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Sample records for cervix cancer patients

  1. Cervix cancer

    Davila Gomez, Heenry Luis; Garcia Valdes, Abel; Alvarez Castillo, Felix

    2010-01-01

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

  2. Cervix cancer

    Pointreau, Y.; Ruffier Loubiere, A.; Barillot, I.; Pointreau, Y.; Denis, F.; Barillot, I.

    2010-01-01

    Cervix cancers declined in most developed countries in recent years, but remain, the third worldwide leading cause of cancer death in women. A precise staging, based on clinical exam, an abdominal and pelvic MRI, a possible PET-CT and a possible lymph node sampling is necessary to adapt the best therapeutic strategy. In France, the treatments of tumors of less than 4 cm without nodal involvement are often based on radiotherapy followed by surgery and, whereas tumors larger than 4 cm and involved nodes are treated with concurrent chemoradiotherapy. Based on an illustrated clinical case, indications, delineation, dosimetry and complications expected with radiotherapy are demonstrated. (authors)

  3. Cancer of the cervix

    Thompson, L.J.

    1990-01-01

    Since the introduction of the Papanicolaou smear and colposcopy, cervical cancers can be diagnosed and treated easily in their preinvasive state. Although theoretically cancer of the cervix should be detected and treated before becoming invasive disease, there are still too many women who develop invasive cancer of the cervix and require radical surgery and/or radiation therapy. The management of patients with recurrent or advanced disease is difficult and challenging.36 references

  4. Immunological analysis of patients with cancer of the cervix uteri

    Komori, Shoichiro

    1977-01-01

    In addition to numerical changes of lymphocytes and monocytes of patients with cancer of the cervix uteri and patients treated with radiation therapy for cancer of the cervix uteri, PHA, PPD, and intractaneous reaction of Candida antigen of them were discussed. The subjects were 31 cases of normal group, 158 cases of cancer of the cervix uteri, and 35 cases which received radiation therapy with a dose of 6,000 R. The number of leukocyte significantly decreased after irradiation with 1,000 R as compared with that before irradiation, but marked decrease was not recognized irrespective of an increase of irradiation dose thereafter. The ratio of lymphocyte to leukocyte significantly decrease after irradiation with 2,000 R, and there were many cases with the ratio of under 20%. The number of lymphocyte significantly decreases after irradiation with 1,000 R, but the decrease was not recognized after irradiation with 2,000 R. The ratio of monocyte to leukocyte significantly increased in the irradiated group with 2,000 R and 3,000 R. With respect to intracutaneous reaction, a lowering of the reaction was recognized in general, and the reaction to non-specific antigen remained strongly. (Tsunoda, M.)

  5. [Cervix cancer].

    Pointreau, Y; Ruffier Loubière, A; Denis, F; Barillot, I

    2010-11-01

    Cervix cancers declined in most developed countries in recent years, but remain, the third worldwide leading cause of cancer death in women. A precise staging, based on clinical exam, an abdominal and pelvic MRI, a possible PET-CT and a possible lymph node sampling is necessary to adapt the best therapeutic strategy. In France, the treatments of tumors of less than 4 cm without nodal involvement are often based on radiotherapy followed by surgery and, whereas tumors larger than 4 cm and involved nodes are treated with concurrent chemoradiotherapy. Based on an illustrated clinical case, indications, delineation, dosimetry and complications expected with radiotherapy are demonstrated. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  6. Positron emission tomography in the management of cervix cancer patients

    Bonardel, G.; Gontier, E.; Soret, M.; Dechaud, C.; Fayolle, M.; Foehrenbach, H.; Chargari, C.; Bauduceau, O.

    2009-01-01

    Since its introduction in clinical practice in the 1990 s, positron emission tomography (PET), usually with 18 F-fluoro-2-deoxy-D-glucose ( 18 F-F.D.G.), has become an important imaging modality in patients with cancer. For cervix carcinoma, F.D.G.-PET is significantly more accurate than computed tomography (CT) and is recommended for loco-regional lymph node and extra pelvic staging. The metabolic dimension of the technique provides additional prognostic information. Ongoing studies now concentrate on more advanced clinical applications, such as the planning of radiotherapy, the response evaluation after the induction of therapy, the early detection of recurrence. Technical innovations, such as PET cameras with better spatial resolution and hybrid positron emission tomography/computed tomography (PET-CT), available now on the whole territory, provide both anatomic and metabolic information in the same procedure. From the point of view of biological metabolism, new radiopharmaceutical probes are being developed. Those hold promise for future refinements in this field. This article reviews the current applications of F.D.G.-PET in patients with cervix cancer. (authors)

  7. Leveraging National Cancer Institute Programmatic Collaboration for Uterine Cervix Cancer Patient Accrual in Puerto Rico

    Charles A. Kunos

    2018-04-01

    Full Text Available Women in the U.S. Commonwealth of Puerto Rico (PR have a higher age-adjusted incidence rate for uterine cervix cancer than the U.S. mainland as well as substantial access and economic barriers to cancer care. The National Cancer Institute (NCI funds a Minority/Underserved NCI Community Oncology Research Program in PR (PRNCORP as part of a national network of community-based health-care systems to conduct multisite cancer clinical trials in diverse populations. Participation by the PRNCORP in NCI’s uterine cervix cancer clinical trials, however, has remained limited. This study reports on the findings of an NCI site visit in PR to assess barriers impeding site activation and accrual to its sponsored gynecologic cancer clinical trials. Qualitative, semi-structured individual, and group interviews were conducted at six PRNCORP-affiliated locations to ascertain: long-term trial accrual objectives; key stakeholders in PR that address uterine cervix cancer care; key challenges or barriers to activating and to enrolling patients in NCI uterine cervix cancer treatment trials; and resources, policies, or procedures in place or needed on the island to support NCI-sponsored clinical trials. An NCI-sponsored uterine cervix cancer radiation–chemotherapy intervention clinical trial (NCT02466971, already activated on the island, served as a test case to identify relevant patient accrual and site barriers. The site visit identified five key barriers to accrual: (1 lack of central personnel to coordinate referrals for treatment plans, medical tests, and medical imaging across the island’s clinical trial access points; (2 patient insurance coverage; (3 lack of a coordinated brachytherapy schedule at San Juan-centric service providers; (4 limited credentialed radiotherapy machines island-wide; and (5 too few radiology medical physicists tasked to credential trial-specified positron emission tomography scanners island-wide. PR offers a unique opportunity to

  8. Medical-and-psychosocial factors influencing on the quality of life in patients with cervix cancer

    Chun, Mi Son; Kang, Seung Hee; Ryu, Hee Sug; Lee, Eun Hyun; Moon, Seong Mi

    2005-01-01

    Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. the purpose of this study was to identify the influencing factors on the quality of life in patients with cancer. One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, type of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life (R 2 = 0.633, F = 16.969, ρ = .000). Cancer stage, symptom distress, mood disturbance, social support (family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. An integrative care program which includes medical-and-psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer

  9. Medical-and-psychosocial factors influencing on the quality of life in patients with cervix cancer

    Chun, Mi Son; Kang, Seung Hee; Ryu, Hee Sug [Ajou University School of Medicine, Suwon (Korea, Republic of); Lee, Eun Hyun [Ajou Univerisity, Suwon (Korea, Republic of); Moon, Seong Mi [Ajou University Hospital, Suwon (Korea, Republic of)

    2005-12-15

    Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. the purpose of this study was to identify the influencing factors on the quality of life in patients with cancer. One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, type of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life (R{sup 2} = 0.633, F = 16.969, {rho} = .000). Cancer stage, symptom distress, mood disturbance, social support (family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. An integrative care program which includes medical-and-psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer.

  10. Cancer cervix?: a retrospective study

    Hirapara, Pushpendra H.; Patidar, Arvindkumar; Walke, Rahul; Jakhar, Shankar Lal; Sharma, Neeti; Kumar, H.S.; Jain, Sandeep; Kalwar, Ashok; Bardia, M.R.

    2012-01-01

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

  11. Patient-based dosimetric comparison of interstitial and intracavitary brachytherapy in cases of cancer cervix

    Bansal, Anil K.; Julka, P.K.; Sharma, D.N.; Rustogi, Ashish; Subramani, V.; Prabhakar, R.; Rath, G.K.; Semwal, Manoj K.; Thulkar, S.

