7 +/- 20.4 micrograms/dl, respectively, p less than 0.001). The SZL was 97.2 +/- 15.8 micrograms/dl in control patients and only showed a significant decrease in stage III or IV and recurrent patients (67.2 +/- 16.6 and 70.4 +/- 17.2 micrograms/dl, respectively). Concerning the copper/zinc ratio, the control group was 1.13 +/- 0.07 as compared to 1.17 +/- 0.07 in CIS (p = 0.06), 1.51 +/- 0.24 in stage I (p less than 0.001), 1.85 +/- 0.37 in stage II (p less than 0.001), 2.66 +/- 0.61 in stage III or IV (p less than 0.001), and 2.50 +/- 0.75 in recurrent patients (p less than 0.001). Taking mean +/- 2.5 SD of the control values as cut off points, the percentages of the recurrent patients with abnormal SCL, SZL, and a Cu/Zn ratio were 65, 30 and 90%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Spontaneous perforation of pyometra in a cervical cancer patient: a case report and literature review

    OpenAIRE

    Vyas, Sameer; Kumar, Ajay; Prakash, Mahesh; Kapoor, Rakesh; Kumar, Pankaj; Khandelwal, Niranjan

    2009-01-01

    Abstract Pyometra is an uncommon condition with an incidence of less than 1% in gynaecologic patients. Spontaneous rupture of pyometra in cervical cancer presenting as generalized peritonitis is very rare. Only four cases have been described in the English literature to the best of our knowledge and from a PubMed search. The index case is an elderly postmenopausal female who was diagnosed with cervical cancer, started on radiotherapy and presented with features of generalized peritonitis. Con...

  18. 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 ...

  19. Perceptions of cervical cancer risk and screening among transmasculine individuals: patient and provider perspectives.

    Science.gov (United States)

    Agénor, Madina; Peitzmeier, Sarah M; Bernstein, Ida M; McDowell, Michal; Alizaga, Natalie M; Reisner, Sari L; Pardee, Dana J; Potter, Jennifer

    2016-10-01

    Transmasculine people (individuals assigned a female sex at birth who identify as male or masculine) are at risk of cervical cancer. Despite low rates of Pap test use in this population, research examining the determinants of cervical cancer screening among transmasculine individuals is scarce. We conducted in-depth interviews and focus groups with 49 participants (32 transmasculine patients and 17 healthcare providers) in order to examine transmasculine individuals' and healthcare providers' perceptions of cervical cancer risk and screening among individuals on the transmasculine continuum. Overall, patients believed that transmasculine individuals should receive regular Pap tests, especially in the event of gynaecological concerns. While healthcare providers' views varied, many perceived transmasculine individuals to be at low risk of cervical cancer. Contrary to existing screening guidelines, several providers believed that transmasculine individuals who did not engage in penile-vaginal intercourse with cisgender men, expressed discomfort about Pap testing or intended to obtain a hysterectomy might not need to be screened regularly or at all. Our findings underscore the importance of educating patients and providers about cervical cancer risk among transmasculine individuals and establishing evidence-based guidelines for cervical cancer screening in this underserved population.

  20. Young Cervical Cancer Patients May Be More Responsive than Older Patients to Neoadjuvant Chemotherapy Followed by Radical Surgery

    OpenAIRE

    Jin Zhou; Xiong Li; Kecheng Huang; Yao Jia; Fangxu Tang; Haiying Sun; Yuan Zhang; Qinghua Zhang; Ding Ma; Shuang Li

    2016-01-01

    Objective To evaluate the effects of age and the clinical response to neoadjuvant chemotherapy (NACT) in patients with cervical cancer who received neoadjuvant chemotherapy followed by radical surgery. Methods A total of 1,014 patients with advanced cervical cancer who received NACT followed by radical surgery were retrospectively selected. Patients were divided into young (aged ≤35 years, n = 177) and older (aged >35 years, n = 837) groups. We compared the short-term responses and survival r...

  1. Optimization of the extent of surgical treatment in patients with stage I in cervical cancer

    Science.gov (United States)

    Chernyshova, A. L.; Kolomiets, L. A.; Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu.

    2016-08-01

    The study included 26 patients with FIGO stage Ia1-Ib1 cervical cancer who underwent fertility-sparing surgery (transabdominaltrachelectomy). To visualize sentinel lymph nodes, lymphoscintigraphy with injection of 99mTc-labelled nanocolloid was performed the day before surgery. Intraoperative identification of sentinel lymph nodes using hand-held gamma probe was carried out to determine the radioactive counts over the draining lymph node basin. The sentinel lymph node detection in cervical cancer patients contributes to the accurate clinical assessment of the pelvic lymph node status, precise staging of the disease and tailoring of surgical treatment to individual patient.

  2. Cryptococcus laurentii fungaemia in a cervical cancer patient

    Directory of Open Access Journals (Sweden)

    Rejane Pereira Neves

    2015-12-01

    Full Text Available ABSTRACT Infections caused by emerging Cryptococcus non-neoformans species are being reported with increasingly frequency. Here, we present a case of fungaemia byCryptococcus laurentii in a woman receiving aggressive immunosuppressive therapy for cervical neoplasia. Three venous blood samples were aseptically collected on consecutive days and C. laurentiiwas isolated and identified through phenotypic and molecular methods. After central venous catheter removal and appropriate antifungal therapy, the patient showed significant improvement and blood culture became negative. Thus, patients following immunosuppressive therapies and using invasive medical devices are at risk of C. laurentii blood infections.

  3. 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 ...

  4. 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 ...

  5. Cardiovascular morbidity after radiotherapy or chemoradiation in patients with cervical cancer

    NARCIS (Netherlands)

    Maduro, John; den Dekker, Heleen; Pras, Elisabeth; de Vries, E.G.; van der Zee, A.G.; Klokman, W.J.; Reyners, A.K.; van Leeuwen, F.E.; Langendijk, J.A.; de Bock, G.H.; Gietema, J.A.

    2010-01-01

    PURPOSE: To evaluate the risk of cardiovascular events (CVE) in patients with cervical cancer treated with radiotherapy or chemoradiation. METHODS AND MATERIALS: The incidence of CVE in patients treated between 1989 and 2002 by radiotherapy or chemoradiation was compared with a Dutch reference popul

  6. The clinical-immunological analysis of a specific and combined immunotherapy of patients with cervical cancer

    Directory of Open Access Journals (Sweden)

    D. K. Kenbayeva

    2012-01-01

    Full Text Available Research objective is the comparative assessment of efficiency of two various ways of an immunotherapy of patients with cervical cancer. 57 patients with cervical cancer, the III stages, distributed on 3 groups – combined radiotherapy, a combination of a radiotherapy and specific immunotherapy, and also a radiotherapy, specific and adaptive immunotherapy are surveyed. Clinical efficiency of treatment was estimated by means of primary tumor regression and 3-year survival rate. The scheme of combined immunotherapy was shown to possess the most clinical efficiency. Positive dynamics of cell immunity indicators was accompanied to clinical efficiency of treatment.

  7. 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 ...

  8. Detection of HPV-16 DNA by PCR in histologically cancer free lymph nodes from patients with cervical cancer

    NARCIS (Netherlands)

    M.F.D. Baay (Marc); J. Koudstaal; H. Hollema; J.M. Duk; M.P.M. Burger; W.G.V. Quint (Wim); E. Stolz (Ernst); P. Herbrink (Paul)

    1997-01-01

    textabstractThe prognostic value of detection of human papillomavirus (HPV) type 16 DNA in histologically cancer free lymph nodes was assessed in left obturator lymph nodes from cervical cancer patients with HPV-16 positive primary tumours. HPV-16 DNA was detected by po

  9. Detection of HPV-16 DNA by PCR in histologically cancer free lymph nodes from patients with cervical cancer

    NARCIS (Netherlands)

    Baay, MFD; Koudstaal, J; Hollema, H; Duk, JM; Burger, MPM; Quint, WGV; Stolz, E; Herbrink, P

    1997-01-01

    The prognostic value of detection of human papillomavirus (HPV) type 16 DNA in histologically cancer free lymph nodes was assessed in left obturator lymph nodes from cervical cancer patients with HPV-16 positive primary tumours. HPV-16 DNA was detected by polymerase chain reaction in 12 of 35 patien

  10. HIV serostatus and tumor differentiation among patients with cervical cancer at Bugando Medical Centre

    Directory of Open Access Journals (Sweden)

    Matovelo Dismas

    2012-08-01

    Full Text Available Abstract Background Evidence for the association between Human immunodeficiency virus infection and cervical cancer has been contrasting, with some studies reporting increased risk of cervical cancer among HIV positive women while others report no association. Similar evidence from Tanzania is scarce as HIV seroprevalence among cervical cancer patients has not been rigorously evaluated. The purpose of this study was to determine the association between HIV and tumor differentiation among patients with cervical cancer at Bugando Medical Centre and Teaching Hospital in Mwanza, North-Western Tanzania. Methods This was a descriptive analytical study involving suspected cervical cancer patients seen at the gynaecology outpatient clinic and in the gynaecological ward from November 2010 to March 2011. Results A total of 91 suspected cervical cancer patients were seen during the study period and 74 patients were histologically confirmed with cervical cancer. The mean age of those confirmed of cervical cancer was 50.5 ± 12.5 years. Most patients (39 of the total 74–52.7% were in early disease stages (stages IA-IIA. HIV infection was diagnosed in 22 (29.7% patients. On average, HIV positive women with early cervical cancer disease had significantly more CD4+ cells than those with advanced disease (385.8 ± 170.4 95% CI 354.8-516.7 and 266.2 ± 87.5, 95% CI 213.3-319.0 respectively p = 0.042. In a binary logistic regression model, factors associated with HIV seropositivity were ever use of hormonal contraception (OR 5.79 95% CI 1.99-16.83 p = 0.001, aged over 50 years (OR 0.09 95% CI 0.02-0.36 p = 0.001, previous history of STI (OR 3.43 95% CI 1.10-10.80 p = 0.035 and multiple sexual partners OR 5.56 95% CI 1.18-26.25 p = 0.030. Of these factors, only ever use of hormonal contraception was associated with tumor cell differentiation (OR 0.16 95% CI 0.06-0.49 p = 0.001. HIV seropositivity was weakly associated with

  11. 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.

  12. 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

  13. 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 ...

  14. The Analysis of High-Risk Molecular Markers for Cervical Cancer Patients under Thirty-Five

    Institute of Scientific and Technical Information of China (English)

    Yi Luo; Jian Wang; Changyin Zhao

    2006-01-01

    OBJECTIVE To explore molecular markers for cervical cancer in female patients below thirty-five years of age, so that the markers may be used to formulate a prognosis and to provide some useful targets for improving therapy.METHODS Pathological data were collected from 64 cervical cancer patients under the age of 35 from June, 1995 to June, 2000 in our institution.The data were retrospectively analyzed as a study group, and compared to data obtained from 90 cervical cancer cases over the age of 35 as controls who underwent treatment during the same time period. Immunohistochemical and quantified image analyses were conducted to look for differences between the two groups in expression of survivin, p27,CD44v6, MMP-2 and TIMP-2.RESULTS The overall 5-year survival rate (65.6%) of the study group was significantly lower (P<0.05) compared to the control group (84.4%). The expression of survivin, MMP-2 and CD44v6 was much higher in the younger study group compared to the older control group, but TIMP-2 displayed higher expression in the control group (P<0.05). There was no significant difference in p27 expression between the two groups (P>0.05).CONCLUSION Young women patients with cervical cancer have a poorer prognosis compared to old women. Our study reveals that survivin,MMP-2, TIMP-2 and CD44v6 expression have a correlation with shorter 5-year survival. Improvement in the prognosis for young cervical cancer patients can be expected using biomedical therapy which targets these molecular markers.

  15. Correlation Between Akt and p53 Protein Expression and Chemoradiotherapy Response in Cervical Cancer Patients

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    IIN KURNIA

    2014-12-01

    Full Text Available Akt is a protein that is associated with cell proliferation and is expressed at high levels in cancer cells. Some research indicates it may play a role in increasing the resistance of cancer cells to chemotherapy treatment. P53 is a tumor suppressor protein that influences the cell cycle and apoptosis. The purpose of this study was to examine the relationship between the expression of Akt and p53 in cancerous tissue before chemoradiation treatment, and the clinical response to treatment of cervical cancer patients. Twenty microscopic tissue samples were taken from cervical cancer biopsies obtained from patients before cancer treatment. The tissue samples were stained with p53 and Akt antibodies via immunohistochemistry technique, to measure expression of both proteins. After completion of chemoradiotherapy, patients’ clinical response to treatment was determined using the pelvic control method. Our results revealed no correlation between expression of Akt and p53 index (P = 0.74 as well as between p53 Index and chemoradiotherapy clinical response (P=0.29. There was significant correlation between expression of Akt and cervical cancer chemoradiotherapy response (P = 0.03. There was no correlation found between p53 index and chemoradiotherapy clinical response (P = 0.29. High expression of Akt may related with high cell proliferation and resistance to chemoradiotherapy.

  16. 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

  17. A Population-based Study of Invasive Cervical Cancer Patients in Beijing: 1993-2008

    Directory of Open Access Journals (Sweden)

    Tong Wang

    2015-01-01

    Full Text Available Background: In recent years, the incidence of cervical cancer has been rising, particularly in young adults, as the second most common gynecological cancer in China. The aim of this study was to explore the incidence change and the epidemiological characteristics of cervical cancer in Beijing over the past 16 years. Methods: All the cases of the study were limited to Beijing residents diagnosed with cervical cancer and registered in Beijing from January 1, 1993, to December 31, 2008. A total of 4100 patients with cervical cancer were obtained from the Statistics Database of Beijing Cancer Registry (BJCaR. According to the registered data, we retrospectively reviewed all original cases which we can acquired in reported hospital. Cervical situ cancer, cervical metastatic cancer, non-Beijing residents and repeatedly registered cases were excluded. Totally, 3641 registered cases were verified correctly. Meanwhile, we also collected the following data: Age, occupation, detected methods, histological type, and staging. The trends of incidence and mortality were analyzed by Joinpoint Regression Program 4.1.1.1 produced by National Cancer Institute (NCI, USA. The annual percent change (APC was calculated using the Joinpoint regression model. Results: The crude rates of incidence and mortality were 10.4 and 1.0 per 100,000 women, respectively during 1993 to 2008. The average WHO age-standardized incidence rates were 11.5 per 100,000 women. There was a decrease in incidence annually by 8.0% (P = 0.3 during 1993-1996 and a rapid increase annually by 18.9% after 1999 (P < 0.01. The median age was 67 years in 1993, but the median age decreased to 45 years in 2008. The peak of the age-specific incidence curve was at 40 years in the most recent period (2005-2008, which was 25-30 years earlier than that in previous periods (1993-1996. In the 2224 cases, the numbers of patients with stage I, II, III and IV were 910 (40.9%, 601 (27%, 542 (24.4%, 171 (7

  18. A Population-based Study of Invasive Cervical Cancer Patients in Beijing: 1993-2008

    Institute of Scientific and Technical Information of China (English)

    Tong Wang; Ming-Hui Wu; Yu-Mei Wu; Wei-Yuan Zhang

    2015-01-01

    Background: In recent years, the incidence of cervical cancer has been rising, particularly in young adults, as the second most common gynecological cancer in China.The aim of this study was to explore the incidence change and the epidemiological characteristics of cervical cancer in Beijing over the past 16 years.Methods: All the cases of the study were limited to Beijing residents diagnosed with cervical cancer and registered in Beijing from January I, 1993, to December 31, 2008.A total of 4100 patients with cervical cancer were obtained from the Statistics Database of Beijing Cancer Registry (BJCaR).According to the registered data, we retrospectively reviewed all original cases which we can acquired in reported hospital.Cervical situ cancer, cervical metastatic cancer, non-Beijing residents and repeatedly registered cases were excluded.Totally, 3641 registered cases were verified correctly.Meanwhile, we also collected the following data: Age, occupation, detected methods, histological type, and staging.The trends of incidence and mortality were analyzed by Joinpoint Regression Program 4.1.1.1 produced by National Cancer Institute (NCI, USA).The annual percent change (APC) was calculated using the Joinpoint regression model.Results: The crude rates of incidence and mortality were 10.4 and 1.0 per 100,000 women, respectively during 1993 to 2008.The average WHO age-standardized incidence rates were 11.5 per 100,000 women.There was a decrease in incidence annually by 8.0% (P =0.3) during 1993-1996 and a rapid increase annually by 18.9% after 1999 (P < 0.01).The median age was 67 years in 1993, but the median age decreased to 45 years in 2008.The peak of the age-specific incidence curve was at 40 years in the most recent period (2005-2008), which was 25-30 years earlier than that in previous periods (1993-1996).In the 2224 cases, the numbers of patients with stage Ⅰ, Ⅱ, Ⅲ and Ⅳ were 910 (40.9%), 601 (27%), 542 (24.4%), 171 (7.7%), respectively

  19. Results of surgical treatment of cervical cancer patients of childbearing age

    Directory of Open Access Journals (Sweden)

    V. S. Navruzova

    2015-01-01

    Full Text Available The world marked increase in the incidence of cervical cancer in young women, especially from 29 to 45 years old. Analysis showed that in patients with preserved ovarian function, not only the effectiveness of the treatment, but also the quality of life. It is associated with the acceleration, earlier puberty and the onset of sexual activity. In recent years more and more widely used radical surgery with preservation of the ovaries and the abduction of the radiation castration and preservation of reproductive function. In the National Cancer Research Centre of the Ministry of Health of the Republic of Uzbekistan analyzed the results of surgical treatment of 204 patients with cervical cancer younger. Age of patients from 23 to 45 years, that is, in the most hard-working, reproductive period. In our study patients met principally with exophytic – 82 (40.2 % and 68 (33.3 % еndophytic growth cervical tumors. Histological in 197 (96.6 % patients with squamous cervical cancer patients with 7 (3.4%. Adenocarcinoma of cervical cancer. Handard examination of the patient are further adapted to determine the level of sex hormones (estradiol, progesterone, determination of the tumor marter CA-125 levels of calcium and phosphate in the blood. 112 patients from the main group and the combined complex therapy surgical treatment with organ-component (conservation and ovarian transposition. The first group included 112 (55.1 % patients, who as part of combination therapy was performed and complex surgical treatment of ovarian transposition. The second group included 92 (44.9% patients who as part of combination therapy and complex surgery performed without ovarian transposition. Each group was divided into 3 subgroup included patients with stage process T1b–2aN0M0. Which performs the combined radiotherapy. The second subgroups included patients with stage process that runs systemic chemotherapy, surgery, combined radiotherapy. The third group included

  20. Synchronous luminescence spectroscopic characterization of blood elements of normal and patients with cervical cancer

    Science.gov (United States)

    Muthuvelu, K.; Shanmugam, Sivabalan; Koteeswaran, Dornadula; Srinivasan, S.; Venkatesan, P.; Aruna, Prakasarao; Ganesan, Singaravelu

    2011-03-01

    In this study the diagnostic potential of synchronous luminescence spectroscopy (SLS) technique for the characterization of normal and different pathological condition of cervix viz., moderately differentiated squamous cell carcinoma (MDSCC), poorly differentiated squamous cell carcinoma (PDSCC) and well differentiated squamous cell carcinoma (WDSSC). Synchronous fluorescence spectra were measured for 70 abnormal cases and 30 normal subjects. Characteristic, highly resolved peaks and significant spectral differences between normal and MDSCC, PDSCC and WDSCC cervical blood formed elements were obtained. The synchronous luminescence spectra of formed elements of normal and abnormal cervical cancer patients were subjected to statistical analysis. Synchronous luminescence spectroscopy provides 90% sensitivity and 92.6% specificity.

  1. Diagnostic significance of diffusion-weighted MRI in patients with cervical cancer: a meta-analysis.

    Science.gov (United States)

    Hou, Bo; Xiang, Shi-Feng; Yao, Gen-Dong; Yang, Su-Jun; Wang, Yu-Fang; Zhang, Yi-Xin; Wang, Jun-Wei

    2014-12-01

    The aim of this meta-analysis is to demonstrate whether diffusion-weighted magnetic resonance imaging (DWI) could assist in the precise diagnosis of cervical cancer or not. Both English and Chinese electronic databases were searched for potential relevant studies followed by a comprehensive literature search without any language restriction. Two reviewers independently assessed the methodological quality of the included trials. Standardized mean difference (SMD) and its corresponding 95 % confidence interval (95 % CI) were calculated in this meta-analysis. We chose Version 12.0 STATA statistical software to analyze our statistical data. Thirteen eligible cohort studies were selected for statistical analysis, including 645 tumor tissues and 504 normal tissues. Combined SMD of apparent diffusion coefficient (ADC) suggested that the ADC value in cervical cancer tissues was significantly lower than that of normal tissue (SMD = 2.80, 95 % CI = 2.64 ~ 2.96, P cervical cancer. DWI could therefore be an important imaging tool in potentially identifying patients with cervical cancer.

  2. 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

  3. An special epithelial staining agents: folic acid receptor-mediated diagnosis (FRD) effectively and conveniently screen patients with cervical cancer.

    Science.gov (United States)

    Lu, Meng-Han; Hu, Ling-Yun; Du, Xin-Xin; Yang, Min; Zhang, Wei-Yi; Huang, Ke; Li, Li-An; Jiang, Shu-Fang; Li, Ya-Li

    2015-01-01

    High-quality screening with cytology has markedly reduced mortality from cervical cancer. However, it needs experienced pathologists to review and make the final decisions. We have developed folic acid receptor-mediated diagnosis (FRD) kits to effectively and conveniently screen patients with cervical cancer. We conduct present study aim to assess clinical significances of FRD in screening cervical cancer. A total of 169 patients were enrolled at Chinese People's liberation Army (PLA) general hospital. We compared diagnostic significances of FRD with thinprep cytology test (TCT). Meanwhile, colposcopy was also performed to confirm any lesion suspicious for cervical cancer. The sensitivity and specificity of FRD were 71.93% and 66.07% in diagnosis cervical cancer, respectively. Meanwhile, the positive predictive values (PPV), negative predictive values (NPV), Youden index were 51.90%, 82.22%, 0.38, respectively. On the other hand, the sensitivity and specificity of TCT in diagnosis cervical cancer were 73.68% and 61.61% respectively. PPV, NPV and Youden index for TCT were 49.41%, 82.14% and 0.35 respectively. Overall, FRD have high values of sensitivity, specificity and Youden index. However, this difference failed to statistical significance. FRD have comparable diagnostic significance with TCT. Therefore, FRD might serve as one effective method to screen cervical cancer. Especially for those patients living in remote regions of China, where cytology was unavailable.

  4. 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 ...

  5. The safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer: a systematic review and meta analysis

    OpenAIRE

    Du HE; Duan, Chunyan; Chen, Jun; Lai, Lin; Chen, Jiaquan; Chen, Dian

    2015-01-01

    Objective: To evaluate the safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer. Methods: A systematic literature search was conducted using the PubMed, EMBASE and Cochrane databases. Studies comparing combined neoadjuvant chemotherapy treatment (NACT)/radical surgery treatment (RST) with RST alone in patients with cervical cancer were eligible for inclusion. Results: Eight studies were finally included in this meta analysis, involving a total of ...

  6. 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

  7. Are We Appropriately Selecting Therapy For Patients With Cervical Cancer? Longitudinal Patterns-of-Care Analysis for Stage IB-IIB Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, Julie A., E-mail: Julie.A2.Carlson@ucdenver.edu [Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States); Rusthoven, Chad [Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States); DeWitt, Peter E. [Colorado Biostatistics Consortium, Aurora, Colorado (United States); Davidson, Susan A. [Department of Obstetrics/Gynecology, Division of Gynecologic Oncology, University of Colorado Denver, Aurora, Colorado (United States); Schefter, Tracey E.; Fisher, Christine M. [Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States)

    2014-11-15

    Purpose: We performed a patterns-of-care analysis evaluating the effects of newer technology and recent research findings on treatment decisions over 26 years to determine whether patients with cervical cancer are being appropriately selected for treatment to optimize the therapeutic ratio. Methods and Materials: A retrospective analysis was conducted using the Surveillance, Epidemiology and End Results (SEER) program from 1983 to 2009. We identified 10,933 women with stage IB-IIB cervical carcinoma. Results: Of the 10,933 subjects identified, 40.1% received surgery, 26.8% received radiation (RT), and 33.1% received surgery plus RT. RT use increased after 2000 compared to prior to 2000, with a corresponding decrease in surgery and surgery plus RT. Among patients with risk factors including tumor size >4 cm, positive parametria, and positive lymph nodes, declining use of surgery plus RT was observed. However, 23% of patients with tumors >4 cm, 20% of patients with positive parametria, and 55% of node-positive patients continued to receive surgery plus RT as of 2009. Factors associated with increased use of surgery plus RT included patient age <50 and node-positive status. Conclusions: In this largest patterns-of-care analysis to date for patients with locally advanced cervical cancer, we found a substantial proportion of patients continue to undergo surgery followed by radiation, despite randomized data supporting the use of definitive radiation therapy, with lower morbidity than surgery and radiation.

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

    Directory of Open Access Journals (Sweden)

    Das Saikat

    2005-01-01

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

  9. Serum nucleosomes during neoadjuvant chemotherapy in patients with cervical cancer. Predictive and prognostic significance

    Directory of Open Access Journals (Sweden)

    Cetina Lucely

    2005-06-01

    Full Text Available Abstract Background It has been shown that free DNA circulates in serum plasma of patients with cancer and that at least part is present in the form of oligo- and monucleosomes, a marker of cell death. Preliminary data has shown a good correlation between decrease of nucleosomes with response and prognosis. Here, we performed pre- and post-chemotherapy determinations of serum nucleosomes with an enzyme-linked immunosorbent assay (ELISA method in a group of patients with cervical cancer receiving neoadjuvant chemotherapy. Methods From December 2000 to June 2001, 41 patients with cervical cancer staged as FIGO stages IB2-IIIB received three 21-day courses of carboplatin and paclitaxel, both administered at day 1; then, patients underwent radical hysterectomy. Nucleosomes were measured the day before (baseline, at day seven of the first course and day seven of the third course of chemotherapy. Values of nucleosomes were analyzed with regard to pathologic response and to time to progression-free and overall survival. Results All patients completed chemotherapy, were evaluable for pathologic response, and had nucleosome levels determined. At a mean follow-up of 23 months (range, 7–26 months, projected progression time and overall survival were 80.3 and 80.4%, respectively. Mean differential values of nucleosomes were lower in the third course as compared with the first course (p >0.001. The decrease in the third course correlated with pathologic response (p = 0.041. Survival analysis showed a statistically significant, better progression-free and survival time in patients who showed lower levels at the third course (p = 0.0243 and p = 0.0260, respectively. Cox regression analysis demonstrated that nucleosome increase in the third course increased risk of death to 6.86 (95% confidence interval [CI 95%], 0.84–56.0. Conclusion Serum nucleosomes may have a predictive role for response and prognostic significance in patients with cervical cancer

  10. Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Grueneisen, Johannes; Kinner, Sonja; Forsting, Michael; Lauenstein, Thomas; Umutlu, Lale [University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schaarschmidt, Benedikt Michael [University Hospital Dusseldorf, University of Dusseldorf, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Heubner, Martin; Aktas, Bahriye [University Hospital Essen, University of Duisburg-Essen, Department of Obstetrics and Gynecology, Essen (Germany); Ruhlmann, Verena [University Hospital Essen, University of Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany)

    2015-11-15

    To assess the diagnostic value of integrated PET/MRI for whole-body staging of cervical cancer patients, as well as to investigate a potential association between PET/MRI derived functional parameters and prognostic factors of cervical cancer. The present study was approved by the local institutional review board. Twenty-seven patients with histopathologically confirmed cervical cancer were prospectively enrolled in our study. All patients underwent a whole-body PET/MRI examination after written informed consent was obtained. Two radiologists separately evaluated the PET/MRI data sets regarding the determination of local tumor extent of primary cervical cancer lesions, as well as detection of nodal and distant metastases. Furthermore, SUV and ADC values of primary tumor lesions were analyzed and correlated with dedicated prognostic factors of cervical cancer. Results based on histopathology and cross-sectional imaging follow-up served as the reference standard. PET/MRI enabled the detection of all 27 primary tumor lesions of the uterine cervix and allowed for the correct determination of the T-stage in 23 (85 %) out of the 27 patients. Furthermore, the calculated sensitivity, specificity and diagnostic accuracy for the detection of nodal positive patients (n = 11) were 91 %, 94 % and 93 %, respectively. PET/MRI correctly identified regional metastatic disease (N1-stage) in 8/10 (80 %) patients and non-regional lymph node metastases in 5/5 (100 %) patients. In addition, quantitative analysis of PET and MRI derived functional parameters (SUV; ADC values) revealed a significant correlation with pathological grade and tumor size (p < 0.05). The present study demonstrates the high potential of integrated PET/MRI for the assessment of primary tumor and the detection of lymph node metastases in patients with cervical cancer. Providing additional prognostic information, PET/MRI may serve as a valuable diagnostic tool for cervical cancer patients in a pretreatment setting

  11. Positron emission tomography-computed tomography has a clinical impact for patients with cervical cancer

    DEFF Research Database (Denmark)

    Sandvik, Rikke Mulvad; Jensen, Pernille Tine; Hendel, Helle Westergren;

    2011-01-01

    Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present s...

  12. Radical surgery in patients with residual disease after (chemo)radiation for cervical cancer

    NARCIS (Netherlands)

    Boers, Aniek; Arts, Henriette J. G.; Klip, Harry; Nijhuis, Esther R.; Pras, Elisabeth; Hollema, Harry; Wisman, G. Bea A.; Nijman, Hans W.; Mourits, Marian J. E.; Reyners, Anna K. L.; de Bock, Geertruida H.; Thomas, Gillian; van der Zee, Ate G. J.

    2014-01-01

    Objective: The aim of this study was to determine possible impact of routinely scheduled biopsies and more radical surgery for residual central disease in locally advanced cervical cancer after (chemo) radiation. Methods/Materials: Data were analyzed of a consecutive series of cervical cancer patien

  13. Positron emission tomography-computed tomography has a clinical impact for patients with cervical cancer

    DEFF Research Database (Denmark)

    Sandvik, Rikke Mulvad; Jensen, Pernille Tine; Hendel, Helle W;

    2011-01-01

    Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present...

  14. ANALYSIS OF APOPTOSIS FACTORS IN PATIENTS WITH PREINVASIVE AND INVASIVE CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    P. I. Kovchur

    2015-01-01

    Full Text Available This article assesses the disturbance degree of apoptotic program in patients with preinvasive and invasive cervical cancer by investigating the expression level of genes of caspases-3, -6, -8 и -9 in mononuclear cells of periphery blood and in tumor tissue on the two regulating levels – on mRNA level (transcriptional and proteolytic activity (post transcriptional. 75 patients with stage III of cervical intraepithelial neoplasias (CIN III  (middle age of 32,9 ± 7,4,45 patients with stage IA (31,3 ± 6,0, 21 – with stage II (43,6 ± 13,2, 15 – with stage III–IV (46,9 ± 11,1 have been examined. The control group has been formed from 30 almost healthy donors without any cervical pathology and papilloma human virus (control 1 and 30 patients with a preinvasive and microinvasive cervical cancer (control 2. It has been found that in proportion of progress of cervix cancer, the membranous expression of CD95 increases in MPB – fraction (peripheral blood monocytes when the a CIN and initial stages of cervix cancer, more than two times. Herewith number CD95+-lymphocytes is positively correlated with stage of cervical cancer (r = 0,91; R2  = 0,82; p << 0,01. It has been found out that the activity gain of caspase-8 (r = 0,92; R2  = 0,86; p << 0,01, caspase-6 (r = 0,77; R2 = 0,59; p << 0,01 and reduction activity of caspase-9 (r = –0,60;  R2 = 0,36; p < 0,01 in mononuclear cells of peripheral blood pointed out on the sensitivity increase to Fas-induced apoptosis. Opposite, in tumor tissue, beginning from CIN stage III, apoptosis-resistant phenotype is formed, it were defined by the expression of caspase-3 (r = –0,72; R2 = 0,52, p < 0,01, caspase-6 (r = –0,59; R2 = 0, 38; p < 0,01 и caspase-9 (r = –0,67; R2 = 0,45; p < 0,01 by mRNA level and proteolytic activity. It has been shown, that the cervical cancer development is accompanied by multilateral disturbances of apoptotic processes, which are realized in decreased function of

  15. Lymphadenectomy in locally advanced cervical cancer study (LiLACS): Phase III clinical trial comparing surgical with radiologic staging in patients with stages IB2-IVA cervical cancer.

    Science.gov (United States)

    Frumovitz, Michael; Querleu, Denis; Gil-Moreno, Antonio; Morice, Philippe; Jhingran, Anuja; Munsell, Mark F; Macapinlac, Homer A; Leblanc, Eric; Martinez, Alejandra; Ramirez, Pedro T

    2014-01-01

    Radiation treatment planning for women with locally advanced cervical cancer (stages IB2-IVA) is often based on positron emission tomography (PET). PET, however, has poor sensitivity in detecting metastases in aortocaval nodes. We have initiated a study with the objective of determining whether pre-therapeutic laparoscopic surgical staging followed by tailored chemoradiation improves survival as compared with PET/computed tomography (CT) radiologic staging alone followed by chemoradiation. This international, multicenter phase III trial will enroll 600 women with stages IB2-IVA cervical cancer and PET/CT findings showing fluorodeoxyglucose-avid pelvic nodes and fluorodeoxyglucose-negative para-aortic nodes. Eligible patients will be randomized to undergo either pelvic radiotherapy with chemotherapy (standard-of-care arm) or surgical staging via a minimally invasive extraperitoneal approach followed by tailored radiotherapy with chemotherapy (experimental arm). The primary end point is overall survival. Secondary end points are disease-free survival, short- and long-term morbidity with pre-therapeutic surgical staging, and determination of anatomic locations of metastatic para-aortic nodes in relationship to the inferior mesenteric artery. We believe this study will show that tailored chemoradiation after pre-therapeutic surgical staging improves survival as compared with chemoradiation based on PET/CT in women with stages IB2-IVA cervical cancer.

  16. 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 ...

  17. Clinical features, outcome and risk factors in cervical cancer patients after surgery for chronic radiation enteropathy

    International Nuclear Information System (INIS)

    Radical hysterectomy and radiotherapy have long been mainstays of cervical cancer treatment. Early stage cervical cancer (FIGO stage IB1–IIA) is traditionally treated using radical surgery combined with radiotherapy, while locally advanced cervical cancer is treated using radiotherapy alone or chemoradiotherapy. In this retrospective study, we describe and analyse the presenting clinical features and outcomes in our cohort and evaluate possible risk factors for postoperative morbidity in women who underwent surgery for chronic radiation enteropathy (CRE). One hundred sixty-six eligible cervical cancer patients who underwent surgery for CRE were retrospectively identified between September 2003 and July 2014 in a prospectively maintained database. Among them, 46 patients received radical radiotherapy (RRT) and 120 received radical surgery plus radiotherapy (RS + RT). Clinical features, postoperative morbidity and mortality, and risk factors for postoperative morbidity were analysed. RS + RT group patients were more likely to present with RTOG/EORTC grade III late morbidity (76.1 % vs 92.5 %; p = 0.004), while RRT group patients tended to show RTOG/EORTC grade IV late morbidity (23.9 % vs 7.5 %; p = 0.004). One hundred forty patients (84.3 %) were treated with aggressive resection (anastomosis 57.8 % and stoma 26.5 %). Overall and major morbidity, mortality and incidence of reoperation in the RRT and RS + RT groups did not differ significantly (63 % vs 64.2 % [p = 1.000], 21.7 % vs 11.7 % [p = 0.137], 6.5 % vs 0.8 % [p = 0.065] and 6.5 % vs 3.3 % [p = 0.360], respectively). However, incidence of permanent stoma and mortality during follow-up was higher in the RRT group than in the RS + RT group (44.2 % vs 12.6 % [p = 0.000] and 16.3 % vs 3.4 % [p = 0.004], respectively). In multivariate analysis, preoperative anaemia was significantly associated with overall morbidity (p = 0.015), while severe intra-abdominal adhesion (p = 0.017), ASA grades III–V (P = 0

  18. 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

  19. 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

  20. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Soisson, A.P.; Soper, J.T.; Clarke-Pearson, D.L.; Berchuck, A.; Montana, G.; Creasman, W.T. (Duke Univ. Medical Center, Durham, NC (USA))

    1990-06-01

    From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.

  1. Changes in Bone Mineral Density in Uterine Cervical Cancer Patients After Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To prospectively investigate the changes in bone mineral density (BMD) after pelvic radiation therapy in patients with uterine cervical cancer. Methods and Materials: Of 52 cervical cancer patients who received pelvic RT in our university hospital between 2009 and 2011, 46 patients without recurrence and who were followed up for more than 12 months were included in the study. The BMD of the irradiated region and nonirradiated regions, serum estradiol, tartrate-resistant acid phosphatase-5b, and N-terminal cross-linking telopeptide of collagen 1 were measured before, at 3 months after, and at 12 months after RT. The patient cohort was divided into 2 groups according to estradiol level before RT, and the groups were defined as postmenopausal (2 before RT and 0.746 and 0.841 g/cm2 12 months after RT, respectively. Significant decreases were observed in both groups (P2 before RT and were significantly decreased to 0.706 and 0.921 g/cm2 12 months after RT (P<.01 and P<.05, respectively). Estradiol significantly decreased 3 months after RT, whereas tartrate-resistant acid phosphatase-5b and N-terminal cross-linking telopeptide of collagen 1 continued to increase over time in the premenopausal group. Conclusions: A decrease in BMD in the irradiated region after RT was observed within 1 year, regardless of menopausal status. Furthermore, in premenopausal patients, pelvic RT caused a decrease in systemic BMD

  2. 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

  3. DNA Damage and Repair Biomarkers in Cervical Cancer Patients Treated with Neoadjuvant Chemotherapy: An Exploratory Analysis.

    Directory of Open Access Journals (Sweden)

    Patrizia Vici

    Full Text Available Cervical cancer cells commonly harbour a defective G1/S checkpoint owing to the interaction of viral oncoproteins with p53 and retinoblastoma protein. The activation of the G2/M checkpoint may thus become essential for protecting cancer cells from genotoxic insults, such as chemotherapy. In 52 cervical cancer patients treated with neoadjuvant chemotherapy, we investigated whether the levels of phosphorylated Wee1 (pWee1, a key G2/M checkpoint kinase, and γ-H2AX, a marker of DNA double-strand breaks, discriminated between patients with a pathological complete response (pCR and those with residual disease. We also tested the association between pWee1 and phosphorylated Chk1 (pChk1, a kinase acting upstream Wee1 in the G2/M checkpoint pathway. pWee1, γ-H2AX and pChk1 were retrospectively assessed in diagnostic biopsies by immunohistochemistry. The degrees of pWee1 and pChk1 expression were defined using three different classification methods, i.e., staining intensity, Allred score, and a multiplicative score. γ-H2AX was analyzed both as continuous and categorical variable. Irrespective of the classification used, elevated levels of pWee1 and γ-H2AX were significantly associated with a lower rate of pCR. In univariate and multivariate analyses, pWee1 and γ-H2AX were both associated with reduced pCR. Internal validation conducted through a re-sampling without replacement procedure confirmed the robustness of the multivariate model. Finally, we found a significant association between pWee1 and pChk1. The message conveyed by the present analysis is that biomarkers of DNA damage and repair may predict the efficacy of neoadjuvant chemotherapy in cervical cancer. Further studies are warranted to prospectively validate these encouraging findings.

  4. DNA Damage and Repair Biomarkers in Cervical Cancer Patients Treated with Neoadjuvant Chemotherapy: An Exploratory Analysis.

    Science.gov (United States)

    Vici, Patrizia; Buglioni, Simonetta; Sergi, Domenico; Pizzuti, Laura; Di Lauro, Luigi; Antoniani, Barbara; Sperati, Francesca; Terrenato, Irene; Carosi, Mariantonia; Gamucci, Teresa; Dattilo, Rosanna; Bartucci, Monica; Vincenzoni, Cristina; Mariani, Luciano; Vizza, Enrico; Sanguineti, Giuseppe; Gadducci, Angiolo; Vitale, Ilio; Barba, Maddalena; De Maria, Ruggero; Mottolese, Marcella; Maugeri-Saccà, Marcello

    2016-01-01

    Cervical cancer cells commonly harbour a defective G1/S checkpoint owing to the interaction of viral oncoproteins with p53 and retinoblastoma protein. The activation of the G2/M checkpoint may thus become essential for protecting cancer cells from genotoxic insults, such as chemotherapy. In 52 cervical cancer patients treated with neoadjuvant chemotherapy, we investigated whether the levels of phosphorylated Wee1 (pWee1), a key G2/M checkpoint kinase, and γ-H2AX, a marker of DNA double-strand breaks, discriminated between patients with a pathological complete response (pCR) and those with residual disease. We also tested the association between pWee1 and phosphorylated Chk1 (pChk1), a kinase acting upstream Wee1 in the G2/M checkpoint pathway. pWee1, γ-H2AX and pChk1 were retrospectively assessed in diagnostic biopsies by immunohistochemistry. The degrees of pWee1 and pChk1 expression were defined using three different classification methods, i.e., staining intensity, Allred score, and a multiplicative score. γ-H2AX was analyzed both as continuous and categorical variable. Irrespective of the classification used, elevated levels of pWee1 and γ-H2AX were significantly associated with a lower rate of pCR. In univariate and multivariate analyses, pWee1 and γ-H2AX were both associated with reduced pCR. Internal validation conducted through a re-sampling without replacement procedure confirmed the robustness of the multivariate model. Finally, we found a significant association between pWee1 and pChk1. The message conveyed by the present analysis is that biomarkers of DNA damage and repair may predict the efficacy of neoadjuvant chemotherapy in cervical cancer. Further studies are warranted to prospectively validate these encouraging findings. PMID:26930412

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

  7. The ways of improvement of combination therapy results in patients with local cervical cancer

    International Nuclear Information System (INIS)

    A new solutions of a scientific task of modern oncogynecology, improvement of the efficacy of treatment for local cervical cancer on the account of expansion of the indications to operative treatment is presented on the clinical material (275 patients with stage II-III CC). The use of the developed technique of multimodality therapy based on the split course of combination radiation therapy against a background of neoadjuvant chemotherapy allowed to convert in 49.6% of cases of immobile tumor process to an operable stage followed by uterus and adnexae removal while at the traditional combination radiotherapy the resectability index was 6.9%.