    2008-01-01

    Brachytherapy in the form of High Dose Rate (HDR) intracavitary radiotherapy (ICRT) along with external beam radiotherapy(EBRT) is the main treatment in cancer cervix. Of late, some large centres have started practicing template based transperineal interstitial brachytherapy (TIB) for advanced/ bulky cancer cervix. Usually, TIB is given for patients with advanced disease/ distorted anatomy or recurrent disease for better lateral target coverage. CT/MRI/USG based planning has made volumetric dosimetry possible for the target and the organs at risk (OARs). This has resulted in better correlation between dose received and treatment outcome in terms of tumour control and late toxicities as against the point dosimetry system. It has been shown by many studies that ICRU based point dose reporting may not represent the actual doses received by the OARs. Though it is expected that TIB gives better target coverage and OAR sparing in advanced/ bulky cancer cervix cases as compared to ICRT, detailed patient studies on the subject have not been reported. We have carried out dosimetric comparison between ICRT and TIB for cancer cervix patients undergoing treatment at our centre in terms of treated volume and doses to OARs

  12. Rectal dose assessment in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer

    Oliveira, Jetro Pereira de; Batista, Delano Valdivino Santos; Bardella, Lucia Helena; Carvalho, Arnaldo Rangel

    2009-01-01

    Objective: The present study was aimed at developing a thermoluminescent dosimetric system capable of assessing the doses delivered to the rectum of patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. Materials and methods: LiF:Mg,Ti,Na powder was the thermoluminescent material utilized for evaluating the rectal dose. The powder was divided into small portions (34 mg) which were accommodated in a capillary tube. This tube was placed into a rectal probe that was introduced into the patient's rectum. Results: The doses delivered to the rectum of six patients submitted to high-dose-rate brachytherapy for uterine cervix cancer evaluated by means of thermoluminescent dosimeters presented a good agreement with the planned values based on two orthogonal (anteroposterior and lateral) radiographic images of the patients. Conclusion: The thermoluminescent dosimetric system developed in the present study is simple and easy to be utilized as compared to other rectal dosimetry methods. The system has shown to be effective in the evaluation of rectal doses in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. (author)

  13. Lymphatic mapping and sentinel node identification in patients with cervix cancer undergoing radical hysterectomy

    Alonso, O.; Lago, G.; Juri, C.; Touya, E.; Arribeltz, G.; Dabezies, L.; Sotero, G.; Martinez, J.; Alvarez, C.

    2002-01-01

    Aim: One of the most important prognostic features of early cervix cancer is the involvement of regional lymph nodes (LN). Although not fully studied, the sentinel node (SN) strategy has the potential of preventing unnecessary extensive LN dissections in these patients. The aim of this study was to determine the feasibility of SN identification by means of preoperative lymphoscintigraphy (PL) and intraoperative gamma probe detection (IGPD) in patients undergoing radical hysterectomy and pelvic/para-aortic lymphadenectomy for the treatment of early cervix carcinoma. Material and Methods: Patients underwent PL with 148-185 MBq of filtered 99mTc-colloidal (Re) sulphide injected into four quadrants of the cervix, 15-17 hours before surgery. Five-minute consecutive planar images of the pelvis were acquired immediately after in a LFOV camera equipped with a LEHR collimator. A sterilized piece of lead foil (1.0 mm thick) was used to shield radiation from the cervix during intraoperative detection of pelvic SN's. An individual LN was considered SN if radioactive counts were 10 times greater than background counts. Results: Complete data are available from 18 patients. The median age was 37 years (range 22-65), 2/18 were staged IA2, 9/18 were staged IB1-2 and 7/18 stage IIA. PL identified one or more SN in 14/18 (78%) of patients, whereas IGPD was successful in 17/18 (94%) patients. A total of 20 SN were harvested, located in the pelvis (n=14), the common iliac vein (n 4) and para-aortic region (n=2). The histopathological report revealed a negative SN in 14/17 patients, and a positive LN in 3/17 cases. One false-negative result was observed in a patient with a negative SN and three positive non-sentinel lymph nodes. Conclusion: Although technically challenging, IGPD with cervix radiation shielding is a sensitive and feasible procedure for SN identification with the potential of changing the surgical treatment of early stage cervix cancer

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

    Dyk, Sylvia van; Kondalsamy-Chennakesavan, Srinivas; Schneider, Michal; Bernshaw, David; Narayan, Kailash

    2014-01-01

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

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

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

    2014-03-15

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

  16. [Complications of surgical stage of treatment in patients with cancer of cervix uteri stage IIB].

    Kryzhanivs'ka, A Ie

    2013-11-01

    The results of treatment of 127 patients, suffering cervix uteri cancer stage IIB in period of 1998 - 2012 yrs, were analyzed. Complications of surgical stage of the combined treatment have had occurred in 40.9% patients, including 40.5% patients, to whom neoadjuvant chemotherapy was conducted and in 41.5%--radiation therapy (RTH). The main postoperative complications--retroperitoneal lymphatic cysts--were revealed in 35.4% patients. The factors, raising the risk of postoperative complications occurrence, are following: the primary tumor spreading, metastatic affection of lymphatic nodes of pelvic cavity, preoperative conduction of RTH or chemotherapy.

  17. Surgical treatments for post-irradiation intestinal injury in uterine cervix cancer patients

    Nozaki, Isao; Yokoyama, Nobuji; Takashima, Shigemitsu

    1997-01-01

    We examined 19 patients with post-irradiation intestinal injury in the uterine cervix cancer for 12 years between 1985 and 1996. We discuss the usefulness and complications of surgery, mainly colostomy. The patients aged from 36 to 80 (average age 61) were treated, and their disease states were 12 cases of rectovaginal fistula, 2 of small intestinal fisfula, 1 of rectum posterior membranous fistula, 3 of proctostenosis, and 14 of proctitis with hemorrhage (including duplication). Surgical methods used were 18 cases of colostomy (2 cases were treated under peritoneum mirror) and 2 of enterocolostomy (including duplication). Eleven out of 19 patients who underwent surgery are alive now. Generally the post-irradiation intestinal injury was intractable, and the method of treatments were limited due to the coexistence of various diseases. The colostomy is safe and less invasive. Therefore patients with uterine cervix cancer having various complications can obtain high quality of life (QOL) such as the improvement of anemia and/or the increase of digestion by the colostomy. (K.H.)

  18. Surgical treatments for post-irradiation intestinal injury in uterine cervix cancer patients

    Nozaki, Isao; Yokoyama, Nobuji; Takashima, Shigemitsu [National Shikoku Cancer Center Hospital, Matsuyama, Ehime (Japan)

    1997-06-01

    We examined 19 patients with post-irradiation intestinal injury in the uterine cervix cancer for 12 years between 1985 and 1996. We discuss the usefulness and complications of surgery, mainly colostomy. The patients aged from 36 to 80 (average age 61) were treated, and their disease states were 12 cases of rectovaginal fistula, 2 of small intestinal fisfula, 1 of rectum posterior membranous fistula, 3 of proctostenosis, and 14 of proctitis with hemorrhage (including duplication). Surgical methods used were 18 cases of colostomy (2 cases were treated under peritoneum mirror) and 2 of enterocolostomy (including duplication). Eleven out of 19 patients who underwent surgery are alive now. Generally the post-irradiation intestinal injury was intractable, and the method of treatments were limited due to the coexistence of various diseases. The colostomy is safe and less invasive. Therefore patients with uterine cervix cancer having various complications can obtain high quality of life (QOL) such as the improvement of anemia and/or the increase of digestion by the colostomy. (K.H.)

  19. Glutathione level and its relation to radiation therapy in patients with cancer of uterine cervix

    Mukundan, H.; Bahadur, A.K.; Kumar, A.; Sardana, S.; Naik, S.L.D.; Ray, A.; Sharma, B.K.

    1999-01-01

    Glutathione functions as an important antioxidant in the destruction of hydrogen peroxide and lipid peroxides by providing substrate for the glutathione peroxidase and also promotes the ascorbic acid. Glutathione plays a vital role in detoxification of xenobiotics, carcinogens, free radicals and maintenance of immune functions. The study was aimed to determine plasma glutathione as well as erythrocyte glutathione and glutathione peroxidase in patients with invasive cervical carcinoma (n=30) before initiation and after completion of radiotherapy and subsequently, at the time of first three monthly follow-up visit. The levels of plasma glutathione, erythrocyte glutathione and glutathione peroxidase activity were found to be lower in all cervical cancer patients as compared to age matched normal control women. The study indicates a change in antioxidant status in relation with the glutathione system among patients with invasive carcinoma of the uterine cervix. This study also demonstrates the effect of radiation therapy on this antioxidant system. (author)

  20. Outcome of cervix uteri cancer patients: Clinical treatment results and toxicity profile in a retrospective study from Saudi Arabia.

    El Sayed, Mohamed E; Bahadur, Yasir A; Hassouna, Ashraf H; Fawzy, Ehab E; Nasr, Azza M; Sadiq, Bakr B; Dada, Reyad; Sait, Khalid H; Anfinan, Nisrin M

    2017-10-01

    This study evaluated the survival outcome, pattern of failure and prognostic factors in cervix uteri cancer patients. We reviewed the data of 60 patients with stages IB-IVA cancer who were treated between January 2004 and December 2010. Most patients (n = 50; 83%) had squamous cell carcinoma. Stage IIB was the most common presentation (n = 41; 68%). Forty-seven patients (78%) received Cisplatin concurrent with radiotherapy (CRT). The 2- and 4-year overall survival (OS) was 82% and 79%, respectively. Prolongation of the overall treatment time (OAT) for greater than 56 days, advanced stage and pretreatment hemoglobin (Hb) levels (cervix uteri cancer patients and the prognostic factors are comparable to those of previous reports. Orthogonal brachytherapy planning and vaginal infiltration negatively predicted relapse. © 2016 John Wiley & Sons Australia, Ltd.

  1. Cytopathologic evaluation of patients submitted to radiotherapy for uterine cervix cancer.

    Padilha, Cátia Martins Leite; Araújo, Mário Lúcio Cordeiro; Souza, Sergio Augusto Lopes de

    2017-04-01

    Cervical cancer is an important public health problem. Pap smear is the leading strategy of screening programs for cervical cancer worldwide. However, delayed diagnosis leads to more aggressive and less effective treatments. Patients with uterine cervix malignancies who are referred for radiotherapy have advanced-stage disease, which results in high rates of locoregional recurrence. The use of radiotherapy as a treatment for cervical cancer causes morphological changes in neoplastic and non-neoplastic epithelial cells, as well as in stromal cells, which make it difficult to diagnose the residual lesion, resulting in a dilemma in cytopathological routine. Based on the difficulties of cytopathologic evaluation for the follow-up of patients treated with radiotherapy for cervical cancer, our objective was to describe the actinic cytopathic effects. Our paper was based on a structured review including the period from June 2015 to April 2016, aiming at an exploratory-descriptive study. Bibliographic investigations were carried out through selection and analysis of articles, list of authors and keywords, selection of new articles focused on the analysis of bibliographic references to previously selected documents, as well as textbooks of recognized merit. The most incident actinic cytopathological alterations as described in the literature are: cellular gigantism, nuclear and cytoplasmic vacuolization, dyskeratosis, bi- and multinucleated (B/M) cells, macro and multiple nucleoli, anisokaryosis, anisonucleolosis and nuclear pyknosis. To date, a protocol has not been established that can precisely differentiate the morphological characteristics between benign cells with actinic effects from recurrent malignant cells on post-radiotherapy smears.

  2. Cytopathologic evaluation of patients submitted to radiotherapy for uterine cervix cancer

    Cátia Martins Leite Padilha

    Full Text Available Summary Cervical cancer is an important public health problem. Pap smear is the leading strategy of screening programs for cervical cancer worldwide. However, delayed diagnosis leads to more aggressive and less effective treatments. Patients with uterine cervix malignancies who are referred for radiotherapy have advanced-stage disease, which results in high rates of locoregional recurrence. The use of radiotherapy as a treatment for cervical cancer causes morphological changes in neoplastic and non-neoplastic epithelial cells, as well as in stromal cells, which make it difficult to diagnose the residual lesion, resulting in a dilemma in cytopathological routine. Based on the difficulties of cytopathologic evaluation for the follow-up of patients treated with radiotherapy for cervical cancer, our objective was to describe the actinic cytopathic effects. Our paper was based on a structured review including the period from June 2015 to April 2016, aiming at an exploratory-descriptive study. Bibliographic investigations were carried out through selection and analysis of articles, list of authors and keywords, selection of new articles focused on the analysis of bibliographic references to previously selected documents, as well as textbooks of recognized merit. The most incident actinic cytopathological alterations as described in the literature are: cellular gigantism, nuclear and cytoplasmic vacuolization, dyskeratosis, bi- and multinucleated (B/M cells, macro and multiple nucleoli, anisokaryosis, anisonucleolosis and nuclear pyknosis. To date, a protocol has not been established that can precisely differentiate the morphological characteristics between benign cells with actinic effects from recurrent malignant cells on post-radiotherapy smears.

  3. Pain management in cancer cervix

    Palat Gayatri

    2005-01-01

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

  4. Magnetic resonance imaging in the evaluation of standard radiotherapy field borders in patients with uterine cervix cancer

    Freire, Geison Moreira; Dias, Rodrigo Souza; Giordani, Adelmo Jose; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo; Ribalta, Julisa Chamorro Lascasas

    2010-01-01

    Objective: to evaluate, by means of magnetic resonance imaging, the standardized field borders in radiotherapy for malignant neoplasm of uterine cervix, and to determine the role of this method in the reduction of possible planning errors related to the conventional technique. Materials and methods: magnetic resonance imaging studies for planning of treatment of 51 patients with uterine cervix cancer were retrospectively analyzed. The parameters assessed were the anterior and posterior field borders on sagittal section. Results: The anterior field border was inappropriate in 20 (39.2%) patients and geographic miss was observed in 37.3% of cases in the posterior border. The inappropriateness of both field borders did not correlate with clinical parameters such as patients' age, tumor staging, histological type and degree. Conclusion: the evaluation of standardized field borders with the use of magnetic resonance imaging has demonstrated high indices of inappropriateness of the lateral field borders, as well as the relevant role of magnetic resonance imaging in the radiotherapy planning for patients with uterine cervix cancer with a view to reduce the occurrence of geographic miss of the target volume. (author)

  5. Radiotherapy Results of Early Uterine Cervix Cancer

    Choi, Doo Ho; Huh, Seung Jae

    1996-01-01

    Purpose : This study was done to analyze survivals, patterns of failure, and complications of early uterine cervix cancer after curative radiotherapy. Methods and Materials : Eighty patients with uterine cervix cancer FIGO Stage IB (48 cases) and Stage IIA (32 cases) treated with radiotherapy were analyzed retrospectively. Patients were treated from November 1985 to May 1993, and minimum follow up period was 24 months. and 6 cases were lost to follow up. All of them were treated with external radiotherapy and different fractions of high dose rate intracavitary radiotherapy. Survival rates, failure patterns, complication rates and degrees of severity were analyzed according to several factors. Results : Overall 5 year survival rate and relapse free survival rate were 72.3%, and 72.8% respectively. Prognostic factors were stage, size, pathology, RT response and there was no significant survival difference among the reasons of radiotherapy choice. There were 19 cases of treatment failure, another 3 cases were not tumor related death, and most of treatment related failure occurred within 24 months. Late complication rate of bladder and rectum were 8.8%, 15% respectively, frequency and severity of complication were correlated with ICR fractionation dose and total dose. Conclusion : These results showed that survival rates of early stage radiation treated cervix cancer patients were comparable to surgical series, but more aggressive treatment methods needed for stage IIA poor prognostic patients, To decrease late complication, choice of proper ICR dose and meticulous vaginal packing is needed

  6. Radiation dose and second cancer risk in patients treated for cancer of the cervix

    Boice, J.D. Jr.; Engholm, G.; Kleinerman, R.A.

    1988-01-01

    The risk of cancer associated with a broad range of organ doses was estimated in an international study of women with cervical cancer. Among 150,000 patients reported to one of 19 population-based cancer registries or treated in any of 20 oncology clinics, 4188 women with second cancers and 6880 matched controls were selected for detailed study. Radiation doses for selected organs were reconstructed for each patient on the basis of her original radiotherapy records. Very high doses, on the order of several hundred gray, were found to increase the risk of cancers of the bladder [relative risk (RR) = 4.0], rectum (RR = 1.8), vagina (RR = 2.7), and possibly bone (RR = 1.3), uterine corpus (RR = 1.3), cecum (RR = 1.5), and non-Hodgkin's lymphoma (RR = 2.5). For all female genital cancers taken together, a sharp dose-response gradient was observed, reaching fivefold for doses more than 150 Gy. Several gray increased the risk of stomach cancer (RR = 2.1) and leukemia (RR = 2.0). Although cancer of the pancreas was elevated, there was no evidence of a dose-dependent risk. Cancer of the kidney was significantly increased among 15-year survivors. A nonsignificant twofold risk of radiogenic thyroid cancer was observed following an average dose of only 0.11 Gy. Breast cancer was not increased overall, despite an average dose of 0.31 Gy and 953 cases available for evaluation (RR = 0.9); there was, however, a weak suggestion of a dose response among women whose ovaries had been surgically removed. Doses greater than 6 Gy to the ovaries reduced breast cancer risk by 44%. A significant deficit of ovarian cancer was observed within 5 years of radiotherapy; in contrast, a dose response was suggested among 10-year survivors

  7. Reappearance of cancer of the cervix 19 years after radiotherapy

    Ampil, F. [Lousiana State Univ. Medical Center, Dept. of Radiology, Louisiana (United States); Bell, M.; Martin, D. [Lousiana State Univ. Medical Center, Dept. of Obstetrics- Gynecology, Louisiana (United States)

    1997-07-01

    Most of the recurrences after Wertheim hysterectomy or definitive radiotherapy for cancer of the cervix occur within two or three years following treatment. Late recurrence is an uncommon event accounting for less than 1% of all patients with cancer of the cervix treated by radiotherapy. We present a case of reappearance of cervical cancer 19 years after irradiation and review the literature. (au) 7 refs.