  8. 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...

  9. Profile and retrospective analysis of the use of preventive strategies in patients with cervical cancer in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Bassey Goddy

    2015-01-01

    Full Text Available Background: Cervical cancer is the commonest malignancy of the female genital tract in developing countries, with a global burden of 530,000 new cases annually. This study aims to review the current situation of this important malignancy and to assess the previous use of preventive measures in patients with cervical cancer at the Port Harcourt Teaching Hospital (UPTH, Port Harcourt, Nigeria. Materials and Methods: This was a retrospective review of all cases of cervical cancer managed at the UPTH, Port Harcourt, Nigeria, between 1 January 2008 and 31 December, 2012. Results: The prevalence of cervical cancer was 3.53% of all gynaecological admissions. The peak age of incidence was 50-59 years, accounting for 40% of the study population. Women with high parity contributed to 93.3% of the study population. Early coitarche was observed in 78.7% and a history of multiple sexual partners in 65.3%. Vaginal bleeding was the commonest clinical feature seen in all the women studied, followed by pelvic pain in 84% of cases. Advanced-stage cervical cancer was seen in 93.4%. None of the women studied had been previously vaccinated against human papilloma virus (HPV, and only 1.3% had had any form of screening methods for early detection of cervical cancer. Conclusion: Cervical cancer remains an important cancer in our environment, and late presentation with advance disease is still the norm despite advances in screening and preventive modalities. The reason for this is buttressed on the finding that despite the availability of these preventive strategies, women in the South-South of Nigeria did not partake of these measures. There is an urgent need to develop programmes to re-sensitise women on the need for screening and vaccination to reduce cancer-associated morbidity and mortality in Port Harcourt, South-South Nigeria.

  10. Reaching women in the Peruvian Andes through cervical cancer screening campaigns: assessing attitudes of stakeholders and patients

    Science.gov (United States)

    Luque, John S; Maupin, Jonathan N; Ferris, Daron G; Guevara Condorhuaman, Wendy S

    2016-01-01

    Background Peru is characterized by high cervical cancer incidence and mortality rates. The country also experiences significant gaps in quality cervical cancer screening coverage for the population. Objective This descriptive mixed methods study conducted in Cusco, Peru, aimed to assess the attitudes and perceptions of medical staff, health care workers, and patients toward a cervical cancer screening program that included both clinic-based and community outreach services conducted by a nongovernmental organization clinic (CerviCusco). The study also explored patient knowledge and attitudes around cervical cancer and about the human papillomavirus (HPV) to inform patient education efforts. Methods The study employed structured interviews with key informants (n=16) primarily from CerviCusco, which provides cervical cancer prevention, screening, diagnosis and treatment services, and surveys with a sample of patients (n=30) receiving services at the clinic and at screening campaigns. Results The majority of key informant medical staff participants felt that the general public had a very negative view of government health services. One theme running throughout the interviews was the perception that the general population lacked a culture of preventive health care and would wait until symptoms were severe before seeking treatment. Regarding services that were received by patients at CerviCusco, the participants responded that the prices were reasonable and more affordable than some private clinics. Patients attending the rural health campaigns liked that the services were free and of good quality. Conclusion CerviCusco has demonstrated its capacity to provide screening outreach campaigns to populations who had not previously had access to liquid-based cytology services. The finding that patients had generally low levels of knowledge about cervical cancer and the HPV vaccine prompted the development of culturally and linguistically appropriate educational and

  11. 10-year epidemiological profile changes for cervical and endometrial cancer patients treated by radiotherapy in the Pernambuco state, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Cantinha, Rebeca S.; Santos, Mariana L.O.; Franca, Elvis J., E-mail: ejfranca@yahoo.com.br, E-mail: marianasantos_ufpe@hotmail.com, E-mail: rebecanuclear@gmail.com [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil); Pessoa, Juanna G.; Melo, Ana M.M.A.; Amancio, Francisco F., E-mail: amdemelo@hotmail.com, E-mail: amanciobike@gmail.com, E-mail: juannapessoa@gmail.com, E-mail: marianasantos_ufpe@hotmail.com [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Departamento de Biofisica e Radiobiologia; Oliveira Neto, Aristides M.; Melo, Jonathan A., E-mail: aristidesoliveira466@hotmail.com, E-mail: jonathan@truenet.com.br [Centro de Radioterapia de Pernambuco (CERAPE), Santo Amaro, PE (Brazil)

    2014-07-01

    Cancer is a worldwide public health problem, its prevention and control are included within 16 strategic objectives of the Brazilian Ministry of Health for the period 2011-2015. Cervical cancer is the fourth most common tumor in the female population, being new 15,590 cases estimated for 2014 according to the Brazilian National Cancer Institute (INCA). Pernambuco is the fifth state with the highest number of cases of cervical cancer and the seventh in cases of endometrial ones, both estimative for 2014. The understanding of the epidemiological profile of these pathologies corroborates strategies for prevention, control and treatment. As Pernambuco has implemented the radiotherapy for cancer treatment since 1998-1999, this work encompassed the comparison of the 1998-1999 epidemiological profile of patients treated by radiotherapy for cervical and endometrial cancer in the State of Pernambuco, Brazil, with 2008-2009 profile - ten years after. Medical record of 490 patients treated at the Center of Radiotherapy of Pernambuco (CERAPE) were compiled according to the patient origin, the affected uterus region, the staging of disease, the type and cell differentiation of the tumor, the age group, and, finally, the realization of hysterectomy as part of the treatment. More than 90% of the patients were affected by cervical cancer in the two investigated periods. For the interval of 1998-1999 the proportion of patients submitted to hysterectomy was quite higher compared to those after ten years. The results also showed a change in the origin of the patients, in which, in 1999, most of the patients were from the capital and the metropolitan area, while, after ten years, patients were mostly from the interior of the State. There was a predominance of squamous cell type tumors in both periods evaluated. For the 1998-1999 interval, tumors were stage 2, moderately differentiated type. Differently, the tumors were mostly stage 3, not differentiated type, for the 2008-2009 period

  12. Intrafraction motion in patients with cervical cancer: The benefit of soft tissue registration using MRI

    International Nuclear Information System (INIS)

    Background and purpose: During radiation delivery, target volumes change their position and shape due to intrafraction motion. The extent of these changes and the capability to correct for them will contribute to the benefit of an MRI-accelerator in terms of PTV margin reduction. Therefore, we investigated the primary CTV motion within a typical IMRT delivery time for cervical cancer patients for various correction techniques: no registration, rigid bony anatomy registration, and rigid soft tissue registration. Materials and methods: Twenty-two patients underwent 2-3 offline MRI exams before and during their radiation treatment. Each MRI exam included four sagittal and four axial MRI scans alternately within 16 min. We addressed the CTV motion by comparing subsequent midsagittal CTV delineations and investigated the correlation with intrafraction bladder filling. Results: The maximum (residual) motions within 16 min for all points on the CTV contour for 90% of the MRI exams without registration, with rigid bony anatomy registration, and with rigid soft tissue registration were 10.6, 9.9, and 4.0 mm. A significant but weak correlation was found between intrafraction bladder filling and CTV motion. Conclusions: Considerable intrafraction CTV motion is observed in cervical cancer patients. Intrafraction MRI-guided soft tissue registration using an MRI-accelerator will correct for this motion.

  13. 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.

  14. Pre-exenterative chemotherapy, a novel therapeutic approach for patients with persistent or recurrent cervical cancer

    Directory of Open Access Journals (Sweden)

    Uribe Jesus

    2005-09-01

    Full Text Available Abstract Background Most cervical cancer patients with pelvic recurrent or persistent disease are not candidates for exenteration, therefore, they only receive palliative chemotherapy. Here we report the results of a novel treatment modality for these patients pre-exenterative chemotherapy- under the rational that the shrinking of the pelvic tumor would allow its resection. Methods Patients with recurrent or persistent disease and no evidence of systemic disease, considered not be candidates for pelvic exenteration because of the extent of pelvic tumor, received 3-courses of platinum-based chemotherapy. Response was evaluated by CT scan and bimanual pelvic examination; however the decision to perform exenteration relied on the physical findings. Toxicity to chemotherapy was evaluated with standard criteria. Survival was analyzed with the Kaplan-Meier method. Results Seventeen patients were studied. The median number of chemotherapy courses was 4. There were 9 patients who responded to chemotherapy, evaluated by bimanual examination and underwent pelvic exenteration. Four of them had pathological complete response. Eight patients did not respond and were not subjected to surgery. One patient died due to exenteration complications. At a median follow-up of 11 months, the median survival for the whole group was 11 months, 3 months in the non-operated and 32 months in those subjected to exenteration. Conclusion Pre-exenterative chemotherapy is an alternative for cervical cancer patients that are no candidates for exenteration because of the extent of the pelvic disease. Its place in the management of recurrent disease needs to be investigated in randomized studies, however, its value for offering long-term survival in some of these patients with no other option than palliative care must be stressed.

  15. Young Cervical Cancer Patients May Be More Responsive than Older Patients to Neoadjuvant Chemotherapy Followed by Radical Surgery.

    Directory of Open Access Journals (Sweden)

    Jin Zhou

    Full Text Available To evaluate the effects of age and the clinical response to neoadjuvant chemotherapy (NACT in patients with cervical cancer who received neoadjuvant chemotherapy followed by radical surgery.A total of 1,014 patients with advanced cervical cancer who received NACT followed by radical surgery were retrospectively selected. Patients were divided into young (aged ≤35 years, n = 177 and older (aged >35 years, n = 837 groups. We compared the short-term responses and survival rates between the groups. The five-year disease-free survival (DFS and overall survival (OS rates were stratified by age, NACT response, and FIGO stage.The overall response rate was 86.8% in the young group and 80.9% in the older group. The young patients had an earlier FIGO stage (P<0.001, a higher rate of adenocarcinoma (P = 0.022, and more lymph node metastasis (P = 0.033 than the older patients. The presence of adenocarcinoma as the histological type (P = 0.024 and positive lymph node metastasis (P<0.001 were identified as independent risk factors for survival. When stratified by age and clinical response, young patients with no response to NACT had a worse clinicopathological condition compared with the other subgroups. Compared with non-responders, responders to NACT had a higher five-year DFS rate (80.1% versus 71.8%; P = 0.019 and OS rate (82.6% versus 71.8%; P = 0.003 among the young patients but not among the older patients.Responders to NACT aged 35 years or younger benefitted the most from NACT, while the young non-responders benefitted the least. Age might represent an important factor to consider when performing NACT in patients with cervical cancer.

  16. Concomitant postoperative radio-chemotherapy in high risk patients with cervical cancer stage IB and HA

    International Nuclear Information System (INIS)

    The aim of the study was to compare the treatment results, prognostic factors and toxicity of radiotherapy when used alone or in combination with Cisplatin in patients with early stage cervical cancer - clinical stage I and MA by RGO, who are in high risk group due to: positive (metastatic) lymph nodes (N+), positive resection line (R+) and have hydronephrosis. For a 5-year period (2007-2012) there were 252 patients with cervical cancer stage IB and MA, who were operated by Wertheim - Meigs, 165 of them received postoperative chemotherapy (Cisplatin) and external beam radiotherapy, while the remaining 87 external beam radiotherapy only. In pelvic region the total dose was 50Gy in daily dose 2Gy in 5 fractions/ week simultaneously with Cisplatin 40 mg/m2 once/ week to total dose 200 - 250 mg.There is an improvement with 8% of 5-years overall survival in the radio-chemotherapy group. Study results signify statistically significant advantage in total survival rate when using combined radio-chemotherapy in patients without accompanying hydronephrosis (p=0.00001), who had negative resection line R0 (p=0,003) and were in 11 clinical stage (p=0.012). There is also a statistically significant correlation between patients with T2 tumors with positive (metastatic) lymph nodes (N+) - 63.2% (p=0.01) and those with T2 tumors with positive resection line (R+) - 56.6% (p=0.01). There was local recurrence in 50% of patients with R+, and in patients with hydronephrosis when N+. Patients in the group on simultaneous radio- and chemotherapy experienced an acceptable early hematological (grade 1) and intestinal toxicity. Use of Cisplatin improves the treatment results. Local recurrence in 50% of R+ patient, as well as in those with accompanying hydronephrosis due to parailliac lymph nodes metastases raise the question for precise p re-treatment staging and the need of dose increase above 50 Gy, regardless the use of Cisplatin. Key words: Cervical Cancer. Radio-Chemotherapy. Factors of

  17. Disease-free and overall survival of patients diagnosed with HPV-associated or HPV-negative cervical cancer

    Science.gov (United States)

    Ibragimova, M. K.; Tsyganov, M. M.; Karabut, I. V.; Kolomiets, L. A.; Choynzonov, E. L.; Litviakov, N. V.

    2015-11-01

    The real-time PCR method is used to study scrapings of cervical epithelium and outer portion of the cervix in 116 patients aged 24-79 years with stage I-IV primary cervical cancer. The comprehensive survey included colposcopy, cytological and histological analysis, detection and genotyping of high-risk human papillomavirus. In 84 patients (72.4%) the presence of human papillomavirus (HPV) of high carcinogenic risk (HCR) is found, in 32 patients (27.6%) the presence of the virus has not been inspected in the tumor. A significant decrease in the survival rate as well as the prevalence of the worst prognosis for patients with HPV-negative cervical cancer are shown.

  18. 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

  19. 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...

  20. Positron emission tomography-computed tomography has a clinical impact for patients with cervical cancer

    DEFF Research Database (Denmark)

    Sandvik, Rikke Mulvad; Jensen, Pernille Tine; Hendel, Helle W;

    2011-01-01

    Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present...... study investigates the positive (PPV) and negative predictive value (NPV) of PET-CT in stage I disease and the clinical impact of the scan results in all disease stages....

  1. [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

  2. 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 ...

  3. 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.

  4. A case of HPV-53-related cervical cancer in an elderly patient

    Directory of Open Access Journals (Sweden)

    Lieveld M

    2014-11-01

    Full Text Available Marusya Lieveld,1 Elizaveta Padalko,2,3 Marleen Praet,4 Davy Vanden Broeck1 1Department of Uro/gynaecology, Ghent University Hospital, Ghent, Belgium; 2Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent, Belgium; 3School of Life Sciences, Hasselt University, Diepenbeek, Belgium; 4N. Goormaghtigh Institute of Pathology, Ghent University Hospital, Ghent, BelgiumZappacosta et al1 recently published a case report concerning a human papillomavirus (HPV-positive invasive cervical cancer in a 79-year-old women who had a history of normal Pap smears. In this article, Anyplex II HPV28 (Seegene is used for HPV genotyping of formalin-fixed paraffin embedded (FFPE tissue, liquid based cytology (LBC specimens and urine samples. It is suggested that HPV53 is present exclusively in the cervical cancer cells, lymph node metastases, and atypical urinary cells of one single case while the surrounding CIN2+ tissue revealed ten different HPV strains. Unfortunately, the HPV genotype results for lymph nodes and urinary cells are not presented while these results underline the potential role of HPV53 in oncogenesis. Moreover, it is generally accepted that one lesion is caused by one HPV infection, detection of multiple HPV types thus indicates the presence of multiple infections,2 suggesting that this patient may have several lesions. Read the original article  

  5. Adjuvant chemotherapy, a valuable alternative option in selected patients with cervical cancer.

    Directory of Open Access Journals (Sweden)

    Shuang Li

    Full Text Available Radiotherapy is the standard treatment for cervical cancer, but causes radiotherapy-induced complications. Recently, chemotherapy has been more extensively utilized. Here, we perform a large-scale comparison of chemotherapy and radiotherapy. From 2002 to 2008, 2,268 patients were grouped according to adjuvant radiotherapy or chemotherapy before and/or after surgery, and we compared the 5-year overall survival (OS and disease-free survival (DFS rates, recurrence rates, side effects, quality of life (QoL, and sexual activity. There were no significant differences between the treatment groups for the 5-year OS and DFS rates (OS: p = 0.053, DFS: p = 0.095, although marginally improved outcomes were observed in the chemotherapy group (OS: 86.5% vs. 82.8%; DFS: 84.5% vs. 81.4%. However, patients with early-stage disease, clinical response, and younger age had increased 5-year OS and DFS rates following chemotherapy compared to radiotherapy (p<0.05. The chemotherapy group exhibited significantly lower 5-year recurrence and distant failure rates compared to the radiotherapy group (p<0.001 and p = 0.007, respectively. Nausea and vomiting were the most frequent short-term complications of chemotherapy, whereas bowel and urinary complications were more frequent in the radiotherapy group. Compared to the chemotherapy group, patients who received radiotherapy reported a lower QoL, less frequent sexual activity, and more severe menopausal symptoms (p<0.05. Cervical cancer patients treated with chemotherapy, especially those with early-stage disease, clinical responses, and younger ages, have more positive outcomes, fewer complications, better QoL and sexual activity, suggesting that chemotherapy may be a valuable alternative option for selected patients.

  6. Changes in Bone Mineral Density in Uterine Cervical Cancer Patients After Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Okonogi, Noriyuki; Saitoh, Jun-ichi; Suzuki, Yoshiyuki, E-mail: syoshi@gunma-u.ac.jp; Noda, Shin-ei; Ohno, Tatsuya; Oike, Takahiro; Ohkubo, Yu; Ando, Ken; Sato, Hiro; Nakano, Takashi

    2013-12-01

    Purpose: To prospectively investigate the changes in bone mineral density (BMD) after pelvic radiation therapy in patients with uterine cervical cancer. Methods and Materials: Of 52 cervical cancer patients who received pelvic RT in our university hospital between 2009 and 2011, 46 patients without recurrence and who were followed up for more than 12 months were included in the study. The BMD of the irradiated region and nonirradiated regions, serum estradiol, tartrate-resistant acid phosphatase-5b, and N-terminal cross-linking telopeptide of collagen 1 were measured before, at 3 months after, and at 12 months after RT. The patient cohort was divided into 2 groups according to estradiol level before RT, and the groups were defined as postmenopausal (<40 pg/mL) and premenopausal (≥40 pg/mL). Results: The mean BMDs within the irradiation field (lumbar vertebra 5) in the postmenopausal and the premenopausal groups were 0.825 and 0.910 g/cm{sup 2} before RT and 0.746 and 0.841 g/cm{sup 2} 12 months after RT, respectively. Significant decreases were observed in both groups (P<.05 and P<.01, respectively). In addition, in the premenopausal group the mean BMDs of the nonirradiated regions at thoracic vertebrae 9-12 and lumbar vertebrae 2-4 were 0.753 and 0.958 g/cm{sup 2} before RT and were significantly decreased to 0.706 and 0.921 g/cm{sup 2} 12 months after RT (P<.01 and P<.05, respectively). Estradiol significantly decreased 3 months after RT, whereas tartrate-resistant acid phosphatase-5b and N-terminal cross-linking telopeptide of collagen 1 continued to increase over time in the premenopausal group. Conclusions: A decrease in BMD in the irradiated region after RT was observed within 1 year, regardless of menopausal status. Furthermore, in premenopausal patients, pelvic RT caused a decrease in systemic BMD.

  7. 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.

  8. 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.

  9. RADIONUCLIDE DIAGNOSIS OF THE FUNCTIONAL STATUS OF THE URETERS IN CERVICAL CANCER PATIENTS RECEIVING COMBINATION TREATMENT

    Directory of Open Access Journals (Sweden)

    L. A. Ashrafyan

    2009-01-01

    Full Text Available Researches of the capabilities of radionuclide diagnosis are one of the most important trends in modern medical science and practice, especially in the area of dynamic renal scintigraphy. This technique proved to be safe and highly informative when used in oncogyne- cology to evaluate defects of renal drainage. However, failure to make an objective evaluation of ureteral patency reduces significant- ly the capabilities of the technique in patients after small pelvis surgery and radiotherapy. The study issues presented in this article are devoted to this particular problem. The authors have developed an original procedure for evaluating renal drainage disorders during dynamic renal scintigraphy. The specific visual and digital parameters which characterize both normal and obstructed urine outflow in the supravesical segment are given. Criteria for serious disorders in urine derivation from the kidneys through the ureters are defined. Risk factors for urine outflow disorders are identified in cervical cancer patients who receive various treatments.

  10. Preoperative serum squamous cell carcinoma antigen levels in clinical decision making for patients with early-stage cervical cancer

    NARCIS (Netherlands)

    Reesink-Peters, N; van der Velden, J; ten Hoor, KA; Boezen, HM; de Vries, EGE; Schilthuis, MS; Mourits, MJE; Nijman, HW; Aalders, JG; Hollema, H; Pras, E; Duk, JM; van der Zee, AGJ

    2005-01-01

    PURPOSE: To prevent morbidity associated with double modality treatment, early-stage cervical cancer patients should only be offered surgery when there is a low likelihood for adjuvant radiotherapy. We analyzed whether serum squamous cell carcinoma antigen (SCC-ag) analysis allows better preoperativ

  11. Prognostic cell biological markers in cervical cancer patients primarily treated with (chemo)radiation : a systematic review

    NARCIS (Netherlands)

    Noordhuis, Maartje G; Eijsink, Jasper J H; Roossink, Frank; de Graeff, Pauline; Pras, Elisabeth; Schuuring, Ed; Wisman, G Bea A; de Bock, Geertruida H; van der Zee, Ate G J

    2011-01-01

    The aim of this study was to systematically review the prognostic and predictive significance of cell biological markers in cervical cancer patients primarily treated with (chemo)radiation. A PubMed, Embase, and Cochrane literature search was performed. Studies describing a relation between a cell b

  12. 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

  13. Anatomic Distribution of Fluorodeoxyglucose-Avid Para-aortic Lymph Nodes in Patients With Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Takiar, Vinita; Fontanilla, Hiral P.; Eifel, Patricia J.; Jhingran, Anuja; Kelly, Patrick [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Iyer, Revathy B. [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Levenback, Charles F. [Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhang, Yongbin; Dong, Lei [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Klopp, Ann, E-mail: aklopp@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-03-15

    Purpose: Conformal treatment of para-aortic lymph nodes (PAN) in cervical cancer allows dose escalation and reduces normal tissue toxicity. Currently, data documenting the precise location of involved PAN are lacking. We define the spatial distribution of this high-risk nodal volume by analyzing fluorodeoxyglucose (FDG)-avid lymph nodes (LNs) on positron emission tomography/computed tomography (PET/CT) scans in patients with cervical cancer. Methods and Materials: We identified 72 PANs on pretreatment PET/CT of 30 patients with newly diagnosed stage IB-IVA cervical cancer treated with definitive chemoradiation. LNs were classified as left-lateral para-aortic (LPA), aortocaval (AC), or right paracaval (RPC). Distances from the LN center to the closest vessel and adjacent vertebral body were calculated. Using deformable image registration, nodes were mapped to a template computed tomogram to provide a visual impression of nodal frequencies and anatomic distribution. Results: We identified 72 PET-positive para-aortic lymph nodes (37 LPA, 32 AC, 3 RPC). All RPC lymph nodes were in the inferior third of the para-aortic region. The mean distance from aorta for all lymph nodes was 8.3 mm (range, 3-17 mm), and from the inferior vena cava was 5.6 mm (range, 2-10 mm). Of the 72 lymph nodes, 60% were in the inferior third, 36% were in the middle third, and 4% were in the upper third of the para-aortic region. In all, 29 of 30 patients also had FDG-avid pelvic lymph nodes. Conclusions: A total of 96% of PET positive nodes were adjacent to the aorta; PET positive nodes to the right of the IVC were rare and were all located distally, within 3 cm of the aortic bifurcation. Our findings suggest that circumferential margins around the vessels do not accurately define the nodal region at risk. Instead, the anatomical extent of the nodal basin should be contoured on each axial image to provide optimal coverage of the para-aortic nodal compartment.

  14. 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.

  15. The safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer: a systematic review and meta analysis

    Science.gov (United States)

    He, Du; Duan, Chunyan; Chen, Jun; Lai, Lin; Chen, Jiaquan; Chen, Dian

    2015-01-01

    Objective: To evaluate the safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer. Methods: A systematic literature search was conducted using the PubMed, EMBASE and Cochrane databases. Studies comparing combined neoadjuvant chemotherapy treatment (NACT)/radical surgery treatment (RST) with RST alone in patients with cervical cancer were eligible for inclusion. Results: Eight studies were finally included in this meta analysis, involving a total of 1302 patients. Meta analysis shows that NACT might have lower lymph node metastasis than RST [OR=0.57, 95% CI (0.41, 0.79), P=0.0008]. However, there are no differentiation between two groups in operation time [SMD=0.16, 95% CI (-0.08, 0.48), P=0.19], intraoperative estimated blood loss [SMD=0.20, 95% CI (-0.19, 0.58), P=0.48], intraoperative and postoperative complication rates [OR=1.33, 95% CI (0.45, 3.92), P=0.60], overall survival rate [OR=1.07, 95% CI (0.48, 2.41), P=0.86] and recurrence rate [OR=1.06, 95% CI (0.56, 2.03), P=0.85]. Conclusions: The safety and efficacy of two treatments are similarly. However, NACT can reduce the rate of lymph node metastasis, which is an independent risk factor for cervical cancer prognosis and may improve the prognosis of cervical cancer. PMID:26628951

  16. Human papillomavirus genotyping by multiplex pyrosequencing in cervical cancer patients from India

    Indian Academy of Sciences (India)

    Cheryl M Travasso; Mona Anand Mansi; Mansi Samarth; Aditi Deshpande; Chandan Kumar-Sinha

    2008-03-01

    Cervical cancer is a leading cause of cancer-related deaths among women in India. Human papillomavirus (HPV) infection is the causative agent of cervical cancer; and infection with the high-risk genotypes, predominantly HPV16 and 18, is the biggest risk factor. Vaccines targeting HPV16 and 18 have been found to confer protection in large-scale clinical trials. HPV genotyping has traditionally been carried out to screen the population “at risk” using indirect methods based on polymerase chain reaction (PCR) using consensus primers combined with various DNA hybridization techniques, and often followed by the sequencing of candidate products. Recently, a high-throughput and direct method based on DNA sequencing has been described for HPV genotyping using multiplex pyrosequencing. We present a pilot study on HPV genotyping of cervical cancer and non-malignant cervical samples using multiplex pyrosequencing. Using genomic DNA from cell lines, cervical biopsies, surgical tissues or formalin-fixed, paraffin-embedded tissue samples, we could successfully resolve 6 different HPV types out of the 7 tested, with their prevalence found to be in agreement with earlier reports. We also resolved coinfections with two different HPV types in several samples. An HPV16 genotype with a specific and recurrent sequence variation was observed in 8 cancer samples and one non-malignant sample. We find this technique eminently suited for high-throughput applications, which can be easily extended to large sample cohorts to determine a robust benchmark for HPV genotypes prevalent in India.

  17. Pelvic insufficiency fracture after radiotherapy in patients with cervical cancer in the era of PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Shin Hyung; Kim, Jae Chul; Lee, Jeong Eun; Park, In Kyu [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2011-12-15

    To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT, bone scintigraphy were reviewed to evaluate the patients with PIF. Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.

  18. A STUDY OF COX-2 INHIBITOR CELECOXIB AND CHEMORADIATION IN PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Kuppa Prakash

    2016-08-01

    Full Text Available AIMS AND OBJECTIVES To evaluate efficacy of concurrent oral Cox-2 Inhibitor (celecoxib and chemoradiation in locoregional control, distant control, disease free survival and/or overall survival in patients with locally advanced cervical cancer. To determine treatment related toxicity rates in patients with locally advanced cervical cancer treated by oral celecoxib, intravenous cisplatin and concurrent pelvic radiation therapy. MATERIALS AND METHODS Study was done for a period of 2 years in a tertiary care cancer hospital which caters to the cancer patients. Advanced squamous, adenocarcinoma or adenosquamous carcinoma of uterine cervix, Patients with age <70 years, ECOG performance status 0-2, Normal haematological investigations, Normal renal function test, Normal liver function test, No disease outside of pelvis. RESULTS This prospective study consisted 30 patients, 15 patients on either arm. Overall pooled mean age for both study and comparison group was 50.3 years with a probability value P=0.91 for age. 14 patients (93.33% in both the arms had a performance status of ECOG 0 or 1 and 1 patient in both arms had ECOG PS-2. Stage distribution of the patients in study arm was 3 in IB2, 2 in IIA, 5 in IIB, 4 in III and 1 in stage IVA. In control arm, out of the 15 patients 2 are in IB2, 2 in IIA, 5 in IIB, 5 in III and 1 in stage IVA. The mean probability value was P=0.65 for stage distribution. 15 patients in arm-A (study arm received pelvic RT 50Gy 2Gy/Fr 5#/week followed by HDR –ICR 3 Fr. 700 cGy/Fr after pelvic RT on an average of 1 week along with weekly cisplatin 40 mg/m2 (50 mg (D1, D8, D15, D22 and Cox-2 inhibitor oral celecoxib 400 mg twice daily (800 mg/d starting from day 1 to throughout the duration of the chemoradiation. 15 patients in arm-B (Control arm received pelvic RT 50Gy 2Gy/Fr 5#/week followed by HDR –ICR 3 Fr. 700 cGy/Fr on an average of 1 week after pelvic RT along with weekly cisplatin 40 mg/m2 (50 mg (D1, D8, D15, D22

  19. [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.

  20. 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

  1. Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

    International Nuclear Information System (INIS)

    In cancer of the uterine cervix, lymph node metastases are associated with a poor prognosis. Even so, the International Federation of Gynecology and Obstetrics (FIGO) does not take into account diagnostic results of methods such as PET/CT, since these are not readily available everywhere. As undetected lymph node metastases can lead to undertreatment, any difference in the underlying prevalence of false-negative scans between CT and PET/CT may be reflected in treatment outcomes. This study investigated survival outcomes in node-negative patients before and after the introduction of PET/CT. This was a single-institution retrospective analysis of 301 patients with a histopathological diagnosis of cervical cancer. The patients were receiving chemoradiotherapy with curative intent according to the standard protocol of the department for patients without lymph node metastases as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18 %) in 5-year overall, disease-free and disease-specific survival, respectively, were observed between the two patient groups. The difference remained significant in univariate and multivariate analyses of overall survival (hazard ratio 0.61, 95 % CI 0.42 - 0.89; p = 0.010), including age, FIGO stage, performance status, BMI, and histopathology. Inclusion of PET/CT in the preradiotherapy diagnostic protocol may lead to nodal stage migration not reflected in the FIGO stage. It was found to be a significant covariate, and could lead to selection bias that needs to be taken into account when designing and reporting on clinical trials. (orig.)

  2. Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Henrik Villibald [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Section for Radiotherapy, Rigshospitalet, Department of Oncology, Copenhagen (Denmark); Loft, Annika [University of Copenhagen, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Berthelsen, Anne Kiil [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); University of Copenhagen, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Christensen, Ib Jarle [University of Copenhagen, The Finsen Laboratory, Rigshospitalet, Copenhagen (Denmark); University of Copenhagen, Biotech Research and Innovation Centre (BRIC), Copenhagen (Denmark); Hoegdall, Claus [University of Copenhagen, Department of Gynecology, Rigshospitalet, Copenhagen (Denmark); Engelholm, Svend Aage [University of Copenhagen, Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)

    2015-11-15

    In cancer of the uterine cervix, lymph node metastases are associated with a poor prognosis. Even so, the International Federation of Gynecology and Obstetrics (FIGO) does not take into account diagnostic results of methods such as PET/CT, since these are not readily available everywhere. As undetected lymph node metastases can lead to undertreatment, any difference in the underlying prevalence of false-negative scans between CT and PET/CT may be reflected in treatment outcomes. This study investigated survival outcomes in node-negative patients before and after the introduction of PET/CT. This was a single-institution retrospective analysis of 301 patients with a histopathological diagnosis of cervical cancer. The patients were receiving chemoradiotherapy with curative intent according to the standard protocol of the department for patients without lymph node metastases as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18 %) in 5-year overall, disease-free and disease-specific survival, respectively, were observed between the two patient groups. The difference remained significant in univariate and multivariate analyses of overall survival (hazard ratio 0.61, 95 % CI 0.42 - 0.89; p = 0.010), including age, FIGO stage, performance status, BMI, and histopathology. Inclusion of PET/CT in the preradiotherapy diagnostic protocol may lead to nodal stage migration not reflected in the FIGO stage. It was found to be a significant covariate, and could lead to selection bias that needs to be taken into account when designing and reporting on clinical trials. (orig.)

  3. 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.

  4. Physical status of human papillomavirus integration in cervical cancer is associated with treatment outcome of the patients treated with radiotherapy.

    Directory of Open Access Journals (Sweden)

    Hye-Jin Shin

    Full Text Available Integration of human papillomavirus (HPV DNA into the host genome is a critical aetiological event in the progression from normal cervix to intraepithelial neoplasm, and finally to invasive cervical cancer. However, there has been little work on how HPV integration status relates to treatment outcome for cervical carcinomas. In the current study, HPV E2 and E6 gene copy numbers were measured in 111 cervical cancer tissues using real-time QPCR. Integration patterns were divided into four groups: single copy-integrated with episomal components (group 1, single copy-integrated without episomal components (group 2, multicopy tandem repetition-integrated (group 3, and low HPV (group 4 groups. A relapse-predicting model was constructed using multivariable Cox proportional hazards model to classify patients into different risk groups for disease-free survival (DFS. The model was internally validated using bootstrap resampling. Oligonucleotide microarray analysis was performed to evaluate gene expression patterns in relation to the different integration groups. DFS rate was inferior in the order of the patients in group 4, group 2/3, and group 1. Multivariate analysis showed that histologic grade, clinical stage group, and integration pattern were significant prognostic factors for poor DFS. The current prognostic model accurately predicted the risk of relapse, with an area under the receiver operating characteristic curve (AUC of 0.74 (bootstrap corrected, 0.71. In conclusion, these data suggest that HPV integration pattern is a potent prognostic factor for tailored treatment of cervical 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. Prognostic Impact of Epidermal Growth Factor Receptor Overexpression in Patients with Cervical Cancer: A Meta-Analysis

    Science.gov (United States)

    Huang, Miao-Ling; Qin, Qing-Feng; Chen, Qing; Fang, Kun; Wang, Ping-Ling

    2016-01-01

    Clinical trials have provided conflicting results regarding whether epidermal growth factor receptor (EGFR) overexpression predicts poor survival in cervical cancer patients. In this study, we perform a meta-analysis of the association between EGFR expression and survival in cervical cancer patients. We searched clinical studies in the Medline, PubMed, Embase, and Web of Science databases. A total of 22 studies with 2,505 patients were included, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for each study. Heterogeneity was assessed using Higgins I2 to select a Mantel-Haenszel fixed effects model (I2 ≤50%) or a DerSimonian-Laird random effects model (I2 ≥50%). High EGFR levels predicted poor overall survival (OS) (HR: 1.40, 95% CI: 1.10–1.78) and disease-free survival (DFS) (HR: 1.84, 95% CI: 1.51–2.24). Stratified analyses showed that EGFR overexpression was significantly related to poor DFS in patients treated with chemoradiation or surgery. Moreover, the pooled odds ratios (ORs) revealed associations between EGFR expression and clinicopathological features, such as lymph node metastasis (OR: 1.72, 95% CI: 1.23–2.40) and tumor size ≥4 cm (OR: 1.64, 95% CI: 1.20–2.23). This meta-analysis demonstrates that EGFR overexpression is closely associated with reduced survival in patients with cervical cancer. These results may facilitate the individualized management of clinical decisions for anti-EGFR therapies in cervical cancer patients. PMID:27438047

  7. Sentinel lymph node identification in patients with early stage cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy

    Institute of Scientific and Technical Information of China (English)

    李斌; 章文华; 刘琳; 吴令英; 张蓉; 李宁

    2004-01-01

    Background In general, sentinel lymph node (SLN) can reflect the whole state of the entire drainage area. The present study evaluated the clinical significance of sentinel lymph node identification in the treatment of early stage cervical cancer.Methods Twenty-eight patients with early stage (Ia-Iia) cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were included in this study. At two locations 8 hours before operation, 0.4 ml 37 Mbq technicium-99 labeled dextran was injected intracervically. After that, preoperative lymphoscintigraphy was performed to detect SLNs. During the operation, lymph nodes were detected ex vivo by a γ-counter to identify SLNs. The samples of SLNs and non-SLNs were used for pathological examination separately and compared with the final results. Results SLNs were identified in 27 of 28 (96.4%) patients. A total of 123 SLNs were identified from 814 nodes. Six patients had altogether 11 positive lymph nodes, which were all SLNs. No patient had false-negative sentinel node. Conclusion SLNs can successfully predict the lymphatic metastasis in patients with cervical cancer. The clinical validity of this technique should be evaluated prospectively.

  8. 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

  9. Occult cervical lymph node metastases in 100 consecutive patients with cN0 tongue cancer

    Institute of Scientific and Technical Information of China (English)

    JIN Wu-long; YE Wei-min; ZHENG Jia-wei; ZHOU Liang; ZHU Han-guang; ZHANG Zhi-yuan; TIAN Jie

    2008-01-01

    Background Squamous cell carcinoma (SCC) of the tongue is one of the most common cancers in the oral and maxillofacial region. To provide clinical evidence for selective neck dissection in management of cN0 patients by analyzing the characteristics and correlation of factors of occult cervical lymph node metastases (OCLNM) in patients with SCC of the tongue.Methods From 2002 to 2006, 100 consecutive patients with SCC of the tongue were reviewed by analyzing the characteristics of OCLNM, diameter of the tumor, T classifications, depth of invasion, forms of growth, pathological grade and degree of differentiation.Results The rate of OCLNM in 100 patients with SCC of the tongue was 22%. The most common region with OCLNM was level Ⅱ in the ipsilateral neck, followed by levels Ⅰ and Ⅲ. There were 51.61% (16/31) of OCLNM in level Ⅱ and 87.10% (27/31) of OCLNM in levels Ⅰ-Ⅲ. There was no significant correlation between the diameter of tumor and OCLNM (P >0.05). OCLNM was statistically significantly correlated with the depth of invasion, forms of growth, pathological grade and degree of differentiation (P <0.05). The rate of occult metastases increased with the increased pathological grade,the decreased degree of differentiation and the increased depth of invasion.Conclusions The most common regions with OCLNM in cN0 patients with SCC of the tongue were levels Ⅰ-Ⅲ in the ipsilateral neck. Supraomohyoid neck dissection should be the elective treatment to the neck in patients with cN0 SCC of the tongue by consideration of the clinical and pathological factors for the depth of invasion, forms of growth, pathological grade, and degree of differentiation.

  10. Unstable chromosome aberrations on peripheral blood lymphocytes from patients with cervical uterine cancer following radiotherapy

    International Nuclear Information System (INIS)

    Absorbed dose determination is an important step for risk assessment related to an exposure to ionizing radiation. However, physical dosimetry cannot be always performed, principally in the case of retrospective estimates. In this context, the use of bioindicators (biological effects) has been proposed, which defines the so-called biological dosimetry. In particular, scoring of unstable chromosomes aberrations (dicentrics, centric rings and fragments) of peripheral blood lymphocytes, while is the most reliable biological method for estimating individual exposure to ionizing radiation. In this work, blood samples from 5 patients, with cervical uterine cancer, were evaluated after partial-body radiotherapy with a source of 69 Co. For this, conventional cytogenetic method was employed, based on Giemsa coloration and fluorescence in situ hybridization, in order to correlate the frequency of unstable chromosome aberrations of blood lymphocytes with absorbed dose, as a result of the radiotherapy. A good agreement was observed between the frequency of chromosome aberrations scored and the values of dose previously calculated by physical dosimetry during patient's radiotherapy. The results presented in this work point out the importance of concerning analyses of unstable chromosome aberrations as biological dosimeter in the investigation of partial-body exposure to ionizing radiation. (author)

  11. Prognostic implication of human papillomavirus types and species in cervical cancer patients undergoing primary treatment.

    Directory of Open Access Journals (Sweden)

    Yat Ming Lau

    Full Text Available High-risk human papillomavirus (HPV types are associated with cervical cancer. It is well established that individual HPV types vary in oncogenicity, but current data on their prognostic implication remain controversial. We examined the association between HPV types/species and the survival of 236 Chinese women aged 26-87 (mean 54.4 years after receiving primary treatment for cervical cancer. Overall, 45.8% were of FIGO stage I, 41.9% stage II, and 12.3% stage III. The four most prevalent types found were HPV-16 (60.2%, HPV-18 (21.6%, HPV-52 (11.9%, and HPV-58 (9.3%. Overall, 19.5% of patients had multiple-type infections, 78.4% harboured one or more alpha-9 species, and 28.8% harboured one or more alpha-7 species. After a median follow-up of 8.0 years, 156 (66.1% patients survived. The 3-year overall survival rate was 75.5%. Factors independently associated with a poorer 3-year overall survival were age >60 years, tumour size >4 cm, lymph node involvement and treatment with radiotherapy+/-chemotherapy. Univariate analysis showed HPV-16 single-type infection was associated with a marginally poorer disease-specific survival (71.6% vs. 87.0%, HR: 1.71, 95% CI = 1.01-2.90, whereas non-HPV-16 alpha-9 species was associated with a better disease-specific survival (90.0% vs. 76.2%, HR: 0.36, 95% CI = 0.16-0.79. However, on multivariate analysis, HPV infection status irrespective of different grouping methods, including individual types, species, single-type or co-infection, did not carry any significant prognostic significance. In conclusion, we did not observe any association between infection with a particular HPV type/species and survival. An HPV type-based stratification in treatment and follow-up plan could not be recommended.

  12. Phase I trial evaluating the antiviral agent Cidofovir in combination with chemoradiation in cervical cancer patients

    Science.gov (United States)

    Deutsch, Eric; Haie-Meder, Christine; Bayar, Mohamed Amine; Mondini, Michele; Laporte, Mélanie; Mazeron, Renaud; Adam, Julien; Varga, Andrea; Vassal, Gilles; Magné, Nicolas; Chargari, Cyrus; Lanoy, Emilie; Pautier, Patricia; Levy, Antonin; Soria, Jean-Charles

    2016-01-01

    Purpose This phase I trial aimed to assess the safety and determine the recommended Phase II dose (RP2D) of Cidofovir combined with chemoradiotherapy in patients with stage IB2-IVA cervical cancer. Experimental design Incremental doses (1, 2.5, 5 and 6.5 mg/kg) of IV Cidofovir were administered weekly for two weeks, and then every 2 weeks from the start of chemoradiotherapy to the initiation of utero-vaginal brachytherapy. Biological expression of HPV was analyzed during treatment and tumor response was assessed according to RECIST v1.0 criteria. Results A total of 15 patients were treated with Cidofovir. Dose-limiting toxicities occurred in 2/6 patients at the 6.5 mg/kg dose level (G3 proteinuria, and G3 acute pyelonephritis with G3 febrile neutropenia). No toxicity occurred at the 5 mg/kg dose level, but only 3 patients received this dose due to trial interruption because of low accrual. The most frequent G3-4 adverse effects observed during the trial were: abdominal pain (n=3), infection (n=2), leuckoneutropenia (n=2), and others (n=6). No toxic death or major renal side effect occurred. The best response was that 8/9 evaluable patients achieved a complete response (89%). In the intention to treat population, the 2-year overall and progression-free survival rates were 93% and 76%, respectively. Biological monitoring of HPV-related markers (decreased p16 expression, and increased p53 and pRb levels) was possible on sequential tumor biopsy samples. The genomic alterations identified were PIK3CA (n=5; one also had a KRAS mutation), and HRAS (n=1) mutations. Conclusion Cidofovir at a dose of 5mg/kg combined with chemoradiotherapy appeared tolerable and yielded tumor regressions. Due to early trial interruption, the RP2D was not confirmed. PMID:27016411

  13. 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

  14. 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

  15. Do clinicians and patients agree regarding symptoms? A comparison after definitive radiochemotherapy in 223 uterine cervical cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, K.; Poetter, R. [Medical Univ. Vienna (Austria). Dept. of Radiotherapy; Nout, R. [University Medical Center Leiden (Netherlands). Dept. of Clinical Oncology; Lindegaard, J. [University Hospital Aarhus (Denmark). Dept. of Oncology; Petric, P. [Institute of Oncology Ljubljana (Slovenia). Dept. of Radiotherapy; Limbergen, E.V. [University Hospital Leuven (Belgium). Dept. of Radiotherapy; Juergenliemk-Schulz, I.M. [University Medical Center Utrecht (Netherlands). Dept. of Radiation Oncology; Haie-Meder, C. [Institut Gustave-Roussy, Villejuif (France). Dept. of Radiotherapy; Doerr, W. [Technische Univ. Dresden (Germany). Dept. of Radiotherapy and Radiooncology

    2012-10-15

    Background: In clinical cancer research of morbidity, low associations between clinician-assessed toxicity/morbidity and patient-reported symptoms are consistently described in the literature. While morbidity grading systems are supposed to follow more or less objective criteria, patient reported symptoms inherently are based on a subjective self-evaluation of the impact on quality of life. The aim of this study was to focus on major discrepancies with high clinical relevance and to evaluate its impact with regard to underreporting of morbidity. Material and methods: Early morbidity assessed by clinicians with CTCAEv.3 and patient reported quality of life (EORTC-QLQ-C30/CX24) were compared regarding 12 overlapping symptoms in 223 patients with uterine cervical cancer 3 months after definitive radio(chemo)therapy in the ongoing EMBRACE study. Mismatches showing discrepancies between both grading systems were classified, if patients reported substantial symptoms (quite a bit/very much) and CTCAE grading was rated G0. Results: In total, 360 substantial symptoms were reported by patients by EORTC-QLQ; 159 (44%) of those were not recognized by CTCAE. Symptoms with the highest occurrence of mismatches overall are urinary frequency, fatigue, and insomnia. Large institutional differences were found, showing two centers with 4 vs. 71% of patients with at least one mismatch. Conclusion: Analysis of mismatches indicated a high risk of underestimation of early morbidity. Thus, nearly half of the patient-reported substantial symptoms were not recognized by CTCAE scoring (G0) 3 months after treatment. Prospective assessment of morbidity in clinical studies should, therefore, integrate patient reported symptoms to receive a complete and comprehensive picture. (orig.)

  16. 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...

  17. Impact of the care provided by gynecologic oncologists on outcomes of cervical cancer patients treated with radical hysterectomy.

    Science.gov (United States)

    Wu, Miao-Fang; Li, Jing; Lu, Huai-Wu; Wang, Li-Juan; Zhang, Bing-Zhong; Lin, Zhong-Qiu

    2016-01-01

    For many malignant diseases, specialized care has been reported to be associated with better outcomes. The purpose of this study is to investigate the influence of gynecologic oncologists on treatment outcomes for cervical cancer patients treated by radical hysterectomy. Records of patients who received radical hysterectomy between January 2005 and June 2010 were reviewed. Perioperative morbidity, recurrence-free survival, and cancer-specific survival were assessed. Cox regression model was used to evaluate gynecologic oncologists as an independent predictor of survival. A total of 839 patients were included. Of these patients, 553 were treated by gynecologic oncologists, while 286 were treated by other subspecialties. With regard to operative outcomes, significant differences in favor of operation by gynecologic oncologists were found in number of patients receiving para-aortic node sampling and dissection (P=0.038), compliance with surgical guidelines (P=0.003), operative time (P<0.0001), estimated blood loss (P<0.0001), transfusion rate (P=0.046), number of removed nodes (P=0.033), and incidences of ureteric injury (P=0.027), cystotomy (P=0.038), and fistula formation (P=0.002). Patients who were operated on by gynecologic oncologists had longer recurrence-free survival (P=0.001; hazard ratio [HR] =0.64; 95% confidence interval [CI] [0.48, 0.84]) and cancer-specific survival (P=0.005; HR=0.64; 95% CI [0.47, 0.87]), and this association remained significant in patients with locally advanced disease. Care by gynecologic oncologists was an independent predictor for improved recurrence-free survival (P<0.0001; HR=0.57; 95% CI [0.42, 0.76]) and cancer-specific survival (P=0.001; HR=0.58; 95% CI [0.42, 0.81]), which was still significant among patients with locally advanced cancer. Given the results, we believe for cervical cancer patients receiving radical hysterectomy, operation by gynecologic oncologists results in significantly improved surgical and survival

  18. 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...

  19. 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.

  20. Predictive role of post-treatment [{sup 18}F]FDG PET/CT in patients with uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hoon Chung, Hyun, E-mail: chhkmj@gmail.com [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kim, Jae Weon, E-mail: chhkmj1@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Keon Wook, E-mail: kangkw@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Park, Noh-Hyun, E-mail: pnhkhr@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Song, Yong-Sang, E-mail: yssong@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chung, June-Key, E-mail: jkchung@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Soon-Beom, E-mail: ksboo308@plaza.snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of)

    2012-08-15

    Objective: To evaluate the efficacy of post-treatment positron emission tomography (PET)/computed tomography (CT) for identification of tumor recurrence, and to determine whether [{sup 18}F]fluorodeoxyglucose (FDG) uptake measured as the maximum standardized uptake value (SUV{sub max}) has predictive role regarding survival in patients with uterine cervical cancer. Methods: Medical records from 276 women with uterine cervical cancer who had post-treatment [{sup 18}F]FDG PET/CT performed were retrospectively reviewed. Results of PET/CT scans were compared with histological or clinical examination. Results: Ninety-five (34.4%) of the 276 patients had documented recurrence by either surgical biopsy or clinical and imaging follow-up. Median duration from treatment to PET/CT scan was 24 months (range, 6-307). The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of post-treatment PET/CT were 94.7%, 87.8%, 80.4%, 97%, and 90.2%, respectively. The PET/CT scan modified both the diagnostic or treatment plan in 67 patients (24.3%). Patients were divided into two groups according to cut-off SUV{sub max} established on the basis of ROC analysis (<5.25 vs. {>=}5.25), and there was a significant difference in OS between groups (p = 0.001). In addition, the 5-year progression-free survival (PFS) and OS rates of patients with a negative PET/CT scan for recurrence were significantly better than those with a positive PET/CT (98.62% vs. 17.83%, p < 0.0001 for PFS, 99.31% vs. 85.38%, p = 0.0015 for OS). Conclusion: Post-treatment PET/CT scan is a sensitive and accurate surveillance modality, and provides prognostic information in uterine cervical cancer. Furthermore, it may allow individualization of patient care.

  1. In vivo electric conductivity of cervical cancer patients based on B₁⁺ maps at 3T MRI.

    Science.gov (United States)

    Balidemaj, E; de Boer, P; van Lier, A L H M W; Remis, R F; Stalpers, L J A; Westerveld, G H; Nederveen, A J; van den Berg, C A T; Crezee, J

    2016-02-21

    The in vivo electric conductivity (σ) values of tissue are essential for accurate electromagnetic simulations and specific absorption rate (SAR) assessment for applications such as thermal dose computations in hyperthermia. Currently used σ-values are mostly based on ex vivo measurements. In this study the conductivity of human muscle, bladder content and cervical tumors is acquired non-invasively in vivo using MRI. The conductivity of 20 cervical cancer patients was measured with the MR-based electric properties tomography method on a standard 3T MRI system. The average in vivo σ-value of muscle is 14% higher than currently used in human simulation models. The σ-value of bladder content is an order of magnitude higher than the value for bladder wall tissue that is used for the complete bladder in many models. Our findings are confirmed by various in vivo animal studies from the literature. In cervical tumors, the observed average conductivity was 13% higher than the literature value reported for cervical tissue. Considerable deviations were found for the electrical conductivity observed in this study and the commonly used values for SAR assessment, emphasizing the importance of acquiring in vivo conductivity for more accurate SAR assessment in various applications.

  2. In vivo electric conductivity of cervical cancer patients based on B_{1}^{+} maps at 3T MRI

    Science.gov (United States)

    Balidemaj, E.; de Boer, P.; van Lier, A. L. H. M. W.; Remis, R. F.; Stalpers, L. J. A.; Westerveld, G. H.; Nederveen, A. J.; van den Berg, C. A. T.; Crezee, J.

    2016-02-01

    The in vivo electric conductivity (σ) values of tissue are essential for accurate electromagnetic simulations and specific absorption rate (SAR) assessment for applications such as thermal dose computations in hyperthermia. Currently used σ-values are mostly based on ex vivo measurements. In this study the conductivity of human muscle, bladder content and cervical tumors is acquired non-invasively in vivo using MRI. The conductivity of 20 cervical cancer patients was measured with the MR-based electric properties tomography method on a standard 3T MRI system. The average in vivo σ-value of muscle is 14% higher than currently used in human simulation models. The σ-value of bladder content is an order of magnitude higher than the value for bladder wall tissue that is used for the complete bladder in many models. Our findings are confirmed by various in vivo animal studies from the literature. In cervical tumors, the observed average conductivity was 13% higher than the literature value reported for cervical tissue. Considerable deviations were found for the electrical conductivity observed in this study and the commonly used values for SAR assessment, emphasizing the importance of acquiring in vivo conductivity for more accurate SAR assessment in various applications.

  3. 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.

  4. 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

  5. Prognostic implications of tumor volume response and COX-2 expression change during radiotherapy in cervical cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Jae Myoung; Park, Won; Huh, Seung Jae; Cho, Eun Yoon; Choi, Yoon La; Bae, Duk Soo; Kim, Byoung Gie [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    The relationship between treatment outcomes, alteration of the expression of biological markers, and tumor volume response during radiotherapy (RT) in patients with uterine cervical cancer was analyzed. Twenty patients with cervical squamous cell carcinoma received definitive RT with (n = 17) or without (n = 3) concurrent chemotherapy. Tumor volumes were measured by three serial magnetic resonance imaging scans at pre-, mid-, and post-RT. Two serial punch biopsies were performed at pre- and mid-RT, and immunohistochemical staining for cyclooxygenase (COX)-2 and epidermal growth factor receptor was performed. The median follow-up duration was 60 months. The median tumor volume response at mid-RT (V2R) was 0.396 (range, 0.136 to 0.983). At mid-RT, an interval increase in the distribution of immunoreactivity for COX-2 was observed in 8 patients, and 6 of them showed poor mid-RT tumor volume response (V2R {>=} 0.4). Four (20%) patients experienced disease progression after 10 to 12 months (median, 11 months). All 4 patients had poor mid-RT tumor volume response (p = 0.0867) and 3 of them had an interval increase in COX-2 expression. Overall survival (OS) and progression-free survival (PFS) decreased in patients with V2R {>=} 0.4 (p 0.0291 for both). An interval increase in COX-2 expression at mid-RT was also associated with a decreased survival (p = 0.1878 and 0.1845 for OS and PFS, respectively). Poor tumor volume response and an interval increase in COX-2 expression at mid-RT decreased survival outcomes in patients with uterine cervical cancer.

  6. 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.

  7. 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...

  8. The lncRNA PVT1 Contributes to the Cervical Cancer Phenotype and Associates with Poor Patient Prognosis.

    Science.gov (United States)

    Iden, Marissa; Fye, Samantha; Li, Keguo; Chowdhury, Tamjid; Ramchandran, Ramani; Rader, Janet S

    2016-01-01

    The plasmacytoma variant translocation 1 gene (PVT1) is an lncRNA that has been designated as an oncogene due to its contribution to the phenotype of multiple cancers. Although the mechanism by which PVT1 influences disease processes has been studied in multiple cancer types, its role in cervical tumorigenesis remains unknown. Thus, the present study was designed to investigate the role of PVT1 in cervical cancer in vitro and in vivo. PVT1 expression was measured by quantitative PCR (qPCR) in 121 invasive cervical carcinoma (ICC) samples, 30 normal cervix samples, and cervical cell lines. Functional assays were carried out using both siRNA and LNA-mediated knockdown to examine PVT1's effects on cervical cancer cell proliferation, migration and invasion, apoptosis, and cisplatin resistance. Our results demonstrate that PVT1 expression is significantly increased in ICC tissue versus normal cervix and that higher expression of PVT1 correlates with poorer overall survival. In cervical cancer cell lines, PVT1 knockdown resulted in significantly decreased cell proliferation, migration and invasion, while apoptosis and cisplatin cytotoxicity were significantly increased in these cells. Finally, we show that PVT1 expression is augmented in response to hypoxia and immune response stimulation and that this lncRNA associates with the multifunctional and stress-responsive protein, Nucleolin. Collectively, our results provide strong evidence for an oncogenic role of PVT1 in cervical cancer and lend insight into potential mechanisms by which PVT1 overexpression helps drive cervical carcinogenesis. PMID:27232880

  9. 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

  10. 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.)

  11. 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.)

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Charafeddine Maya

    2010-09-01

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

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

    International Nuclear Information System (INIS)

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

  15. 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.

  16. 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

  17. Retrospective analysis on 1563 cases of cervical cancer patients%子宫颈癌患者1563例发病因素分析

    Institute of Scientific and Technical Information of China (English)

    贺新爱; 陈海平; 张继林

    2008-01-01

    Objective To analyze the trend of cervical cancer, age structure and influencing factors. Methods Retrospective study and survey. The 1563 patients with cervical cancer and gynecological medical examination of 600 non-cervical cancer patients who took part in Physical examination in the obstetrics and gynecology department received the enclosed analysis questionnaire. Results Cervical cancer is becoming a trend of cervical cancer patients being younger, high risk period at the age of 36 to 55, and the downward trend towards the menopausal women. The number of being pregnant, ma]-sexuality (the first sexual intercourse at a younger age, or many sexual partners), and smoking are the causes which lead to cervical cancer. Conclusion Give great importance to a trend of cervical cancer patients being younger; screening, publicity and education about cervical cancer;, missionaries and strengthen anti-cancer awareness, promote a healthy lifestyle, which is the key to prevention and treatment of cervical cancer.%目的 分析子宫颈癌的发病趋势、年龄构成和诱导因素.方法 采用回顾性研究和调查的方法,对1980年1月至2006年1月收治的1563例子宫颈癌患者的临床资料以及妇产科体检的600名非子宫颈癌妇女进行封闭式调查问卷.结果 子宫颈癌发生有年轻化趋势,36~55岁为高危年龄段,绝经期妇女发生率显著下降.孕产次数、不良性行为(初次性交年龄小、多个性伴侣)、吸烟等是子宫颈癌发生的诱因.结论 重视子宫颈癌年轻化趋势,加强子宫颈癌筛查、加强宣教、增加防癌意识,倡导健康生活方式是防治子宫颈癌的关键.

  18. 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

  19. 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.

  20. 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.

  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. 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

  4. 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.

  5. 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.

  6. 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...

  7. 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

  8. Repeat CT-scan assessment of lymph node motion in locally advanced cervical cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Bondar, Luiza; Velema, Laura; Mens, Jan Willem; Heijmen, Ben; Hoogeman, Mischa [Erasmus Medical Center Cancer Institute, Department of Radiation Oncology, 3008 AE, Rotterdam (Netherlands); Zwijnenburg, Ellen [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands)

    2014-12-15

    In cervical cancer patients the nodal clinical target volume (CTV, defined using the major pelvic blood vessels and enlarged lymph nodes) is assumed to move synchronously with the bony anatomy. The aim of this study was to verify this assumption by investigating the motion of the major pelvic blood vessels and enlarged lymph nodes visible in CT scans. For 13 patients treated in prone position, four variable bladder-filling CT scans per patient, acquired at planning and after 40 Gy, were selected from an available dataset of 9-10 CT scans. The bladder, rectum, and the nodal-vessels structure containing the iliac vessels and all visible enlarged nodes were delineated in each selected CT scan. Two online patient setup correction protocols were simulated. The first corrected bony anatomy translations and the second corrected translations and rotations. The efficacy of each correction was calculated as the overlap between the nodal-vessels structure in the reference and repeat CT scans. The motion magnitude between delineated structures was quantified using nonrigid registration. Translational corrections resulted in an average overlap of 58 ± 13% and in a range of motion between 9.9 and 27.3 mm. Translational and rotational corrections significantly improved the overlap (64 ± 13%, p value = 0.007) and moderately reduced the range of motion to 7.6-23.8 mm (p value = 0.03). Bladder filling changes significantly correlated with the nodal-vessels motion (p < 0.001). The motion of the nodal-vessels was large, nonrigid, patient-specific, and only moderately synchronous with the bony anatomy. This study highlights the need for caution when reducing the CTV-to-PTV (PTV planning target volume) margin of the nodal CTV for highly conformal radiation techniques. (orig.) [German] Bei Zervixkarzinompatientinnen wird davon ausgegangen, dass das nodale klinische Zielvolumen (CTV, definiert anhand der grossen Blutgefaesse des Beckens und vergroesserter Lymphknoten) sich synchron mit

  9. Patterns of care in patients with cervical cancer 2012. Results of a survey among German radiotherapy departments and out-patient health care centers

    International Nuclear Information System (INIS)

    Platinum-based primary or adjuvant chemoradiation is the treatment of choice for patients with cervical cancer. However, despite national guidelines and international recommendations, many aspects in diagnosis, therapy, and follow-up of patients with cervical cancer are not based on valid data. To evaluate the current patterns of care for patients with cervical cancer in Germany, a questionnaire with 25 items was sent to 281 radiooncologic departments and out-patient health care centers. The response rate was 51 %. While 87 % of institutions treat 0-25 patients/year, 12 % treat between 26 and 50 and only 1 % treat more than 50 patients/year. In 2011, the stage distribution of 1,706 treated cervical cancers were IB1, IB2, IIA, IIB, IIIA/IIIB, and IV in 11, 12, 11, 22, 28, and 16 %, respectively. CT (90 %) and MRI (86 %) are mainly used as staging procedures in contrast to PET-CT with 14 %. Interestingly, 27 % of institutions advocate surgical staging prior to chemoradiation. In the majority of departments 3D-based (70 %) and intensity-modulated radiotherapy (76 %) are used for percutaneous radiation, less frequently volumetric arc techniques (26 %). Nearly all colleagues (99.3 %) apply conventional fractioning of 1.8-2 Gy for external-beam radiotherapy, in 19 % combined with a simultaneous integrated boost. Cisplatinum mono is used as a radiosensitizer with 40 mg/m2 weekly by 90 % of radiooncologists. For boost application in the primary treatment, HDR (high-dose rate) brachytherapy is the dominant technique (84 %). In patients after radical hysterectomy pT1B1/1B2, node negative and resection in sound margins adjuvant chemoradiation is applied due to the occurrence of 1-4 other risk factors in 16-97 %. There is a broad spectrum of recommended primary treatment strategies in stages IIB and IVA. Results of the survey underline the leading role but also differences in the use of chemoradiation in the treatment of cervical cancer patients in Germany. (orig.)

  10. Proteomic biomarkers predicting lymph node involvement in serum of cervical cancer patients. Limitations of SELDI-TOF MS

    Directory of Open Access Journals (Sweden)

    Van Gorp Toon

    2012-06-01

    Full Text Available Abstract Background Lymph node status is not part of the staging system for cervical cancer, but provides important information for prognosis and treatment. We investigated whether lymph node status can be predicted with proteomic profiling. Material & methods Serum samples of 60 cervical cancer patients (FIGO I/II were obtained before primary treatment. Samples were run through a HPLC depletion column, eliminating the 14 most abundant proteins ubiquitously present in serum. Unbound fractions were concentrated with spin filters. Fractions were spotted onto CM10 and IMAC30 surfaces and analyzed with surface-enhanced laser desorption time of flight (SELDI-TOF mass spectrometry (MS. Unsupervised peak detection and peak clustering was performed using MASDA software. Leave-one-out (LOO validation for weighted Least Squares Support Vector Machines (LSSVM was used for prediction of lymph node involvement. Other outcomes were histological type, lymphvascular space involvement (LVSI and recurrent disease. Results LSSVM models were able to determine LN status with a LOO area under the receiver operating characteristics curve (AUC of 0.95, based on peaks with m/z values 2,698.9, 3,953.2, and 15,254.8. Furthermore, we were able to predict LVSI (AUC 0.81, to predict recurrence (AUC 0.92, and to differentiate between squamous carcinomas and adenocarcinomas (AUC 0.88, between squamous and adenosquamous carcinomas (AUC 0.85, and between adenocarcinomas and adenosquamous carcinomas (AUC 0.94. Conclusions Potential markers related with lymph node involvement were detected, and protein/peptide profiling support differentiation between various subtypes of cervical cancer. However, identification of the potential biomarkers was hampered by the technical limitations of SELDI-TOF MS.

  11. Optimal pathological response indicated better long-term outcome among patients with stage IB2 to IIB cervical cancer submitted to neoadjuvant chemotherapy.

    Science.gov (United States)

    Huang, Kecheng; Sun, Haiying; Chen, Zhilan; Li, Xiong; Wang, ShaoShuai; Zhao, Xiaolin; Tang, Fangxu; Jia, Yao; Hu, Ting; Du, Xiaofang; Wang, Haoran; Lu, Zhiyong; Huang, Jia; Gui, Juan; Wang, Xiaoli; Zhou, Shasha; Wang, Lin; Zhang, Jincheng; Guo, Lili; Yang, Ru; Shen, Jian; Zhang, Qinghua; Li, Shuang; Wang, Shixuan

    2016-01-01

    The role of pathological response in long-term outcome is still unclear in cervical cancer patients treated with neoadjuvant chemotherapy (NACT) in China. This study aimed to investigate the effect of optimal pathologic response (OPR) on survival in the patients treated with NACT and radical hysterectomy. First, 853 patients with stage IB2-IIB cervical cancer were included in a retrospective analysis; a Cox proportional hazards model was used to investigate the relationship between pathological response and disease-free survival (DFS). In the retrospective database, 64 (7.5%) patients were found to have achieved an OPR (residual disease <3 mm stromal invasion); in the multivariate Cox model, the risk of death was much greater in the non-OPR group than in the OPR group (HR, 2.61; 95%CI, 1.06 to 6.45; P = 0.037). Next, the role of OPR was also evaluated in a prospective cohort of 603 patients with cervical cancer. In the prospective cohort, 56 (9.3%) patients were found to have achieved an OPR; the log-rank tests showed that the risk of recurrence was higher in the non-OPR patients than in the OPR group (P = 0.05). After combined analysis, OPR in cervical cancer was found to be an independent prognostic factor for DFS. PMID:27325186

  12. Pretreatment serum lactate dehydrogenase is an independent prognostic factor for patients receiving neoadjuvant chemotherapy for locally advanced cervical cancer.

    Science.gov (United States)

    Li, Jing; Wu, Miao-Fang; Lu, Huai-Wu; Chen, Qing; Lin, Zhong-Qiu; Wang, Li-Juan

    2016-08-01

    For locally advanced cervical cancer (LACC), hypoxia is a characteristic property. This study aimed to investigate whether baseline lactic dehydrogenase (LDH) level, which is a marker of hypoxia, had clinical value in determining neoadjuvant chemotherapy (NACT) response and prognosis for LACC patients. The study cohort included 418 patients with a median follow-up of 37.5 months. Cox proportional hazards models were used to assess the prognostic value of baseline LDH levels. Multivariate logistic regression analysis was performed to identify independent predictors of complete response after NACT. Backward stepwise selection with the Akaike information criterion was used to identify factors that could be entered into the multivariate regression model. Compared with patients with LDH levels NACT (adjusted odds ratio [OR], 0.29; 95% CI, 0.15-0.58; P NACT. PMID:27350066

  13. Up-to-date opportunities of cervical lymph nodes ultrasound investigation in patients, suffering from oral cavity cancer

    Directory of Open Access Journals (Sweden)

    Yu. V. Alymov

    2016-01-01

    Full Text Available Background. Incidence of oral cancer in Russia is 4.52 and mortality – 2.44. Head and neck cancer is characterized by the high risk of development of metastases in regional lymph nodes. Lymph nodes status exerts influence on the treatment plan and appears to be the major predictive factor. Regional metastases result into two-fold decrease of five-year survival. Therefore, evaluation and treatment of metastatic lymph nodes is of prime importance. Objective. The aim of this manuscript was to illustrate and summarize publications devoted to modern methods of ultrasound evaluation of cervical lymph node status in patients with squamous cell carcinoma of the oral cavity. Results. Numerous studies have demonstrated, that standard ultrasound investigation (in B-mode is characterized by high sensitivity and specificity (specificity varies from 71.0 to 96.4 %, and specificity – from 46.6 to 91.0 %, according to different studies. In addition, ultrasound efficiency exceeds that of CT. Accuracy of ultrasound as the method of cervical lymph node investigation has increased after implementation of such methods, as elastography and elastometry (this techniques allow to achieve sensitivity of 98.1 % and specificity of 100 %. 

  14. Exploring the Cervical Cancer Screening Experiences of Black Lesbian, Bisexual, and Queer Women: The Role of Patient-Provider Communication.

    Science.gov (United States)

    Agénor, Madina; Bailey, Zinzi; Krieger, Nancy; Austin, S Bryn; Gottlieb, Barbara R

    2015-01-01

    Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, focus group discussions were conducted in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, the authors enrolled 18 black LBQ women who participated in one of four focus groups. Using thematic analysis, patient-provider communication was identified, which consisted of four sub-themes--health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and sociodemographic background--as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women's health care, and increasing the presence of LBQ women of color in health care settings. PMID:25909663

  15. The lncRNA PVT1 Contributes to the Cervical Cancer Phenotype and Associates with Poor Patient Prognosis.

    Directory of Open Access Journals (Sweden)

    Marissa Iden

    Full Text Available The plasmacytoma variant translocation 1 gene (PVT1 is an lncRNA that has been designated as an oncogene due to its contribution to the phenotype of multiple cancers. Although the mechanism by which PVT1 influences disease processes has been studied in multiple cancer types, its role in cervical tumorigenesis remains unknown. Thus, the present study was designed to investigate the role of PVT1 in cervical cancer in vitro and in vivo. PVT1 expression was measured by quantitative PCR (qPCR in 121 invasive cervical carcinoma (ICC samples, 30 normal cervix samples, and cervical cell lines. Functional assays were carried out using both siRNA and LNA-mediated knockdown to examine PVT1's effects on cervical cancer cell proliferation, migration and invasion, apoptosis, and cisplatin resistance. Our results demonstrate that PVT1 expression is significantly increased in ICC tissue versus normal cervix and that higher expression of PVT1 correlates with poorer overall survival. In cervical cancer cell lines, PVT1 knockdown resulted in significantly decreased cell proliferation, migration and invasion, while apoptosis and cisplatin cytotoxicity were significantly increased in these cells. Finally, we show that PVT1 expression is augmented in response to hypoxia and immune response stimulation and that this lncRNA associates with the multifunctional and stress-responsive protein, Nucleolin. Collectively, our results provide strong evidence for an oncogenic role of PVT1 in cervical cancer and lend insight into potential mechanisms by which PVT1 overexpression helps drive cervical carcinogenesis.

  16. 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

  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. The value of 3.0Tesla diffusion-weighted MRI for pelvic nodal staging in patients with early stage cervical cancer

    NARCIS (Netherlands)

    Klerkx, W.M.; Veldhuis, W.B.; Spijkerboer, A.M.; Bosch, M.A. van den; Mali, W.P.Th.; Heintz, A.P.; Bipat, S.; Sie-Go, D.M.; Velden, J.; Schreuder, H.W.B.; Stoker, J.; Peeters, P.H.M.

    2012-01-01

    OBJECTIVE: The purpose of this study is to investigate the diagnostic accuracy of 3.0Tesla (3T) diffusion-weighted magnetic resonance imaging (MRI) in addition to conventional MRI for the detection of lymphadenopathy in patients with early stage cervical cancer compared to histopathological evaluati

  19. Intra-patient semi-automated segmentation of the cervix-uterus in CT-images for adaptive radiotherapy of cervical cancer

    NARCIS (Netherlands)

    L. Bondar (Luiza); M.S. Hoogeman (Mischa); W. Schillemans; B.J.M. Heijmen (Ben)

    2013-01-01

    textabstractFor online adaptive radiotherapy of cervical cancer, fast and accurate image segmentation is required to facilitate daily treatment adaptation. Our aim was twofold: (1) to test and compare three intra-patient automated segmentation methods for the cervix-uterus structure in CT-images and

  20. 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

  1. Sentinel Lymph Node Mapping With Near-Infrared Fluorescent Imaging Using Indocyanine Green: A New Tool for Laparoscopic Platform in Patients With Endometrial and Cervical Cancer.

    Science.gov (United States)

    Buda, Alessandro; Bussi, Beatrice; Di Martino, Giampaolo; Di Lorenzo, Paolo; Palazzi, Sharon; Grassi, Tommaso; Milani, Rodolfo

    2016-02-01

    Indocyanine green (ICG) represents a feasible alternative to the more traditional methods of sentinel lymph node (SLN) mapping, and interest in this promising tracer is growing. This report outlines our experience with ICG in a minimally invasive laparoscopic approach in women with endometrial cancer and cervical cancer using the Storz SPIES ICG near-infrared fluorescence imaging technology. A total of 49 patients with clinical stage I endometrial cancer (n = 40) or stage I cervical cancer (n = 9) were retrospectively reviewed. All patients had undergone simple or radical laparoscopic hysterectomy with pelvic and/or aortic lymphadenectomy and SLN mapping by means of an intracervical injection of ICG dye at the 3 o'clock and 9 o'clock locations after the induction of general anesthesia. The detection rate of ICG was 100% (49 of 49). The rate of bilateral SLN detection was 86% (42 of 49). Positive lymph nodes were found in 6 patients (12%), with at least 1 positive SLN. The sensitivity and negative predictive value of SLN detection were 100%. All procedures were successfully completed without conversion to open laparotomy, and no intraoperative or postoperative complications occurred. In our preliminary experience, ICG showed a high overall detection rate, and bilateral mapping appears to be a feasible alternative to the more traditional methods of SLN mapping in patients with endometrial cancer and cervical cancer. Laparoscopic SLN mapping with ICG appears to be safe, easy, and reproducible, with a positive impact on patient management.

  2. Evaluation of cervical lymph node metastasis in thyroid cancer patients using real-time CT navigated ultrasonography: preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Na, Dae Kwon; Choi, Yoon Jung; Choi, Seon Hyeong; Kook, Shin Ho; Park, Hee Jin [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    To evaluate the diagnostic accuracy of real-time neck computed tomography (CT)-guided ultrasonography (US) in detecting cervical neck lymph node metastasis (LNM) in patients with papillary thyroid cancer (PTC). We retrospectively reviewed data from 176 patients (mean age, 43 years; range, 23 to 74 years) with surgically confirmed PTC who underwent preoperative US, neck CT, and neck CTguided US. We then compared the sensitivities and diagnostic accuracies of each of the three above modalities in detecting cervical LNM. Preoperative US showed 17.3% sensitivity and 58.5% diagnostic accuracy in detecting central LNM compared with 64.3% sensitivity and 89.2% diagnostic accuracy in detecting lateral neck LNM. Neck CT showed 23.5% sensitivity and 55.7% diagnostic accuracy in detecting central LNM and 71.4% sensitivity with 90.9% diagnostic accuracy in detecting lateral neck LNM. CT-guided US exhibited 37.0% sensitivity and 63.1% diagnostic accuracy in detecting central LNM compared with 92.9% sensitivity and 96.0% diagnostic accuracy in detecting lateral LNM. CT-guided US showed higher diagnostic accuracy with superior sensitivity in detecting central and lateral LNM than did US (P<0.001, P=0.011) and CT (P=0.026, P=0.063). Neck CT-guided US is a more accurate technique with higher sensitivity for detecting cervical LNM than either US or CT alone. Therefore, our data indicate that neck CT-guided US is an especially useful technique in preoperative examinations.

  3. 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

  4. Helical Tomotherapy With Simultaneous Integrated Boost After Laparoscopic Staging in Patients With Cervical Cancer: Analysis of Feasibility and Early Toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, Simone, E-mail: simone.marnitz@charite.de [Department of Radiooncology, Charite University Medicine, Berlin (Germany); Koehler, Christhardt [Department of Gynecology, Charite University Medicine, Berlin (Germany); Burova, Elena; Wlodarczyk, Waldemar; Jahn, Ulrich; Gruen, Arne; Budach, Volker; Stromberger, Carmen [Department of Radiooncology, Charite University Medicine, Berlin (Germany)

    2012-02-01

    Purpose: To demonstrate the feasibility and safety of the simultaneous integrated boost technique for dose escalation in combination with helical tomotherapy in patients with cervical cancer. Methods and Materials: Forty patients (International Federation of Gynecology and Obstetrics Stage IB1 pN1-IVA) underwent primary chemoradiation with helical tomotherapy. Before therapy, 29/40 patients underwent laparoscopic pelvic and para-aortic lymphadenectomy. In 21%, 31%, and 3% of the patients, pelvic, pelvic and para-aortic, and skip metastases in the para-aortic region could be confirmed. All patients underwent radiation with 1.8-50.4 Gy to the tumor region and the pelvic (para-aortic) lymph node region (planning target volume-A), and a simultaneous boost with 2.12-59.36 Gy to the boost region (planning target volume-B). The boost region was defined using titan clips during laparoscopic staging. In all other patients, standardized borders for the planning target volume-B were defined. High-dose-rate brachytherapy was performed in 39/40 patients. The mean biologic effective dose to the macroscopic tumor ranged from 87.5 to 97.5 Gy. Chemotherapy consisted of weekly cisplatin 40 mg/m{sup 2}. Dose-volume histograms and acute gastrointestinal, genitourinary, and hematologic toxicity were evaluated. Results: The mean treatment time was 45 days. The mean doses to the small bowel, rectum, and bladder were 28.5 {+-} 6.1 Gy, 47.9 {+-} 3.8 Gy, and 48 {+-} 3 Gy, respectively. Hematologic toxicity Grade 3 occurred in 20% of patients, diarrhea Grade 2 in 5%, and diarrhea Grade 3 in 2.5%. There was no Grade 3 genitourinary toxicity. All patients underwent curettage 3 months after chemoradiation, which confirmed complete pathologic response in 38/40 patients. Conclusions: The concept of simultaneous integrated boost for dose escalation in patients with cervical cancer is feasible, with a low rate of acute gastrointestinal and genitourinary toxicity. Whether dose escalation can be

  5. 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.

  6. Interstitial magnetic resonance lymphography is an effective diagnostic tool for the detection of lymph node metastases in patients with cervical cancer

    Directory of Open Access Journals (Sweden)

    Hong Ying

    2012-08-01

    Full Text Available Abstract Background The aim of the present study was to determine the feasibility of detecting sentinel lymph node (SLN metastases using interstitial magnetic resonance (MR lymphography in patients with cervical cancer. MR data were compared to pathological results from the lymph nodes excised during surgery. Methods Twenty-eight patients with cervical cancer were enrolled and studied from January 2006 to December 2010. All patients underwent interstitial MR lymphography to determine the presence of sentinel lymph nodes and visualize lymphatic vessel drainage in the pelvis. Radical hysterectomy and excision of pelvic lymph nodes was performed according to their lesion grade. Gadodiamide was injected either intradermally into the bipedal toe web, into the labia majora or into the cervical tissue. MR results were compared with pathological reports. Results In 28 patients, lymphatic vessel drainage and lymph node groups were clearly visualized. Of these, 5 were MR lymphography positive and 23 were MR lymphography negative. Six had pathologically proven metastasis, five had true positives and 1 had a false negative in the obturator lymph node. Conclusions Interstitial MR lymphography can be used to determine the extent and shape of pelvic lymphatic vessel drainage and lymph node metastases in patients with cervical cancer.

  7. 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.

  8. 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....

  9. 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.

  10. 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...

  11. 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 ...

  12. 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.

  13. Intrathoracic versus Cervical Anastomosis after Resection of Esophageal Cancer: A matched pair analysis of 72 patients in a single center study

    Directory of Open Access Journals (Sweden)

    Klink Christian D

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to analyze the early postoperative outcome of esophageal cancer treated by subtotal esophageal resection, gastric interposition and either intrathoracic or cervical anastomosis in a single center study. Methods 72 patients who received either a cervical or intrathoracic anastomosis after esophageal resection for esophageal cancer were matched by age and tumor stage. Collected data from these patients were analyzed retrospectively regarding morbidity and mortality rates. Results Anastomotic leakage rate was significantly lower in the intrathoracic anastomosis group than in the cervical anastomosis group (4 of 36 patients (11% vs. 11 of 36 patients (31%; p = 0.040. The hospital stay was significantly shorter in the intrathoracic anastomosis group compared to the cervical anastomosis group (14 (range 10–110 vs. 26 days (range 12 – 105; p = 0.012. Wound infection and temporary paresis of the recurrent laryngeal nerve occurred significantly more often in the cervical anastomosis group compared to the intrathoracic anastomosis group (28% vs. 0%; p = 0.002 and 11% vs. 0%; p = 0.046. The overall In-hospital mortality rate was 6% (4 of 72 patients without any differences between the study groups. Conclusions The present data support the assumption that the transthoracic approach with an intrathoracic anastomosis compared to a cervical esophagogastrostomy is the safer and more beneficial procedure in patients with carcinoma of the lower and middle third of the esophagus due to a significant reduction of anastomotic leakage, wound infection, paresis of the recurrent laryngeal nerve and shorter hospital stay.