  8. Monocytopenia; Induction by Vinorelbine, Cisplatin and Doxorubicin in Breast, Non-Small Cell Lung and Cervix Cancer Patients

    Nazir, Taha; Taha, Nida; Islam, Azahrul; Abraham, Suraj; Mahmood, Adeel; Mustafa, Mazhar

    2016-01-01

    Background The neoplasm is still a potential threat for breast, Non-Small Cell Lung (NSCL) and cervix cancer patients. Those gradually invade into other body organs, inducing complex pathological complications. Whereas, the anticancer drugs suppress the bone marrow, resulting serious hematological toxicities. Thus, the monocytic toxicity may the chance of infections, particularly in AID’s patients. Objective We aimed this retrospective study to investigate the monocytopenia induced by vinorelbine following chemotherapy in cancer patients. Patients and method A total 60 adult cancer patients were divided into two groups; Group-1 patients received the treatment of Vinorelbine alone while group 2 patients received Vinorelbine based combination chemotherapy. Result The overall comparison of mean monocyte count (×103 per μl) with time showed a significant statistical difference (p value <0.001) for G-I and no significant difference for G-II (p value <0.08). The independent comparison of mean values for two groups at every week confirms the non-significant statistical difference during all of the five weeks (p values 0.551, 0.112, 0.559, 0.372, 0.468 respectively). In addition of that, the comparison of mean values observed before therapy with that of week 4 (after therapy) showed significant difference in G-I (p value <0.001) and non-significant in G-II (p value 0.053). Conclusion Monocytopenia is induced in both of the chemotherapy protocols allows the clinical oncologists and consultant physicians to select either of the chemotherapy protocol. The therapeutic efficacy should constitute the intervening consideration to treat the breast, cervix and NSCL (Non-Small Cell Lung’s) cancers. PMID:27833519

  9. Three-dimensional brachytherapy optimization techniques in the treatment of patients with cervix cancer

    Haie-Meder, C.; Mazeron, R.; Verezesan, O.; Monnier, L.; Vieillot, S.; Dumas, I.; Lhomme, C.; Morice, P.; Barillot, I.

    2009-01-01

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

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

    Shyamkishore Shrivastava

    2013-01-01

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

  11. Evaluation of the effect of routine packed red blood cell transfusion in anemic cervix cancer patients treated with radical radiotherapy

    Kapp, Karin S.; Poschauko, Johann; Geyer, Edith; Berghold, Andrea; Oechs, Astrid C.; Petru, Edgar; Lahousen, Manfred; Kapp, Daniel S.

    2002-01-01

    Purpose: It is well established that anemia predicts diminished radiocurability in cervix cancer. However, the therapeutic benefit of measures to correct the anemia remains controversial. The objective of this study was to determine the impact of routine transfusion in patients with hemoglobin level (hb-l) ≤11 g/dl. Methods and Materials: Since 1985, it has been departmental policy to attempt to correct hb-l ≤11 g/dl before and/or during radiotherapy by red blood cell transfusion (RBCT) in patients undergoing radical radiotherapy for primary cervix cancer. To assess the benefit of RBCT, the charts of 204 patients (FIGO: IB-IV) treated until 1997 were reviewed. Parameters analyzed for their impact on disease-specific survival (DSS), pelvic control (PC), and metastases-free survival (MFS) included pretreatment hb-l, treatment hb-l, stage, tumor size, and lymph node status. To determine any differences in outcome according to type of anemia, a separate analysis was performed, grouping patients by cause of anemia (tumor vs. other medical illness related). Results: Each of the parameters tested was significantly correlated with the end points studied in univariate analysis. Patients whose hb-l were corrected (18.5%) had an outcome that did not differ significantly from that of nontransfused patients, whereas DSS, PC, and MFS (all: p<0.001) were significantly decreased in nonresponders to RBCT. Subgroup analysis showed no impact of hb-l in patients with other medical illness-related anemia (n=12). In multivariate analysis treatment, but not pretreatment, hb-l remained predictive for DSS, PC, and MFS. Persistent anemia was associated with a significantly increased risk of death (relative risk: 2.1) and pelvic failure (relative risk: 2.4) compared with nontransfused patients. If only patients with tumor anemia were considered, the respective risks increased (2.7; 3.6). None of the patients with other causes of anemia recurred, whether or not their hb-l was maintained

  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

    Arias, Freddy; Sanchez Sabando, Jaime

    2006-01-01

    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. Cervix cancer; Cancer du col uterin

    Pointreau, Y.; Ruffier Loubiere, A.; Barillot, I. [Service de radiotherapie, centre regional universitaire de cancerologie Henry-S.-Kaplan CHU de Tours, Hpital Bretonneau, 37 - Tours (France); Pointreau, Y. [Universite Francois-Rabelais de Tours, GICC, 37 - Tours (France); CNRS, UMR 6239 -Genetique, Immunotherapie, Chimie et Cancer-, 37 - Tours (France); CHRU de Tours, laboratoire de pharmacologie-toxicologie, 37 - Tours (France); Denis, F. [Centre Jean-Bernard, 72 - Le Mans (France); Barillot, I. [Universite Francois-Rabelais, 37 - Tours (France)

    2010-07-01

    Cervix cancers declined in most developed countries in recent years, but remain, the third worldwide leading cause of cancer death in women. A precise staging, based on clinical exam, an abdominal and pelvic MRI, a possible PET-CT and a possible lymph node sampling is necessary to adapt the best therapeutic strategy. In France, the treatments of tumors of less than 4 cm without nodal involvement are often based on radiotherapy followed by surgery and, whereas tumors larger than 4 cm and involved nodes are treated with concurrent chemoradiotherapy. Based on an illustrated clinical case, indications, delineation, dosimetry and complications expected with radiotherapy are demonstrated. (authors)

  14. Moving beam irradiation in combined therapy of cervix uteri cancer

    Kim, O M; Zholkiver, K I

    1976-07-01

    Postoperative moving beam irradiation in a dose of 3900 to 365 rad was conducted in 98 patients with the I--II stages of cervix uteri cancer. Skin reactions to irradiation were absent, marked leukopenia developed in 4 patients. Of 39 patients followed up for more than 5 years 35 have lived without relapses and metastases.

  15. Large Cell Neuroendocrine Cancer (LCNEC of uterine cervix

    Gehanath Baral

    2009-01-01

    Full Text Available A rare type of cervical cancer was encountered as a neuroendocrine cancer of cervix. Clinically, the patient presented with bleeding per vagina. She refused biopsy in her first visit and did not come for follow up. However, after few months she came and since there was a polypoid growth from cervix, she was advised to undergo hysterectomy. Histopathologically, it was diagnosed as large cell type of neuroendocrine cancer. Multimodality systemic treatment was offered as per literature. Ibrahim Med. Coll. J. 2009; 3(1: 36-38

  16. Plasma osteopontin levels in patients with head and neck cancer and cervix cancer are critically dependent on the choice of ELISA system

    Vordermark, Dirk; Said, Harun M; Katzer, Astrid; Kuhnt, Thomas; Hänsgen, Gabriele; Dunst, Jürgen; Flentje, Michael; Bache, Matthias

    2006-01-01

    The tumor-associated glycoprotein osteopontin (OPN) is discussed as a plasma surrogate marker of tumor hypoxia and as an indicator of the presence of pleural mesothelioma in asbestos-exposed individuals. The clinical introduction of plasma OPN measurements requires the availability of a reliable enzyme-linked immunosorbence assay (ELISA). We compared previously described and currently available ELISA systems on 88 archival plasma samples obtained from patients with head and neck or cervix cancer between 20 days before and 171 after the start of radiotherapy. Median (range) plasma OPN levels were 667 (148.8–2095) ng/ml and 9.8 (3.5–189.5) ng/ml for a previously described and a newly marketed assay, respectively. Although results for different assays were significantly correlated (r = 0.38, p < 0.05, Spearman rank test), between-assay factors ranged from 2.0 to 217.9 (median 74.6) in individual patients. OPN levels in cervix cancer patients were comparable to those of head and neck cancer patients. Commercially available OPN ELISA systems produce different absolute plasma OPN levels, compromising a comparison of individual patient data with published results. However, different assays appear to have a similar capacity to rank patients according to plasma OPN level. A review of literature data suggests that plasma OPN levels measured even with identical ELISA systems can only be compared with caution

  17. Burden, quality of life and distress of the main caregiver in head and neck, cervix and rectal cancer patients

    Miguel I

    2017-03-01

    Full Text Available Purpose: Based on Portuguese experience, current practice does not focus sufficiently on the caregiver needs through caring of the cancer patient. Understanding the impact of different tumor types on caregiver burden, quality of life, and distress may help with organizing resources more efficiently to provide enhanced support for patients and caregivers. Methods: Ninety main caregivers of patients with cervix, rectal and head and neck cancer were interviewed at Instituto Português de Oncologia de Lisboa Francisco Gentil. The Portuguese versions of Zarit Burden Interview, Caregiver Quality of Life Index - Cancer (CQOLC Scale and the distress thermometer were used. Results: The majority of caregivers were female (76.7%, median age was 45.5years (20-79, 40% were spouses and 38.7% sons/daughters. Zarit Burden Interview average score was 25.2 ± 11.6, higher on head and neck cancer group. 59.5% of caregivers had moderate burden and no cases of severe burden. Mean quality of life score was 64.8 ± 15.8 which was lower in the head and neck group. Average distress score across the three groups was seven and rectal group presented a lower score than the other two groups. A subgroup analysis (gender, kinship relation, employment status and cohabitation before starting care of caregivers characteristics showed no statistical differences. Conclusion: There were little differences in the experience of caring within caregivers based on the three different cancer groups, although caregivers of patients with head and neck cancer scored consistently worse in the three scales studied. More efforts should be taken to optimize coping strategies for these caregivers, as well as non-cohabitant and active caregivers, who had a worse caring experience.