  14. 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.

  15. Vascular intervention treatment role and signiifcance in patients with advanced ovarian cancer and cervical cancer%血管介入治疗对晚期卵巢癌与宫颈癌的治疗作用及意义

    Institute of Scientific and Technical Information of China (English)

    吕峰泉; 李焕祥; 刘武军; 马彦寿

    2015-01-01

    ObjectiveTo analysis of vascular interventional therapy in the treatment of patients with advanced ovarian cancer and cervical cancer role and signiifcance.Methods30 cases of advanced ovarian cancer and 30 cases of cervical cancer patients with vascular interventional therapy, and 30 cases of advanced ovarian cancer and 30 cases of cervical cancer patients with traditional surgery.ResultsThe vascular interventional treatment of patients with advanced ovarian cancer and cervical cancer patients with efficient and survival rate were obviously higher than that of traditional surgical treatment of patients, with signiifcant difference (P<0.05). ConclusionVascular interventional treatment of advanced ovarian cancer, and cervical cancer patients had a higher therapeutic effect and signiifcance.%目的分析血管介入治疗对晚期卵巢癌与宫颈癌的治疗作用及意义。方法30例晚期卵巢癌及30例宫颈癌患者采用血管介入治疗,另外30例晚期卵巢癌及30例宫颈癌患者采用传统手术治疗。结果晚期卵巢癌与宫颈癌患者血管介入治疗的有效率、存活率都明显高于传统手术治疗的患者,差异具有统计学意义(P<0.05)。结论血管介入治疗晚期卵巢癌与宫颈癌患者有较高的治疗作用及意义。

  16. 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.

  17. The influence of number of high risk factors on clinical outcomes in patients with early-stage cervical cancer after radical hysterectomy and adjuvant chemoradiation

    Science.gov (United States)

    Lim, Soyi; Lee, Seok-Ho; Park, Chan-Yong

    2016-01-01

    Objective The purpose of this study was to evaluate the prognosis according to the number of high risk factors in patients with high risk factors after radical hysterectomy and adjuvant chemoradiation therapy for early stage cervical cancer. Methods Clinicopathological variables and clinical outcomes of patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB1 to IIA cervical cancer who had one or more high risk factors after radical hysterectomy and adjuvant chemoradiation therapy were retrospectively analyzed. Patients were divided into two groups according to the number of high risk factors (group 1, single high risk factor; group 2, two or more high risk factors). Results A total of 93 patients were enrolled in the present study. Forty nine out of 93 (52.7%) patients had a single high risk factor, and 44 (47.3%) had two or more high risk factors. Statistically significant differences in stage and stromal invasion were observed between group 1 and group 2. However, age, histology, tumor size, and lymphovascular space invasion did not differ significantly between the groups. Distant recurrence occurred more frequently in group 2, and the probability of recurrence and death was higher in group 2. Conclusion Patients with two or more high risk factors had worse prognosis in early stage cervical cancer. For these patients, consideration of new strategies to improve survival may be worthwhile. Conduct of further clinical trials is warranted for development of adjuvant treatment strategies individualized to each risk group. PMID:27200308

  18. Detection of human papillomavirus de-oxy-ribose nucleic acid and its genotypes in cervical cancer patients: A step toward vaccine production

    Directory of Open Access Journals (Sweden)

    Virendra Bhandari

    2016-01-01

    Full Text Available Background: India has a highest global burden of cervical cancer. Infection with a high-risk human papillomavirus (HPV genotype has been identified as the most important etiologic risk factor for the development of cervical cancer. Aim: The aim of the study was to detect the genotype of high-risk HPV-de-oxy-ribose nucleic acid (DNA in a patient suspected of cervical cancer and to study the epidemiological factors related to cervical cancer patients. Materials and Methods: The present prospective study was carried out from January 2013 to December 2013 in the molecular medicine laboratory located in our tertiary care super-specialty hospital. Fifty-two female patients who presented in the Gynecology and Oncology Outpatient Department with vaginal bleeding were included in the study. Followed by the detection of HPV genotype using specific markers, restriction fragment length polymorphism was done using different digestion enzymes. Results: Of the 52 cervical samples subjected to polymerase chain reaction for the detection of high-risk HPV-DNA, 44 (84.6% samples tested positive, and 8 (15.3% samples lacked the HPV-DNA. The overall distribution of the major HPV types was as follows: HPV16 (50% was the most prevalent genotype, followed by HPV18 (15.3%. Other genotypes included 1.9% HPV33 and 1.9% HPV62 while infection with the mixed type (HPV16 and HPV18 was seen in 15.3% of patients. Conclusion: As we switch from cytology-based screening to HPV-based screening, genotyping could potentially provide information on individual risk stratification, therapeutic decisions, epidemiological studies, and vaccine development.

  19. 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

  20. Randomized controlled trial of live lactobacillus acidophilus plus bifidobacterium bifidum in prophylaxis of diarrhea during radiotherapy in cervical cancer patients

    International Nuclear Information System (INIS)

    Radiation-induced diarrhea is frequently observed during pelvic radiotherapy. This study was performed to determine the ability of a probiotic containing live lactobacillus acidophilus plus bifidobacterium bifidum to reduce the incidence of radiation-induced diarrhea in locally advanced cervical cancer patients. Patients who were undergoing pelvic radiotherapy concurrent with weekly cisplatin were randomly assigned to a study drug or placebo, in a double-blind study. Diarrhea was graded weekly according the Common Toxicity Criteria (CTC) system. Stool consistency and white and red blood cell count in stool were also assessed. The primary endpoint was to reduce the incidence of diarrhea, defined by a CTC grade 2 or more, and the need for anti-diarrheal medication. A total of 63 patients were enrolled. Grade 2 -3 diarrhea was observed in 45% of the placebo group (n = 31) and 9% of the study drug group (n = 32) (p = 0.002). Anti-diarrheal medication use was significantly reduced in the placebo group (p = 0.03). The patients in the study drug group had a significantly improved stool consistency (p < 0.001). Live lactobacillus acidophilus plus bifidobacterium bifidum reduced the incidence of radiation-induced diarrhea and the need for anti-diarrheal medication and had a significant benefits on stool consistency

  1. Association Between HIF-1 Alpha Gene Polymorphisms and Response in Patients Undergoing Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer.

    Science.gov (United States)

    Chen, Qing; Tian, Wei-Jie; Huang, Miao-Ling; Liu, Chang-Hao; Yao, Ting-Ting; Guan, Mei-Mei

    2016-01-01

    BACKGROUND The aim of the study was to assess whether HIF-1α polymorphisms have an effect on the response to chemotherapy of locally advanced cervical cancer (LACC) patients treated with platinum-based neoadjuvant chemotherapy (NACT) and radical surgery. MATERIAL AND METHODS We conducted a retrospective study in 162 LACC patients. Hypoxia-inducible factor 1α C1772T and G1790A genetic polymorphisms were ascertained using direct sequencing methods. RESULTS The C1772T polymorphism was significantly related to response to chemotherapy (P=0.002), and there was an increased chance of treatment response in patients with the C/C genotype (OR=4.7; 95% CI: 1.67-13.49; P=0.004). The C1772T polymorphism was also associated with poor tumor grade (adjusted OR, 2.98; 95% CI: 1.08-8.13; P=0.037). However, The G1790A polymorphism was not associated with response (P>0.05). CONCLUSIONS The C1772T polymorphism was significantly related to response to chemotherapy and poor tumor grade. Our results may help to better manage individual patients and to improve clinical decision making regarding use of NACT. PMID:27593081

  2. Long-term impact of initial surgical and medical therapy on young patients with papillary thyroid cancer and bilateral cervical metastases

    Institute of Scientific and Technical Information of China (English)

    JI Qing-hai; ZHANG Ling; ZHU Yong-xue; HUANG Cai-ping

    2008-01-01

    Background There are few reviews on the clinical features and prognosis of young patients with papillary thyroid cancer and bilateral cervical metastases. We have investigated the long-term impact of initial surgical and medical therapy on such patients.Methods A retrospective study was performeojon 24 young patients (11 females and 13 males) with papillary thyroid cancer and bilateral cervical lymph node metastases, ranging in age from 11 to 20 years (mean age, 16.6 years), who were treated in our Institution from 1 January 1970 to 31 December 1985.Results All the patients in this group were followed up for 20 years. The survival of the patients at 20 years was 91.7%. The recurrence of local tumor and distant metastases was 20.8% and 12.5%, respectively. Based on analysis of the clinical data, we determined that the completeness of the surgical excision had a significant correlation with tumor recurrence.Conclusion These young patients with papillary thyroid cancer and cervical metastases have a good prognosis after suitable treatment.

  3. [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

  4. Efficacy of concurrent single-agent chemotherapy using radiotherapy in patients with cervical cancer: a meta-analysis.

    Science.gov (United States)

    Zhang, Ying; Yang, Zhicheng; Zhou, Yijin; Pan, Jingjing; Liu, Yongyuan

    2015-01-01

    Concurrent chemoradiotherapy has proven to be more effective on patients with advanced cervical cancer than radiotherapy alone. Although cisplatin has been recommended to be the standard agent in chemotherapy, it has some limitations in clinical use because of its strong side effects. Moreover, the optimal chemotherapy regimen remains unclear. A comprehensive electronic search was conducted via the Internet retrieval system to identify eligible trials. The ending points included response, overall survival (OS), local recurrent, and distant metastasis rates. Odds ratios and 95% confidence interval were calculated to compare the effects. Fifteen trials with 1142 patients were eligible. With regard to the response rate, only nedaplatin showed a significant improvement compared with cisplatin. Docetaxel, pacitaxel, fluoropyrimidine, paclitaxel liposome, and irinotecan did not show any advantages. When targeted on OS or local recurrent rate, no significant advantage was found when these single-drug regimens were compared with cisplatin. However, when aimed at distant metastasis rate, fluoropyrimidine showed a disadvantage to cisplatin, whereas others showed equal efficacy. Nedaplatin, docetaxel, pacitaxel, and fluoropyrimidine showed a better effect on reducing chemotherapy toxicity than cisplatin. Single-drug chemotherapy concurrent with radiotherapy, except for nedaplatin, may have no advantage on clinical outcomes when compared with cisplatin but showed a better effect on reducing chemotherapy toxicity, which could be used as an alternative to patients who can not tolerate the side effects of cisplatin. Nedaplatin is also effective and safe, and may be highly valuable in clinical applications. PMID:26309518

  5. 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

  6. 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...

  7. 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 ...

  8. 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

  9. 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.

  10. 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

  11. 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 ...

  12. Diagnostic performance of diffusion-weighted MRI for detection of pelvic metastatic lymph nodes in patients with cervical cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Shen, G; Zhou, H; Jia, Z; Deng, H

    2015-08-01

    In recent years, diffusion-weighted (DW) MRI has emerged as a new technique for detecting the pelvic lymph metastases in patients with cervical cancer. The aim of this meta-analysis was to assess the diagnostic value of DW imaging (DWI) for benign/malignant discrimination of pelvic lymph nodes (LNs). Studies about DWI for the detection of metastatic LNs were searched in the PubMed, EMBASE, Web of Science, EBSCO, the Cochrane Library and three Chinese databases. Based on the extracted data, we determined pooled sensitivities, specificities and diagnostic odds ratios (DORs) across studies, calculated positive and negative likelihood ratios (LRs) and constructed summary receiver operating characteristic curves with area under the curve (AUC) and Q* obtained. We also analysed the heterogeneity between studies based on subgroup analysis, threshold effect and publication bias. In total, 15 studies involving 1021 patients met the inclusion criteria. The pooled sensitivity, specificity and DOR of DWI were 0.86 [95% confidence interval (CI), 0.84-0.89], 0.84 (95% CI, 0.83-0.86) and 47.21 (95% CI, 25.67-86.81), respectively. LR syntheses yielded overall positive LR of 6.55 (95% CI, 4.77-9.01) and negative LR of 0.17 (95% CI, 0.12-0.23). The AUC and Q* index were 0.9384 and 0.8754, respectively. The heterogeneity was relatively high between studies; however, there was no evidence for threshold effect and publication bias. DWI is beneficial in the pelvic nodal assessment in patients with cervical cancer. Large-scale, high-quality trials with standard protocols are required to evaluate its clinical value for discrimination of metastatic from non-metastatic pelvic LNs in patients with cervical cancer. Advances in knowledge include providing evidence to assess the role of DWI in nodal staging of cervical cancer.

  13. ANTI-MÜLLERIAN HORMONE AND INHIBIN-B LEVEL PROFILE IN CERVICAL CANCER PATIENTS TREATED WITH PACLITAXEL AND CISPLATIN COMBINATION

    Directory of Open Access Journals (Sweden)

    N. Abdulah

    2014-06-01

    Full Text Available Background: The age of nulliparous women has increased in developed countries and the 5-year survival rate for the late stage does not exceed 58%. Moreover, as more women are delaying child-bearing, preservation of fertility and reproductive function is a major concern when young women are counseled with regard to the effects of treatment for cervical cancer. Objective: To determine the effect of the combination chemotherapy on serum levels of Anti-Mullerian Hormone (AMH and inhibin B. Methods: This study is a prospective cohort study in 16 cervical cancer patients aged 28-48 years who received Paclitaxel-Cisplatin chemotherapy. AMH and inhibin B levels were examined before and after third series chemotherapy. Statistical analysis used the Wilcoxon test with a level of significance selected at 0.05. Results: There is a significant decrease in median serum levels of AMH and inhibin B patients between before and after Paclitaxel–Cisplatin chemotherapy with p=0.000 (P <0.05. Similarly, a decrease in the median value of serum levels of AMH and inihibin B after Paclitaxel-Cisplatin chemotherapy in each series of chemotherapy was significant with p=0.000 (P <0.05. Conclusions: Serum levels of AMH and inhibin B in cervical cancer patients who received the combination chemotherapy decreased dramatically after 3 months of chemotherapy and the factors that contribute to the diminution is age.

  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. 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

  16. 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

  17. 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.

  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. 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

  20. Inappropriate cervical injection of radiotracer for sentinel node mapping in a uterine cervix cancer patient: importance of lymphoscintigraphy and blue dye injection

    Directory of Open Access Journals (Sweden)

    Sima Kadkhodayan

    2014-10-01

    Full Text Available Herein, we report a case of sentinel lymph node mapping in a uterine cervix cancer patient, referring to the nuclear medicine department of our institute. Lymphoscintigraphy images showed inappropriate intra‐cervical injection of radiotracer. Blue dye technique was applied for sentinel lymph node mapping, using intra‐cervical injection of methylene blue. Two blue/cold sentinel lymph nodes, with no pathological involvement, were intra‐operatively identified, and the patient was spared pelvic lymph node dissection. The present case underscores the importance of lymphoscintigraphy imaging in sentinel lymph node mapping and demonstrates the added value of blue dye injection in selected patients. It is suggested that preoperative lymphoscintigraphy imaging be considered as an integral part of sentinel lymph node mapping in surgical oncology. Detailed results of lymphoscintigraphy images should be provided for surgeons prior to surgery, and in case the sentinel lymph nodes are not visualized, use of blue dye for sentinel node mapping should be encouraged.

  1. 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...

  2. 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

  3. 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....

  4. Chemoradiation With Paclitaxel and Carboplatin in High-Risk Cervical Cancer Patients After Radical Hysterectomy: A Korean Gynecologic Oncology Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taek Sang [Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Kang, Soon Beom, E-mail: tslee70@gmail.com [Department of Obstetrics and Gynecology, Konkuk University Medical Center, Seoul (Korea, Republic of); Kim, Young Tak [Department of Obstetrics and Gynecology, Asan Medical Center, Seoul (Korea, Republic of); Park, Byung Joo [Department of Preventive Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Man [Department of Obstetrics and Gynecology, Asan Medical Center, Seoul (Korea, Republic of); Lee, Jong Min [Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Kim, Seok Mo [Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Kim, Young Tae [Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jae Hoon [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Tai [Department of Obstetrics and Gynecology, Hanyang University Medical Center, Seoul (Korea, Republic of)

    2013-06-01

    Purpose: To evaluate the efficacy and toxicity of concurrent chemoradiation with paclitaxel and carboplatin in patients with high-risk cervical cancer. Methods and Materials: Patients after radical hysterectomy for cervical cancer, with at least 1 high-risk characteristic, were administered paclitaxel 135 mg/m{sup 2}, carboplatin area under the curve = 5 every 3 weeks for 3 cycles concomitant with radiation therapy as adjuvant treatment. Results: This prospective study enrolled 71 consecutive patients. Sixty-six patients (93%) completed the planned treatment. The majority of grade 3/4 neutropenia or nonhematologic toxicities were usually self-limited. Diarrhea grades 3/4 were observed in 4 patients (5.6%). One patient developed anaphylactic shock after infusion of paclitaxel. With a median follow-up of 57 months, recurrences occurred in 16 patients. Multivariable analysis indicated that common iliac lymph node involvement is an independent risk factor for disease recurrence (odds ratio 13.48; 95% confidence interval 2.93-62.03). In the intent-to-treat population (n=71), the estimated 5-year disease-free survival and overall survival rates were 77.3% and 80.3% respectively. In the per-protocol population (n=62), disease-free survival was 78.9% and overall survival was 83.9%. Conclusions: Concurrent chemoradiation with paclitaxel/carboplatin is well tolerated and seems to be effective for patients who undergo radical hysterectomy. Therefore, a prospective, randomized controlled study should be designed to evaluate efficacy of this approach for patients with high-risk cervical cancer.

  5. Clinical Relevance of CDH1 and CDH13 DNA-Methylation in Serum of Cervical Cancer Patients

    Directory of Open Access Journals (Sweden)

    Günther K. Bonn

    2012-07-01

    Full Text Available This study was designed to investigate the DNA-methylation status of E-cadherin (CDH1 and H-cadherin (CDH13 in serum samples of cervical cancer patients and control patients with no malignant diseases and to evaluate the clinical utility of these markers. DNA-methylation status of CDH1 and CDH13 was analyzed by means of MethyLight-technology in serum samples from 49 cervical cancer patients and 40 patients with diseases other than cancer. To compare this methylation analysis with another technique, we analyzed the samples with a denaturing high performance liquid chromatography (DHPLC PCR-method. The specificity and sensitivity of CDH1 DNA-methylation measured by MethyLight was 75% and 55%, and for CDH13 DNA-methylation 95% and 10%. We identified a specificity of 92.5% and a sensitivity of only 27% for the CDH1 DHPLC-PCR analysis. Multivariate analysis showed that serum CDH1 methylation-positive patients had a 7.8-fold risk for death (95% CI: 2.2–27.7; p = 0.001 and a 92.8-fold risk for relapse (95% CI: 3.9–2207.1; p = 0.005. We concluded that the serological detection of CDH1 and CDH13 DNA-hypermethylation is not an ideal diagnostic tool due to low diagnostic specificity and sensitivity. However, it was validated that CDH1 methylation analysis in serum samples may be of potential use as a prognostic marker for cervical cancer patients.

  6. A reusable localized surface plasmon resonance biosensor for quantitative detection of serum squamous cell carcinoma antigen in cervical cancer patients based on silver nanoparticles array

    Directory of Open Access Journals (Sweden)

    Zhao Q

    2014-02-01

    Full Text Available Qianying Zhao,1 Ruiqi Duan,1 Jialing Yuan,1 Yi Quan,1 Huan Yang,2 Mingrong Xi1 1Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, 2State Key Laboratory of Optical Technologies for Micro-fabrication, Institute of Optics and Electronics, Chinese Academy of Science, Chengdu, Sichuan, People's Republic of China Abstract: Squamous cell carcinoma antigen (SCCa, as a tumor biomarker, plays an important role in adjuvant diagnosis, treatment evaluation, and prognosis prediction for cervical cancer patients. Localized surface plasmon resonance (LSPR technique based on noble metal nanoparticles bypasses the disadvantages of traditional testing strategies, in terms of free-labeling, short assay time, good sensitivity, and selectivity. Herein, we develop a novel and reusable LSPR biosensor for the detection of SCCa. First, a triangle-shaped silver nanoparticle array was fabricated using the nanosphere lithography method. Next, we investigated and verified the feasibility of amino coupling method using 11-mercaptoundecanoic acid (MUA to form a functionalized chip surface with monoclonal anti-SCCa antibodies on the silver nanoparticles for distinct detection of SCCa. Different concentrations of SCCa were successfully tested in both buffer and human serum by the ultrasensitive and specific LSPR system, with a linear quantitative detection range of 0.1–1,000 pM under optimal conditions. With appropriate regeneration solution, for example 50 mM glycine-HCl (pH 2.0, the LSPR biosensor featured effective fabrication reproducibility, which reduced both production cost and testing time. Our study represents the first application of the LSPR biosensor in cervical cancer, and demonstrates that the rapid, simple, and reusable nanochip can serve as a potential alternative for clinical serological diagnosis of SCCa in cervical cancer patients. Keywords: localized surface plasmon resonance, nanotechnology, biosensor

  7. 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.

  8. 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.

  9. 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

  10. 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....

  11. The Utility and indication of FDG-PET scan in patients with cervical cancer: experience in patients with no evidence of recurrence with conventional radiologic examination and tumor markers

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the clinical feasibility of FDG-PET(Positron Emission Tomography) scan in patients with clinically no evidence of disease after treatment of cervical cancer. One hundred and one patients with clinically NED(no evidence of disease) state after treatment of cervical cancer underwent PET scan. FDG-PET scan was obtained with a GE Advance Scanner, beginning at 50 minutes after injection of 370-555 MBq(10-15 mCi) of 18F FDG. Regional scan was also obtained with emission image. Uptake exceeding 3.0 SUV was determined as a positive finding. Recurrence was confirmed by CT, MRI, and needle biopsy if possible. Among 101 patients showing no evidence of disease, 17 patients(16.8%) showed abnormal PET scan findings. Clinically, 8 patients(7.9%) were confirmed to have recurrent lesion by CT, MRI or by needle biopsy. PET scan could detect recurrent lesions in the mediastinum or lung(10/17), pelvis(7/17), and supraclavicular lymph node(2/17). The sensitivity and specificity of PET scan in patients with cervical cancer showing no evidence of disease were 100% and 90.3%, respectively. The positive predictive value, negative predictive value and false positive rate were 47.1%, 100% and 52.9%. PET scan could detect 7.9% of early recurrence in patients with cervical cancer with NED status. FDG-PET scan may be a useful method in detecting metastases or recurrence of a cervical cancer showing no evidence of disease by routine conventional imaging studies

  12. The Utility and indication of FDG-PET scan in patients with cervical cancer: experience in patients with no evidence of recurrence with conventional radiologic examination and tumor markers

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    2000-12-01

    The purpose of this study was to investigate the clinical feasibility of FDG-PET(Positron Emission Tomography) scan in patients with clinically no evidence of disease after treatment of cervical cancer. One hundred and one patients with clinically NED(no evidence of disease) state after treatment of cervical cancer underwent PET scan. FDG-PET scan was obtained with a GE Advance Scanner, beginning at 50 minutes after injection of 370-555 MBq(10-15 mCi) of 18F FDG. Regional scan was also obtained with emission image. Uptake exceeding 3.0 SUV was determined as a positive finding. Recurrence was confirmed by CT, MRI, and needle biopsy if possible. Among 101 patients showing no evidence of disease, 17 patients(16.8%) showed abnormal PET scan findings. Clinically, 8 patients(7.9%) were confirmed to have recurrent lesion by CT, MRI or by needle biopsy. PET scan could detect recurrent lesions in the mediastinum or lung(10/17), pelvis(7/17), and supraclavicular lymph node(2/17). The sensitivity and specificity of PET scan in patients with cervical cancer showing no evidence of disease were 100% and 90.3%, respectively. The positive predictive value, negative predictive value and false positive rate were 47.1%, 100% and 52.9%. PET scan could detect 7.9% of early recurrence in patients with cervical cancer with NED status. FDG-PET scan may be a useful method in detecting metastases or recurrence of a cervical cancer showing no evidence of disease by routine conventional imaging studies.

  13. 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.

  14. 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.

  15. 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...

  16. Tumor-Targeting Salmonella typhimurium A1-R in Combination with Trastuzumab Eradicates HER-2-Positive Cervical Cancer Cells in Patient-Derived Mouse Models.

    Directory of Open Access Journals (Sweden)

    Yukihiko Hiroshima

    Full Text Available We have previously developed mouse models of HER-2-positive cervical cancer. Tumors in nude mice had histological structures similar to the original tumor and were stained by anti-HER-2 antibody in the same pattern as the patient's cancer. We have also previously developed tumor-targeting Salmonella typhimurium A1-R and have demonstrated its efficacy against patient-derived tumor mouse models, both alone and in combination. In the current study, we determined the efficacy of S. typhimurium A1-R in combination with trastuzumab on a patient-cancer nude-mouse model of HER-2 positive cervical cancer. Mice were randomized to 5 groups and treated as follows: (1 no treatment; (2 carboplatinum (30 mg/kg, ip, weekly, 5 weeks; (3 trastuzumab (20 mg/kg, ip, weekly, 5 weeks; (4 S. typhimurium A1-R (5 × 107 CFU/body, ip, weekly, 5 weeks; (5 S. typhimurium A1-R (5 × 107 CFU/body, ip, weekly, 5 weeks + trastuzumab (20 mg/kg, ip, weekly, 5 weeks. All regimens had significant efficacy compared to the untreated mice. The relative tumor volume of S. typhimurium A1-R + trastuzumab-treated mice was smaller compared to trastuzumab alone (p = 0.007 and S. typhimurium A1-R alone (p = 0.039. No significant body weight loss was found compared to the no treatment group except for carboplatinum-treated mice (p = 0.021. Upon histological examination, viable tumor cells were not detected, and replaced by stromal cells in the tumors treated with S. typhimurium A1-R + trastuzumab. The results of the present study suggest that S. typhimurium A1-R and trastuzumab in combination are highly effective against HER-2-expressing cervical cancer.

  17. 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...

  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.

  19. 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

  20. 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

  1. Evaluation of chemotherapy response with serum squamous cell carcinoma antigen level in cervical cancer patients: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Mingzhu Yin

    Full Text Available MRI does not always reflect tumor response after chemotherapy. Therefore, it is necessary to explore additional parameters to more accurately evaluate tumor response for the subsequent clinical determination about radiotherapy or radical surgery. A training cohort and an external validation cohort were used to examine the predictive performance of SCC-ag to evaluate tumor response from teaching hospital of Harbin Medical University. The study included 397 women with SCC (age: 28-73 years. Patients consecutively enrolled between August 2008 and January 2010 (n = 205 were used as training cohort. Patients consecutively enrolled between February 2010 and May 2011 (n = 192 were used as validation cohort. A multivariate regression analysis of the data from the training cohort indicated that serum SCC-ag level is an independent factor for neo-adjuvant chemotherapy (NACT response. Analysis of the data from the validation cohort suggested that chemotherapy response could be more accurately predicted by SCC-ag than by magnetic resonance imaging (MRI (sensitivity (Se: 0.944 vs. 0.794; specificity (Sp: 0.727 vs. 0.636; positive predictive value (PPV: 0.869 vs. 0.806; negative predictive value (NPV: 0.873 vs. 0.618; the area under ROC curve (AUC: 0.898 vs. 0.734. Combining SCC-ag with MRI was more powerful than MRI alone (Se: 0.952 vs. 0.794; Sp: 0.833 vs. 0.636; PPV: 0.916 vs. 0.806; NPV: 0.902 vs. 0.618; AUC: 0.950 vs. 0.734. Our study indicates that serum SCC-ag level is a sensitive and reliable measure to evaluate cervical cancer response to chemotherapy. Using SCC-ag in combination with MRI findings further improves the predictive power.

  2. [Expression of TREM-1 in patients with invasive cervical cancer and precursor lesions].

    Science.gov (United States)

    Anaya-Prado, Roberto; Norzgaray-Ibarra, Fabiola Geovanna; Bravo-Cuéllar, Alejandro; Pérez-Avila, Carlos Eduardo; Schadegg-Peña, Daniel; Anaya-Fernández, Michelle M

    2015-01-01

    Introducción: se ha demostrado que la glicoproteína TREM-1 pertenece a la superfamilia de las inmunoglobulinas que induce la secreción de varias citocinas proinflamatorias. El objetivo de este trabajo fue medir la expresión de TREM-1 en pacientes con cáncer cervical. Métodos: en este estudio transversal analítico incluimos 4 grupos de pacientes: GI: mujeres con lesión intraepitelial (LI) escamosa de bajo grado (n = 15 p/g); GII: pacientes con LI escamosa de alto grado (n = 9 p/g); GIII: pacientes con cáncer cervical invasor (n = 9 p/g), y GIV: pacientes sanas (n = 15 p/g). En todas las pacientes se midió la expresión de TREM-1 y el Índice Medio de Fluorescencia (IMF) en neutrófilos y monocitos, así como los niveles de leucocitos, neutrófilos y monocitos. Usamos t de Student para muestras independientes. Para estas mismas variables, aplicamos prueba de suma de rangos de Mann-Whitney, ANOVA y Turkey. Para las variables cualitativas se utilizó la prueba de Chi cuadrada. Resultados: los porcentaje de expresión de TREM-1 en neutrófilos y monocitos, además del IMF en neutrófilos en los 4 grupos, no fue significativamente diferente. El IMF de TREM-1 en monocitos fue significativamente diferente al comparar el grupo II y grupo III frente al grupo IV (p estudio documenta una mayor expresión de TREM-1 en monocitos de pacientes con cáncer avanzado.

  3. Relationship Between Low Hemoglobin Levels and Outcomes After Treatment With Radiation or Chemoradiation in Patients With Cervical Cancer: Has the Impact of Anemia Been Overstated?

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, Andrew J.; Allen, Pamela K.; Klopp, Ann H. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Meyer, Larissa A. [Department of Gynecologic Oncology and Reproductive Medicine, 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)

    2015-01-01

    Purpose: Previous reports have suggested that anemia increases rates of recurrence after radiation therapy for cervical cancer. However, these studies may not have fully corrected for confounding risk factors. Using a well-characterized cohort of cervical cancer patients, we examined the association between anemia and outcomes before and after the introduction of chemoradiation as standard of care. Methods and Materials: We reviewed the records of 2454 patients who underwent definitive radiation therapy from 1980 through 2011. Minimum hemoglobin level (Hgb{sub min}) was recorded for 2359 patients (96%). Endpoints included freedom from central recurrence (FFCR), freedom from distant metastasis (FFDM), and disease-specific survival (DSS). Results: For the entire cohort, hemoglobin concentrations of 9, 10, and 12 g/dL before and during radiation were all significantly associated with FFCR, FFDM, and DSS (all P<.001) on univariate analysis. However, on multivariate analysis, only Hgb{sub min} less than 10 g/dL during RT (RT-Hgb{sub <10}) remained significant, and it was correlated with lower DSS (P=.02, hazard ratio [HR] = 1.28) and FFDM (P=.03, HR = 1.33) but not with FFCR. In a subset analysis of patients receiving chemoradiation (n=678), RT-Hgb{sub <10} was associated only with DSS (P=.008, HR = 1.49), not with FFCR or FFDM. In this subgroup, despite an association between RT-Hgb{sub <10} and DSS, the use of transfusion was not correlated with benefit. Conclusions: No evidence was found supporting anemia as an independent predictor of central recurrence in patients treated with definitive radiation therapy with or without chemotherapy. Less emphasis on correcting anemia in cervical cancer patients may be warranted.

  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. 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

  6. 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

  7. The Significance of Tumoral ERCC1 Status in Patients With Locally Advanced Cervical Cancer Treated With Chemoradiation Therapy: A Multicenter Clinicopathologic Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Doll, Corinne M., E-mail: Corinne.Doll@albertahealthservices.ca [Department of Oncology, University of Calgary, Calgary, AB (Canada); Aquino-Parsons, Christina [Department of Radiation Oncology, University of British Columbia, Vancouver, BC (Canada); Pintilie, Melania [Department of Biostatistics, Ontario Cancer Institute/Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Klimowicz, Alexander C. [Department of Oncology, University of Calgary, Calgary, AB (Canada); Petrillo, Stephanie K. [Department of Pathology, University of Calgary, Calgary, AB (Canada); Milosevic, Michael [Department of Radiation Oncology, University Health Network, University of Toronto, Toronto, ON (Canada); Craighead, Peter S. [Department of Oncology, University of Calgary, Calgary, AB (Canada); Clarke, Blaise [Department of Pathology, University of Toronto, Toronto, ON (Canada); Lees-Miller, Susan P. [Departments of Biochemistry and Molecular Biology, and Oncology, University of Calgary, Calgary, AB (Canada); Fyles, Anthony W. [Department of Radiation Oncology, University Health Network, University of Toronto, Toronto, ON (Canada); Magliocco, Anthony M. [Department of Pathology, Lee Moffitt Cancer Center, Tampa, Florida (United States)

    2013-03-01

    Purpose: ERCC1 (excision repair cross-complementation group 1) expression has been shown to be a molecular marker of cisplatin resistance in many tumor sites, but has not been well studied in cervical cancer patients. The purpose of this study was to measure tumoral ERCC1 in patients with locally advanced cervical cancer treated with chemoradiation therapy (CRT) in a large multicenter cohort, and to correlate expression with clinical outcome parameters. Methods and Materials: A total of 264 patients with locally advanced cervical cancer, treated with curative-intent radical CRT from 3 major Canadian cancer centers were evaluated. Pretreatment formalin-fixed, paraffin-embedded tumor specimens were retrieved, and tissue microarrays were constructed. Tumoral ERCC1 (FL297 antibody) was measured using AQUA (R) technology. Statistical analysis was performed to determine the significance of clinical factors and ERCC1 status with progression-free survival (PFS) and overall survival (OS) at 5 years. Results: The majority of patients had International Federation of Gynecology and Obstetrics (FIGO) stage II disease (n=119, 45%); median tumor size was 5 cm. OS was associated with tumor size (HR 1.16, P=.018), pretreatment hemoglobin status (HR 2.33, P=.00027), and FIGO stage. In addition, tumoral ERCC1 status (nuclear to cytoplasmic ratio) was associated with PFS (HR 2.33 [1.05-5.18], P=.038) and OS (HR 3.13 [1.27-7.71], P=.013). ERCC1 status was not significant on multivariate analysis when the model was adjusted for the clinical factors: for PFS (HR 1.49 [0.61-3.6], P=.38); for OS (HR 2.42 [0.94-6.24] P=.067). Conclusions: In this large multicenter cohort of locally advanced cervical cancer patients treated with radical CRT, stage, tumor size, and pretreatment hemoglobin status were significantly associated with PFS and OS. ERCC1 status appears to have prognostic impact on univariate analysis in these patients, but was not independently associated with outcome on

  8. 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...

  9. 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

  10. The first experience of using 99mTc-Al2O3-based radiopharmaceutical for the detection of sentinel lymph nodes in cervical cancer patients

    Science.gov (United States)

    Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu.; Medvedeva, A. A.; Zelchan, R. V.; Chernyshova, A. L.; Kolomiets, L. A.

    2016-08-01

    The purpose of the study was to evaluate the feasibility of using 99mTc-Al2O3-based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (T1aNxMx-T2bNxMx) treated at the Tomsk Cancer Research Institute. In the 18 hours before surgery, 80 MBq of the 99mTc-Al2O3 in peritumoral injected, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3 (the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac (14%), obturator (14%), presacral and retrosacral regions (14%), and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image.

  11. The use of 99mTc-Al2O3 for detection of sentinel lymph nodes in cervical cancer patients

    Science.gov (United States)

    Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu; Medvedeva, A. A.; Zelchan, R. V.; Chernyshova, A. L.; Kolomiets, L. A.

    2016-06-01

    The purpose of the study was to evaluate the feasibility of using 99mTc-Al2O3- based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (TlaNxMx- T2bNxMx) treated at the Tomsk Cancer Research Institute. At 18 hours before surgery, 80 MBq of the 99mTc-Al2O3 were injected peritumorally, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3(the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac, obturator, presacral and retrosacral regions (they amounted to 14%, respectively),and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image.

  12. 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...

  13. 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.

  14. 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 ...

  15. 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.

  16. Patterns of Radiation Therapy Practice for Patients Treated for Intact Cervical Cancer in 2005 to 2007: A Quality Research in Radiation Oncology Study

    International Nuclear Information System (INIS)

    Purpose: To assess practice patterns and compliance with clinical performance measures for radiation therapy (RT) for patients with intact carcinoma of the cervix. Methods and Materials: Trained research associates reviewed the records of 261 randomly selected patients who received RT for cervix carcinoma between 2005 and 2007 from 45 facilities randomly selected after stratification by practice type. National estimates of patient and treatment characteristics were calculated from survey data using SUDAAN statistical software. Results: From the survey data, we estimated that only 8% of US facilities treated on average more than 3 eligible patients per year. No small or medium nonacademic facilities in the survey treated more than 3 eligible patients per year. Approximately 65.5% of patients began treatment in a facility that treated 3 or fewer eligible patients per year. Although 87.5% of patients had brachytherapy as part of their treatment, the proportion treated with external beam RT only was about double that estimated from the 1996 to 1999 survey. The use of high-dose-rate brachytherapy sharply increased, particularly in small nonacademic facilities. Overall, patients treated in nonacademic facilities were more likely to have incomplete or protracted treatment; 43% of patients treated in small nonacademic facilities did not have treatment completed within 10 weeks. Also, patients treated in facilities that treated 3 or fewer eligible patients per year were significantly less likely to receive concurrent chemotherapy than were patients treated in other facilities. Conclusion: Survey results indicate a disturbingly high rate of noncompliance with established criteria for high-quality care of patients with cervical cancer. Noncompliance rates are particularly high in nonacademic facilities, especially those that treat relatively few patients with intact cervical cancer

  17. 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.

  18. 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.

  19. Relations between pathological markers and radioiodine can and {sup 18}F-FDG PET/CT findings in papillary thyroid cancer patients with recurrent cervical nodal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Dept. of Nuclear Medicine, Catholic Kwandong University International St. Mary' s Hospital, Seoul (Korea, Republic of); Min, Hye Sook [Dept. of athology, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Sang Mi [Dept. of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kwon, Hyun Woo; Chung, June Key [Dept. of Nuclear Medicine,Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    The aim of this study was to investigate relationships between the immunohistochemical results and radioiodine scan and {sup 18}F-FDG PET findings in papillary thyroid cancer (PTC) patients with recurrent cervical nodal metastases. A total of 46 PTC patients who had undergone a radioiodine scan and/or {sup 18}F-FDG PET/CT and a subsequent operation on recurrent cervical lymph nodes were enrolled. Twenty-seven patients underwent {sup 18}F-FDG PET/CT, 8 underwent radioiodine scans, and 11 underwent both scans. In all surgical specimens, the immunoexpressions of thyroglobulin (Tg), sodium-iodide symporter (NIS), glucose transporter 1 (Glut-1), and somatostatin receptor 1 and 2A (SSTR1 and SSTR2A) were assessed, and associations between these expressions and radioiodine scan and {sup 18}F-FDG PET findings were evaluated. Of the 38 patients who underwent {sup 18}F-FDG PET/CT, all patients with weak Tg expression had positive {sup 18}F-FDG uptake, while only 45 % of the patients with moderate or strong Tg expression showed positive uptake (p = 0.01). The proportion of patients with positive {sup 18}F-FDG uptake increased as the degree of Glut-1 expression with luminal accentuation increased. Of the 19 patients who underwent a radioiodine scan, the proportion with positive radioiodine uptake was greater among patients with strong NIS and SSTR2A expression than among patients expressing these markers at weak levels (p = 0.04 for all). All three patients with weak Tg expression were negative for radioiodine uptake. The {sup 18}F-FDG uptakes of recurrent cervical nodes are related to strong Glut-1 expression with luminal accentuation and weak Tg expression, whereas radioiodine uptake is related to the strong expressions of NIS and SSTR2A.

  20. 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.

  1. 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.

  2. 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.