  18. Dissection of the sentry ganglion by laparoscopic boarding in patients with cervix uterine cancer clinical stages IA2 at IIB

    Valdez U, J.J.; Pichardo M, P.A.; Cortes M, G.; Escudero de los Rios, P.

    2005-01-01

    The obtained results in presently study demonstrate that the feasibility of the detection of the sentry ganglion in cervix uterine cancer using a boarding by laparoscopic via, being necessary the use of twice labelled as much with patent blue and radioisotope (colloid of labelled rhenium with 99m Tc, total dose of 3 MCi) to achieve the identification of the ganglion. (Author)

  19. Interleukin 2 and alpha interferon induced in vitro modulation of spontaneous cell mediated cytotoxicity in patients with cancer of the uterine cervix undergoing radiotherapy

    Radhakrishna Pillai, M.; Balaram, P.; Padmanabhan, T.K.; Abraham, T.; Nair, M.K.; Regional Cancer Centre, Trivandrum

    1989-01-01

    In vitro modulation of spontaneous cell mediated cytotoxicity by interferon and interleukin 2 was carried out using peripheral blood lymphocytes from patients with cancer of the uterine cervix before and at different intervals after commencement of radiation treatment. A total of 150 patients with various stages of the disease were included and cytotoxicity was measured using the single cell cytotoxic assay. These results indicate a beneficial effect in vitro of interleukin 2 and interferon in augmenting spontaneous cell mediated cytotoxicity, a possibly vital antitumour immune mechanism in patients with relatively early cervix cancer. Natural killer cell, lymphokine activated killer cell and interferon activated killer cell activity was depressed immediately following radiotherapy. The activity of these cell types later on increased above pretreatment levels in patients with stages I, IIA and IIB. A similar rebound above pretreatment levels was not observed in patients with stages III and IV. (orig.)

  20. Basic evaluation of measurement of the serum level of squamous cell carcinoma-related antigen (SCC) and its value in following irradiated patients with cancer of the uterine cervix

    Obata, Yasunori; Tadokoro, Masanori; Kazato, Sadayuki

    1987-01-01

    The measuremet of the serum level of squamous cell carcinoma-related antigen (SCC) purified from liver metastasis of cancer of the uterine cervix by an RIA kit is basically evaluated. The results of sensitivity, the recovery test, dilution test and variance test are good enough for clinical application. In gynecological disorders, the possitive rate is high (62 % [29/47]) in patients with cancer of the uterine cervix. Furthermore, the rate and level are related with the clinical staging. The changes of the serum SCC level in irradiated patients with cancer of the uterine cervix were a good reflection of the effectiveness of the treatment. (author)

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

    Srinivasagopalan, Nappinnai, Solayappan

    2015-07-01

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

  2. Computed tomography of iliopsoas involvement in uterine cervix cancer

    Chung, Jin Uk; Choi, Byung Ihn; Kim, Seung Hyup; Han, Man Chung; Kim, Chu Wan

    1987-01-01

    Uterine cervix carcinomas spread by direct local extension, lymphatic permeation and hematogenous dissemination. Their metastatic foci are closely related to iliopsoas compartment anatomically no matter what the pattern of spread is. Therefore, iliopsoas involvement in uterine cervix cancer may occur frequently. The authors reviewed pelvis CT of 218 cervix cancer patients for recent one year from March 1986 to February 1987 at Seoul National University Hospital. Among them, 10 cases showed iliopsoas involvement. Pattern of iliopsoas involvement was classified into four types: infiltrative type (three cases), localized mass type (three cases), mass with bone destruction type (two cases), paraaortic lymphadenopathy type (two cases). In all cases except 3 cases of infiltrative type, lymphadenopathy or bone metastasis adjacent to iliopsoas lesion was identified. And this finding suggested that the route of iliopsoas involvement in cervix cancer would be secondary infiltration from metastatic focus of adjacent lymph node or bone. Recognition of iliopsoas involvement of cervix caner may prevent misdiagnosis and predict the degree of disease dissemination

  3. Molecular diagnostics detect radio resistant tumor in cancer cervix

    Nagarajan, B.

    2004-01-01

    After successful external radiation/intracavitary and interstitial radiation therapy some cancer cervix patients presented with recurrent tumors on 6-12 months follow up period. They had high level of IL-6 on first reporting. This augurs well with the premise that up regulation of IL-6 might be involved in tumor progression

  4. DETECTION OF CANCEROUS LESION BY UTERINE CERVIX IMAGE SEGMENTATION

    P. Priya

    2014-02-01

    Full Text Available This paper works at segmentation of lesion observed in cervical cancer, which is the second most common cancer among women worldwide. The purpose of segmentation is to determine the location for a biopsy to be taken for diagnosis. Cervix cancer is a disease in which cancer cells are found in the tissues of the cervix. The acetowhite region is a major indicator of abnormality in the cervix image. This project addresses the problem of segmenting uterine cervix image into different regions. We analyze two algorithms namely Watershed, K-means clustering algorithm, Expectation Maximization (EM Image Segmentation algorithm. These segmentations methods are carried over for the colposcopic uterine cervix image.

  5. Prognostic value of response to external radiation in stage IIIB cancer cervix in predicting clinical outcomes: A retrospective analysis of 556 patients from India

    Saibishkumar, Elantholi P.; Patel, Firuza D.; Sharma, Suresh C.; Karunanidhi, Gunaseelan; Ghoshal, Sushmita; Kumar, Vinay; Kapoor, Rakesh

    2006-01-01

    Background and purpose: To evaluate the prognostic significance of response to external beam radiation (EBRT) in predicting the clinical outcomes in stage IIIB cancer cervix and to find out factors affecting response to EBRT. Patients and methods: This retrospective study included 556 patients of cancer cervix stage IIIB treated between 1996 and 2001 with EBRT (46 Gy/23fx/4.5 weeks) followed by intracavitary radiotherapy (ICRT). At the end of EBRT, response to EBRT was grouped as 'no gross residual tumor'(NRT) or 'gross residual tumor'(GRT). Results: Follow up ranged from 2 to 93 months with a median of 36 months. Median dose to point A was 81 Gy. At the end of EBRT, 393 patients (70.7%) attained NRT response. NRT responders had significantly better 5 year pelvic control, disease free survival (DFS) and overall survival (OS) than those who had a GRT response (75.6 vs. 54.6%; 60.6 vs. 31.9% and 62.6 vs. 33.7%, respectively; all P values <0.0001). Apart from response to EBRT, overall treatment time also has emerged as an independent factor to affect all clinical outcomes in multivariate analysis but age had significant impact on pelvic control only. Age was the only factor, which significantly influenced the response to EBRT in univariate as well as multivariate analysis (P=<0.001, OR=1.973, 95% C.I. 1.357-2.868). Patients with age more than 50 years had more NRT response (77%) than patients with age less than 50 years (63.8%). Conclusions: Patients who attain NRT response to EBRT will have an impressive long term pelvic control, DFS and OS in stage IIIB cancer cervix. Older patients (≥50 years) attain significantly higher NRT rates than younger patients

  6. Role of antioxidant therapy in ameliorating the side effects of post-operative radiotherapy on genetic material of cancer cervix patients

    Korraa, S.; Elmaghraby, T.; Arian, F.; Mahfouz, M.

    2003-01-01

    The oxidative stress found in cancer patients and radiotherapy was resulted from the increased production of oxidants in the body and the inefficiency of endogenous antioxidant system to eliminate such oxidants. The present study was carried out to investigated whether supplementation of cancer cervix patients during radiotherapy with antioxidants can ameliorate the damaging effects of radiation on DNA of circulating lymphocytes or not. Accordingly, apoptosis, DNA-fragmentation, lipid peroxidation and the frequency of micronuclei among cancer cervix patient undergoing post-operative radiotherapy (n=40) were measured with and without the administration course of antioxidant antox (including 60 mg vitamin C 10 mg vitamin E, 1000 U I vitamin A and 50 mg selenium). Patients were divided into 2 groups each of 20 patients. The first group was administered the antioxidant antox, 200 mg per day, during radiotherapy and one week more post-cessation of radiotherapy , while the second group did not supplemented with antox. All parameters were investigated in a control group of 20 normal healthy women and in the 40 patient ones

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

    2004-01-01

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

  8. In vivo Raman spectroscopy of cervix cancers

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

    2014-03-01

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

  9. Uterine cervix cancer and pregnancy

    Orna, Victor; Rueda, Miguel

    2005-01-01

    Objective: Describe a pathology with a high incidence in our means, in association with pregnancy in this case, graphically report they type of cervical malignancy, clinical manifestations, diagnose and treatment according to stage. Clinical case: We present a young patient with cervical pathology (endofitic bleeding lesion) diagnosed during the first trimester of pregnancy, with complete pregnancy, that consult because of genital bleeding, founding an endofitic lesion by colposcopic exam and which biopsy and pap test reported a scamous cell carcinoma, image diagnostic procedures reveal a 6 month product, that after surgical ending of pregnancy, wa treated by radical hysterectomy. Conclusions: It is important to recognize that in cervical pathology; cervical cancer during pregnancy is a great challenge for the specialist, the diagnostic evaluation that includes biopsies, must be realized in the same way, except from the endocervical canal. The treatment of choice for women is early stages of pregnancy is radical hysterectomy, during the last half of pregnancy it is possible to wait the viability of the product planning the childbirth surgically as soon as possible. (The author)

  10. Biological dose estimation of partial body exposures in cervix cancer patients

    Di Giorgio, Marina; Nasazzi, Nora B.; Taja, Maria R.; Roth, B.; Sardi, M.; Menendez, P.