  3. Patterns of care in patients with cervical cancer 2012. Results of a survey among German radiotherapy departments and out-patient health care centers

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, S.; Rauer, A.; Budach, V. [Charite Universitaetsmedizin, Department of Radiooncology, Berlin (Germany); Koehler, C.; Schneider, A.; Mangler, M. [Charite Universitaetsmedizin, Department of Gynecology, Berlin (Germany); Tsunoda, A. [Barretos Cancer Centre, Department of Gynecologic Oncology, Barretos (Brazil)

    2014-01-15

    Platinum-based primary or adjuvant chemoradiation is the treatment of choice for patients with cervical cancer. However, despite national guidelines and international recommendations, many aspects in diagnosis, therapy, and follow-up of patients with cervical cancer are not based on valid data. To evaluate the current patterns of care for patients with cervical cancer in Germany, a questionnaire with 25 items was sent to 281 radiooncologic departments and out-patient health care centers. The response rate was 51 %. While 87 % of institutions treat 0-25 patients/year, 12 % treat between 26 and 50 and only 1 % treat more than 50 patients/year. In 2011, the stage distribution of 1,706 treated cervical cancers were IB1, IB2, IIA, IIB, IIIA/IIIB, and IV in 11, 12, 11, 22, 28, and 16 %, respectively. CT (90 %) and MRI (86 %) are mainly used as staging procedures in contrast to PET-CT with 14 %. Interestingly, 27 % of institutions advocate surgical staging prior to chemoradiation. In the majority of departments 3D-based (70 %) and intensity-modulated radiotherapy (76 %) are used for percutaneous radiation, less frequently volumetric arc techniques (26 %). Nearly all colleagues (99.3 %) apply conventional fractioning of 1.8-2 Gy for external-beam radiotherapy, in 19 % combined with a simultaneous integrated boost. Cisplatinum mono is used as a radiosensitizer with 40 mg/m{sup 2} weekly by 90 % of radiooncologists. For boost application in the primary treatment, HDR (high-dose rate) brachytherapy is the dominant technique (84 %). In patients after radical hysterectomy pT1B1/1B2, node negative and resection in sound margins adjuvant chemoradiation is applied due to the occurrence of 1-4 other risk factors in 16-97 %. There is a broad spectrum of recommended primary treatment strategies in stages IIB and IVA. Results of the survey underline the leading role but also differences in the use of chemoradiation in the treatment of cervical cancer patients in Germany. (orig

  4. Thrombotic thrombocytopenic purpura and myoglobinuric acute renal failure following radiation therapy in a patient with polymyositis and cervical cancer

    International Nuclear Information System (INIS)

    A 73-year-old woman was admitted to receive radiation treatment for uterine cervical cancer, however a complex series of events ensued, leading to death. She developed an acute exacerbation of polymyositis complicated by thrombocytopenic purpura, rhabdomyolysis and acute renal failure. Radiation therapy may have produced an immune disturbance leading to the acute exacerbation of polymyositis. Auto-immune-mediated endothelial damage might have triggered a series of events leading to thrombotic thrombocytopenic purpura. Rhabdomyolysis seemed to be the main cause of acute renal failure. (author)

  5. Survival outcomes in patients with cervical cancer after inclusion of PET/CT in staging procedures

    DEFF Research Database (Denmark)

    Hansen, Henrik Villibald; Loft, Annika; Berthelsen, Anne Kiil;

    2015-01-01

    as assessed by pretreatment CT or PET/CT. Patients were stratified into two groups: PET/CT and non-PET/CT. Patient characteristics and treatment outcomes were acquired from the treatment database. RESULTS: Significant differences of 23 % (95 % CI 17 - 29 %), 19 % (95 % CI 13 - 25 %) and 12 % (95 % CI 6 - 18...

  6. 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.

  7. 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

  8. Perioperative nursing of cervical cancer patients with diabetes mellitus%宫颈癌合并糖尿病患者围手术期的护理

    Institute of Scientific and Technical Information of China (English)

    张网萍

    2011-01-01

    目的 探讨宫颈癌合并糖尿病患者围手术期的护理方法,以提高手术的成功率.方法 观察并总结对32例宫颈癌合并糖尿病患者手术治疗围手术期的护理.结果 通过心理护理、饮食管理、运动指导、血糖控制、并发症预防提高了手术的成功率.术后发生心律失常1例,低血糖反应2例,切口感染1例,经合理治疗和精心护理均治愈出院.结论 规范而得当的护理是保证宫颈癌合并糖尿病患者手术成功的关键之一.%Objective To investigate the perioperative nursing approach to improving the success rate of surgery on cervical cancer patients with diabetes mellitus. Methods Perioperative nursing of thirty- two cases of cervical cancer surgical treatment of patients with diabetes mellitus was observed. Results Through psychological care, diet management, exercise guidance, glycemial control, prevention of complications, the success rate of surgery can be improved. One case of post- operative arrhythmias, 2 cases with low blood sugar reactions, 1 case with wound infection,after appropriate treatment and careful nursing, were cured. Conclusion Normative nursing care is one of the key factors to successful operation on patients with diabetes mellitus cervical cancer.

  9. Preoperative PET/CT FDG standardized uptake value of pelvic lymph nodes as a significant prognostic factor in patients with uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hyun Hoon [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Cheon, Gi Jeong; Kang, Keon Wook [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Jae Weon; Park, Noh-Hyun [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University, WCU Biomodulation Major, Department of Agricultural Biotechnology, College of Agriculture and Life Sciences, Seoul (Korea, Republic of)

    2014-04-15

    Using integrated PET/CT, we evaluated the prognostic relevance in uterine cervical cancer of preoperative pelvic lymph node (LN) [{sup 18}F]FDG uptake. Patients with FIGO stage IB to IIA uterine cervical cancer were imaged with FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the FDG maximum standardized uptake value (SUV{sub max}) in the pelvic LN (SUV{sub LN}) on PET/CT. Clinical data, treatment modalities, and results in 130 eligible patients were reviewed. The median postsurgical follow-up was 34 months (range 6 to 109 months). Receiver operating characteristic analysis identified SUV{sub LN} 2.36 as the most significant cut-off value for predicting recurrence. SUV{sub LN} was correlated with SUV{sub tumour} (P = 0.002), primary tumour size (P = 0.004), and parametrial invasion (P = 0.013). Univariate analyses showed significant associations between recurrence and SUV{sub LN} (P = 0.001), SUV{sub tumour} (P = 0.007), pelvic LN metastasis (P = 0.002), parametrial invasion (P < 0.001), primary tumour size (P = 0.007), suspected LN metastasis on MRI (P = 0.024), and FIGO stage (P = 0.026). Multivariate analysis identified SUV{sub LN} (P = 0.013, hazard ratio, HR, 4.447, 95 % confidence interval, CI, 1.379 - 14.343) and parametrial invasion (P = 0.013, HR 6.728, 95 % CI 1.497 - 30.235) as independent risk factors for recurrence. Patients with SUV{sub LN} ≥2.36 and SUV{sub LN} <2.36 differed significantly in terms of recurrence (HR 15.20, P < 0.001). Preoperative pelvic LN FDG uptake showed a strong significant association with uterine cervical cancer recurrence. (orig.)

  10. Expression of TRF2 and its prognostic relevance in advanced stage cervical cancer patients

    OpenAIRE

    Ozden, Sevgi; Tiber, Pinar Mega; Ozgen, Zerrin; Ozyurt, Hazan; Serakinci, Nedime; Orun, Oya

    2014-01-01

    Background Telomeres are protective caps consisted of specific tandem repeats (5′-TTAGGG-3′). Shortening of telomeres at each cell division is known as “mitotic clock” of the cells, which renders telomeres as important regulators of lifespan. TRF2 is one of the critical members of shelterin complex, which is a protein complex responsible from the preservation of cap structure, and loss or mutation of TRF2 results in DNA damage, senescence or apoptosis. Since cancer is frequently associated wi...

  11. 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

  12. Effectiveness of cervical conization versus simple total hysterectomy, patients with in situ cervix cancer, Instituto Oncologico Nacional Dr. Juan Tanca Marengo Guayaquil 1996-1998

    International Nuclear Information System (INIS)

    The cancer in the cervix is the main cause of oncologic disease in the women in Ecuador. This investigation tries to find out the more adequate surgical treatment used in the patients with early cervix cancer, in agreed with the cost benefit relationship. This work has not been before done in the ION SOLCA, because of that, there is only information reports of other countries. We make a bibliographic review of previous reports about the surgical treatments of the cancer in situ of the cervix, that is the cervical conization and the simple total hysterectomy, likewise, we analyse the results of the efficacy of both treatments in the patients attended during three years in the National Oncologic Institute SOLCA, by means of a 5 years follow up. In this retrospective study, it was compared the efficacy between the cervical conization and the simple total hysterectomy in the treatment of patients with in situ cancer of cervix who went to the service of surgery of the Oncologic National Institute SOLCA Guayaquil during 1996, 1997 and 1998 and whom were followed up during 5 years. This is a bibliographic documental investigation, in which, we got information about the object of study from the department of statistics in the ION SOLCA; the techniques used were the analysis and the documental statistic collection. We revised 246 clinical histories of patients with cancer in situ of cervix, of which, 128 were included and 118 were excluded. The reasons for exclusion were the lack of posttreatment controls and data record. The data collection was accomplished by formularies. The 128 clinical histories were classified in three groups: the group in which it was done only the conization. The group in which it was done only the simple total hysterectomy. The group in which it was done both treatment. (The author)

  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. 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

  15. Hyperthermia treatment planning for cervical cancer patients based on electrical conductivity tissue properties acquired in vivo with EPT at 3 T MRI.

    Science.gov (United States)

    Balidemaj, Edmond; Kok, Henny Petra; Schooneveldt, Gerben; van Lier, Astrid L H M W; Remis, Rob F; Stalpers, Lukas J A; Westerveld, Henrike; Nederveen, Aart J; van den Berg, Cornelis A T; Crezee, Johannes

    2016-08-01

    Introduction The reliability of hyperthermia treatment planning (HTP) is strongly dependent on the accuracy of the electric properties of each tissue. The values currently used are mostly based on ex vivo measurements. In this study, in vivo conductivity of human muscle, bladder content and cervical tumours, acquired with magnetic resonance-based electric properties tomography (MR-EPT), are exploited to investigate the effect on HTP for cervical cancer patients. Methods Temperature-based optimisation of five different patients was performed using literature-based conductivity values yielding certain antenna settings, which are then used to compute the temperature distribution of the patient models with EPT-based conductivity values. Furthermore, the effects of altered bladder and muscle conductivity were studied separately. Finally, the temperature-based optimisation was performed with patient models based on EPT conductivity values. Results The tumour temperatures for all EPT-based dielectric patient models were lower compared to the optimal tumour temperatures based on literature values. The largest deviation was observed for patient 1 with ΔT90 = -1.37 °C. A negative impact was also observed when the treatment was optimised based on the EPT values. For four patients ΔT90 was less than 0.6 °C; for one patient it was 1.5 °C. Conclusions Electric conductivity values acquired by EPT are higher than commonly used from literature. This difference has a substantial impact on cervical tumour temperatures achieved during hyperthermia. A higher conductivity in the bladder and in the muscle tissue surrounding the tumour leads to higher power dissipation in the bladder and muscle, and therefore to lower tumour temperatures.

  16. Unstable chromosome aberrations on peripheral blood lymphocytes from patients with cervical uterine cancer following radiotherapy; Aberracoes cromossomicas instaveis em linfocitos de pacientes com cancer de colo de utero

    Energy Technology Data Exchange (ETDEWEB)

    Magnata, Simey de Souza Leao Pereira

    2002-09-01

    Absorbed dose determination is an important step for risk assessment related to an exposure to ionizing radiation. However, physical dosimetry cannot be always performed, principally in the case of retrospective estimates. In this context, the use of bioindicators (biological effects) has been proposed, which defines the so-called biological dosimetry. In particular, scoring of unstable chromosomes aberrations (dicentrics, centric rings and fragments) of peripheral blood lymphocytes, while is the most reliable biological method for estimating individual exposure to ionizing radiation. In this work, blood samples from 5 patients, with cervical uterine cancer, were evaluated after partial-body radiotherapy with a source of {sup 69} Co. For this, conventional cytogenetic method was employed, based on Giemsa coloration and fluorescence in situ hybridization, in order to correlate the frequency of unstable chromosome aberrations of blood lymphocytes with absorbed dose, as a result of the radiotherapy. A good agreement was observed between the frequency of chromosome aberrations scored and the values of dose previously calculated by physical dosimetry during patient's radiotherapy. The results presented in this work point out the importance of concerning analyses of unstable chromosome aberrations as biological dosimeter in the investigation of partial-body exposure to ionizing radiation. (author)

  17. Pre-operative MR evaluation of features that indicate the need of adjuvant therapies in early stage cervical cancer patients. A single-centre experience

    International Nuclear Information System (INIS)

    Objectives: This study compared the MR measurement of minimum uninvolved cervical stroma and maximum stromal invasion, and the detection of positive lymph nodes with the pathological results. In addition, tumour type and grade were correlated with nodal status and apparent diffusion coefficient (ADC) values. Methods: Patients who underwent surgery and MR at our centre for early stage cervical cancer (FIGO IA1-IIB) were included. Data recorded included: age, date of MR, clinical FIGO (International Federation of Gynacology and Obstetrics) stage, histological type and grade, adjuvant therapy, pre-surgical conisation. MR evaluation included: measurement of the minimum uninvolved stroma, maximum thickness of stromal involvement, presence and site of positive pelvic lymph nodes, calculation of ADC values. Statistical analysis was performed to compare MR and pathological results. The agreement between MR and pathology in measuring depth of stromal invasion was analysed by Bland–Altman plot, calculating the limits of agreement (LoA). Results: 113/217 patients underwent adjuvant therapies. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MR in evaluation of minimum thickness of uninvolved cervical stroma were 88%, 75%, 70%, 90% and 80%; the same values in evaluation of pelvic positive lymph nodes were 64%, 85%, 65%, 84% and 78%. The mean difference between MR and pathological results in measuring maximum depth of stromal invasion was −0.65 mm (95% LoA: −9.37 mm; 8.07 mm). Depth of stromal invasion was strongly related to positive nodal status (p < 0.001). ADC values (available in 51/217 patients) were not associated with the features assessed. Conclusions: Pre-surgical MR is accurate (80%) in evaluating the minimum thickness of uninvolved cervical stroma; MR measurements of maximum depth of stromal invasion differed ±9 mm from the pathological results in 95% of cases. Furthermore, a strong association was found between

  18. Pre-operative MR evaluation of features that indicate the need of adjuvant therapies in early stage cervical cancer patients. A single-centre experience

    Energy Technology Data Exchange (ETDEWEB)

    Rizzo, Stefania, E-mail: stefania.rizzo@ieo.it [Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141 Milan (Italy); Calareso, Giuseppina [Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141 Milan (Italy); Maccagnoni, Sara; Angileri, Salvatore Alessio [Department of Health Sciences, University of Milan, via A.di Rudinì 8, 20142 Milan (Italy); Landoni, Fabio [Division of Gynecology, European Institute of Oncology, via Ripamonti 435, 20141 Milan (Italy); Raimondi, Sara; Pasquali, Elena [Division of Epidemiology and Biostatistics, European Institute of Oncology, via Ripamonti 435, 20141 Milan (Italy); Lazzari, Roberta [Division of Radiotherapy, European Institute of Oncology, via Ripamonti 435, 20141 Milan (Italy); Bellomi, Massimo [Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141 Milan (Italy); Department of Health Sciences, University of Milan, via A.di Rudinì 8, 20142 Milan (Italy)

    2014-05-15

    Objectives: This study compared the MR measurement of minimum uninvolved cervical stroma and maximum stromal invasion, and the detection of positive lymph nodes with the pathological results. In addition, tumour type and grade were correlated with nodal status and apparent diffusion coefficient (ADC) values. Methods: Patients who underwent surgery and MR at our centre for early stage cervical cancer (FIGO IA1-IIB) were included. Data recorded included: age, date of MR, clinical FIGO (International Federation of Gynacology and Obstetrics) stage, histological type and grade, adjuvant therapy, pre-surgical conisation. MR evaluation included: measurement of the minimum uninvolved stroma, maximum thickness of stromal involvement, presence and site of positive pelvic lymph nodes, calculation of ADC values. Statistical analysis was performed to compare MR and pathological results. The agreement between MR and pathology in measuring depth of stromal invasion was analysed by Bland–Altman plot, calculating the limits of agreement (LoA). Results: 113/217 patients underwent adjuvant therapies. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MR in evaluation of minimum thickness of uninvolved cervical stroma were 88%, 75%, 70%, 90% and 80%; the same values in evaluation of pelvic positive lymph nodes were 64%, 85%, 65%, 84% and 78%. The mean difference between MR and pathological results in measuring maximum depth of stromal invasion was −0.65 mm (95% LoA: −9.37 mm; 8.07 mm). Depth of stromal invasion was strongly related to positive nodal status (p < 0.001). ADC values (available in 51/217 patients) were not associated with the features assessed. Conclusions: Pre-surgical MR is accurate (80%) in evaluating the minimum thickness of uninvolved cervical stroma; MR measurements of maximum depth of stromal invasion differed ±9 mm from the pathological results in 95% of cases. Furthermore, a strong association was found between

  19. 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

  20. 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.)

  1. Individualized Prediction of Overall Survival After Postoperative Radiation Therapy in Patients With Early-Stage Cervical Cancer: A Korean Radiation Oncology Group Study (KROG 13-03)

    International Nuclear Information System (INIS)

    Purpose: A nomogram is a predictive statistical model that generates the continuous probability of a clinical event such as death or recurrence. The aim of the study was to construct a nomogram to predict 5-year overall survival after postoperative radiation therapy for stage IB to IIA cervical cancer. Methods and Materials: The clinical data from 1702 patients with early-stage cervical cancer, treated at 10 participating hospitals from 1990 to 2011, were reviewed to develop a prediction nomogram based on the Cox proportional hazards model. Demographic, clinical, and pathologic variables were included and analyzed to formulate the nomogram. The discrimination and calibration power of the model was measured using a concordance index (c-index) and calibration curve. Results: The median follow-up period for surviving patients was 75.6 months, and the 5-year overall survival probability was 87.1%. The final model was constructed using the following variables: age, number of positive pelvic lymph nodes, parametrial invasion, lymphovascular invasion, and the use of concurrent chemotherapy. The nomogram predicted the 5-year overall survival with a c-index of 0.69, which was superior to the predictive power of the International Federation of Gynecology and Obstetrics (FIGO) staging system (c-index of 0.54). Conclusions: A survival-predicting nomogram that offers an accurate level of prediction and discrimination was developed based on a large multi-center study. The model may be more useful than the FIGO staging system for counseling individual patients regarding prognosis

  2. Intra-patient semi-automated segmentation of the cervix-uterus in CT-images for adaptive radiotherapy of cervical cancer

    Science.gov (United States)

    Luiza Bondar, M.; Hoogeman, Mischa; Schillemans, Wilco; Heijmen, Ben

    2013-08-01

    For online adaptive radiotherapy of cervical cancer, fast and accurate image segmentation is required to facilitate daily treatment adaptation. Our aim was twofold: (1) to test and compare three intra-patient automated segmentation methods for the cervix-uterus structure in CT-images and (2) to improve the segmentation accuracy by including prior knowledge on the daily bladder volume or on the daily coordinates of implanted fiducial markers. The tested methods were: shape deformation (SD) and atlas-based segmentation (ABAS) using two non-rigid registration methods: demons and a hierarchical algorithm. Tests on 102 CT-scans of 13 patients demonstrated that the segmentation accuracy significantly increased by including the bladder volume predicted with a simple 1D model based on a manually defined bladder top. Moreover, manually identified implanted fiducial markers significantly improved the accuracy of the SD method. For patients with large cervix-uterus volume regression, the use of CT-data acquired toward the end of the treatment was required to improve segmentation accuracy. Including prior knowledge, the segmentation results of SD (Dice similarity coefficient 85 ± 6%, error margin 2.2 ± 2.3 mm, average time around 1 min) and of ABAS using hierarchical non-rigid registration (Dice 82 ± 10%, error margin 3.1 ± 2.3 mm, average time around 30 s) support their use for image guided online adaptive radiotherapy of cervical cancer.

  3. 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

  4. Pharmacological and safety evaluation of CIGB-300, a casein kinase 2 inhibitor peptide, administered intralesionally to patients with cervical cancer stage IB2/II

    Directory of Open Access Journals (Sweden)

    Soriano-García JL

    2013-08-01

    Full Text Available CIGB-300 is a pro-apoptotic casein kinase 2 inhibitor peptide with potential anticancer action. An open-label and dose scaling Phase I trial was carried out to investigate the peptide tumor uptake, pharmacokinetics, toxicity, and levels of a CIGB-300 response biomarker in patients with cervical cancer stage IB2/II. Fourteen patients were included; six of them received 35 mg, 6 received 70 mg and the two remaining patients received 245 mg of CIGB-300 prior chemoradiotherapy. CIGB-300 was applied by intratumor injections during 5-consecutive days. For pharmacokinetic and biodistribution studies, the peptide was radiolabeled with 99mTc in the first administration and whole body gammagraphy and plasma testing were done during 48 h. Data showed that the maximum tolerated dose was 70 mg for CIGB-300 in this clinical setting. Furthermore, an allergic-like syndrome was identified as the dose limiting toxicity, which was well-correlated with plasmatic histamine levels. Importantly, the mean tumor uptake was 14.9 mg and 10.4 mg for CIGB-300 doses of 35 and 70 mg, respectively. Also, the kidneys were the main target organ for drug elimination. Finally, treatment with CIGB-300 significantly reduced the B23/nucleophosmin levels in tumor specimens. CIGB-300 meets potentialities to be tested in future trials in a neoadjuvant setting prior to chemoradiotherapy in cervical cancer.

  5. Individualized Prediction of Overall Survival After Postoperative Radiation Therapy in Patients With Early-Stage Cervical Cancer: A Korean Radiation Oncology Group Study (KROG 13-03)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jin [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Han, Seungbong [Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Kim, Young Seok, E-mail: ysk@amc.seoul.kr [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Nam, Joo-Hyun [Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Kim, Hak Jae [Department of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Jae Weon [Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul (Korea, Republic of); Park, Won [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Byoung-Gie [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jin Hee [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Cha, Soon Do [Department of Obstetrics and Gynecology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Kim, Juree [Department of Radiation Oncology, Cheil General Hospital and Women' s Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of); Lee, Ki-Heon [Department of Obstetrics and Gynecology, Cheil General Hospital and Women' s Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of); Yoon, Mee Sun [Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do (Korea, Republic of); and others

    2013-11-15

    Purpose: A nomogram is a predictive statistical model that generates the continuous probability of a clinical event such as death or recurrence. The aim of the study was to construct a nomogram to predict 5-year overall survival after postoperative radiation therapy for stage IB to IIA cervical cancer. Methods and Materials: The clinical data from 1702 patients with early-stage cervical cancer, treated at 10 participating hospitals from 1990 to 2011, were reviewed to develop a prediction nomogram based on the Cox proportional hazards model. Demographic, clinical, and pathologic variables were included and analyzed to formulate the nomogram. The discrimination and calibration power of the model was measured using a concordance index (c-index) and calibration curve. Results: The median follow-up period for surviving patients was 75.6 months, and the 5-year overall survival probability was 87.1%. The final model was constructed using the following variables: age, number of positive pelvic lymph nodes, parametrial invasion, lymphovascular invasion, and the use of concurrent chemotherapy. The nomogram predicted the 5-year overall survival with a c-index of 0.69, which was superior to the predictive power of the International Federation of Gynecology and Obstetrics (FIGO) staging system (c-index of 0.54). Conclusions: A survival-predicting nomogram that offers an accurate level of prediction and discrimination was developed based on a large multi-center study. The model may be more useful than the FIGO staging system for counseling individual patients regarding prognosis.

  6. 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...

  7. 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.

  8. 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,…

  9. 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....

  10. Role of monocyte and lymphocyte counts in prognosis of cervical cancer

    OpenAIRE

    Aanchal Jain; Saurabh Bobdey; Jignasa Sathwara; Ganesh, B.; Sushma Saoba; Arshi Khan

    2016-01-01

    Background: Inflammation seems to play a very crucial role in the growth and progression of many cancers. It has been reported that a peripheral blood count has been used as a cost-effective and simple parameter of systemic inflammation in critically ill patients. The aim of this study is to investigate whether components of WBC counts can predict the prognosis of patients with cervical cancer. Methods: Medical records of 549 cervical cancer patients diagnosed between 1 January 2008 to 31 ...

  11. Health-Related Quality of Life in Cervical Cancer Survivors: A Population-Based Survey

    NARCIS (Netherlands)

    I.J. Korfage; M.L. Essink-Bot; F. Mols; L. van de Poll-Franse; R. Kruitwagen; M. van Ballegooijen

    2009-01-01

    PURPOSE: In a population-based sample of cervical cancer survivors, health-related quality of life (HRQoL) was assessed 2-10 years postdiagnosis. METHODS AND MATERIALS: All patients given a diagnosis of cervical cancer in 1995-2003 in the Eindhoven region, The Netherlands, and alive after Jan 2006 w

  12. Health-Related Quality of Life in Cervical Cancer Survivors: A Population-Based Survey

    NARCIS (Netherlands)

    I.J. Korfage (Ida); M.L.E. Essink-Bot (Marie-Louise); F. Mols (Floortje); L.V. van de Poll-Franse (Lonneke); R.F.M.P. Kruitwagen (Roy); M. van Ballegooijen (Marjolein)

    2009-01-01

    textabstractPURPOSE: In a population-based sample of cervical cancer survivors, health-related quality of life (HRQoL) was assessed 2-10 years postdiagnosis. METHODS AND MATERIALS: All patients given a diagnosis of cervical cancer in 1995-2003 in the Eindhoven region, The Netherlands, and alive afte

  13. 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.

  14. The expression andprognostic value ofprotein tyrosine kinase 6 inearly-stage cervical squamous cell cancer

    Institute of Scientific and Technical Information of China (English)

    XiaoJingWang; YingXiong; ZeBiaoMa; JianChuanXia; YanFangLi

    2016-01-01

    Background:Protein tyrosine kinase 6 (PTK6) is overexpressed in many epithelial tumors and predicts poor progno‑sis. However, PTK6 expression status and its role in cervical squamous cell cancer are unknown. This study aimed to investigate the expression level and clinical signiifcance of PTK6 in early‑stage cervical squamous cell cancer. Methods:Quantitative reverse transcription‑polymerase chain reaction (qRT‑PCR) and western blotting analysis were performed to detect PTK6 mRNA and protein expression levels in 10 freshly frozen, early‑stage cervical squamous cell cancer specimens and adjacent non‑tumorous cervical tissues. The expression of PTK6 was detected using immuno‑histochemical staining in 150 formalin‑ifxed, paraffn‑embedded, early‑stage cervical squamous cell cancer sections and 10 normal cervical tissue sections. Results:The mRNA and protein levels of PTK6 in cancer tissues were higher than those in adjacent non‑tumorous cervical tissues. Immunohistochemical analysis showed that PTK6 was not expressed in normal cervical tissues but was overexpressed in the cytoplasm of cervical squamous cell cancer cells. The level of PTK6 expression was signiif‑cantly associated with tumor grade (P=0.020). The 5‑year overall survival rate of patients with high PTK6 expression was lower than that of patients with low PTK6 expression (81.3% vs. 96.2%,P=0.008). Multivariate Cox regression analysis showed that the expression level of PTK6 in cervical squamous cell cancer was an independent prognostic factor for patient survival (hazard ratio=5.999, 95% conifdence interval 1.622–22.191,P Conclusions:PTK6 is overexpressed in cervical squamous cell cancer. Increased PTK6 expression is associated with reduced 5‑year overall survival. PTK6 expression is an independent prognostic predictor for cervical cancer.

  15. 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

  16. 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...

  17. 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

  18. Normal Tissue Complication Probability Analysis of Acute Gastrointestinal Toxicity in Cervical Cancer Patients Undergoing Intensity Modulated Radiation Therapy and Concurrent Cisplatin

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Daniel R.; Song, William Y. [Center for Advanced Radiotherapy Technologies, Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Moiseenko, Vitali [Department of Medical Physics, Vancouver Cancer Centre, BC (Canada); Rose, Brent S.; Yashar, Catheryn M.; Mundt, Arno J. [Center for Advanced Radiotherapy Technologies, Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Mell, Loren K., E-mail: lmell@ucsd.edu [Center for Advanced Radiotherapy Technologies, Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States)

    2012-05-01

    Purpose: To test the hypothesis that increased bowel radiation dose is associated with acute gastrointestinal (GI) toxicity in cervical cancer patients undergoing concurrent chemotherapy and intensity-modulated radiation therapy (IMRT), using a previously derived normal tissue complication probability (NTCP) model. Methods: Fifty patients with Stage I-III cervical cancer undergoing IMRT and concurrent weekly cisplatin were analyzed. Acute GI toxicity was graded using the Radiation Therapy Oncology Group scale, excluding upper GI events. A logistic model was used to test correlations between acute GI toxicity and bowel dosimetric parameters. The primary objective was to test the association between Grade {>=}2 GI toxicity and the volume of bowel receiving {>=}45 Gy (V{sub 45}) using the logistic model. Results: Twenty-three patients (46%) had Grade {>=}2 GI toxicity. The mean (SD) V{sub 45} was 143 mL (99). The mean V{sub 45} values for patients with and without Grade {>=}2 GI toxicity were 176 vs. 115 mL, respectively. Twenty patients (40%) had V{sub 45} >150 mL. The proportion of patients with Grade {>=}2 GI toxicity with and without V{sub 45} >150 mL was 65% vs. 33% (p = 0.03). Logistic model parameter estimates V50 and {gamma} were 161 mL (95% confidence interval [CI] 60-399) and 0.31 (95% CI 0.04-0.63), respectively. On multivariable logistic regression, increased V{sub 45} was associated with an increased odds of Grade {>=}2 GI toxicity (odds ratio 2.19 per 100 mL, 95% CI 1.04-4.63, p = 0.04). Conclusions: Our results support the hypothesis that increasing bowel V{sub 45} is correlated with increased GI toxicity in cervical cancer patients undergoing IMRT and concurrent cisplatin. Reducing bowel V{sub 45} could reduce the risk of Grade {>=}2 GI toxicity by approximately 50% per 100 mL of bowel spared.

  19. Incorporating a 3-dimensional printer into the management of early-stage cervical cancer.

    Science.gov (United States)

    Baek, Min-Hyun; Kim, Dae-Yeon; Kim, Namkug; Rhim, Chae Chun; Kim, Jong-Hyeok; Nam, Joo-Hyun

    2016-08-01

    We used a 3-dimensional (3D) printer to create anatomical replicas of real lesions and tested its application in cervical cancer. Our study patient decided to undergo radical hysterectomy after seeing her 3D model which was then used to plan and simulate this surgery. Using 3D printers to create patient-specific 3D tumor models may aid cervical cancer patients make treatment decisions. This technology will lead to better surgical and oncological outcomes for cervical cancer patients. J. Surg. Oncol. 2016;114:150-152. © 2016 Wiley Periodicals, Inc. PMID:27222318

  20. 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

  1. 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

  2. Combined pre-treatment MRI and 18F-FDG PET/CT parameters as prognostic biomarkers in patients with cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Miccò, Maura, E-mail: miccom@mskcc.org [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Vargas, Hebert Alberto; Burger, Irene A. [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Kollmeier, Marisa A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 1006 (United States); Goldman, Debra A. [Department of Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd Street, New York, NY 10065 (United States); Park, Kay J. [Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Abu-Rustum, Nadeem R. [Department of Surgery, Gynecologic Oncology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Hricak, Hedvig; Sala, Evis [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States)

    2014-07-15

    Objective: To determine the associations of quantitative parameters derived from multiphase contrast-enhanced magnetic resonance imaging (CE-MRI), diffusion-weighted (DW) MRI and 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/computed tomography (PET/CT) with clinico-histopathological prognostic factors, disease-free survival (DFS) and overall survival (OS) in patients with cervical cancer. Methods and materials: Our institutional review board approved this retrospective study of 49 patients (median age, 45 years) with histopathologically proven IB-IVB International Federation of Gynecology and Obstetrics (FIGO) cervical cancer who underwent pre-treatment pelvic MRI and whole-body 18F-FDG PET/CT between February 2009 and May 2012. Maximum diameter ({sub max}TD), percentage enhancement (PE) and mean apparent diffusion coefficient (ADC{sub mean}) of the primary tumor were measured on MRI. Maximum standardized uptake value (SUV{sub max}), metabolic tumor volume (MTV), total lesion glycolysis (TLG) were measured on 18F-FDG PET/CT. Correlations between imaging metrics and clinico-histopathological parameters including revised 2009 FIGO stage, tumor histology, grade and lymph node (LN) metastasis at diagnosis were evaluated using the Wilcoxon rank sum test. Cox modeling was used to determine associations with DFS and OS. Results: Median follow-up was 17 months. 41 patients (83.6%) were alive. 8 patients (16.3%) died of disease. Progression/recurrence occurred in 17 patients (34.6%). Significant differences were observed in ADC{sub mean}, SUV{sub max}, MTV and TLG according to FIGO stage (p < 0.001–0.025). There were significant correlations between ADC{sub mean}, MTV, TLG and LN metastasis (p = 0.017–0.032). SUV{sub max} was not associated with LN metastasis. FIGO stage (p = 0.017/0.033), LN metastases (p = 0.001/0.020), ADC{sub mean} (p = 0.007/0.020) and MTV (p = 0.014/0.026) were adverse predictors of both DFS/OS. {sub max}TD (p = 0.005) and TLG (p

  3. 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.

  4. "STUDY OF CONCURRENT CISPLATIN AND EXTERNAL RADIOTHERAPY PRIOR TO RADICAL HYSTERECTOMY AND LYMPHADENECTOMY IN PATIENTS WITH STAGE IB-IIB CERVICAL CANCER"

    Directory of Open Access Journals (Sweden)

    M. Modares Gilani

    2004-06-01

    Full Text Available The purpose of this study was to describe the feasibility of a combined preoperative chemoradiation program Ib-IIa, bulky and suspicious IIb by radical surgery in patients with stage Ib-IIb cervical cancer. From September 1999 to April 2002, 30 patients with carcinoma of the cervix were treated with preoperative external beam radiotherapy of 45 Gy in 5 weeks. Patients received concurrent continuous infusion of cisplatin 50 mg/m2 for one day in week during 5 weeks of radiation. Radical surgery was performed 4-6 weeks after completion of the preoperative treatment. Toxicity with chemoradiation was usually mild. Two patients developed vesicovaginal fistula, and four developed long-term hydronephrosis that needed ureteral stenting. Clinical response was observed in 100% of the patients (23.7% complete response. The analysis of the surgical specimens revealed complete pathological response in 43.3% of the cases and partial pathological response in 56.7%. The degree of pathological response was not predictable by the degree of clinical response. Thirty months disease-free survival and overall survival were 66.3% and 77.31%, respectively. Patients with complete and partial pathological response were not significantly different in terms of disease-free survival (p= 0.08 and overall survival (p= 0.3. Cisplatin in preoperative chemoradiation is effective and usually welltolerated in bulky cervical cancer and parametrial invasion, inducing a high rate of clinical and pathological complete responses. When this therapy is followed by radical surgery, disease-free and overall survival rates are higher. The latter may be possible only through extensive surgical resection with a parallel increase in complication rates.

  5. 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.

  6. Postoperative low-pelvic irradiation for stage I-IIA cervical cancer patients with risk factors other than pelvic lymph node metastasis

    International Nuclear Information System (INIS)

    Purpose: To retrospectively investigate whether postoperative low-pelvic radiotherapy (RT) is an appropriate treatment for node-negative, high-risk Stage I-IIA cervical cancer patients. Methods and Materials: A total of 228 Stage I-IIA cervical cancer patients treated by radical surgery and postoperative RT were included in this study. All patients had histopathologically negative pelvic node metastasis, but at least one of the following risk factors: parametrial involvement, positive or close resection margins, invasion depth two-thirds or greater cervical stromal thickness. Seventy-nine patients (35%) received 30-50 Gy (median 44) to whole pelvis and a boost dose to the low pelvis (whole-pelvic RT group); the other 149 patients (65%) received low-pelvic RT only (low-pelvic RT group). For both groups, the total external RT dose to the low pelvis ranged from 40 to 60 Gy (median 50). The potential factors associated with survival, small bowel (gastrointestinal) complications, and leg lymphedema were analyzed, and patients who had a relapse in the upper pelvis were identified. Results: The 5-year overall and disease-specific survival rate was 84% and 86%, respectively. After multivariate analysis, only bulky tumor (≥4 cm) and non-squamous cell carcinoma were significantly associated with survival. Parametrial involvement, lymph-vascular invasion, ≤50.4 Gy to the low pelvis, positive or close margins, and low-pelvic RT alone did not significantly affect survival. Grade I-V small bowel complications occurred in 33 patients (15%). Whole pelvic RT and >50.4 Gy to the low pelvis, but not old age and treatment technique (AP-PA vs. box), were significantly associated with gastrointestinal complications. Three patients (2%) in the low-pelvic RT group and 6 patients (8%) in the whole-pelvic RT group were found to have Grade III or higher small bowel complications (p=0.023). Thirty-one percent of patients developed lymphedema of the leg. A dose to the low pelvis >50.4 Gy

  7. 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....

  8. Paraneoplastic SIADH and Dermatomyositis in Cervical Cancer: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Guy Jones

    2009-11-01

    Full Text Available We present the first known case of a patient with cervical squamous cell carcinoma complicated by paraneoplastic syndromes of both dermatomyositis and inappropriate secretion of antidiuretic hormone (SIADH. The patient in this case presented with generalized body pain and vaginal bleeding. Her cervical cancer was diagnosed as stage IIB by physical exam, imaging, and cervical biopsy, her dermatomyositis was confirmed by muscle and skin biopsy, and her SIADH was diagnosed based on laboratory findings.

  9. 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

  10. The utility of diffusion-weighted MR imaging in cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen Jianyu, E-mail: Chenjianyu5562@163.co [Department of Radiology, Second Affiliated Hospital, Sun Yat-sen University, 107 Yanjiangxi Road, Guangzhou 510120 (China); Zhang Yun, E-mail: Zhangyun.7@163.co [State Key Laboratory of Oncology in Southern China, Guangzhou, 510060 (China) and Imaging Diagnosis and Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou, 510060 (China); Liang Biling, E-mail: liangbil@126.co [Department of Radiology, Second Affiliated Hospital, Sun Yat-sen University, 107 Yanjiangxi Road, Guangzhou 510120 (China); Yang Zehong, E-mail: Yangzehong2000@163.co [Department of Radiology, Second Affiliated Hospital, Sun Yat-sen University, 107 Yanjiangxi Road, Guangzhou 510120 (China)

    2010-06-15

    Purpose: To investigate the value of diffusion-weighted MR imaging (DWI) in detection of cervical cancer, and to determine the diagnostic accuracy of apparent diffusion coefficient (ADC) values for evaluating cervical cancer before and after chemoradiotherapy. Materials and methods: Thirty-three patients with cervical squamous carcinoma and 20 patients with other pelvic abnormalities underwent diffusion-weighted imaging (DWI) in addition to routine MR imaging. The ADC values of normal cervical tissue, cervical area before and after chemoradiotherapy were measured and compared. Receiver operating characteristic (ROC) analysis was employed to investigate whether ADC values could help in discrimination among normal cervical tissue, cervical cancer before and after therapy, and to obtain the optimal ADC threshold value. Results: Cervical cancer lesion demonstrated obviously hyperintensity on DWI images. The mean ADC value of cervical carcinoma (1.110 {+-} 0.175 x 10{sup -3} mm{sup 2}/s) was significantly lower than that of normal cervical tissue (1.593 {+-} 0.151 x 10{sup -3} mm{sup 2}/s) (P < 0.001). The mean ADC value of the cervical area in 22 patients treated by chemoradiotherapy (1.436 {+-} 0.129 x 10{sup -3} mm{sup 2}/s) was significantly higher than that before therapy (1.013 {+-} 0.094 x 10{sup -3} mm{sup 2}/s) (P < 0.001). The difference of ADC values between normal cervical tissue and cervical area after therapy was statistically significant (P < 0.01). The optimal ADC threshold values for distinguishing between normal cervical tissue and cervical carcinoma was 1.359 x 10{sup -3} mm{sup 2}/s, between cervical area before and after therapy was 1.255 x 10{sup -3} mm{sup 2}/s, between normal cervical tissue and cervical area after therapy was 1.525 x 10{sup -3} mm{sup 2}/s. The sensitivity and specificity were 100% and 84.8%, 95.5% and 100%, 70% and 81.8%, respectively. Conclusion: DWI can be applied for the detection of cervical cancer because of its superior

  11. 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.)

  12. 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.)

  13. [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.

  14. Diagnosis of cervical cancer cell taken from scanning electron and atomic force microscope images of the same patients using discrete wavelet entropy energy and Jensen Shannon, Hellinger, Triangle Measure classifier

    Science.gov (United States)

    Aytac Korkmaz, Sevcan

    2016-05-01

    The aim of this article is to provide early detection of cervical cancer by using both Atomic Force Microscope (AFM) and Scanning Electron Microscope (SEM) images of same patient. When the studies in the literature are examined, it is seen that the AFM and SEM images of the same patient are not used together for early diagnosis of cervical cancer. AFM and SEM images can be limited when using only one of them for the early detection of cervical cancer. Therefore, multi-modality solutions which give more accuracy results than single solutions have been realized in this paper. Optimum feature space has been obtained by Discrete Wavelet Entropy Energy (DWEE) applying to the 3 × 180 AFM and SEM images. Then, optimum features of these images are classified with Jensen Shannon, Hellinger, and Triangle Measure (JHT) Classifier for early diagnosis of cervical cancer. However, between classifiers which are Jensen Shannon, Hellinger, and triangle distance have been validated the measures via relationships. Afterwards, accuracy diagnosis of normal, benign, and malign cervical cancer cell was found by combining mean success rates of Jensen Shannon, Hellinger, and Triangle Measure which are connected with each other. Averages of accuracy diagnosis for AFM and SEM images by averaging the results obtained from these 3 classifiers are found as 98.29% and 97.10%, respectively. It has been observed that AFM images for early diagnosis of cervical cancer have higher performance than SEM images. Also in this article, surface roughness of malign AFM images in the result of the analysis made for the AFM images, according to the normal and benign AFM images is observed as larger, If the volume of particles has found as smaller. She has been a Faculty Member at Fırat University in the Electrical- Electronic Engineering Department since 2007. Her research interests include image processing, computer vision systems, pattern recognition, data fusion, wavelet theory, artificial neural

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. Orem自理理论在宫颈癌术后化疗患者护理中的应用%Orem Self-care Theory in Nursing Patients With Cervical Cancer After Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    罗红

    2016-01-01

    Objective To explore the postoperative chemotherapy in patients with cervical cancer in nursing implementation of orem self-care theory value. Methods Selected 60 cases of cervical cancer patients,the 60 cases of cervical cancer patients accepting chemotherapy,postoperative dynamic randomization method was divided into two groups,were given routine nursing and orem self-care theory care,compared two groups of patients with cervical cancer care effect difference. Results Anxiety and depression score lower than group B,group A group a life self-care ability was better than that of group B(P<0.05). Conclusion Postoperative chemotherapy for cervical cancer patients received Orem self-care theory care,can al eviate the patient's bad mood,improve their quality of life.%目的:探究宫颈癌术后化疗患者在护理中实施Orem自理理论的价值。方法选取宫颈癌患者60例,这60例宫颈癌患者均接受术后化疗,动态随机化法分为2组,分别给予常规护理以及Orem自理理论护理,对比2组宫颈癌患者护理效果的差异。结果A组焦虑、抑郁评分低于B组, A组生活自理能力优于B组(P<0.05)。结论宫颈癌患者术后化疗中接受Orem自理理论护理,可缓解患者的不良情绪,提高其生活质量。

  1. 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.

  2. 宫颈癌术后下肢淋巴水肿的研究进展%Research progress on postoperative lower extremity lymphedema in cervical cancer patients

    Institute of Scientific and Technical Information of China (English)

    王霞; 丁焱

    2014-01-01

    It introduced the incidence,assessment methods and risk fac-tors of postoperative lower extremity lymphedema in cervical cancer pa-tients,expounded the treatment and nursing research of postoperative lower extremity lymphedema in cervical cancer patients from five as-pects of complex treatments,microwave hyperthermia,drug therapy, traditional Chinese medical care,surgical treatment,and introduced the perioperative interventions.It prompted that medical staff should master the risk factors of lower extremity lymphedema,do well discharge guid-ance for patients,make the patients learn the self identify of symptoms and signs of lymphedema,so as to early detection and early intervention.%介绍了宫颈癌术后下肢淋巴水肿的发病率、评估方法、危险因素,从复合理疗、微波热疗、药物治疗、中医护理、手术疗法5方面阐述了宫颈癌术后下肢淋巴水肿的治疗及护理研究,并介绍了围术期预防措施。提示,医护人员应掌握下肢淋巴水肿发生的危险因素,做好对病人的出院指导,教会病人自我识别淋巴水肿的症状和体征,以期早期发现,早期干预。

  3. Cervical Cancer Screening after Perimenopause: How Is Human Papillomavirus Test Performed?

    Science.gov (United States)

    2016-01-01

    Cervical cancer is the third most prevalent cancer in women around the world. Recently in Korea, the incidence of cervical cancer has decreased, but in all stages of cervical intraepithelial neoplasia (CIN), CIN has shown a 91% increase from 1999 to 2008. Persistent human papillomavirus (HPV) infection has been found to be the main cause of cervical cancer. HPV types 16 and 18 have been found in 70% of cervical cancer patients around the world. Cervical cancer screening such as cytology has limitations in terms of sensitivity and specificity. A discussion about the need for the HPV test is becoming active in order to compensate for the limitation of cytology. After the role of HPV in cervical cancer was identified, the importance of HPV detection test as a screening was emphasized. Several tests have been developed and each test has its own advantages and disadvantages, and new test method to overcome the disadvantages is still being developed. Today's guidelines and tests are those you would choose from among the large number of cervical cancer screening guidelines and tests, based on the consideration that the selected guidelines and the test are effective.

  4. Cervical Cancer Screening after Perimenopause: How Is Human Papillomavirus Test Performed?

    Science.gov (United States)

    Chung, Soo-Ho

    2016-08-01

    Cervical cancer is the third most prevalent cancer in women around the world. Recently in Korea, the incidence of cervical cancer has decreased, but in all stages of cervical intraepithelial neoplasia (CIN), CIN has shown a 91% increase from 1999 to 2008. Persistent human papillomavirus (HPV) infection has been found to be the main cause of cervical cancer. HPV types 16 and 18 have been found in 70% of cervical cancer patients around the world. Cervical cancer screening such as cytology has limitations in terms of sensitivity and specificity. A discussion about the need for the HPV test is becoming active in order to compensate for the limitation of cytology. After the role of HPV in cervical cancer was identified, the importance of HPV detection test as a screening was emphasized. Several tests have been developed and each test has its own advantages and disadvantages, and new test method to overcome the disadvantages is still being developed. Today's guidelines and tests are those you would choose from among the large number of cervical cancer screening guidelines and tests, based on the consideration that the selected guidelines and the test are effective. PMID:27617239

  5. Reducing Uncertainties About the Effects of Chemoradiotherapy for Cervical Cancer : A Systematic Review and Meta-Analysis of Individual Patient Data From 18 Randomized Trials

    NARCIS (Netherlands)

    Vale, Claire; Tierney, Jayne F.; Stewart, Lesley A.; Brady, Mark; Dinshaw, Ketayun; Jakobsen, Anders; Parmar, Mahesh K. B.; Thomas, Gillian; Trimble, Ted; Alberts, David S.; Chen, Hongwei; Cikaric, Slobodan; Eifel, Patricia J.; Garipagaoglu, Melahat; Keys, Henry; Kantardzic, Nermina; Lal, Punita; Lanciano, Rachelle; Leborgne, Felix; Lorvidhaya, Vicharn; Onishi, Hiroshi; Pearcey, Robert G.; Pras, Elizabeth; Roberts, Kenneth; Rose, Peter G.; Thomas, Gillian; Whitney, Charles W.

    2008-01-01

    Background After a 1999 National Cancer Institute (NCI) clinical alert was issued, chemoradiotherapy has become widely used in treating women with cervical cancer. Two subsequent systematic reviews found that interpretation of the benefits was complicated, and some important clinical questions were

  6. Intravoxel incoherent motion magnetic resonance imaging for diagnosis of cervical cancer and evaluation of response of uterine cervical cancer to radiochemotherapy:A pilot study

    Institute of Scientific and Technical Information of China (English)

    Yanchun Wang; Daoyu Hu; Shan Hu; Xuemei Hu; Jianjun Li; Yaqi Shen; Xiaoyu Liu; Zhi Wang; Xiaoyan Meng; Zhen Li

    2015-01-01

    Objective The aim of this study was to investigate the ability of intravoxel incoherent motion (IVIM) dif usion-weighted magnetic resonance imaging (MRI) to diagnose cervical cancer and to evaluate the response of uterine cervical cancer to radiochemotherapy (CRT). Methods This prospective study was approved by the institutional review board, and informed consent was obtained from al patients. A total of 23 patients with primary cervical cancer who were undergoing CRT and 16 age-matched healthy subjects were prospectively recruited for IVIM (b = 0–800 s/mm2) and stan-dard pelvic MRI. Bi-exponential analysis was performed to derive f (perfusion fraction), D* (pseudo-dif usion coef icient), and D (true molecular dif usion coef icient) in cervical cancer (n = 23) and the normal cervix (n= 16). The apparent dif usion coef icient (standard ADC) was calculated. The independent-samples t-test and paired-samples t-test were used for comparisons. Results Pre-treatment cervical cancer had the lowest standard ADC (1.15 ± 0.13 × 10-3 mm2/s) and D (0.89 ± 0.10 × 10-3 mm2/s) values, and these were significantly dif erent from the normal cervix and post-treatment cervical cancer (P = 0.00). The f (16.67 ± 5.85%) was lowest in pre-treatment cervical cancer and was significantly dif erent from the normal cervix and post-treatment cervical cancer (p = 0.012 and 0.00, respectively). No dif erence was observed in D*. Conclusion IVIM is potential y promising for dif erentiating between the normal cervix and cervical can-cer because pre-treated cervical cancer has low perfusion and dif usion IVIM characteristics. Further, the standard ADC, D, and f of cervical cancer showed a tendency to normalize after CRT; thus, IVIM may be useful for monitoring the response to CRT in cervical cancer.

  7. 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.).

  8. SU-E-I-05: A Correction Algorithm for Kilovoltage Cone-Beam Computed Tomography Dose Calculations in Cervical Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, J; Zhang, W; Lu, J [Cancer Hospital of Shantou University Medical College, Shantou, Guangdong (China)

    2015-06-15

    Purpose: To investigate the accuracy and feasibility of dose calculations using kilovoltage cone beam computed tomography in cervical cancer radiotherapy using a correction algorithm. Methods: The Hounsfield units (HU) and electron density (HU-density) curve was obtained for both planning CT (pCT) and kilovoltage cone beam CT (CBCT) using a CIRS-062 calibration phantom. The pCT and kV-CBCT images have different HU values, and if the HU-density curve of CBCT was directly used to calculate dose in CBCT images may have a deviation on dose distribution. It is necessary to normalize the different HU values between pCT and CBCT. A HU correction algorithm was used for CBCT images (cCBCT). Fifteen intensity-modulated radiation therapy (IMRT) plans of cervical cancer were chosen, and the plans were transferred to the pCT and cCBCT data sets without any changes for dose calculations. Phantom and patient studies were carried out. The dose differences and dose distributions were compared between cCBCT plan and pCT plan. Results: The HU number of CBCT was measured by several times, and the maximum change was less than 2%. To compare with pCT, the CBCT and cCBCT has a discrepancy, the dose differences in CBCT and cCBCT images were 2.48%±0.65% (range: 1.3%∼3.8%) and 0.48%±0.21% (range: 0.1%∼0.82%) for phantom study, respectively. For dose calculation in patient images, the dose differences were 2.25%±0.43% (range: 1.4%∼3.4%) and 0.63%±0.35% (range: 0.13%∼0.97%), respectively. And for the dose distributions, the passing rate of cCBCT was higher than the CBCTs. Conclusion: The CBCT image for dose calculation is feasible in cervical cancer radiotherapy, and the correction algorithm offers acceptable accuracy. It will become a useful tool for adaptive radiation therapy.

  9. Knowledge, attitudes, and practices for cervical cancer screening among the Bhutanese refugee community in Omaha, Nebraska.

    Science.gov (United States)

    Haworth, Rebecca J; Margalit, Ruth; Ross, Christine; Nepal, Tikka; Soliman, Amr S

    2014-10-01

    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. The study aimed to investigate cervical cancer and screening knowledge and perceptions about the susceptibility and severity of cervical cancer and perceived benefits and barriers to screening. Self-administered questionnaires and focus groups based on the Health Belief Model were conducted among 42 healthy women from the Bhutanese refugee community in Omaha. The study revealed a significant lack of knowledge in this community regarding cervical cancer and screening practices, with only 22.2 % reporting ever hearing of a Pap test and 13.9 % reporting ever having one. Only 33.3 % of women were in agreement with their own perceived susceptibility to cervical cancer. Women who reported ever hearing about the Pap test tended to believe more strongly about curability of the disease if discovered early than women who never heard about the test (71.4 vs. 45.0 %, for the two groups. respectively). Refugee populations in the United States are in need for tailored cancer education programs especially when being resettled from countries with high risk for cancer. PMID:25060231

  10. 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

  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. Clinical analysis of cervical cancer with skin metastasis in 5 patients%宫颈癌皮肤转移5例临床分析

    Institute of Scientific and Technical Information of China (English)

    那仁花; 张云霞; 古丽娜·库尔班

    2015-01-01

    目的:探讨宫颈癌皮肤转移患者的临床特点、诊治过程及预后。方法我院自2006年6月至2011年6月共收治宫颈癌患者574例,其中5例确诊为宫颈癌皮肤转移。收集该5例患者的临床、病理及随访资料,并分析其临床特点、诊治过程及预后。结果宫颈癌皮肤转移的发生率为087%(5/574),均为宫颈癌ⅡA~ⅢB 期患者。其中,4例在确诊宫颈癌并完成治疗后的随访过程中发现皮肤转移;1例为初治患者,入院后1个月发现逐渐增大的皮肤结节,手术切除后确诊为皮肤转移。 4例患者合并肺部、骨骼等其他部位的转移。 4例患者行手术完整切除皮肤病灶,术后1例因合并有多发骨转移且骨痛明显接受核素治疗,1例行全身化疗,2例仅接受对症支持治疗。 1例患者因头皮转移病灶向内侵犯颅骨,无法行手术切除,行穿刺检查诊断转移后接受调强适形放疗。随访中3例患者死亡,另 2例诊断宫颈癌皮肤转移分别为3个月、5个月,仍存活。结论宫颈癌皮肤转移发生率低,通常合并有其他脏器的转移,治疗较困难,预后较差。%Objective To explore the clinical features, treatment and prognosis of cervical cancer patients with skin metasta⁃sis. Methods From June 2006 to June 2011, 574 cervical cancer patients were treated in our hospital, in which 5 cases was diag⁃nosed as cervical cancer with skin metastasis. The clinical, pathological and follow⁃up data of 5 patients were collected and their clini⁃cal features, treatment and prognosis were analyzed. Results The incidence rate of cervical cancer with skin metastasis was 0 87%(5/ 574), with stage ⅡA to ⅢB. Among them, 4 cases were diagnosed during the follow⁃up of cervical cancer. One patient was diag⁃nosed after resection in her first hospitalization. There were 4 patients with pulmonary, skeletal and other sites of metastasis. Four patients skin

  13. 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 ...

  14. Microvessel density and p53 in detecting cervical cancer by FDG PET in cases of suspected recurrence

    NARCIS (Netherlands)

    A.A.M. van der Veldt; L. Hooft; P.J. van Diest; J. Berkhof; M.R. Buist; E.F.I. Comans; O.S. Hoekstra; C.F.M. Molthoff

    2006-01-01

    Purpose: Cervical cancer is the second most frequently diagnosed cancer in women worldwide. About one-third of patients experience recurrent disease. A better chance of survival might be achieved by the early detection of recurrent cervical cancer. [F-18] fluoro-2-deoxy- D-glucose (FDG) PET could be

  15. 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.

  16. 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.

  17. 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...

  18. Prognostic Impact of Anemia in Patients with Cervical Cancer%贫血与子宫颈癌预后的关系

    Institute of Scientific and Technical Information of China (English)

    赵辉; 孔为民

    2011-01-01

    Objective:To study the prognostic factor and evaluate the effect of anemia on disease-free survival in patients with cervical cancer. Methods: The clinical data of 291 patients with cervical cancer were analyzed retrospectively. Age, weight,blood type, histological type, International Federation of Gynecology and obstetrics (FIGO) stage, histological grade, the first treatment, anemia, the time of operation, blood loss, blood transfusion, the kind of blood transfusion were studied. Univariate analysis and multivariate Cox proportional hazards regression models were used. Results: The univariate analysis showed that tumor differentiation, tumor size, age, blood transfusion, anemia and FIGO stage had significant effect on prognosis, while age, weight, blood type, pathological type, the first treatment method, operative time, blood loss, and blood transfusion had not. Multivariate Cox model analysis showed that the independent factors include FIGO stage and tumor differentiation. Conclusions: FIGO stage and tumor differentiation are the independent factors of patients with cervical cancer. Anemia may affect the prognosis of cervical cancer, however, multivariate analysis in this study do not prove that anemia is the independent prognostic factors.%目的:探讨子宫颈癌患者的预后相关因素,研究贫血对子宫颈癌患者无病生存期(disease free survival,DFS)的影响,为子宫颈癌合并贫血患者的治疗提供参考.方法:回顾分析291例有病理诊断、完整随访的子宫颈癌患者的临床资料,以无病生存期为观察指标,将年龄、体质量、血型、病理类型、国际妇产科协会(FIGO)分期、分化程度、首次治疗方式、是否贫血、手术时间、术中出血量、是否输血、输血种类、输血量等纳入寿命表.计算1年、2年和5年生存率,通过单因素Kaplan-Meier法进行分析,多因素分析采用Cox比例风险回归模型.结果:单因素分析显示肿瘤分化程度、肿瘤大小

  19. Telomerase in relation to clinicopathologic prognostic factors and survival in cervical cancer

    NARCIS (Netherlands)

    Wisman, GBA; Knol, AJ; Helder, MN; Krans, M; de Vries, EGE; Hollema, H; de Jong, S; van der Zee, AGJ

    2001-01-01

    We investigated, in cervical cancer, the relation between telomerase activity, telomerase RNA (hTR) and mRNA of the catalytic subunit of telomerase, hTERT, with "classic" clinicopathological factors as well as survival. Frozen specimens were obtained from 107 consecutive patients with cervical cance

  20. Effectiveness of immune therapy combined with chemotherapy on the immune function and recurrence rate of cervical cancer

    OpenAIRE

    Chen, Bin; Liu, Lifen; Xu, Haiyan; YANG, YIJIN; Zhang, Ling; Zhang, Fengchun

    2015-01-01

    The aim of this study was to compare the immune function of patients with cervical cancer and the cancer recurrence rate in patients treated with biological immune therapy combined with chemotherapy or with chemotherapy only. A total of 79 postoperative patients with cervical cancer participated in the present study. They were randomly divided into a control group and an experimental group. Patients in the control group were treated with cisplatin chemotherapy. Patients in the experimental gr...

  1. Analysis on proteome among cervical cancer patients of Uighur nationality in Xinjiang%新疆维吾尔族宫颈癌蛋白质组图谱分析

    Institute of Scientific and Technical Information of China (English)

    陈锐; 石瑛; 彭靖淇; 张琼; 周琦

    2013-01-01

    目的:探讨筛选并建立新疆维吾尔族子宫颈癌血清蛋白质组图谱诊断模型可能的临床价值.方法:采用CM10蛋白芯片和SELDI-TOF-MS技术检测40例子宫颈鳞癌、30例宫颈上皮内瘤变Ⅲ级和15例健康人的血清蛋白质组图谱,ZUCI-蛋白芯片数据分析系统分析并建立维吾尔族子宫颈癌蛋白质组图谱诊断模型.结果:宫颈癌与宫颈上皮内瘤变Ⅲ级患者和健康人存在139种差异蛋白质质谱峰,有分类意义的蛋白质7种.其中质荷比为6 467.26、6 993.199在正常对照组、上皮内瘤变组和宫颈癌组中表达逐渐降低;1 081.275、1 083.193、1 122.849、8 929.189、15 939.86在正常对照组、上皮内瘤变组和宫颈癌组中表达逐渐增高.这7个质荷比峰建立了维吾尔族宫颈癌蛋白质组图谱诊断模型,其准确度85.00%,敏感度72.73%.结论:该组建立的诊断模型可以有效区分维吾尔族宫颈癌患者和正常妇女,为新疆维吾尔族宫颈癌癌的诊断与筛查提供了一条崭新途径.%Objective: To explore the clinical value of screening and constructing diagnostic model of serum proteome among cervical cancer patients of Uighur nationality. Methods: CM10 protein chip and SELDI - TOF - MS technology were used to detect serum proteins in 40 patients with cervical squamous cancer, 30 patients with cervical intracpithelial neoplasia (CIN) U , and 15 healthy women, the diagnostic model of proteome among cervical cancer patients of Uighur nationality was analyzed and constructed by ZUCI - protein chip data analytic system. Results: A total of 139 kinds of differentially expressed proteins were screened out in patients with cervical cancer and CIN Ⅲ and healthy women, and 7 kinds of proteins had significance. The mass - to - charge ratios were 6 467. 26 and 6 993. 199 , respectively, which decreased gradually in normal control group, CIN group, and cervical cancer group; 1 081.275, 1 083. 193, 1 122. 849, 8 929. 189

  2. Sentinel node biopsy as an indicator for pelvic nodes dissection in early stage cervical cancer.

    OpenAIRE

    Rhim, Chae-Chun; Park, Jong-Sup; Bae, Seog-Nyeon; Namkoong, Sung-Eun

    2002-01-01

    The purpose of this study was to investigate the feasibility of sentinel node frozen biopsy to minimize the extensive pelvic lymph nodes dissection in early stage cervical cancer patients on the basis that the risk of skip metastasis to the paraaortic area is negligible. Twenty-six patients with early stage cervical cancer were enrolled in this study. Technetium-99m colloid albumin (Tc(99m)) was injected intradermally around the tumor for allowing preoperative lymphoscintigraphy and intraoper...

  3. Patterns of Radiotherapy Practice for Patients With Cervical Cancer in Japan, 2003-2005: Changing Trends in the Pattern of Care Process

    Energy Technology Data Exchange (ETDEWEB)

    Tomita, Natsuo, E-mail: ntomita@aichi-cc.jp [Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya (Japan); Toita, Takafumi [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya (Japan); Shinoda, Atsunori [Department of Radiology, Shinshu University School of Medicine, Matsumoto (Japan); Uno, Takashi [Department of Radiology, Graduate School of Medicine, Chiba University, Chiba (Japan); Numasaki, Hodaka; Teshima, Teruki [Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita (Japan); Mitsumori, Michihide [Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto (Japan)

    2012-08-01

    Purpose: The patterns of care study (PCS) of radiotherapy for cervical cancer in Japan over the last 10 years was reviewed. Methods and Materials: The Japanese PCS working group analyzed data from 1,200 patients (1995-1997, 591 patients; 1999-2001, 324 patients; 2003-2005, 285 patients) with cervical cancer treated with definitive radiotherapy in Japan. Results: Patients in the 2001-2003 survey were significantly younger than those in the 1999-2001 study (p < 0.0001). Histology, performance status, and International Federation of Gynecology and Obstetrics stage were not significantly different among the three survey periods. Use of combinations of chemotherapy has increased significantly during those periods (1995-1997, 24%; 1999-2001, 33%; 2003-2005, 54%; p < 0.0001). The ratio of patients receiving concurrent chemotherapy has also dramatically increased (1995-1997, 20%; 1999-2001, 54%; 2003-2005, 83%; p < 0.0001). As for external beam radiotherapy (EBRT), the application rate of four-field portals has greatly increased over the three survey periods (1995-1997, 2%; 1999-2001, 7%; 2003-2005, 21%; p < 0.0001). In addition, the use of an appropriate beam energy for EBRT has shown an increase (1995-1997, 67%; 1999-2001, 74%; 2003-2005, 81%; p = 0.064). As for intracavitary brachytherapy (ICBT), an iridium source has become increasingly popular (1995-1997, 27%; 1999-2001, 42%; 2003-2005, 84%; p < 0.0001). Among the three surveys, the ratio of patients receiving ICBT (1995-1997, 77%; 1999-2001, 82%; 2003-2005, 78%) has not changed. Although follow-up was inadequate in each survey, no significant survival differences were observed (p = 0.36), and rates of late Grade 3 or higher toxicity were significantly different (p = 0.016). Conclusions: The Japanese PCS has monitored consistent improvements over the past 10 years in the application of chemotherapy, timing of chemotherapy, and EBRT methods. However, there is still room for improvement, especially in the clinical

  4. Treatment of cervical cancer in the Republic of Srpska

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    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.

  5. 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%

  6. 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)

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

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    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

  8. The male role in cervical cancer

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    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.

  9. Superior cervical ganglion mimicking retropharyngeal adenopathy in head and neck cancer patients: MRI features with anatomic, histologic, and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Loke, S.C.; Karandikar, A.; Goh, J.P.N. [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore); Ravanelli, M.; Farina, D.; Maroldi, R. [Department of Radiology, University of Brescia, Brescia (Italy); Ling, E.A. [National University of Singapore, Department of Anatomy, Yong Loo Lin School of Medicine, Singapore (Singapore); Tan, T.Y. [Changi General Hospital, Department of Radiology, Singapore (Singapore)

    2016-01-15

    To describe the unique MRI findings of superior cervical ganglia (SCG) that may help differentiate them from retropharyngeal lymph nodes (RPLNs). A retrospective review of post-treatment NPC patients from 1999 to 2012 identified three patients previously irradiated for NPC that were suspected of having recurrent nodal disease in retropharyngeal lymph nodes during surveillance MRI. Subsequent surgical exploration revealed enlarged SCG only; no retropharyngeal nodal disease was found. A cadaveric head specimen was also imaged with a 3T MRI before and after dissection. In addition, SCG were also harvested from three cadaveric specimens and subjected to histologic analysis. The SCG were found at the level of the C2 vertebral body, medial to the ICA. They were ovoid on axial images and fusiform and elongated with tapered margins in the coronal plane. T2-weighted (T2W) signal was hyperintense. No central elevated T1-weighted (T1W) signal was seen within the ganglia in non-fat-saturated sequences to suggest the presence of a fatty hilum. Enhancement after gadolinium was present. A central ''black dot'' was seen on axial T2W and post-contrast images in two of the three SCG demonstrated. Histology showed the central black line was comprised of venules and interlacing neurites within the central portion of the ganglion. The SCG can be mistaken for enlarged RPLNs in post-treatment NPC patients. However, there are features which can help differentiate them from RPLNs, preventing unnecessary therapy. These imaging findings have not been previously described. (orig.)

  10. Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

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    Victoria K Fort

    2011-03-01

    Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

  11. Correlates of Cervical Cancer Screening among Vietnamese American Women

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    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.

  12. Copper, zinc, and magnesium tissue and serum levels in patients with cervical carcinoma.

    Science.gov (United States)

    Altintas, A; Vardar, M A; Gönlüsen, F; Atay, Y; Evrüke, C; Arpaci, A; Aridogan, N

    1995-01-01

    Serum and cervical tissue copper (Cu), zinc (Zn) and magnesium (Mg) levels were determined by atomic absorption spectrophotometry in 65 women with cervical carcinoma and compared with levels in 30 healthy women. The patients mean serum Cu level (184.8 +/- 12.3 mugr/dl) was significantly higher than the control group (p cancerous tissues of patients with cervical carcinoma were not statistically significant (p > 0.05). There was also no significant difference between FIGO Stage I and IIA patients according to their serum and tissue concentrations of these trace elements. We concluded that serum and tissue copper, zinc and magnesium determinations have no use in cervical carcinoma management.

  13. 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...

  14. Nursing experience of cervical cancer after treatment in patients with adverse reactions%宫颈癌腔内后装治疗护理体会

    Institute of Scientific and Technical Information of China (English)

    刘金萍; 刘翠平

    2014-01-01

    Objective:To take effective nursing measures , reduce cervical cancer after treatment in patients with adverse reactions and complications, make the patient safety smooth completion of treatment .Methods:From 2011-2013, 78 cases of cervical cancer patients with iridium -192 lumen loading after treatment in the process of psychological counseling , diet nursing , the observation in the process of treatment and rehabilitation of the patients with guidance .Results:The complete treatment plan with proper care , the desired therapeutic effect.Conclusion:The correct implementation of iridium -192 cavity after treatment in patients with effective nursing care , the whole life cycle of a complete treatment .%目的:采取有效地护理措施,减少宫颈癌后装治疗患者不良反应及并发症的发生,使患者安全顺利完成治疗。方法:2011~2013年对78例宫颈癌患者]~192腔内后装治疗过程中心理疏导、饮食护理,治疗过程中的病情观察、有效护理,对患者的康复指导,使患者积极配合治疗,提高治疗信心。结果:通过正确护理措施的实施,78例患者均顺利完成治疗计划,达到预期治疗效果,淡化病人角色,提高生存质量。结论:正确实施]-192腔内后装治疗患者的有效护理,有利于减少和避免不良反应及并发症的发生,患者生存率高,耐受好,顺利完成整个周期的治疗。

  15. 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.

  16. The predictive value of serum squamous cell carcinoma antigen in patients with cervical cancer who receive neoadjuvant chemotherapy followed by radical surgery: a single-institute study.

    Directory of Open Access Journals (Sweden)

    Xiong Li

    Full Text Available Neoadjuvant chemotherapy (NACT could affect the levels of squamous cell carcinoma antigen (SCC-Ag. This study evaluates the predictive value of pre- and posttreatment SCC-Ag levels in patients with cervical cancer who were treated with NACT followed by radical surgery.A total of 286 patients with Stage IB1-IIIB squamous cell carcinoma of the uterine cervix who were treated with NACT followed by radical hysterectomy were analyzed retrospectively. The relationship between SCC-Ag levels, the clinicopathologic parameters, the response to NACT and the three-year survival rate was investigated.The levels of SCC-Ag were elevated (>3.5 ng/mL in 43.8% of patients before NACT, and 13.0% of patients after NACT. Pre- and posttreatment levels of SCC-Ag correlated with the response to NACT (P = 0.010, and P3.5 ng/mL (P3.5 ng/mL indicated a poor response to NACT and a higher risk of lymph node metastases. Elevated posttreatment levels of SCC-Ag were correlated with poor DFS and OS.

  17. Promoter polymorphism in the matrix metalloproteinase-1 and risk of cervical cancer in Korean women.

    Science.gov (United States)

    Ju, Woong; Kang, Sokbom; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang; Kang, Soon Beom; Lee, Hyo Pyo

    2005-01-20

    The aim of this investigation was to analyze the association between a single nucleotide polymorphism (SNP) in the matrix metalloproteinase (MMP)-1 promoter gene -1607 bp region and cervical cancer risk in Korean women. The blood samples of 232 cervical cancer patients and 332 non-cancer control subjects who managed at Seoul National University Hospital from 1999 to 2002 were collected. Polymorphism in MMP-1 promoter -1607 region was determined using TaqMan method. Allele frequency and genotype distribution in the cervical cancer group were compared with those of the control group to determine whether this polymorphism elevates the susceptibility of Korean women to cervical cancer. The relationship between this SNP and cancer invasiveness was also evaluated by collating clinicopathologic data of those in the cancer group, such as FIGO stage, lymph node status, histologic type and parametrial invasion. In the cervical cancer group, the allele frequency of 2G was 66.1%, in the control group 68.2%, showing no significant difference (P=0.41). Similarly the genotypes with insertion (2G/2G) or deletion (1G/1G) polymorphism showed no increased risk for cervical cancer susceptibility compared with 1G/2G genotype. A subgroup analysis of the clinicopathologic parameters in cancer group also showed no significant difference suggesting the lack of an association between SNP of the MMP-1 promoter -1607 bp region and cervical cancer invasiveness. In conclusion, this study shows that Korean with specific polymorphism in MMP-1 are neither more susceptible to develop cervical cancer nor more vulnerable for cancer progression.

  18. 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)

  19. 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.

  20. Clinical study of radioprotective effects of amifostine (YM-08310, WR-2721) on long-term outcome for patients with cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mitsuhashi, Norio; Takahashi, Iku; Takahashi, Mitsuhiro; Hayakawa, Kazushige; Niibe, Hideo (Gumma Univ. School of Medicine (Japan))

    1993-06-15

    A retrospective analysis was performed to investigate the radioprotective effects of amifostine on the long-term outcome of radiation therapy for patients with carcinoma of the uterine cervix. Eighty-three patients with histologically proven epidermoid carcinoma (Stage II-IVA disease) of the uterine cervix were treated with definite radiation therapy between January 1978 and December 1984. Forty-six patients were treated with radiation alone, whereas 37 patients were treated with radiation plus amifostine daily from the initiation of the course of radiation therapy. The median total dose of amifostine given was 1300 mg/m[sub 2], with a range of 280 mg/m[sup 2] to 3700 mg/m[sup 2]. The 5-year overall actuarial survival for the patients treated with radiation along and with radiation plus amifostine were: 72% and 88% in Stage II disease (p = 0.45); 52% and 50% in Stage III disease (p = 0.68); and 40% and 43% in Stage IVA disease (p = 0.51), respectively. The 5-year intra-pelvic recurrence rates in the patients treated with amifostine were almost the same as those observed in the patients treated without amifostine (0% vs. 6% in Stage II disease; 15% vs. 10% in Stage III disease; 25% vs. 40% in Stage IVA disease). There was also no statistically significant difference of the chronic rectal or bladder complication rate between the groups treated by each regimen. The authors concluded that any radioprotective effects of amifostine on tumor tissue and any beneficial effects of amifostine against chronic radiation injury were not observed in the patients with cervical cancer followed up for more than 5 years after radiation therapy. 17 refs., 3 figs., 3 tabs.

  1. Expression of the CXCL12/CXCR4 and CXCL16/CXCR6 axes in cervical intraepithelial neoplasia and cervical cancer

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    Ye Zheng

    2013-05-01

    Full Text Available The chemokine CXCL12 is highly expressed in gynecologic tumors and is widely known to play a biologically relevant role in tumor growth and spread. Recent evidence suggests that CXCL16, a novel chemokine, is overexpressed in inflammation-associated tumors and mediates pro-tumorigenic effects of inflammation in prostate cancer. We therefore analyzed the expression of CXCL12 and CXCL16 and their respective receptors CXCR4 and CXCR6 in cervical intraepithelial neoplasia (CIN and cervical cancer and further assessed their association with clinicopathologic features and outcomes. Tissue chip technology and immunohistochemistry were used to analyze the expression of CXCL12, CXCR4, CXCL16, and CXCR6 in healthy cervical tissue (21 cases, CIN (65 cases, and cervical carcinoma (60 cases. The association of protein expression with clinicopathologic features and overall survival was analyzed. These four proteins were clearly detected in membrane and cytoplasm of neoplastic epithelial cells, and their distribution and intensity of expression increased as neoplastic lesions progressed through CIN1, CIN2, and CIN3 to invasive cancer. Furthermore, the expression of CXCR4 was associated significantly with the histologic grade of cervical carcinoma, whereas the expression of CXCR6 was associated significantly with lymph node metastasis. In Kaplan-Meier analysis, patients with high CXCR6 expression had significantly shorter overall survival than did those with low CXCR6 expression. The elevated co-expression levels of CXCL12/CXCR4 and CXCL16/CXCR6 in CIN and cervical carcinoma suggest a durative process in cervical carcinoma development. Moreover, CXCR6 may be useful as a biomarker and a valuable prognostic factor for cervical cancer.

  2. Expression of the CXCL12/CXCR4 and CXCL16/CXCR6 axes in cervical intraepithelial neoplasia and cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Yu Huang; Jia Zhang; Zhu-Mei Cui; Jing Zhao; Ye Zheng

    2013-01-01

    The chemokine CXCL12 is highly expressed in gynecologic tumors and is widely known to play a biologically relevant role in tumor growth and spread.Recent evidence suggests that CXCL16,a novel chemokine,is overexpressed in inflammation-associated tumors and mediates pro-tumorigenic effects of inflammation in prostate cancer.We therefore analyzed the expression of CXCL12 and CXCL16 and their respective receptors CXCR4 and CXCR6 in cervical intraepithelial neoplasia (CIN) and cervical cancer and further assessed their association with clinicopathologic features and outcomes.Tissue chip technology and immunohistochemistry were used to analyze the expression of CXCL12,CXCR4,CXCL16,and CXCR6 in healthy cervical tissue (21 cases),CIN (65 cases),and cervical carcinoma (60 cases).The association of protein expression with clinicopathologic features and overall survival was analyzed.These four proteins were clearly detected in membrane and cytoplasm of neoplastic epithelial cells,and their distribution and intensity of expression increased as neoplastic lesions progressed through CIN1,CIN2,and CIN3 to invasive cancer.Furthermore,the expression of CXCR4 was associated significantly with the histologic grade of cervical carcinoma,whereas the expression of CXCR6 was associated significantly with lymph node metastasis.In Kaplan-Meier analysis,patients with high CXCR6 expression had significantly shorter overall survival than did those with low CXCR6 expression.The elevated co-expression levels of CXCL12/CXCR4 and CXCL16/CXCR6 in CIN and cervical carcinoma suggest a durative process in cervical carcinoma development.Moreover,CXCR6 may be useful as a biomarker and a valuable prognostic factor for cervical cancer.

  3. Cervical cancer survival prediction using hybrid of SMOTE, CART and smooth support vector machine

    Science.gov (United States)

    Purnami, S. W.; Khasanah, P. M.; Sumartini, S. H.; Chosuvivatwong, V.; Sriplung, H.

    2016-04-01

    According to the WHO, every two minutes there is one patient who died from cervical cancer. The high mortality rate is due to the lack of awareness of women for early detection. There are several factors that supposedly influence the survival of cervical cancer patients, including age, anemia status, stage, type of treatment, complications and secondary disease. This study wants to classify/predict cervical cancer survival based on those factors. Various classifications methods: classification and regression tree (CART), smooth support vector machine (SSVM), three order spline SSVM (TSSVM) were used. Since the data of cervical cancer are imbalanced, synthetic minority oversampling technique (SMOTE) is used for handling imbalanced dataset. Performances of these methods are evaluated using accuracy, sensitivity and specificity. Results of this study show that balancing data using SMOTE as preprocessing can improve performance of classification. The SMOTE-SSVM method provided better result than SMOTE-TSSVM and SMOTE-CART.

  4. 30 years of preventive studies of uterine cervical cancer 1982-2012

    Directory of Open Access Journals (Sweden)

    Garrido JL

    2014-10-01

    Full Text Available Purpose: To show and describe the clinical evolution of cervical cancer screening patients following the protocol established by the University of Padua. Methods: 12,679 patients were examined using Pap smear, colposcopy and biopsy in cases it was required. Results: From these large group of patients, 6,411 were diagnosed as patients at risk of developing cancer, from which 4,257 only had HPV infection, 1,150 had dysplastic lesions, 210 had cervical cancer and 794 cases were classified as simple oncogenic risk.

  5. Psychological Nursing Experience of Cervical Cancer Patients in Perioperative Period%宫颈癌患者围手术期的心理护理体会

    Institute of Scientific and Technical Information of China (English)

    路爱玲

    2015-01-01

    目的 了解宫颈癌患者的心理状态,探讨心理护理的有效方法.方法 针对性地实施相应的心理护理.结果 心理护理能够消除患者负面心理反应,使其积极配合治疗和护理,取得良好的护理效果.结论 护士在临床工作中需加强与患者交流,了解其内心状态,实施相应的心理护理.%Objective To understand the psychological state of patients with cervical cancer, and explore the effective methods of psychological nursing. Methods The corresponding psychological nursing pertinence.Results Psychological nursing could eliminate negative psychology reaction of patients and positive teamwork treatment and nursing, made good effect of nursing.Conclusion Nurses in clinical work should strengthen exchanges with patients, understand their psychological state, and give the implementation of the corresponding psychological care.

  6. Clinical Usefulness of 18F-FDG PET/CT in the Detection of Early Recurrence in Treated Cervical Cancer Patients with Unexplained Elevation of Serum Tumor Markers

    OpenAIRE

    Chong, Ari; Ha, Jung-Min; Jeong, Shin Young; Song, Ho-Chun; Min, Jung Joon; Bom, Hee-Seung; Choi, Ho-Sun

    2013-01-01

    We investigated the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for restaging of treated uterine cervix squamous cell cancer with tumor maker elevation that was not explained by other conventional evaluation. We enrolled 32 cases who underwent PET/CT for the restaging of treated cervical cancer with tumor marker elevation that was not explained by recent conventional evaluation. All enrolled cases had squamous cell carcinoma. Increased ...