    2000-01-01

    fraction. Cells containing aberrations will have been in the irradiated part of the body. Normal undamaged cells will comprise two subpopulations; those from the unexposed fraction and irradiated cells representing the first term (e -γ ) of the Poisson series. From the degree of the deviation from Poisson, the fraction of irradiated lymphocytes of the body and its mean dose can be obtained. The alternative Qdr method considers the yield of dicentrics and rings only from those cells that contain unstable aberrations and assumes that these cells were irradiated in situ. The Qdr value represents the expected frequency of dicentrics and rings among first division damaged cells (containing dicentrics, rings and excess acentric fragments). It is dose dependent, but independent of dose homogeneity and of a dilution of damaged cells by undamaged cells. Qdr assumes that the excess acentric fragments follow the Poisson distribution, but this is not borne out by data from in vitro experiments. It also assumes that cells containing excess acentric fragments will have been in the irradiated fraction of the body. However, their induction is not radiation specific, showing a variable spontaneous frequency, As these limitations are thought to be important, they were avoided by considering the yield of dicentrics + rings in those damaged cells which contain just dicentrics + rings (Qdr reduced equations). This simplified equation produces a dose estimate identical to that obtained by Dolphin method. Therefore, we apply Qdr reduced equation for data analysis. After inhomogeneous exposures, information on the absorbed dose and its distribution in the body is of great importance for an early assessment of irradiation consequences in the exposed individuals. As cancer patients undergoing partial-body fractionated radiotherapy may provide a model for in vivo irradiation, the objective of this work has been to assess the possibilities and limitations of Qdr method to determine reliable dose

  11. Detection of organ movement in cervix cancer patients using a fluoroscopic electronic portal imaging device and radiopaque markers

    Kaatee, Robert S.J.P.; Olofsen, Manouk J.J.; Verstraate, Marjolein B.J.; Quint, Sandra; Heijmen, Ben J.M.

    2002-01-01

    Purpose: To investigate the use of a fluoroscopic electronic portal imaging device (EPID) and radiopaque markers to detect internal cervix movement. Methods and Materials: For 10 patients with radiopaque markers clamped to the cervix, electronic portal images were made during external beam irradiation. Bony structures and markers in the portal images were registered with the same structures in the corresponding digitally reconstructed radiographs of the planning computed tomogram. Results: The visibility of the markers in the portal images was good, but their fixation should be improved. Generally, the correlation between bony structure displacements and marker movement was poor, the latter being substantially larger. The standard deviations describing the systematic and random bony anatomy displacements were 1.2 and 2.6 mm, 1.7 and 2.9 mm, and 1.6 and 2.7 mm in the lateral, cranial-caudal, and dorsal-ventral directions, respectively. For the marker movement those values were 3.4 and 3.4 mm, 4.3 and 5.2 mm, 3.2 and 5.2 mm, respectively. Estimated clinical target volume to planning target volume (CTV-PTV) planning margins (∼11 mm) based on the observed overall marker displacements (bony anatomy + internal cervix movement) are only marginally larger than the margins required to account for internal marker movement alone. Conclusions: With our current patient setup techniques and methods of setup verification and correction, the required CTV-PTV margins are almost fully determined by internal organ motion. Setup verification and correction using radiopaque markers might allow decreasing those margins, but technical improvements are needed

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

    Ohkawa, Reiko; Takamizawa, Hiroyoshi; Arai, Tatsuo; Morita, Shinroku.

    1981-01-01

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

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

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

    1981-03-01

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

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

    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.

  15. Radiotherapy in the cancer of cervix

    Lederman, M.V.

    1978-01-01

    Radiotherapy is the most efficient method of treatment of the carcinoma of the cervix. It is usually accepted also that the incidence of some sequels is justifiable as soon as it be kept in the lowest level possible. Trying to find out if this has correlation with the incidence of hypogastrium subcutaneous fibrosis in the cervix carcinoma treatment, 96 patients treated at Instituto de Radioterapia Osvaldo Cruz were analysed. The incidence of fibrosis was related to treatment techniques, tumor dose and TDF factor. The results indicated that TDF factor is the only one that can be directly related to the incidence of this sequel. The critical value for TDF factor was fixed at 110, and any increase on it elevates the fibrosis incidence by a factor of 5. Finally it is recommended that the TDF calculation should be utilized as the main factor in the selection of the several parameters involved in this kind of treatment. (F.R.) [pt

  16. Combined and surgical treatment of cervix uteri cancer

    Shuvaeva, N.I.; Kundukhova, E.M.; Vekhova, L.I.; Volkova, M.A.; Falileeva, E.P.; Troitskaya, I.B.

    1980-01-01

    The many-year experience with the treatment of the cervix uteri cancer has indicated that a combined method in case of the appropriate indications provides for high and persistant delayed results. The five-year recovery of patients at all stages was noted in 78.7% (1 stage-87.3%; 2 stage-71.6 %, 3 stage-41.7%). Improvement of therapeutic and diagnostic methods, strict adherence to the principles of a differential approach to selecting the type of therapy enabled increasing the per cent of a five-year cure from 68.9%' (1945-46) to 91.8% in 1965-69. The clinical features of microinvasive cervix uteri canner (stage 1a) made it possible to reduce the extent of the treatment applied on account of excluding a radiation component and lessening the extent of surgical intervention. A five-year cure by the surgical method in patients with cancer of stage 1a made up 97%. The results of the combined therapy in patients cervix uteri with stage 1b within the same period yielded 94%

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

    M G Janaki

    2010-01-01

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

  18. Rectal dose assessment in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer; Avaliacao da dose no reto em pacientes submetidas a braquiterapia de alta taxa de dose para o tratamento do cancer do colo uterino

    Oliveira, Jetro Pereira de [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Faculdade de Medicina; Rosa, Luiz Antonio Ribeiro da [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)], e-mail: lrosa@ird.gov.br; Batista, Delano Valdivino Santos; Bardella, Lucia Helena [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil). Unit of Medical Physics; Carvalho, Arnaldo Rangel [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Lab. of Thermoluminescent Dosimetry

    2009-03-15

    Objective: The present study was aimed at developing a thermoluminescent dosimetric system capable of assessing the doses delivered to the rectum of patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. Materials and methods: LiF:Mg,Ti,Na powder was the thermoluminescent material utilized for evaluating the rectal dose. The powder was divided into small portions (34 mg) which were accommodated in a capillary tube. This tube was placed into a rectal probe that was introduced into the patient's rectum. Results: The doses delivered to the rectum of six patients submitted to high-dose-rate brachytherapy for uterine cervix cancer evaluated by means of thermoluminescent dosimeters presented a good agreement with the planned values based on two orthogonal (anteroposterior and lateral) radiographic images of the patients. Conclusion: The thermoluminescent dosimetric system developed in the present study is simple and easy to be utilized as compared to other rectal dosimetry methods. The system has shown to be effective in the evaluation of rectal doses in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. (author)

  19. Radiation therapy in the treatment of cancer of the cervix

    Brown, G.S.

    1987-01-01

    The success of radiotherapy in dealing with cancer of the cervix lies in the understanding of its natural history and staging as well as the major forms of treatment. It is, therefore, imperative that all gynecological and radiation oncologists have at their command a thorough understanding of carcinoma of the cervix

  20. Radiotherapy for Locoregional Recurrent Cervix Cancer after Surgery

    Yang, Mi Gyoung

    1994-01-01

    Purpose: The role of radiotherapy in the management of patients with locoregional recurrent cervix cancer after radical surgery were retrospectively analyzed. Methods and materials: Twenty-eight patients treated with radiotherapy for locoregional recurrence after primary surgery for carcinoma of the cervix between 1989 and 1993 were analyzed. The median follow-up of survivors was 15 months (ranged 7-43 months). Eight patients had their disease confined to the vagina and 19 patients(68%) had pelvic mass as part of their locoregional recurrent disease. Within 24 months after the initial surgery, 82% of recurrences manifested themselves. All patients had whole pelvic irradiation with or without intracavitary radiotherapy(ICR). Results: Complete response(CR) was achieved in 18 patients(64%). Five of eighteen patients(28%) with initial CR developed second locoregional recurrence. Response to radiotherapy correlated strongly with tumor volume, site of recurrence and total radiation dose. The overall 2 year survival rate was 43% and the disease free survival was 31%. Survival rate was significantly influenced by the factors of interval from operation to recurrence, size and site of recurrent tumor, radiation dose, response of radiotherapy, lymph node status as initial presentation. The principal cause of death was lung metastasis(36%). Conclusion: Radiotherapy is an excellent modality for control of locoregional recurrent cervix cancer. To improve local control and survival rate, whole pelvic external radiotherapy in addition to ICR with more than 75.0Gy at the depth of 1.0cm from vaginal mucosa is needed and frequent follow up and early detection of recurrence is suggested as well

  1. Cervix Regression and Motion During the Course of External Beam Chemoradiation for Cervical Cancer

    Beadle, Beth M.; Jhingran, Anuja; Salehpour, Mohammad; Sam, Marianne; Iyer, Revathy B.; Eifel, Patricia J.