  7. Short-course palliative radiotherapy for uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won [Dept. of Radiation Oncology, Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of); Nam, Ji Ho; Jeon, Sang Ho [Dept. of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2013-12-15

    The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

  8. Clinical Usefulness of serum total cholesterol as an index of hypothyroidism in patients after cervical radiation

    International Nuclear Information System (INIS)

    Cervical radiation therapy is often applied to patients with head and neck cancers because radiation has a high sensitivity to these cancers and permits the preservation of functions and physical form. However, it has been shown that various complications can result from radiation therapy. We have encountered some patients who showed hypercholesterolemia resulting from cervical radiation. Therefore, we have paid close attention to the relationship between hypercholesterolemia after cervical radiation and hypothyroidism. Thyroid hormone tests in these patients with hypercholesterolemia after cervical radiation showed high thyroid stimulating hormone (TSH) and low free thyroxine (fT4), indicating the presence of hypothyroidism. After administration of levothyroxine Na, their fT4 levels increased and both TSH levels and serum total cholesterol levels decreased. In conclusion, in patients who have received cervical radiation, we recommend monitoring serum total cholesterol periodically to detect hypothyroidism easily before the appearance of its symptoms. (author)

  9. Clinical Usefulness of serum total cholesterol as an index of hypothyroidism in patients after cervical radiation

    Energy Technology Data Exchange (ETDEWEB)

    Iguma, Yoko; Iwai, Chikako; Okuyama, Masako; Futami, Takahiro; Inui, Ken-ichi [Kyoto Univ. (Japan). Hospital; Asato, Ryo [Kyoto Univ. (Japan). Graduate School of Medicine

    2003-02-01

    Cervical radiation therapy is often applied to patients with head and neck cancers because radiation has a high sensitivity to these cancers and permits the preservation of functions and physical form. However, it has been shown that various complications can result from radiation therapy. We have encountered some patients who showed hypercholesterolemia resulting from cervical radiation. Therefore, we have paid close attention to the relationship between hypercholesterolemia after cervical radiation and hypothyroidism. Thyroid hormone tests in these patients with hypercholesterolemia after cervical radiation showed high thyroid stimulating hormone (TSH) and low free thyroxine (fT{sub 4}), indicating the presence of hypothyroidism. After administration of levothyroxine Na, their fT{sub 4} levels increased and both TSH levels and serum total cholesterol levels decreased. In conclusion, in patients who have received cervical radiation, we recommend monitoring serum total cholesterol periodically to detect hypothyroidism easily before the appearance of its symptoms. (author)

  10. Dosimetrically Triggered Adaptive Intensity Modulated Radiation Therapy for Cervical Cancer

    International Nuclear Information System (INIS)

    Purpose: The widespread use of intensity modulated radiation therapy (IMRT) for cervical cancer has been limited by internal target and normal tissue motion. Such motion increases the risk of underdosing the target, especially as planning margins are reduced in an effort to reduce toxicity. This study explored 2 adaptive strategies to mitigate this risk and proposes a new, automated method that minimizes replanning workload. Methods and Materials: Thirty patients with cervical cancer participated in a prospective clinical study and underwent pretreatment and weekly magnetic resonance (MR) scans over a 5-week course of daily external beam radiation therapy. Target volumes and organs at risk (OARs) were contoured on each of the scans. Deformable image registration was used to model the accumulated dose (the real dose delivered to the target and OARs) for 2 adaptive replanning scenarios that assumed a very small PTV margin of only 3 mm to account for setup and internal interfractional motion: (1) a preprogrammed, anatomy-driven midtreatment replan (A-IMRT); and (2) a dosimetry-triggered replan driven by target dose accumulation over time (D-IMRT). Results: Across all 30 patients, clinically relevant target dose thresholds failed for 8 patients (27%) if 3-mm margins were used without replanning. A-IMRT failed in only 3 patients and also yielded an additional small reduction in OAR doses at the cost of 30 replans. D-IMRT assured adequate target coverage in all patients, with only 23 replans in 16 patients. Conclusions: A novel, dosimetry-triggered adaptive IMRT strategy for patients with cervical cancer can minimize the risk of target underdosing in the setting of very small margins and substantial interfractional motion while minimizing programmatic workload and cost

  11. 宫颈癌患者阴道微生物的分布特点%Distribution Characteristics of Microorganisms in the Vagina of Patients with Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    逯彩虹; 李保红; 李小斌; 王海波; 刘丽宁; 戴卫红; 李萍

    2011-01-01

    目的 探讨乳酸杆茵与常见阴道病原体在阴道黏膜上的分布特点以及与宫颈癌的关系.方法 检测65例正常宫颈、70例慢性宫颈炎、110例宫颈上皮内瘤变(CIN)、142例宫颈癌妇女阴道黏膜分泌物中乳酸杆菌的定植密度、霉茵、细茵性阴道病(BV)、支原体、衣原体、滴虫、淋茵、人乳头瘤状病毒(HPV16/18)的感染情况,了解宫颈癌患者阴道黏膜乳酸杆茵与常见病原体的分布特点以及在宫颈癌发病中作用.结果 CIN组和宫颈癌组阴道黏膜乳酸杆菌的定植密度逐渐减少(P<0.01),霉菌、滴虫、支原体、衣原体、BV、HPV的检出率逐渐增加(P<0.01).除宫颈癌组外,其余各组乳酸杆茵阴性患者阴道霉茵、滴虫、支原体、衣原体、BV、HPV的检出率均明显高于乳酸杆菌阳性患者(P<0.01).宫颈癌组和CIN组感染亚组乳酸杆菌定植密度明显低于慢性宫颈炎组和正常宫颈组(P<0.01).在正常宫颈组、慢性宫颈炎组、CIN组内感染亚组乳酸杆菌定植密度明显少于非感染亚组(P<0.01);但在宫颈癌组内比较无统计学差异.宫颈癌组和CIN组中HPV感染患者阴道乳酸杆茵阴性率高于慢性宫颈炎组和正常宫颈组;宫颈癌组和CIN组中HPV感染患者阴道乳酸杆茵阳性组乳酸杆菌定植密度明显少于慢性宫颈炎组和正常宫颈组(P<0.01).CIN组和宫颈癌组中HPV16/18、BV的感染率增加最明显,其次是衣原体、支原体、霉菌、滴虫;淋茵的检出率在各组中均很低.结论 乳酸杆茵抑制阴道常见病原体的繁殖与感染及宫颈上皮细胞异常增生与癌变.宫颈癌发生与阴道黏膜乳酸杆菌减少、阴道菌群失调相关.%Objective To study the distribution characteristics of lactobacillus and common pathogens in the vaginal mucosa and their relationship with cervical cancer. Methods The planting density of lactobacillus and the detection rates of common pathogens including mycete

  12. 宫颈癌治疗后下肢淋巴水肿的分析%Analysis of Lower Limb Lymphedema in Cervical Cancer Patients after Treatment

    Institute of Scientific and Technical Information of China (English)

    孙小红; 孔为民

    2015-01-01

    Objective To investigate the correlative factors of occurrence oflower limbs lymphedema ( LLL) in cervical cancer patients after treatment.Methods Data of 218 cervical cancer patients were retrospectively studied,and the incidence of LLL and correlative factors were calculated.Results The incidence of LLL in patients with cervical cancer after treatment was 19.3%.Among all the patients who received different regimes,the incidence of LLL in patients with surgery combined with radio-therapy was the highest (22/75 cases,29.3%);the incidence of LLL in patients who received simple radiotherapy was 16.3%(16/98 cases);and the incidence of LLL in patients who received surgery alone was 8.9%(16/98 cases).There had significant difference (P=0.014 <0.05).Among the patients who received lymphadenectomy during surgery,the incidence of LLL was 27.9%,and the incidence was 5.8%among those who did not receive lymphadenectomy,and there had significant difference ( P=0.008<0.05).For the patients who received radiotherapy,the incidence of LLL was 26.8%among those whose pelvic dose at point B was more than 45Gy,while the incidence was 13.1%when the dose was not more than 45Gy,there had significant differ-ence(P=0.038<0.05).Conclusion LLL is one of the most common complications in cervical cancer patients after treatment. The incidence of LLL differs with different treatment methods.LLL is influenced by multiple factors such as radiotherapy com-bined with surgery,and the dose of external irradiation.%目的:分析宫颈癌治疗后下肢淋巴水肿的发生相关因素。方法回顾性分析218例宫颈癌患者的资料,通过统计学分析得出淋巴水肿的发生率及其相关因素。结果宫颈癌治疗后下肢淋巴水肿总发生率为19.3%。手术联合放疗的患者下肢淋巴水肿的发生率最高,为29.3%;单纯放疗组发生率为16.3%,单纯手术治疗组发生率为8.9%,三组之间差异具有统计学意义(P=0.014<0

  13. Risk of cervical cancer in women with autoimmune diseases, in relation with their use of immunosuppressants and screening

    DEFF Research Database (Denmark)

    Dugué, Pierre-Antoine; Rebolj, Matejka; Hallas, Jesper;

    2015-01-01

    Severely immunosuppressed individuals have a strongly increased risk of cervical cancer. In patients with autoimmune diseases (AID), who have defects in their immune system and receive immunosuppressants, the risk of cervical cancer is less clear. We conducted a cohort study, using Danish nationw...

  14. Influence Factors of Cancer-related Fatigue of Patients with Cervical Cancer%宫颈癌患者癌因性疲乏的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    郑艳; 王喜华; 李萍

    2014-01-01

    目的:调查宫颈癌放疗患者家庭功能和癌因性疲乏的现况,分析癌因性疲乏的影响因素。方法应用一般情况调查表、疾病相关因素调查表、家庭功能评定量表和疲劳评定量表,采用配额抽样法对新疆乌鲁木齐市3所三级甲等医院放疗科的124例宫颈癌患者进行调查。结果85例患者存在中、重度家庭功能障碍,72例患者存在中、重度癌因性疲乏,患者的家庭功能总分与癌因性疲乏总分呈正相关(r=0.759,P<0.05)。多元逐步回归分析显示,家庭功能、年龄、医疗付费方式、血清钾水平、工作情况、健康教育、放疗不良反应和白细胞水平是宫颈癌放疗患者癌因性疲乏的主要影响因素(P<0.05);结论宫颈癌放疗患者家庭功能越低,患者的癌因性疲乏程度越重。提高家庭成员对患者的关爱,对于高龄、自费、文化程度偏低及治疗期间继续工作的患者和合并代谢紊乱并伴有放疗不良反应的患者,早期应考虑对其癌因性疲乏实施干预,帮助她们预防和减轻疲乏。%Objective To survey the current status of family functioning and cancer-related fatigue of patients with cervical cancer and to analyze the influence factors of cancer-related fatigue. Methods With general questionnaires, disease-related factors questionnaires, Family Assessment Device and Fatigue Assessment Instrument, we employed a quota sampling method to investigate 124 cervical cancer patients in radiotherapy departments of Class Ⅲ GradeⅠ hospitals in Urumqi, Xinjiang. Results Medium and heavy family dysfunction was found among 85 patients and medium and heavy cancer-related fatigue among 75 patients. Pearson correlation analysis showed there was a positive correlation between patients ’ family function and cancer related fatigue (r=0.759, P<0.01). Multiple regression analysis showed that family functioning, age, medical payment method, serum potassium

  15. 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

  16. Long noncoding RNA PVT1 promotes cervical cancer progression through epigenetically silencing miR-200b.

    Science.gov (United States)

    Zhang, Shaorong; Zhang, Guanli; Liu, Jingying

    2016-08-01

    Long noncoding RNA PVT1 has been reported to be dysregulated and play vital roles in a variety of cancers. However, the functions and molecular mechanisms of PVT1 in cervical cancer remain unclear. The objective of this study was to investigate the expression, clinical significance, biological roles, and underlying functional mechanisms of PVT1 in cervical cancer. Our results revealed that PVT1 is upregulated in cervical cancer tissues. Enhanced expression of PVT1 is associated with larger tumor size, advanced International Federation of Gynecology and Obstetrics stage, and poor prognosis of cervical cancer patients. Using gain-of-function and loss-of-function approaches, we demonstrated that overexpression of PVT1 promotes cervical cancer cells proliferation, cell cycle progression and migration, and depletion of PVT1 inhibits cervical cancer cell proliferation, cell cycle progression, and migration. Mechanistically, we verified that PVT1 binds to EZH2, recruits EZH2 to the miR-200b promoter, increases histone H3K27 trimethylation level on the miR-200b promoter, and inhibits miR-200b expression. Furthermore, the effects of PVT1 on cervical cell proliferation and migration depend upon silencing of miR-200b. Taken together, our findings confirmed that PVT1 functions as an oncogene in cervical cancer and indicated that PVT1 is not only an important prognostic marker, but also a potential therapy target for cervical cancer. PMID:27272214

  17. Histone acetylation and histone deacetylase activity of magnesium valproate in tumor and peripheral blood of patients with cervical cancer. A phase I study

    Directory of Open Access Journals (Sweden)

    Cabrera Gustavo

    2005-07-01

    Full Text Available Abstract Background The development of cancer has been associated with epigenetic alterations such as aberrant histone deacetylase (HDAC activity. It was recently reported that valproic acid is an effective inhibitor of histone deacetylases and as such induces tumor cell differentiation, apoptosis, or growth arrest. Methods Twelve newly diagnosed patients with cervical cancer were treated with magnesium valproate after a baseline tumor biopsy and blood sampling at the following dose levels (four patients each: 20 mg/kg; 30 mg/kg, or 40 mg/kg for 5 days via oral route. At day 6, tumor and blood sampling were repeated and the study protocol ended. Tumor acetylation of H3 and H4 histones and HDAC activity were evaluated by Western blot and colorimetric HDAC assay respectively. Blood levels of valproic acid were determined at day 6 once the steady-state was reached. Toxicity of treatment was evaluated at the end of study period. Results All patients completed the study medication. Mean daily dose for all patients was 1,890 mg. Corresponding means for the doses 20-, 30-, and 40-mg/kg were 1245, 2000, and 2425 mg, respectively. Depressed level of consciousness grade 2 was registered in nine patients. Ten patients were evaluated for H3 and H4 acetylation and HDAC activity. After treatment, we observed hyperacetylation of H3 and H4 in the tumors of nine and seven patients, respectively, whereas six patients demonstrated hyperacetylation of both histones. Serum levels of valproic acid ranged from 73.6–170.49 μg/mL. Tumor deacetylase activity decreased in eight patients (80%, whereas two had either no change or a mild increase. There was a statistically significant difference between pre and post-treatment values of HDAC activity (mean, 0.36 vs. 0.21, two-tailed t test p Conclusion Magnesium valproate at a dose between 20 and 40 mg/kg inhibits deacetylase activity and hyperacetylates histones in tumor tissues.

  18. 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.

  19. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix

    Energy Technology Data Exchange (ETDEWEB)

    Naganawa, Shinji; Sato, Chiho; Ishigaki, Takeo [Nagoya University School of Medicine, Department of Radiology, Nagoya (Japan); Kumada, Hisashi; Miura, Shunichi [Toyohashi Municipal hospital, Department of Radiology, Toyohashi, Aich (Japan); Takizawa, Osamu [Siemens-Asahi Medical Technologies Ltd, Tokyo (Japan)

    2005-01-01

    A relation between apparent diffusion coefficient (ADC) values and tumor cellular density has been reported. The purpose of this study was to measure the ADC values of cervical cancers in the uterus and compare them with those of normal cervical tissues, and to test whether ADC could differentiate between normal and malignant cervical tissues in the uterus. Twelve consecutive female patients with cervical cancer of the uterus and ten female patients with other pelvic abnormalities were included in this study. ADC was measured at 1.5 T with b-factors of 0, 300 and 600 s/mm{sup 2} using single-shot echo-planar diffusion-weighted imaging and a parallel imaging technique. The mean ADC value of cervical cancer lesions was 1.09{+-}0.20 x 10{sup -3} mm{sup 2}/s, and that of normal cervix tissue was 1.79{+-}0.24 x 10{sup -3} mm{sup 2}/s (P<0.0001). In nine patients treated by chemotherapy and/or radiation therapy, the mean ADC value of the cervical cancer lesion increased significantly after therapy (P<0.001). The present study showed, with a small number of patients, that ADC measurement has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix. Further study is necessary to determine the accuracy of ADC measurement in monitoring the treatment response. (orig.)

  20. 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

  1. Epidemiology of cervical cancer with special focus on India

    Directory of Open Access Journals (Sweden)

    Sreedevi A

    2015-04-01

    Full Text Available Aswathy Sreedevi, Reshma Javed, Avani Dinesh Community Medicine, AIMS, Kochi, Amrita Vishwa Vidyapeetham, Kerala, India Abstract: Cervical cancer is on the declining trend in India according to the population-based registries; yet it continues to be a major public health problem for women in India. Multifactorial causation, potential for prevention, and the sheer threat it poses make cervical cancer an important disease for in-depth studies, as has been attempted by this paper. This paper attempts to review the available knowledge regarding the epidemiology and pattern of cervical cancer; types of HPV (human papilloma virus prevalent among cervical cancer patients and among women in general, high-risk groups such as commercial sex workers, and HIV (human immunodeficiency virus-positive women; and the role of the national program on cancer in control efforts. The peak age of incidence of cervical cancer is 55–59 years, and a considerable proportion of women report in the late stages of disease. Specific types of oncogenic HPV-16, 18 have been identified in patients with cervical cancer. Other epidemiological risk factors are early age at marriage, multiple sexual partners, multiple pregnancies, poor genital hygiene, malnutrition, use of oral contraceptives, and lack of awareness. A multipronged approach is necessary which can target areas of high prevalence identified by registries with a combination of behavior change communication exercises and routine early screening with VIA. Sensitizing the people of the area, including menfolk, is necessary to increase uptake levels. Vaccination against types 16 and 18 can also be undertaken after taking into confidence all stakeholders, including the parents of adolescent girls. Preventing and treating cervical cancer and reducing the burden are possible by targeting resources to the areas with high prevalence. Keywords: cervical cancer, HPV, screening, prevention, epidemiology, India

  2. Dermatomyositis related to the relapse of cervical cancer

    Directory of Open Access Journals (Sweden)

    Marta Stawczyk-Macieja

    2015-04-01

    Full Text Available Dermatomyositis (DM is a rare syndrome which belongs to the group of idiopathic inflammatory myopathies (IIM. The diagnosis of DM in adults is an indication for diagnostic evaluation towards malignancy. The exacerbation of clinical symptoms or laboratory markers of DM may indicate the relapse of neoplasm, therefore close follow-up visits of patients are obligatory. We present the case of a woman with a two-month history of progressive muscle weakness, dysphagia and oedemo-erythematous skin lesions limited to the face and trunk. The patient was diagnosed with DM associated with the relapse of cervical cancer.

  3. 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.

  4. Cervical cancer screening: knowledge, health perception and attendance rate among Hong Kong Chinese women

    Directory of Open Access Journals (Sweden)

    Sharron SK Leung

    2010-07-01

    Full Text Available Sharron SK Leung1, Ivy Leung21School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong; 2Quality Healthcare Medical Services, Hong KongPurpose: Cervical cancer screening has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. However, cervical screening attendance rates are still far from satisfactory in many countries. Strategies, health promotion and education programs need to be developed with clear evidence of the causes and factors relating to the low attendance rate. The study aims to assess the prediction of cervical screening attendance rate by Chinese women’s knowledge about cervical cancer and cervical screening as well as their perception of health.Patients and methods: A survey with self-reported questionnaires was conducted on 385 Chinese women recruited from a community clinic in Hong Kong. Participants were Chinese women, Hong Kong residents, aged 18–65 years, able to read Chinese or English, and were not pregnant.Results: Women aged 37 years or less, with at least tertiary education, who perceived having control over their own health and had better knowledge on risk factors, were more likely to attend cervical cancer screening. Many participants had adequate general knowledge but were unable to identify correct answers on the risk factors.Conclusion: Health promotion efforts need to focus on increasing women’s knowledge on risk factors and enhancing their perceived health control by providing more information on the link between screening and early detection with lower incidence rates and mortality from cervical cancer.Keywords: cervical screening attendance, cervical cancer, health perception and knowledge, perceived health control, Chinese

  5. 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 ...

  6. 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.

  7. 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.

  8. [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

  9. 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 ...

  10. Robotic thyroidectomy and cervical neck dissection for thyroid cancer

    Science.gov (United States)

    Paek, Se Hyun

    2016-01-01

    A robotic approach for thyroid surgery was developed to overcome the limitations of endoscopic thyroidectomy and provide many technical advantages. This approach facilitates the surgeon’s control through a magnified three-dimensional view, decreased tremor, and freedom of motion with articulated instruments. Robotic thyroidectomy is safe and technically feasible in patients with well-differentiated, low-risk thyroid cancer. Furthermore, robotic thyroidectomy may become a good surgical alternative option for patients with more advanced thyroid cancer. Our modified bilateral axillo-breast approach (BABA) for central and lateral cervical neck lymph node (LN) dissection has yielded excellent surgical outcomes as an open procedure. The incorporation of robotics in thyroid cancer surgery will continue to evolve, and the surgical indications for robotic thyroidectomy will continue to expand. Further analyses that include long-term outcomes and randomized comparative trials remain important. PMID:27294043

  11. A Correlative Analysis of Cervical Lesions in Patients with Vulva Condyloma Acuminatum

    Institute of Scientific and Technical Information of China (English)

    Qing Li; Weihong Li; Huanzi Li; Zhihua Liu

    2006-01-01

    OBJECTIVE To analyze the relation ship among vulva condyloma acuminatum, high-risk human papillomavirus (HPV) infections and cervical epithelium lesions.METHODS From May 2002 to April 2004 patients with vulva condyloma acuminatum were examined employing vulva biospy, colposcopy, highrisk HPV-DNA test and cervical bioscopy.RESUTS In 418 cases of vulva condyloma acuminatum, verified by pathologic analysis, high-risk HPV (+) infections were detected in 68.7% (287/418) of the cases. Among those patients, 20.6% (59/287) had concurrent subclinical cervical intraepithelial neoplastic (CIN) lesions. Among the high-risk HPV(-) 31.3 % (131), patients 7.6% (10/131) had concurrent subclinical CIN lesions. Pathological examination results: cervicitis,167 (40.0%); cervical HPV infection, 182 (43.5%); CIN-Ⅰ, 51(12.2%); CIN-Ⅱ, 16 (3.83%); CIN-Ⅲ, 2 (0.5%); cervical cancer, none. Another patient had vulva condyloma acuminatum with valva intraepithelial neoplasia (VIN) Ⅱ~Ⅲ.CONCLUSION It was concluded that simultaneous cervical HPV infection of many types was rather common in patients with vulva condyloma acuminatum. Vulva condyloma acuminatum is the chief clinical symptom which hints at a high possibility of infection with high-risk HPV. The patients are at high-risk for CIN and cervical cancer. We must pay more attention to the cervix in cases with vulva condyloma acuminatum.

  12. Diagnostic value of transvaginal ultrasound in patients with cervical cancer%经阴道超声在宫颈癌患者中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    高晓艳; 王旭; 张玲

    2016-01-01

    Objective By observing the effects of transvaginal ultrasound diagnosis of cervical cancer applied to investigate its clinical value .Method A retrospective analysis of our hospital in May 2010-May 2015 period 160 cases of cervical cancer clinical imaging data , patients were using transvaginal color Doppler ultrasound , abdominal color Doppler ultrasound , and surgical pathol-ogy results the gold standard for both the accuracy of diagnostic results were compared and analyzed .Results After diagnosis found that vaginal ultrasound diagnostic accuracy of 93.8%, significantly higher than abdominal ultrasound diagnostic accuracy of 52.5%, P <0.05.Conclusion After diagnosis found that vaginal ultrasound diagnostic accuracy of 93.8%, significantly high-er than abdominal ultrasound diagnostic accuracy of 52.5%, P <0.05.%目的:通过观察阴道超声应用于宫颈癌诊断的效果来探讨其临床应用价值。方法回顾性分析我院2010年5月~2015年5月期间160例宫颈癌患者临床影像学资料,患者均分别采用阴道彩色多普勒超声、腹部彩色多普勒超声检查,同时以手术病理结果为金标准,对两者诊断结果准确性进行比较与分析。结果经诊断发现,阴道超声诊断准确率93.8%明显高于腹部超声诊断准确率52.5%, P <0.05。结论应用经阴道彩色多普勒超声于宫颈癌诊断中具有较高诊断价值,有利于疾病诊断。

  13. Correlation Between Radiation Dose to 18F-FDG-PET Defined Active Bone Marrow Subregions and Acute Hematologic Toxicity in Cervical Cancer Patients Treated With Chemoradiotherapy

    International Nuclear Information System (INIS)

    Purpose: To test the hypothesis that radiation dose to 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET)-defined active bone marrow (BMACT) subregions is correlated with hematologic toxicity in cervical cancer patients treated with chemoradiotherapy. Methods and Materials: The conditions of 26 women with cervical cancer who underwent 18F-FDG-PET before treatment with concurrent cisplatin and intensity-modulated radiation therapy were analyzed. BMACT was defined as the subregion of total bone marrow (BMTOT) with a standardized uptake value (SUV) equal to or above the mean for that individual. Inactive bone marrow (BMINACT) was defined as BMTOT − BMACT. Generalized linear modeling was used to test the correlation between BMACT and BMINACT dose–volume metrics and hematologic nadirs, particularly white blood cell count (WBC) and absolute neutrophil count (ANC). Results: Increased BMACT mean dose was significantly associated with decreased log(WBC) nadir (β = −0.04; 95% CI, −0.07to −0.01; p = 0.009), decreased log(ANC) nadir (β = −0.05; 95% CI, −0.08 to −0.02; p = 0.006), decreased hemoglobin nadir (β = −0.16; 95% CI, −0.27 to −0.05; p = 0.010), and decreased platelet nadir (β = −6.16; 95% CI, −9.37 to −2.96; p INACT mean dose and log(WBC) nadir (β = −0.01; 95% CI, −0.06 to 0.05; p = 0.84), log(ANC) nadir (β = −0.03; 95% CI, −0.10 to 0.04; p = 0.40), hemoglobin nadir (β = −0.09; 95% CI, −0.31 to 0.14; p = 0.452), or platelet nadir (β = −3.47; 95% CI, −10.44 to 3.50; p = 0.339). Conclusions: Irradiation of BM subregions with higher 18F-FDG-PET activity was associated with hematologic toxicity, supporting the hypothesis that reducing dose to BMACT subregions could mitigate hematologic toxicity. Future investigation should seek to confirm these findings and to identify optimal SUV thresholds to define BMACT.

  14. 宫颈糜烂与宫颈CIN及宫颈癌相关性的临床分析%Analysis of the relationship between cervical erosion and CIN or cervical cancer

    Institute of Scientific and Technical Information of China (English)

    庞辰珠

    2011-01-01

    目的:探讨宫颈糜烂与宫颈CIN及宫颈癌的关系.方法:对2008~2009年在山西省人民医院门诊就医的宫颈糜烂患者临床资料进行分析.结果:宫颈CIN及宫颈癌趋于年轻化,宫颈糜烂与宫颈CIN及宫颈癌之间无明显相关性.结论:宫颈糜烂是宫颈CIN及宫颈癌的前期表现,但宫颈靡烂面积、深度与宫颈CIN及宫颈癌不成正比.%Objective: To study the relationship between cervical erosion and CIN or cervical cancer. Methods: To analyze the clinical data of cervical erosion in outpatient treatment from 2008 to 2009 in Shanxi Province Peopled Hospital. Results: The patients with cervical CIN and cervical cancer tend to be younger. The significant correlation was not found between cervical erosion and cervical CIN or cervical cancer. Conclusion: Cervical erosion is the pre - show of CIN and cervical cancer. But the area and depth of the Cervical erosion with cervical CIN and cervical cancer is not directly proportional.

  15. Performance of Implementing Guideline Driven Cervical Cancer Screening Measures in an Inner City Hospital System

    Science.gov (United States)

    Wieland, Daryl L.; Reimers, Laura L.; Wu, Eijean; Nathan, Lisa M.; Gruenberg, Tammy; Abadi, Maria; Einstein, Mark H.

    2013-01-01

    Objective In 2006, the American Society for Colposcopy and Cervical Pathology (ASCCP) updated evidence based guidelines recommending screening intervals for women with abnormal cervical cytology. In our low-income inner city population, we sought to improve performance by uniformly applying the guidelines to all patients. We report the prospective performance of a comprehensive tracking, evidence-based algorithmically driven call-back and appointment scheduling system for cervical cancer screening in a resource-limited inner city population. Materials and Methods Outreach efforts were formalized with algorithm-based protocols for triage to colposcopy, with universal adherence to evidence-based guidelines. During implementation from August 2006 through July 2008, we prospectively tracked performance using the electronic medical record with administrative and pathology reports to determine performance variables such as the total number of Pap tests, colposcopy visits, and the distribution of abnormal cytology and histology results, including all CIN 2,3 diagnoses. Results 86,257 gynecologic visits and 41,527 Pap tests were performed system-wide during this period of widespread and uniform implementation of standard cervical cancer screening guidelines. The number of Pap tests performed per month varied little. The incidence of CIN 1 significantly decreased from 117/171 (68.4%) the first tracked month to 52/95 (54.7%) the last tracked month (p=0.04). The monthly incidence rate of CIN 2,3, including incident cervical cancers did not change. The total number of colposcopy visits declined, resulting in a 50% decrease in costs related to colposcopy services and approximately a 12% decrease in costs related to excisional biopsies. Conclusions Adherence to cervical cancer screening guidelines reduced the number of unnecessary colposcopies without increasing numbers of potentially missed CIN 2,3 lesions, including cervical cancer. Uniform implementation of administrative

  16. 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.

  17. 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.

  18. Effect of Psychological Nursing on Quality of Life of Patients With Cervical Cancer Surgery%心理护理对宫颈癌手术患者生活质量的影响分析

    Institute of Scientific and Technical Information of China (English)

    蔡亚兰

    2015-01-01

    Objective Impact of psychological nursing on life quality of patients with cervical cancer surgery is to be studied.Methods Chose 46 patients who were operated with cervical cancer surgery in hospital from July 2014 to July 2015 and separated them into groups according to numerical methods. 23 patients in control group were given perioperative conventional nursing,while 23 patients in study group were given psychological nursing and then compared patients'quality of life and their satisfaction degrees between two groups.Results Patients' quality of life in study group was much higher than that in control group,besides, patients'satisfaction degree in study group was higher. There was a nursing differential between two groups and such a differential had statistic value(P<0.05).Conclusion Psychological nursing exerts a positive impact on life quality for patients with cervical cancer. It is conducive to improving patients'quality of life.%目的 分析心理护理对宫颈癌手术患者生活质量的影响.方法 研究对象取2014年7月~2015年7月本院宫颈癌手术患者46例,按照数字法分组.23例围术期患者采取常规护理,入组对照组;在该基础上,给予另23例患者心理护理,入组研究组.对比组间生活质量与满意度.结果 研究组生活质量评分高,满意度高,差异具有统计学意义(P<0.05).结论 宫颈癌手术患者采用心理护理,生活质量提高,作用效果理想.

  19. 1990-2007年4223例子宫颈癌住院患者的调查分析%Analysis of 4223 hospitalized patients with cervical cancer during 1990-2007

    Institute of Scientific and Technical Information of China (English)

    吴云燕; 梁美蓉; 李隆玉; 曾四元

    2008-01-01

    Objective To analyze the changes in epidemiology and treatment of hospitalized patients with cervical cancer during 1990-2007.Methods Overall.4648 patients witIl cervical cancer were diagnosed in our hospital from Jan 1990 to Nov 2007.but only 4223 patients with initial treatment in Oily hospital were studied retrospectively.Pearson Chi-square test was used to compare tlle age,stage,histopathologie type and treatment metheds between different times.Results (1)The meal]age of cervical cancer patients gradually decreased over the past 18 years,from 54.4 years during 1990-1999 to 47.2 years during 2000-2007:the proportion of young patients aged≤35 years increased from 4.77%(89/1865)during 1990-1999 to 11.75%(277/2358)during 2000-2007.(2)The proportion of patients with cervical cancer(stage I a-H a)increased from 14.32%(267/1865)during 1990-1999 to 40.75%(961/2358)during 2000-2007,whereas the proportion of patients with cervical cancer(stage Ⅱ b-lV)decreased from 85.68%(1598/1865)during 1990-1999 to 59.25%(1397/2358)during 2000-2007.(3)There was no significant change in histopathologie type of cervical cancer,and squamous cell careinoma of cervix remained the main type of cervical cancer.(4)The treatment pattern of cervical cancer changed significantly:radiotherapy was the main method(75.28%)for eervical cancer during 1990-1 999.but during 2000-2007.it was replaced by concurrent chemoradiotherapy(35.79%).Conclusions The proportion of young women with cervical cancer was increased during 1990-2007.and at the same period early stage cervical cancer increased.but late stage cervical cancer decreased.It is obvious that chemotherapy has become the important therapy in cervical cancer.%目的 分析不同时期宫颈癌住院患者的发病年龄、临床病理特征及治疗方式的变化,以期为宫颈癌的治疗策略提供参考.方法 对1990年1月至2007年11月在江西省妇幼保健院住院、接受初次治疗的4223例宫颈癌患者的l临床和病理

  20. Identification of biomarkers for cervical cancer in peripheral blood lymphocytes using oligonucleotide microarrays

    Institute of Scientific and Technical Information of China (English)

    SHENG Jie; ZHANG Wei-yuan

    2010-01-01

    Background Oligonucleotide microarrays are increasingly being used to identify gene expression profiles that associated with complex genetic diseases. Peripheral lymphocytes communicate with cells and extracellular matrixes in almost all tissues and organs in human body, suggesting that the gene expression profiles in peripheral lymphocytes may reflect the presence of disease in the body. This study aimed to identify molecular biomarkers for cervical cancer in peripheral blood lymphocytes by using oligonucleotide microarrays.Methods Total RNA was extracted from peripheral blood lymphocytes of 24 early stage cervical cancer patients and 18 healthy controls. We used 22K Human Genome microarrays to profile peripheral blood lymphocytes from 4 early stage cervical cancer patients and compared their gene expression profiles with those from 3 healthy controls. Differentially expressed genes would be identified if they had adjusted P values of less than 0.05 and a groupwise average fold change greater than 1.5 or less than 0.67. Then the selected 5 genes were validated in the remaining 20 early stage cervical cancer patients and the 15 healthy controls by using real-time reverse-transcription polymerase chain reaction (RT-PCR).Results Genes identified by the gene selection program expressed differently between the blood samples of the early stage cervical cancer patients and those of the healthy controls. To validate the gene expression data, 5 genes were analyzed by real-time RT-PCR. In three of the 5 identified genes, tenasin-c (TNC), nuceolin (NCL), and enolase 2 (ENO2) showed a significant up-regulation in the blood samples of the early stage cervical cancer patients versus that of the healthy controls.Conclusions The up-regulation of TNC, NCL, and ENO2 in peripheral blood may be used to identify novel blood biomarkers for detecting cervical cancer in a clinically accessible surrogate tissue, and thus to provide a possibility to develop a noninvasive and predictive

  1. 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....

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    conditions the Tofts (TM), extended Tofts (ETM), compartmental tissue uptake model (C-TU) and 2-compartment exchange model (2CXM) were the optimal tracer kinetic models (TKMs) for the analysis of DCE-MRI in patients with cervical cancer. Material and methods. Ten patients with locally advanced cervical...

  3. 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...

  4. Genetic Variants of NPAT-ATM and AURKA are Associated With an Early Adverse Reaction in the Gastrointestinal Tract of Patients With Cervical Cancer Treated With Pelvic Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Atsuko; Suga, Tomo; Shoji, Yoshimi [RadGenomics Project, National Institute of Radiological Sciences, Chiba (Japan); Kato, Shingo; Ohno, Tatsuya; Ishikawa, Hitoshi [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Yoshinaga, Shinji [Research Center for Radiation Protection, National Institute of Radiological Sciences, Chiba (Japan); Ohara, Kiyoshi [Tsukuba University Hospital, Tsukuba (Japan); Ariga, Hisanori [Tohoku University Hospital, Miyagi (Japan); Nomura, Kuninori [Toyama University Hospital, Toyama (Japan); Shibamoto, Yuta [Nagoya City University Hospital, Aichi (Japan); Ishikawa, Ken-Ichi; Moritake, Takashi; Michikawa, Yuichi; Iwakawa, Mayumi [RadGenomics Project, National Institute of Radiological Sciences, Chiba (Japan); Imai, Takashi, E-mail: imait@nirs.go.jp [RadGenomics Project, National Institute of Radiological Sciences, Chiba (Japan)

    2011-11-15

    Purpose: This study sought to associate polymorphisms in genes related to cell cycle regulation or genome maintenance with radiotherapy (RT)-induced an early adverse reaction (EAR) in patients with cervical cancer. Methods and Materials: This study enrolled 243 cervical cancer patients who were treated with pelvic RT. An early gastrointestinal reaction was graded using the National Cancer Institute Common Toxicity Criteria, version 2. Clinical factors of the enrolled patients were analyzed, and 208 patients were grouped for genetic analysis according to their EAR (Grade {<=}1, n = 150; Grade {>=}2, n = 58). Genomic DNA was genotyped, and association with the risk of EAR for 44 functional single-nucleotide polymorphisms (SNPs) of 19 candidate genes was assessed by single-locus, haplotype, and multilocus analyses. Results: Our analysis revealed two haplotypes to be associated with an increased risk of EAR. The first, comprising rs625120C, rs189037T, rs228589A, and rs183460G, is located between the 5' ends of NPAT and ATM (OR = 1.86; 95% CI, 1.21-2.87), whereas the second is located in the AURKA gene and comprises rs2273535A and rs1047972G (OR = 1.75; 95% CI, 1.10-2.78). A third haplotype, rs2273535T and rs1047972A in AURKA, was associated with a reduced EAR risk (OR = 0.42; 95% CI, 0.20-0.89). The risk of EAR was significantly higher among patients with both risk diplotypes than in those possessing the other diplotypes (OR = 3.24; 95% CI, 1.52-6.92). Conclusions: Individual radiosensitivity of intestine may be determined by haplotypes in the NPAT-ATM and AURKA genes. These variants should be explored in larger association studies in cervical cancer patients.

  5. Genetic Variants of NPAT-ATM and AURKA are Associated With an Early Adverse Reaction in the Gastrointestinal Tract of Patients With Cervical Cancer Treated With Pelvic Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: This study sought to associate polymorphisms in genes related to cell cycle regulation or genome maintenance with radiotherapy (RT)-induced an early adverse reaction (EAR) in patients with cervical cancer. Methods and Materials: This study enrolled 243 cervical cancer patients who were treated with pelvic RT. An early gastrointestinal reaction was graded using the National Cancer Institute Common Toxicity Criteria, version 2. Clinical factors of the enrolled patients were analyzed, and 208 patients were grouped for genetic analysis according to their EAR (Grade ≤1, n = 150; Grade ≥2, n = 58). Genomic DNA was genotyped, and association with the risk of EAR for 44 functional single-nucleotide polymorphisms (SNPs) of 19 candidate genes was assessed by single-locus, haplotype, and multilocus analyses. Results: Our analysis revealed two haplotypes to be associated with an increased risk of EAR. The first, comprising rs625120C, rs189037T, rs228589A, and rs183460G, is located between the 5’ ends of NPAT and ATM (OR = 1.86; 95% CI, 1.21–2.87), whereas the second is located in the AURKA gene and comprises rs2273535A and rs1047972G (OR = 1.75; 95% CI, 1.10–2.78). A third haplotype, rs2273535T and rs1047972A in AURKA, was associated with a reduced EAR risk (OR = 0.42; 95% CI, 0.20–0.89). The risk of EAR was significantly higher among patients with both risk diplotypes than in those possessing the other diplotypes (OR = 3.24; 95% CI, 1.52–6.92). Conclusions: Individual radiosensitivity of intestine may be determined by haplotypes in the NPAT-ATM and AURKA genes. These variants should be explored in larger association studies in cervical cancer patients.

  6. PKM2 enhances chemosensitivity to cisplatin through interaction with the mTOR pathway in cervical cancer.

    Science.gov (United States)

    Zhu, Haiyan; Wu, Jun; Zhang, Wenwen; Luo, Hui; Shen, Zhaojun; Cheng, Huihui; Zhu, Xueqiong

    2016-01-01

    Pyruvate kinase M2 (PKM2) is a key driver of aerobic glycolysis in cancer cells and has been shown to be up-regulated by mTOR in vitro. Our previous proteomic profiling studies showed that PKM2 was significantly upregulated in cervical cancer tissues after treatment with neoadjuvant chemotherapy (NACT). Whether PKM2 expression predicts cisplatin-based NACT sensitivity and is mTOR dependent in cervical cancer patients remains unclear. Using paired tumor samples (pre- and post-chemotherapy) from 36 cervical cancer patients, we examined mTOR, HIF-1α, c-Myc, and PKM2 expression in cervical cancer samples and investigated the response to cisplatin-based NACT. In addition, we established PKM2 suppressed cervical cancer cell lines and evaluated their sensitivity to cisplatin in vitro. We found that the mTOR/HIF-1α/c-Myc/PKM2 signaling pathway was significantly downregulated in post-chemotherapy cervical cancer tissues. High levels of mTOR, HIF-1α, c-Myc, and PKM2 were associated with a positive chemotherapy response in cervical cancer patients treated with cisplatin-based NACT. In vitro, PKM2 knockdown desensitized cervical cancer cells to cisplatin. Moreover, PKM2 had complex interactions with mTOR pathways. mTOR, HIF1α, c-Myc, and PKM2 expression in cervical cancer may serve as predictive biomarkers to cisplatin-based chemotherapy. PKM2 enhances chemosensitivity to cisplatin through interaction with the mTOR pathway in cervical cancer. PMID:27492148

  7. 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...

  8. 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.

  9. 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...

  10. The Role of Pretreatment FDG-PET in Treating Cervical Cancer Patients With Enlarged Pelvic Lymph Node(s) Shown on MRI: A Phase 3 Randomized Trial With Long-Term Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Shinn-Yn [Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taiwan (China); Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan (China); Tsai, Chien-Sheng [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan (China); Chang, Yu-Chen [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taiwan (China); Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Ng, Koon-Kwan [Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan (China); Chang, Ting-Chang [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Kao, Wei-Heng [Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Lai, Chyong-Huey [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Hong, Ji-Hong, E-mail: jihong@adm.cgmh.org.tw [Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taiwan (China); Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taiwan (China)

    2015-07-01

    Purpose: This report is the second analysis of a prospective randomized trial to investigate the impact of {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) on cervical cancer patients with enlarged pelvic lymph nodes identified by magnetic resonance imaging. Methods and Materials: Patients with newly diagnosed cervical cancer with enlarged pelvic lymph nodes but free of enlarged para-aortic lymph nodes (PALN) were eligible. Patients were randomized to receive either pretreatment FDG-PET (PET arm) or not (control arm). The whole pelvis was the standard irradiation field for all patients except those with FDG-avid extrapelvic findings. Results: In all, 129 patients were enrolled. Pretreatment PET detected extrapelvic metastases in 7 patients. No new patient experienced treatment failure during the additional 4-year follow-up period. There were no significant differences between the PET arm and the control arm regarding overall survival, disease-free survival, and freedom from extrapelvic metastasis. In the control arm, 8 of 10 patients with PALN relapse had limited extrapelvic nodal failures; their 5-year disease-specific survival was 34.3%. By contrast, only 1 of 5 patients with PALN relapse in the PET arm experienced such limited failures; their 5-year survival rate was 0%. Conclusions: Although the pretreatment detection of PALN did not translate into survival benefit, it indeed decreased the need for extended-field concurrent chemoradiation therapy.