    2009-01-01

    Purpose: To evaluate the magnitude of cervix regression and motion during external beam chemoradiation for cervical cancer. Methods and Materials: Sixteen patients with cervical cancer underwent computed tomography scanning before, weekly during, and after conventional chemoradiation. Cervix volumes were calculated to determine the extent of cervix regression. Changes in the center of mass and perimeter of the cervix between scans were used to determine the magnitude of cervix motion. Maximum cervix position changes were calculated for each patient, and mean maximum changes were calculated for the group. Results: Mean cervical volumes before and after 45 Gy of external beam irradiation were 97.0 and 31.9 cc, respectively; mean volume reduction was 62.3%. Mean maximum changes in the center of mass of the cervix were 2.1, 1.6, and 0.82 cm in the superior-inferior, anterior-posterior, and right-left lateral dimensions, respectively. Mean maximum changes in the perimeter of the cervix were 2.3 and 1.3 cm in the superior and inferior, 1.7 and 1.8 cm in the anterior and posterior, and 0.76 and 0.94 cm in the right and left lateral directions, respectively. Conclusions: Cervix regression and internal organ motion contribute to marked interfraction variations in the intrapelvic position of the cervical target in patients receiving chemoradiation for cervical cancer. Failure to take these variations into account during the application of highly conformal external beam radiation techniques poses a theoretical risk of underdosing the target or overdosing adjacent critical structures

  2. Management of Locally Advanced Cancer Cervix an Indian Perspective.

    Singh, J K; Chauhan, Richa

    2015-01-01

    Cervical cancer has a major impact on the lives of Indian women with an estimated 122, 844 new cases of cervical cancer in the year 2012. About 80% of these cases present in a locally advanced stage leading to high morbidity and mortality. Because of lack of public awareness and infrastructure for screening and early detection in developing countries, this late presentation is likely to continue in the coming years. Radiation therapy has been the treatment of choice for patients with locally advanced cancer cervix. Many clinical trials and meta-analyses have shown a significant improvement in overall and progression-free survival with decreased local and distant recurrences with the use of concurrent chemotherapy with radiation. Most of these trials have been done in women from developed countries where the patient and disease profile are entirely different from ours. Recently, few trials from India have also shown promising results in locally advanced cancer cervix with concurrent chemoradiotherapy but toxicities remain a major concern. Further exploration is required for the use of concurrent chemo radiation prior to incorporating it into routine clinical practice.

  3. On the percutaneous radiotherapy of uterine cervix cancer

    Breit, A.; Ries, G.

    1986-01-01

    Whereas the local effect of radiotherapy in the postoperative treatment of uterine cervix cancer developing lymphogenic metastases may be regarded as clearly demonstrated, there is no evidence of its effect on the survival of patients. A definite answer to this question is only possible on the basis of prospective studies. In primary radiotherapy, more importance than in former days is given to percutaneous irradiation which allows a more homogeneous dose to the small pelvis. According to the present state of knowledge it is not justified to do without contact therapy except in cases of a very advanced disease. (orig.) [de

  4. The incidence of parametrial tumor involvement in select patients with early cervix cancer is too low to justify parametrectomy

    Stegeman, M.; Louwen, M.; van der Velden, J.; ten Kate, F. J. W.; den Bakker, M. A.; Burger, C. W.; Ansink, A. C.

    2007-01-01

    OBJECTIVE: To determine the incidence of parametrial involvement in a select group of patients with early cervical cancer. METHODS: We retrospectively reviewed the records of patients with cervical cancer and a maximum tumor diameter of 2 cm, infiltration depth <10 mm and negative pelvic lymph nodes

  5. Accelerated Hyperfractionated Radiotherapy for Locally Advanced Uterine Cervix Cancers

    Seo, Young Seok; Cho, Chul Koo; Yoo, Seong Yul

    2008-01-01

    To assess the efficacy of the use of accelerated hyperfractionated radiotherapy (AHRT) for locally advanced uterine cervix cancers. Between May 2000 and September 2002, 179 patients were identified with FIGO stage IIB, IIIB, and IVA cancers. Of the 179 patients, 45 patients were treated with AHRT (AHRT group) and 134 patients were treated with conventional radiotherapy (CRT group), respectively. Patients undergoing the AHRT regimen received a dose of 30 Gy in 20 fractions (1.5 Gyx2 fractions/day) to the whole pelvis. Subsequently, with a midline block, we administered a parametrial boost with a dose of 20 Gy using 2 Gy fractions. Patients also received two courses of low-dose-rate brachytherapy, up to a total dose of 85∼90 Gy to point A. In the CRT group of patients, the total dose to point A was 85∼90 Gy. The overall treatment duration was a median of 37 and 66 days for patients that received AHRT and CRT, respectively. Statistical analysis was calculated by use of the Kaplan-Meier method, the log-rank test, and Chi-squared test. For patients that received cisplatin-based concurrent chemotherapy and radiotherapy, the local control rate at 5 years was 100% and 79.2% for the AHRT and CRT group of patients, respectively (p=0.028). The 5-year survival rate for patients with a stage IIB bulky tumor was 82.6% and 62.1% for the AHRT group and CRT group, respectively (p=0.040). There was no statistically significant difference for severe late toxicity between the two groups (p=0.561). In this study, we observed that treatment with AHRT with concurrent chemotherapy allows a significant advantage of local control and survival for locally advanced uterine cervix cancers

  6. Descriptive study of breast and cervix cancer, in patients treated with linear accelerator, at the Centro Medico de Radioterapia Irazu, between 2000 and 2001, and proposed a database

    Calvo Jimenez, Kattia; Marchena Mendoza, Mario

    2008-01-01

    A descriptive study of breast and cervix cancer was performed in patients who have received treatment linear accelerator, during the period 2000 - 2001 in the Centro Medico de Radioterapia Irazu. The survival of the patients was assessed to five years (2006). One proposal called database is the product of analysis performed and consistent with the objectives set. The idea to develop the database of these features in the medical center, arises because the Centre was at that time with the only linear accelerator in the country and also all the necessary information of patients was easily accessible. A population of 438 records, with a common pathology was analyzed under the following variables: type of cancer, identification of anatomic region, province, age, sex, type of radiation, number of sessions, referral hospital, physician, physician referral. This work is relevant, because breast and cervical cancers have been a major cause of mortality, ranked among the five most common malignancies in women. From there to have adequate information systems, has led policy makers and health professionals to have a better outlook for their level of management. (author) [es

  7. Phase II study of weekly 4'-epidoxorubicin in patients with metastatic adenocarcinoma of the cervix: an EORTC Gynaecological Cancer Cooperative Group study

    van der Burg, M. E.; Bolis, G.; Bakker, P. J.; Curran, D.; Sahmoud, T.; Vermorken, J. B.

    1997-01-01

    In this study 22 patients with metastatic adenocarcinoma of the cervix were treated with a weekly bolus injection of 4'-epidoxorubicin at a dose of 12 mg/m2. Seventeen patients had received prior radiotherapy, all patients were chemo-naive. Toxicity was generally absent or very mild. One patient had

  8. Current status of treatment of cancer of uterine cervix, (1)

    Arai, Tatsuo; Morita, Shinroku; Murakami, Yuko; Motoya, Yoshifumi

    1981-01-01

    High dose rate intracavitary irradiation for cancer of the uterine cervix was examined. The 5-year survival rate of this method showed no significant difference from that of the low dose rate intracavitary irradiation, nor did the onset of regional injury show any difference. The optimal dose for stage 1 and 2 was 2900 +- 300 rad, which was approx. 60% of that of the low dose rate method. Elevation of ESR affected the survival rate only in stage 3 and 4 cases. The 5-year survival rate of cases with normal kidney function was twice that of abnormal cases. Radiotherapy of cancer of uterine cervix produced a 5-year survival rate of 58.8% and a cancer morbidity rate of 33.1%; patients with metastasis cannot be cured. The basic form of dose distribution by intracavitary irradiation was tumbler of Manchester's technique. The radiation source was placed in accordance with the conditions established by this technique, and the dose distribution was corrected with a computer. (Chiba, N.)

  9. A Preliminary Investigation into the Incidence of Cancer of the Cervix

    considered by some to have a protective effect in carcino- genesis of the ... PATIENTS AND METHODS ... Then we compared the histologically confirmed cancers from the ... comparison of histologically confirmed cancers of females in the 4 .... Unspecified. Contraceptive loop. Depo-Provera. Erosion of cervix. Cervicitis.