  11. The incidence of venous thromboembolism in cervical cancer: a nationwide population-based study

    Directory of Open Access Journals (Sweden)

    Tsai Shiang-Jiun

    2012-06-01

    Full Text Available Abstract Background Venous thromboembolism (VTE is a life-threatening condition that occurs as a complication of cervical cancer. The aim of this study was to evaluate the incidence of VTE in cervical cancer patients during a 5-year follow-up. Methods The study analyzed data deposited between 2003 and 2008 in the National Health Insurance Research Database (NHIRD, provided by the National Health Research Institutes in Taiwan. Totally, 1013 cervical cancer patients after treatment and 2026 appendectomy patients were eligible. The Kaplan-Meier method and the Cox proportional hazards model were used to assess the VTE risk. Results The 5-year cumulative risk for VTE was significantly higher in the cervical cancer group than in the control group (3.3% vs 0.3%, p vs 30.3%, p  Conclusions The cumulative risk of VTE was significantly higher in cervical cancer patients, and these patients also had lower survival rates. Strategies to reduce these risks need to be examined.

  12. 宫颈癌围手术期患者家属应激水平影响因素分析%INFLUENCING FACTORS AFFECTING STRESS LEVEL OF FAMILY MEMBERS OF CERVICAL CANCER PATIENTS DURING PERIOPERATIVE PERIOD

    Institute of Scientific and Technical Information of China (English)

    张慧芳; 颜春英

    2015-01-01

    目的::探讨宫颈癌围手术期患者家属应激水平的影响因素,为制定相关心理干预措施提供理论依据。方法:应用家属应激量表(RSS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)调查90例宫颈癌围手术期患者家属的应激水平和焦虑、抑郁状况,并采用Pearson直线相关分析和Stepwise多元线性回归分析分析影响患者家属应激水平的因素。结果:宫颈癌围手术期患者家属应激反应水平较高,焦虑情况较轻,存在中至重度抑郁。直线相关分析显示,RSS及其三个因子评分与焦虑、抑郁均呈正相关关系(P<0.05)。多元线性回归分析表明,家属的民族、宗教信仰、家庭类型、焦虑、抑郁水平是影响其应激水平的因素(P<0.05)。结论:宫颈癌患者家属在围手术期同样存在严重的心理问题,医护人员应给予切实有效的心理指导,降低患者家属的心理应激水平。%Objective:To investigate the inlfuencing factors affecting stress level of family members of cervical cancer patients during perioperative period and provide theoretical basis for formulating psychological intervention measures. Methods:RSS scale, SAS scale and SDS scale were used to evaluate the stress level, anxiety and depression status of family members of cervical cancer patients during perioperative period; Pearson linear correlation analysis and Stepwise multiple linear regression analysis were applied to analyze the inlfuencing factors affecting stress level of family members of cervical cancer patients.Results:The stress level of family members of cervical cancer patients was higher; the anxiety status was lighter but the depression status was moderate to severe. Linear correlation analysis showed RSS and its’ 3 factors positively correlated with anxiety and depression status. Multiple linear regression analysis showed nation, religion, family type, anxiety level and depression level were

  13. Sentinel lymph node mapping in early stage of endometrial and cervical cancers

    Directory of Open Access Journals (Sweden)

    Tajossadat Allameh

    2015-01-01

    Full Text Available Background: The sentinel lymph node (SLN is defined as the first chain node in the lymphatic basin that receives primary lymphatic flow. If the SLN is negative for metastatic disease, then other nodes are expected to be disease-free. SLN techniques have been extensively applied in the staging and treatment of many tumors, including melanoma, breast and vulvar cancers. This study aims to evaluate our technique in SLN mapping in early stage endometrial and cervical cancers. Materials and Methods: We scheduled a cross-sectional pilot study for patients undergoing staging surgery for endometrial and cervical cancer from November 2012 to February 2014 in Beheshti and Sadoughi Hospitals. Our SLN mapping technique included 1 h preoperative or intraoperative injection of 4 ml of 1% methylene blue dye in the tumor site. At the time of surgery, blue lymph nodes were removed and labeled as SLNs. Then systematic lymph node dissection was completed, and all of the nodes were sent for pathologic examination concerning metastatic involvement. All of the sentinel nodes were first stained with hematoxylin and eosin and examined. Those negative in this study were then stained with immunohistochemistry using anti-keratin antibody. Descriptive statistics, sensitivity, negative predictive values (NPV, false negative (FN and detection rates were calculated. Results: Twenty-three patients including 62% endometrial and 38% cervical cancers enrolled in the study. Median of SLN count in the endometrial and cervical cancers was 3 and 2, respectively. Among endometrial and cervical cancers, detection rate of metastatic disease was 80% and 87.5%, respectively. The FN rate for this technique was 0 and the sensitivity and NPV are 100% for both endometrial and cervical cancers. Conclusion: Considering the lower risk of metastases in early stage of both endometrial and cervical cancers, SLN technique allows for confident and accurate staging of cancer.

  14. 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.

  15. High parity and hormonal contraception use as risk factors for cervical cancer in East Kalimantan

    Directory of Open Access Journals (Sweden)

    Swandari Paramita

    2010-11-01

    Full Text Available Aim: To find risk factors associated with cervical cancer.Methods: This a case-control study conducted in A.W. Sjahranie County General Hospital at Samarinda East Kalimantan from January until July 2009. There were 58 patients for each case and control group. Variables in this study were age, menarche, menopause, age of first marriage, parity, spouse’s smoking status, hormonal contraception use, type of hormonal contraception, duration of hormonal contraception, IUD (intra uterine device contraception use and duration of IUD contraception.Results: final data analysis shows that parity and duration of hormonal contraception use increased the risk of cervical cancer. Women who had 5-12 children than 0-4 children had 2.6-folds increased risk to be cervical cancer. Compared to women never use of hormonal contraception, those who ever had hormonal contraception for 1-4 years and 5-25 years had two time and 4.5 times increased risk to be cervical cancer respectively.Conclusion: Cervical cancer screening recommended to be focused on high-risk groups, among others, women with the number of children born more than fi ve people or women in particular users of hormonal contraception methods with a range of use more than fi ve years. (Med J Indones 2010; 19:268-72Keywords: Cervical cancer, hormonal contraception, menarche, parity

  16. Adjustment of treatment parameters for photodynamic therapy of cervical pre-cancer and cancer

    Directory of Open Access Journals (Sweden)

    I. P. Aminodova

    2015-01-01

    Full Text Available Comprehensive study for optimization of parameters of photodynamic action with fotoditazin in patients with tumor and pre-tumor cervical diseases was conducted. The study included 52 female patients: pre-invasive cervical diseases were diagnosed in 34 (CIN I – in 9, CIN II – in 13, CIN III – in 12, cervical cancer – in 11 (8 had squamous cell cancer, 3 – adenocarcinoma of cervical canal, chronic cervicitis – in 7. The study agent in the form of 0,5% gel was applied on cervix in dose of 1 ml. To detect optimal interval between gel application and conduction of photodynamic therapy dynamics of accumulation and elimination of photosensitizer by means of its fl uorescence was studied. Fotoditazin was shown to have good accumulation in pathological tissues. The maximal agent accumulation was noticed in 30 min, continued about 15 min, and then gradually decreased. Maximal fl uorescence of photosensitizer was observed in foci of malignant tumor and severe intraepithelial neoplasia. To detect optimal light dose for irradiation cytological study of cell smear from specimen after light exposure with different light doses was performed. The minimal light dose necessary for activation of photochemical reaction pathway was 100 J/cm2, and optimal – 250 J/cm2. This dose allowed to destroy all atypical cells in the area of light exposure after application of gel fotoditazin. According to obtain data we suppose that the most effi cient regimen of photodynamic therapy with local application of fotoditazin-gel for treating dysplasia and pre-invasive cervical cancer was a dose of laser irradiation of 250 J/cm2 with duration of application of 30–45 min. 

  17. The current status and influencing factors of quality of life in patients with cervical cancer%宫颈癌患者生存质量状况及其影响因素研究

    Institute of Scientific and Technical Information of China (English)

    徐昊; 丁焱

    2011-01-01

    Objective To investigate the status and influencing factors of quality of life(QOL) in patients with cervical cancer. Methods A total of 473 patients with cervical cancer were investigated with the Functional Assessment of Cancer Therapy scale-Cervix (FACT-Cx). Results The mean score.of QOL was 118.65±19.72. Marital status,perceived family relationship, performance status and perceived financial burden were influencing factors of patients' QOL. Conclusions The quality of life in patients with cervical cancer is in middle to high level. It is suggested to provide interventions to improve the quality of life for patients with heavy financial burden,poor family relationship,worse performance status and single.%目的 调查宫颈癌患者生存质量状况,分析其影响因素。方法 采用宫颈癌生存质量评估量表(FACT-Cx)对473例宫颈癌患者进行调查。结果 患者生存质量总分均值为(118.65±19.72)分。单身、家庭关系一般、活动状况较差和经济负担重是生存质量的影响因素。结论 宫颈癌患者生存质量得分处于较好水平。应加强对经济负担较量、家庭关系较差、单身和活动状态较差患者的干预,以提高其生存质量。

  18. 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

  19. Predictors of Grade 3 or Higher Late Bowel Toxicity in Patients Undergoing Pelvic Radiation for Cervical Cancer: Results From a Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Chopra, Supriya, E-mail: schopra@actrec.gov.in [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Dora, Tapas [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Chinnachamy, Anand N. [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India); Thomas, Biji [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Kannan, Sadhna [Epidemiology and Clinical Trials Unit, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Engineer, Reena; Mahantshetty, Umesh [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India); Phurailatpam, Reena; Paul, Siji N. [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Shrivastava, Shyam Kishore [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India)

    2014-03-01

    Purpose: The present study investigates relationship between dose–volume parameters and severe bowel toxicity after postoperative radiation treatment (PORT) for cervical cancer. Methods and Materials: From June 2010 to December 2012, a total of 71 patients undergoing PORT were included. Small bowel (SB) and large bowel (LB) loops were contoured 2 cm above the target volume. The volume of SB and LB that received 15 Gy, 30 Gy, and 40 Gy was calculated (V15 SB, V15 LB, V30 SB, V30 LB, V40 SB, V 40 LB). On follow-up, bowel toxicity was scored using Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. A reciever operating characteristic (ROC) curve identified volume thresholds that predicted for grade 3 or higher toxicity with highest specificity. All data was dichotomized across these identified cut-off values. Univariate and multivariate analysis was performed using SPSS, version 15. Results: The median patient age was 47 years (range, 35-65 years). Of the 71 patients, 46 received image-guided intensity modulated radiation therapy, and 25 received conformal radiation (50 Gy in 25 fractions for 5 weeks). Overall, 63 of 71 patients received concurrent chemotherapy. On a median follow-up of 18 months (range, 8-29 months), grade 2 or higher bowel toxicity was seen in 22 of 71 patients (30.9%) and grade 3 or higher bowel toxicity was seen in 9 patients (12.6%). On univariate analysis, V15 SB <275 cc (P=.01), V30 SB <190 cc (P=.02), V40 SB <150 cc (P=.01), and V15 LB <250 cc (P=.03), and V40 LB <90 cc (P=.04) predicted for absence of grade 3 or higher toxicity. No other patient- or treatment-related factors were statistically significant. On multivariate analysis, only V15 SB (P=.002) and V15 LB (P=.03) were statistically significant. Conclusions: V 15 Gy SB and LB are independent predictors of late grade 3 or higher toxicity. Restricting V15 SB and V15 LB to <275 cc and <250 cc can reduce grade 3 or higher toxicity to less than 5%.

  20. 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.

  1. 护理干预与宫颈癌术后尿潴留发生率的Meta分析%Meta analysis on nursing intervention and rate of postoperative urinary retention for patients undergoing cervical cancer operation

    Institute of Scientific and Technical Information of China (English)

    张意玲; 杨邵英

    2011-01-01

    Objective To study the relation between nursing intervention and rate of postoperative urinary retention for patients undergoing cervical cancer operation by Meta analysis. Method Take Meta analysis with fixed effect model on randomized controlled study results of 28 domestic literature on nursing intervention and postoperative urinary retention of cervical cancer operation by RevMan 4.2. Result There is a significant relation between nursing intervention and reducing the rate of postoperative urinary retention of cervical cancer operation (Z= 14. 99, P<0. 00001). Relative risk (RR) is 0. 25. 95% confidence interval (CI) is 0. 2l~0. 30. Conclusion Nursing intervention is an important method to reduce postoperative urinary retention of cervical cancer operation.%目的 通过Meta分析探讨护理干预与宫颈癌术后尿潴留之间的相互关系.方法 采用RevMan 4.2分析专用软件,对国内28篇关于护理干预与宫颈癌术后尿潴留关系文献的随机对照研究结果,进行固定效应模型的Meta分析.结果 综合护理干预与降低宫颈癌术后尿潴留之间关联明显(Z=14.99,P<0.00001),合并计算的相对危险度(RR值)为0.25,95%置信区间(CI)为0.21~0.30.结论 综合护理干预是减少宫颈癌术后尿潴留发生的一个重要手段.

  2. Risk factors for lower-limb lymphedema after surgery for cervical cancer

    International Nuclear Information System (INIS)

    Lower-limb lymphedema (LLL) is a prevalent complication that is encountered after treatment for gynecological malignancies. The aim of this study was to evaluate the risk factors for postoperative LLL in patients with cervical cancer. We conducted a retrospective chart review for patients who had undergone surgery, including systematic lymphadenectomy, for cervical cancer. Patients who died of cancer, were evaluated for short periods of time (<2 years), had missing medical records, or were suffering from deep venous thrombosis were excluded. We utilized the International Society of Lymphology staging of lymphedema severity as the diagnostic criteria for LLL, and patients with stage II or III lymphedema, as objectively determined by physicians, were included in the group of patients with LLL. Multivariate analysis was performed to confirm independent risk factors. A total of 155 patients with cervical cancer were evaluated. Thirty-one patients (20.0%) contracted LLL with a median follow-up of 6.1 years. Suprafemoral node dissection (odds ratio, 9.5; 95% confidence interval, 1.2-73.3; P=0.031) and adjuvant radiotherapy (3.7; 1.2-10.9; P=0.019) were identified as independent risk factors. Given that the effectiveness of the above two therapeutic options for cervical cancer is currently controversial, the clinical benefits of these therapies should be reevaluated specifically to conserve the quality of life for patients with this disease. (author)

  3. 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

  4. 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...

  5. 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.

  6. 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.

  7. The Psychological Intervention Effect on Cervical Cancer Accepted Chemoradiotherapy Patients' Quality of Life%心理干预对宫颈癌同期放化疗患者生存质量的影响

    Institute of Scientific and Technical Information of China (English)

    曾红学; 王蓉; 李金伟

    2014-01-01

    目的:探讨接受放化疗宫颈癌患者生存质量及心理干预对其的影响。方法:对84例宫颈癌患者按照随机数字表法分为两组,一组给予心理干预(干预组),一组未给予心理干预(对照组)。采用欧洲癌症研究与治疗组织研制的生存质量核心量表,对两组进行生存质量测量和评价,研究心理干预对生存质量的影响。结果:治疗后,干预组各项生存质量指数如功能量表及症状量表均明显高于对照组,比较差异均有统计学意义(P<0.05)。结论:宫颈癌患者同期放化疗实施心理干预,能显著提高患者的生存质量。%Objective:To discuss chemoradiotherapy to the cervical cancer patient quality of life,the appraisal of psychology intervention to its quality of life influence.Method:84 patients with cervical cancer were randomly divided into two groups,one group to the positive psychological intervention(intervention group),another group of no psychological intervention(control group),each group had 42 cases. Quality of life core meter which the European cancer research and the treatment organization develop(EORTC QLQ-C30)were used,carried on the quality of life survey and the appraisal to the cervical cancer who accepted chemoradiotherapy patient,discussed that the psychology intervention to the patient quality of life influence.Result:The quality of life in the intervention group index function scale and symptom score were significantly higher than the control group,and the differences between the two groups were statistically significant(P<0.05).Conclusion:Implement the psychological intervention in cervical cancer patients who accepted chemoradiotherapy,can significantly improve patients' quality of life.

  8. 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

  9. 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...

  10. 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...

  11. 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...

  12. 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.

  13. 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.

  14. The influence of psychological nursing on the quality of life of patients with cervical cancer after operation%宫颈癌术后心理护理对患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    杨银娣

    2016-01-01

    Objective To explore the influence of psychological nursing on the quality of life of patients with cervical cancer after operation.Methods Selects Lianyungang Maternal and Child health care hospital of cervical cancer postoperative 100 patients, divided into the experimental group and the control group according to the principle of randomized, controlled, were given routine nursing with psychological nursing and conventional nursing, compared two groups of patients quality of life differences.Results The quality of life in the experimental group was significantly higher than that in the control group.Conclusion In cervical cancer patients to carry out psychological care can significantly improve the quality of life of patients after surgery.%目的:探讨心理护理对宫颈癌术后患者生活质量的影响。方法:选取连云港市妇幼保健院宫颈癌术后患者100名,按随机对照原则分为实验组和对照组,分别给予常规护理加心理护理和单纯常规护理,比较两组患者之间生活质量的差异。结果:实验组生活质量明显高于对照组。结论:在宫颈癌患者中开展心理护理能够明显提高患者术后的生活质量。

  15. Carbonic anhydrase XII expression is associated with histologic grade of cervical cancer and superior radiotherapy outcome

    International Nuclear Information System (INIS)

    To investigate whether expression of carbonic anhydrase XII (CA12) is associated with histologic grade of the tumors and radiotherapy outcomes of the patients with invasive cervical cancer. CA12 expression was examined by immunohistochemical stains in cervical cancer tissues from 183 radiotherapy patients. Histological grading was classified as well (WD), moderately (MD) or poorly differentiated (PD). Oligonucleotide microarray experiment was performed using seven cervical cancer samples to examine differentially expressed genes between WD and PD cervical cancers. The association between CA12 and histological grade was analyzed by chi-square test. CA12 and histological grades were analyzed individually and as combined CA12 and histologic grade categories for effects on survival outcome. Immunohistochemical expression of CA12 was highly associated with the histologic grade of cervical cancer. Lack of CA12 expression was associated with PD histology, with an odds ratio of 3.9 (P = 0.01). Microarray analysis showed a fourfold reduction in CA12 gene expression in PD tumors. CA12 expression was marginally associated with superior disease-free survival. Application of the new combined categories resulted in further discrimination of the prognosis of patients with moderate and poorly differentiated tumor grade. Our study indicates that CA12 may be used as a novel prognostic marker in combination with histologic grade of the tumors

  16. Augmented serum level of major histocompatibility complex class I-related chain A (MICA) protein and reduced NKG2D expression on NK and T cells in patients with cervical cancer and precursor lesions

    International Nuclear Information System (INIS)

    Cervical cancer is the second most common cancer in women worldwide. NK and cytotoxic T cells play an important role in the elimination of virus-infected and tumor cells through NKG2D activating receptors, which can promote the lysis of target cells by binding to the major histocompatibility complex class I-related chain A (MICA) proteins. Increased serum levels of MICA have been found in patients with epithelial tumors. The aim of this study was to compare the levels of soluble MICA (sMICA) and NKG2D-expressing NK and T cells in blood samples from patients with cervical cancer or precursor lesions with those from healthy donors. Peripheral blood with or without heparin was collected to obtain mononuclear cells or sera, respectively. Serum sMICA levels were measured by ELISA and NKG2D-expressing immune cells were analyzed by flow cytometry. Also, a correlation analysis was performed to associate sMICA levels with either NKG2D expression or with the stage of the lesion. Significant amounts of sMICA were detected in sera from nearly all patients. We found a decrease in the number of NKG2D-expressing NK and T cells in both cervical cancer and lesion groups when compared to healthy donors. Pearson analysis showed a negative correlation between sMICA and NKG2D-expressing T cells; however, we did not find a significant correlation when the analysis was applied to sMICA and NKG2D expression on NK cells. Our results show for the first time that high sMICA levels are found in sera from patients with both cervical cancer and precursor lesions when compared with healthy donors. We also observed a diminution in the number of NKG2D-expressing NK and T cells in the patient samples; however, a significant negative correlation between sMICA and NKG2D expression was only seen in T cells

  17. HPV阴性的宫颈癌和癌前病变中p14ARF蛋白表达及其临床意义%Expression and clinical significance of p14ARF protein in HPV - negative patients with cervical cancer and cervical precancerous lesion

    Institute of Scientific and Technical Information of China (English)

    尹香花; 苏悦; 隋玉梅; 成艳

    2011-01-01

    Objective:To explore the relationship between pl4ARF protein, matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs) and early diagnosis, invasion and metastasis of cervical cancer by detecting their expression levels in cervical canc-er and cervical intraepithelial neoplasia (CIN) of human papillomavirus ( HPV ) - negative patients. Methods: 30 HPV - negative patients with chronic cervicitis, 35 HPV - negative patients with CIN and 35 HPV - negative patients with cervical invasive cancer were selected as study ob-jects by PCR. Immunohistochemical SP staining was used to detect the expression level of pl4ARF protein, clinicopathological characteristics and the correlation with the depth of invasion and lymph node metastasis. Results :P14ARF protein specifically expressed in the nuclei and cyto-plasm of CIN and cervical cancer cells, and it never expressed in normal squamous epithelium and glandular epithelium, there was no correla-tion between P14ARF protein expression and clinical stages, while it was related to the degree of differentiation and lymph node metastasis. Conclusion: pl4ARF protein detection can be used as an index for early diagnosis of cervical cancer among HPV - negative patients, which also can be used as an index to predict the potential of invasion and metastasis of cervical cancer and clinical prognosis.%目的:通过检测人乳头状瘤病毒(HPV)感染阴性的官颈癌和宫颈上皮内瘤变中p14ARF和基质金属蛋白酶MMPs及其抑制物TIMPs的表达,探讨其与官颈癌早期诊断、侵袭转移的关系.方法:以PCR方法筛查HPV阴性的慢性官颈炎30例、官颈上皮内瘤变(CIN) 35例及官颈浸润癌35例作为研究对象,采用SP染色法检测p14ARF蛋白在其中的表达,分析p14ARF蛋白在官颈癌组织中的表达、临床病理特征及其与浸润深度、淋巴结转移的相关性.结果:p14ARF蛋白特异性表达在HPV阴性的CIN病变、宫颈癌细胞核及胞质中,在

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

    OpenAIRE

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

    2015-01-01

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

  19. 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.

  20. 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.

  1. Preoperative neoadjuvant chemotherapy in the patients with locally advanced cervical cancer%术前新辅助化疗在局部晚期宫颈癌患者中的应用

    Institute of Scientific and Technical Information of China (English)

    王丹丹

    2014-01-01

    目的:探讨术前新辅助化疗(NACT)在局部晚期宫颈癌患者治疗中的疗效及毒副反应。方法76例局部晚期宫颈癌患者根据是否接受NACT分为两组,其中观察组39例给予NACT后再接受根治性切除术治疗,而对照组37例患者直接接受单纯根治性切除术治疗,评价NACT治疗后的有效率以及两组术后情况。结果观察组NACT的有效率为76.9%,主要毒副反应为轻度恶心呕吐及骨髓抑制,未影响治疗的顺利进行。观察组淋巴结转移率及术后复发率均低于对照组(P<0.05)。结论 NACT有利于局部晚期宫颈癌的完全切除,能够降低患者淋巴结转移及术后复发的可能。%Objective To investigate the efficacy and toxicities of preoperative neoadjuvant chemotherapy (NACT) in the treatment of patients with locally advanced cervical cancer. Methods The 76 patients with locally advanced cervical cancer patients were divided into two groups, 39 patients of the observation group received the NACT and radical operation, while 37 patients of the control group directly received radical operation, the response rate of NACT and the postoperative conditions of the two groups were evaluated comparatively. Results The response rate of NACT was 76.9%in the observation group, the main toxicities were mild nausea and vomiting, and bone marrow suppression, they did not affect the smooth progress of treatment. The lymph node metastasis rate and the recurrence rate of the observation group were lower than those of the control group (P<0.05). Conclusion NACT is in favor of total resection of locally advanced cervical cancer, and it can reduce the possibility of lymph node metastasis and recurrence of the patients with locally advanced cervical cancer.

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

    NARCIS (Netherlands)

    Pras, E; Willemse, PHB; Canrinus, AA; de Bruijn, HWA; Sluiter, WJ; ten Hoor, KA; Aalders, JG; Szabo, BG; de Vries, EGE

    2002-01-01

    Purpose: To analyze whether serum squamous cell carcinoma (SCC) antigen and cytokeratin-19 fragments (CYFRA) levels can assist in selecting patients with locally advanced cervical cancer who will benefit from combined treatment or additive surgery. Methods and Materials: Of 114 patients with cervica

  3. Comparison of the Prognostic Value of F-18 Pet Metabolic Parameters of Primary Tumors and Regional Lymph Nodes in Patients with Locally Advanced Cervical Cancer Who Are Treated with Concurrent Chemoradiotherapy.

    Directory of Open Access Journals (Sweden)

    Gun Oh Chong

    Full Text Available This study investigated the metabolic parameters of primary tumors and regional lymph nodes, as measured by pre-treatment F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT to compare the prognostic value for the prediction of tumor recurrence. This study also identified the most powerful parameter in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy.Fifty-six patients who were diagnosed with cervical cancer with pelvic and/or paraaortic lymph node metastasis were enrolled in this study. Metabolic parameters including the maximum standardized uptake value (SUVmax, the metabolic tumor volume (MTV, and total lesion glycolysis (TLG of the primary tumors and lymph nodes were measured by pre-treatment F-18 FDG PET/CT. Univariate and multivariate analyses for disease-free survival (DFS were performed using the clinical and metabolic parameters.The metabolic parameters of the primary tumors were not associated with DFS. However, DFS was significantly longer in patients with low values of nodal metabolic parameters than in those with high values of nodal metabolic parameters. A univariate analysis revealed that nodal metabolic parameters (SUVmax, MTV and TLG, paraaortic lymph node metastasis, and post-treatment response correlated significantly with DFS. Among these parameters, nodal SUVmax (hazard ratio [HR], 4.158; 95% confidence interval [CI], 1.1-22.7; p = 0.041 and post-treatment response (HR, 7.162; 95% CI, 1.5-11.3; p = 0.007 were found to be determinants of DFS according to a multivariate analysis. Only nodal SUVmax was an independent pre-treatment prognostic factor for DFS, and the optimal cutoff for nodal SUVmax to predict progression was 4.7.Nodal SUVmax according to pre-treatment F-18 FDG PET/CT may be a prognostic biomarker for the prediction of disease recurrence in patients with locally advanced cervical cancer.

  4. 提高年轻宫颈癌患者手术后性生活质量的护理探讨%Improvement of postoperative quality of sex life of young patients with cervical cancer

    Institute of Scientific and Technical Information of China (English)

    高红娟

    2012-01-01

    Objective To explore nursing interventions on the postoperative quality of sex life of young patients with cervical cancer. Methods A total of 60 cervical cancer patients under 35 years old who underwent surgery were equally randomized into treatment group and control group. Questionnaire forms were administered to the patients of the two groups in the 3rd, 6th and 12th month postoperatively. Results The quality of sex life in the treatment group was higher than in the control group. The difference was statistically significant (P < 0.05). Conclusion The nursing intervention can markedly improve the postoperative quality of sex life of patients with cervical cancer.%目的 探讨护理干预对年轻宫颈癌手术患者出院后性生活质量的影响.方法 选取接受手术治疗的35周岁以下宫颈癌患者60例,随机分为干预组和对照组各30例,在患者术后3个月、6个月、9个月对两组采用发放调查表进行评估.结果 研究组的生活质量明显高于对照组,差异有统计学意义(P<0.05).结论 护理干预可明显提高宫颈癌患者术后性生活质量.

  5. 宫颈病变患者人乳头瘤病毒16亚型E2基因多态性检测%Detection of E2 gene polymorphism of human papillomavirus type 16 in patients with cervical lesions and cervical cancer

    Institute of Scientific and Technical Information of China (English)

    邱峰; 袁丽娜; 黄宪章

    2012-01-01

    Objective To investigate the incidence of human papillomavirus type 16 (HPV16) infection in patients with cervical diseases and analyze E2 gene mutations and its correlation with cervical lesions. Methods Specific primers were designed according to the full-length E2 gene sequence of HPV16 from the GenBank. PCR was used to analyze the incidence of HFV16 infection in the exfoliated cell samples from 379 patients with different cervical diseases positive for high-risk HPV. The polymorphisms of E2 gene of HPV16 were analyzed by high-resolution melting. Results Of the 379 exfoliated cell samples from the cervix, 78 were positive for HPV16 infection. The positivity rates of HPV16 infection was 44,8% in patients with cervical cancer, 31.5% in patients with CIN Ⅱ-Ⅲ, 241% in patients with CIM I and 9.6% in patients with cervical inflammation. The frequencies of E2 gene 68C and 133G variations were significantly higher in patients with CIN Ⅱ-Ⅲ and those with cervical cancer than in those with CIN I and those with cervical inflammation (P<0.05). Conclusion HPV16 is an important cause of cervical cancer, and HPV16 infection rate increases with the pathological progression of the cervical lesions. The naturally occurring sequence variations of HPV16 E2 gene may cause alterations uf the carcinogenic potential of the virus,%目的 分析宫颈病变中人乳头瘤病毒(HPV) 16亚型E2基因的多态与宫颈病变的关系,了解E2基因变异情况及其与宫颈病变的相关性.方法 应用PCR和高分辨率熔解曲线方法针对379例HPV高危亚型阳性宫颈脱落细胞样本进行HPV16感染情况及HPV16亚型E2基因68位点和133位点多态分布情况进行检测.结果 379例HPV高危亚型阳性宫颈标本共检出78例HPV 16亚型附性,其在宫颈癌、CINⅡ~Ⅲ、CIN Ⅰ、炎症患者中的检岀率分别为44.8%、31.5%、24.1%和9.6%;HPV16 E2基因68C和133G的频率在中重度宫颈内瘤样病变和宫颈癌中明显高于轻度

  6. 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

  7. 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.

  8. 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.

  9. The association of rectal equivalent dose in 2 Gy fractions (EQD2) to late rectal toxicity in locally advanced cervical cancer patients who were evaluated by rectosigmoidoscopy in Faculty of Medicine, Chiang Mai University

    Energy Technology Data Exchange (ETDEWEB)

    Tharavichtikul, Ekkasit; Chitapanarux, Taned; Chakrabandhu, Somvilai; Klunklin, Pitchayaponne; Onchan, Wimrak; Wanwilairat, Somsak; Chitapanarux, Imjai [Faculty of Medicine, Chiang Mai University, Chiang Mai (Thailand); Meungwong, Pooriwat [Lampang Cancer Hospital, Lampang (Thailand); Traisathit, Patrinee [Faculty of Science, Chiang Mai University, Chiang Mai (Thailand); Galalae, Razvan [aculty of Medicine, Christian-Albrechts University at Kiel, Kiei (Germany)

    2014-06-15

    To evaluate association between equivalent dose in 2 Gy (EQD2) to rectal point dose and gastrointestinal toxicity from whole pelvic radiotherapy (WPRT) and intracavitary brachytherapy (ICBT) in cervical cancer patients who were evaluated by rectosigmoidoscopy in Faculty of Medicine, Chiang Mai University. Retrospective study was designed for the patients with locally advanced cervical cancer, treated by radical radiotherapy from 2004 to 2009 and were evaluated by rectosigmoidoscopy. The cumulative doses of WPRT and ICBT to the maximally rectal point were calculated to the EQD2 and evaluated the association of toxicities. Thirty-nine patients were evaluated for late rectal toxicity. The mean cumulative dose in term of EQD2 to rectum was 64.2 Gy. Grade 1 toxicities were the most common findings. According to endoscopic exam, the most common toxicities were congested mucosa (36 patients) and telangiectasia (32 patients). In evaluation between rectal dose in EQD2 and toxicities, no association of cumulative rectal dose to rectal toxicity, except the association of cumulative rectal dose in EQD2 >65 Gy to late effects of normal tissue (LENT-SOMA) scale > or = grade 2 (p = 0.022; odds ratio, 5.312; 95% confidence interval, 1.269-22.244). The cumulative rectal dose in EQD2 >65 Gy have association with > or = grade 2 LENT-SOMA scale.

  10. 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...

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  12. 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.

  13. 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 ...

  14. 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...

  15. 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...

  16. Postoperative radiation for cervical cancer with pathologic risk factors

    International Nuclear Information System (INIS)

    Purpose: To examine the efficacy of postoperative radiation therapy for early-stage cervical cancer with pathologic risk factors. Methods and Materials: We reviewed the charts of 83 patients who received postoperative radiation therapy at our facility from March 1980 to November 1993 for early stage cervix cancer with positive surgical margins, positive pelvic or periaortic lymph nodes, lymphovascular space invasion, deep invasion, or for disease discovered incidentally at simple hysterectomy. Twenty-eight patients received low dose rate (LDR) intracavitary radiation with or without external beam pelvic irradiation and 55 patients received external beam pelvic irradiation with high dose rate (HDR) intracavitary implants. Of these 83 patients, 66 were evaluable--20 LDR and 46 HDR patients. All patients received 45-50 Gy external beam irradiation and 20 Gy LDR equivalent intracavitary irradiation prescribed to 0.5 cm below the mucosa. Ninety percent of the LDR group and 92% of the HDR group completed treatment within < 56 days. Treatment-related toxicities were scored according to the GOG toxicity scale. Mean and median follow-up times were 101 months and 111 months (3-172 months) for the LDR group and 42 and 40 months (3-98 months) for the HDR group. Results: The 5-year disease-free survival was 89% for the LDR group and 72% for the HDR group. Local control was observed in 90% (18 out of 20) of the LDR patients and 89% (41 out of 46) of the HDR patients for an overall local control rate of 89.5%. Two of 20 LDR patients (10%) experienced recurrence (two pelvic with distant metastasis). Nine of 46 HDR patients (22%) had recurrence of disease (three pelvic, four distant metastasis, and two pelvic with distant metastasis). In the HDR group, 6 out of 16 (38%) with positive lymph nodes died of disease whereas, 27 out of 30 (90%) of the patients with negative lymph nodes remain free of disease. Three of 20 (15%) LDR patients and 4 out of 46 (9%) HDR patients experienced

  17. Pilot prospective evaluation of {sup 18}F-FPPRGD{sub 2} PET/CT in patients with cervical and ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Minamimoto, Ryogo; Jamali, Mehran; Gambhir, Sanjiv Sam [Stanford University, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford, CA (United States); Stanford University, Molecular Imaging Program at Stanford (MIPS), Department of Radiology, Stanford, CA (United States); Karam, Amer; Dorigo, Oliver [Stanford University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford, CA (United States); Barkhodari, Amir; Iagaru, Andrei [Stanford University, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford, CA (United States)

    2016-06-15

    We report the effect of antiangiogenic therapy on the biodistribution of {sup 18}F-FPPRGD{sub 2} (a surrogate biomarker of integrin α{sub v}β{sub 3} expression), and the potential of {sup 18}F-FPPRGD{sub 2} to predict the prognosis in patients with cervical cancer and ovarian cancer in this clinical scenario. Data from six women, age range 30 - 59 years (mean ± SD 44.0 ± 12.5 years), who had undergone a {sup 18}F-FPPRGD{sub 2} PET/CT scan and bevacizumab-containing therapy were prospectively collected and analyzed. We compared baseline {sup 18}F-FPPRGD{sub 2} and {sup 18}F-FDG uptake in the lesions and tumor-to-background (T/B) ratios. The maximum and mean {sup 18}F-FPPRGD{sub 2} standardized uptake values (SUV{sub max} and SUV{sub mean}) were recorded for 13 normal organs, as well as in all the identified malignant lesions on the pretreatment scan and the 1-week post-treatment scan. We also measured changes in {sup 18}F-FPPRGD{sub 2} uptake from before to 1 week after treatment{sub ,} and compared them to the changes in {sup 18}F-FDG uptake from before to 6 weeks after treatment. Treatment outcomes were correlated with these changes. The uptake in lesions and T/B ratio of {sup 18}F-FPPRGD{sub 2} were lower than those of {sup 18}F-FDG (SUV{sub max} 3.7 ± 1.3 vs. 6.0 ± 1.8, P < 0.001; SUV{sub mean} 2.6 ± 0.7 vs. 4.2 ± 1.3, P < 0.001; T/B ratio based on SUV{sub max} 2.4 ± 1.0 vs. 2.6 ± 1.0, P < 0.04; T/B ratio based on SUV{sub mean} 1.9 ± 0.6 vs. 2.4 ± 1.0, P < 0.003). One patient did not return for the follow-up scan and in another patient no lesions were identified on the pretreatment scan. {sup 18}F-FPPRGD{sub 2} uptake in lesions in the remaining four patients had significantly changed 1 week after treatment (SUV{sub mean} 3.3 ± 1.0 vs. 2.7 ± 1.0, P < 0.001), while uptake in all normal tissues analyzed was not affected by treatment. One patient with clinical disease progression had a decrease in lesional {sup 18}F-FPPRGD{sub 2} SUV{sub mean} of 1

  18. The Influence of the b-Value Combination on Apparent Diffusion Coefficient Based Differentiation Between Malignant and Benign Tissue in Cervical Cancer

    NARCIS (Netherlands)

    J.P. Hoogendam; W.M. Klerkx; G.A.P. de Kort; S. Bipat; R.P. Zweemer; D.M.D.S. Sie-Go; R.H.M. Verheijen; W.P.T.M. Mali; W.B. Veldhuis

    2010-01-01

    Purpose: To analyze the influence of different b-value combinations on apparent diffusion coefficient (ADC)based differentiation of known malignant and benign tissue in cervical cancer patients. Materials and Methods: A total of 35 patients with stage IB1, IB2, IIA cervical cancer underwent a 3.0T M

  19. Comorbidity and age affect treatment policy for cervical cancer: a population-based study in the south of The Netherlands, 1995-2004.

    NARCIS (Netherlands)

    Aa, M.A. van der; Siesling, S.; Kruitwagen, R.F.P.M.; Lybeert, M.L.; Coebergh, J.W.; Janssen-Heijnen, M.L.

    2008-01-01

    OBJECTIVE: The aim of this study was to estimate the effects of age and comorbidity on the choice of treatment modalities and prognosis for patients with cervical cancer. METHODS: All patients with cervical cancer newly diagnosed between 1995 and 2004 (n=775) were selected from the population-based

  20. Relevant factors of nosocomial infection in cervical cancer patients underwent radical surgery%宫颈癌根治术患者医院感染相关因素分析

    Institute of Scientific and Technical Information of China (English)

    祝英杰; 王毅; 魏向群

    2011-01-01

    目的 分析宫颈癌根治术后患者医院感染的状况、特点、病原菌分布及其耐药性,探究其预防措施.方法 对2009年10月-2010年9月在医院行宫颈癌根治术患者120例进行医院感染相关因素调查分析.结果 120例宫颈癌根治术患者发生医院感染40例次,例次感染率为33.3%;手术部位感染最多见,占52.5%,其次为消化道感染,占27.5%;检出病原菌24株,以真菌(12株)占首位,其次为大肠埃希菌(9株);大肠埃希菌对亚胺培南的耐药率为0,对头孢他啶、头孢吡肟、阿米卡星耐药率分别为12.5%、12.5%、12.5%.结论 为减少医院感染的发生,除应严格无菌技术操作及加强术后切口的引流外,合理使用抗菌药物是预防医院感染的重要环节.%OBJECTIVE To analyze the status, characteristics, pathogenic distribution and drug resistance of nosocomial infection (NI) in cervical cancer patients after'surgical procedures and explore preventive measures. METHODS Relevant factors of nosocomial infections in 120 patients with cervical cancer after radical hysterectomy and pelvic lymphadenectomy from Oct. 2009 to Sep. 2010 were investigated. RESULTS In the 120 patients with cervical cancer after radical surgery, there were 40 cases of nosocomial infections, with the infection rate of 30. 0%( the main infection site was surgical site infection (SSI) (52. 5%), followed by gastrointestinal infection (27.5%). Among the 24 strains of pathogenic microbes, the predominant microorganisms were fungi (12 strains) .followed by Escherichia coli (9 strains). E. Coli showed the lowest resistance rate to imipenem, followed by ceftazidime, cefepime and amikacin. The drug resistance rates were 0, 12. 5%, 12. 5% and 12. 5% respectively. CONCLUSION It is vital to prevent and control surgical nosocomial infections by strict application of aseptic technique, enhancing incision drain and rational use of antimicrobial agents. OBJECTIVE To analyze the