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

    Pinkston, J.A.; Sekine, Ichiro.

    1980-12-01

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

  11. Intraarterial Scintigraphy in recurrent Cervix Cancer - The Evaluation of Radionuclide therapeutic Trials -

    Kim, Eun Young; Suh, Jin Suck; Park, Chang Yun; Lee, Jong Tae; Yoo, Hyung Sik

    1990-01-01

    We performed 17 intraarterial scintigraphies in six patients with recurrent cervix cancer. With Seldinger method, the agent (four different radiopharmaceuticals) was perfused at the same speed of infusion of anticancer drugs (25 cc/hour) through internal iliac artery. There were four different radiopharmaceuticals; 131 I-Lipiodol, 99m Tc(Technetium)-HSA (Human Serum Albumin), 99m Tc-Sucralfate and 99m Tc-MAA (Macroaggregated Albumin). We evaluate the distribution pattern of radioactivity by the use of ratio of Tumor/Extratumor uptake (T/ET ratio). Our results reveals that 99m Tc-MAA scan showed the highest T/ET ratio and the other were not ideal agents for intraarterial therapy of recurrent cervix cancer. In conclusion, an ideal radioisotope and tracer which can block capillary, for example MAA, should be re-evaluated or produced in order to treat the patient with recurrent cervix cancer.

  12. Quantitative comparison between treatment results for uterine cervix cancer by radiation therapy and surgery

    Iinuma, Takeshi; Fukuhisa, Kenjiro; Arai, Tatsuo

    1983-01-01

    Treatment results for uterine cervix cancer were evaluated using a new concept named ''Effective Survival Rate''. This rate was calculated by subtracting the weighted sum of incidence rates of various complications from the 5-year survival rate. The numerical values for various complications were assigned as follows: surgical death, 1.0; severe complications, such as fistula ureterovaginalis and ileus, 0.5; mild complications, such as rectum and urinary bladder complications, 0.3 and 0.2. These values were determined with reference to the Karnofsky index of performance status. The effective survival rate was calculated for patients with satage 2 and 3 uterine cervix cancer treated by radiation therapy and surgery, and compared as a function of age between 30 and 70 years. We concluded that the effective survival rate was comparable for radiation therapy and surgery for stage 2 uterine cervix cancer. However, in patients with stage 3, radiation therapy was superior. (author)

  13. The brachytherapy vaginal cuff boost in patients with cervix cancer IB1-IB2 that have been treated with surgery plus pelvic radiotherapy in ION SOLCA, Guayaquil Ecuador from November 1 to October 2002

    Gamboa, Eugenia; Falquez, Roberto

    2003-01-01

    To determine if the additional vaginal cuff irradiation is necessary or not in patients with cervix cancer, stages IB 1- IB 2, that has been treated previously with radical hysterectomies and pelvic radiotherapy, to get better local control and global survival versus presence of complications. We studied 54 patients from Radiation Oncology Department of ION SOLCA Guayaquil Ecuador, with cervix cancer stages IB1 - IB2, that have been treated with surgery plus pelvic radiotherapy plus or not brachytherapy. They have been divides into two arms, group one included surgery plus Rx T (radiotherapy) plus BxT (Brachytherapy), and group two included those patients with surgery plus external RxT alone. We studied, aged, histologic type, surgery type, doses and techniques of teletherapy and brachytherapy and we analyzed the presence of complications. Conclusions: The brachytherapy vaginal cuff boost in patients with cervix cancer IB1-IB2 that have been treated with surgery plus pelvic radiotherapy is not useful to get better local control and global survival in some patients carefully chosen without desfavorable factors, because this therapy represent and increase in the complication. (The author)

  14. Sexual and menstrual practices: risks for cervix cancer | Maree ...

    Cervix cancer is the cancer that causes most female deaths in South Africa. Little is known about the sexual and menstrual practices in high-risk communities in South Africa. Knowledge of the risks inherent in these practices might lead to changed behaviour. The purpose of this study was to investigate if there are inherent ...

  15. The role of polymorphisms of genes repair pathway to the radiotoxicity in patients with cancer of the cervix

    Carvalho, Ana Terra Silva

    2012-01-01

    Background: In Brazil, cervical cancer is the second most common among women. Radiation therapy is part of its interdisciplinary management, playing an important role in their loco regional control. The major challenge of modern medicine in radiotherapy is to develop predictive methods that can determine the level of radiosensitivity of the patient and the healthy surrounding tissue in order to individualize the prescribed radiation dose, to prevent severe side effects and promoting better local tumor control. This study evaluated the acute and chronic adverse effects on the skin, lower gastrointestinal tract and urinary tract of radiotherapy in 47 cervical cancer patients. Methods and Materials: Biological material was collected and DNA from peripheral blood was extracted of ali patients studied. The fragments of TP53 and ATM were amplified to be sequenced, to verify if there are any polymorphisms witch could be responsible to the radiosensitivity of the patients. Results and Discussion: In a univariate analysis, the variable age was strongly associated with a risk of acute toxicity skin (p=O,023). Patients that received a high dose of external beam radiation and patients who have undergone brachytherapy, showed a significantly higher incidence of chronic urinary tract toxicity (p=O,031) and (p=O,019), respectively. The exchange G>A in the position 5557 of the A TM gene was significantly associated with the risk of acute lower gastrointestinal tract (p=O,008). There wasn't association between the other TP53 polymorphisms analyzed and the frequency of side effects (p>O,05). Our data revealed that patients who evolved significant association presented death (p=O,019) with the increase of chronic skin radiossensitivity. Conclusions: These observations corroborate the importance of investigating the genetic profile to predict adverse side effects in cervical cancer patients undergoing radiotherapy. These genes have an important role in DNA repair pathways and probably

  16. Germline mutation in RNASEL predicts increased risk of head and neck, uterine cervix and breast cancer.

    Bo Eskerod Madsen

    Full Text Available UNLABELLED: THE BACKGROUND: Ribonuclease L (RNASEL, encoding the 2'-5'-oligoadenylate (2-5A-dependent RNase L, is a key enzyme in the interferon induced antiviral and anti-proliferate pathway. Mutations in RNASEL segregate with the disease in prostate cancer families and specific genotypes are associated with an increased risk of prostate cancer. Infection by human papillomavirus (HPV is the major risk factor for uterine cervix cancer and for a subset of head and neck squamous cell carcinomas (HNSCC. HPV, Epstein Barr virus (EBV and sequences from mouse mammary tumor virus (MMTV have been detected in breast tumors, and the presence of integrated SV40 T/t antigen in breast carcinomas correlates with an aggressive phenotype and poor prognosis. A genetic predisposition could explain why some viral infections persist and induce cancer, while others disappear spontaneously. This points at RNASEL as a strong susceptibility gene. METHODOLOGY/PRINCIPAL FINDINGS: To evaluate the implication of an abnormal activity of RNase L in the onset and development of viral induced cancers, the study was initiated by searching for germline mutations in patients diagnosed with uterine cervix cancer. The rationale behind is that close to 100% of the cervix cancer patients have a persistent HPV infection, and if a defective RNase L were responsible for the lack of ability to clear the HPV infection, we would expect to find a wide spectrum of mutations in these patients, leading to a decreased RNase L activity. The HPV genotype was established in tumor DNA from 42 patients diagnosed with carcinoma of the uterine cervix and somatic tissue from these patients was analyzed for mutations by direct sequencing of all coding and regulatory regions of RNASEL. Fifteen mutations, including still uncharacterized, were identified. The genotype frequencies of selected single nucleotide polymorphisms (SNPs established in the cervix cancer patients were compared between 382 patients

  17. Particularities in the biodistribution and pharmacokinetic of labeled peptide with 99mTc in regional administration of patient with cervix cancer

    Palau San Pedro, A.; Lopez Diaz, A.; Martin Escuela, J. M.; Galvez Perez, E.

    2013-01-01

    This study had as objective characterize the biodistribution pharmacokinetic and dosimetry of labeled peptide with 9 9mTc in two dose levels, prepared in 2ml, starting from its intratumoral injection in patient with cervix cancer. The protocol selection to use, the correction and calculate methods were analysis object keeping in mind that antecedents of studies of this type didn't exist and that the administration intratumoral can originate new problems not foreseen in conventional intravenous studies. This study carried out mensurations of sensibility that should be corrected in a particular way. A careful protocol of acquisition was designed able to detect the behavior of the radio-peptide in the time, with a serial gathering of samples of blood and urine until the 24 hours, as well as images of the whole body up to 48h. For the quantification of the images they were necessary also the classic corrections of background and of overlapping of structures. The labeled peptide with 9 9mTc administered for intralesional way, like it was of waiting it presented a very high reception tumoral, being this maxim in the first images, however the product was absorbed quickly in blood, reaching its maximum levels in most of the patients as much in serum as in total blood, in the first 5-15 minutes of having administered. (Author)

  18. Magnetic resonance imaging in the evaluation of standard radiotherapy field borders in patients with uterine cervix cancer;Ressonancia magnetica para avaliacao dos limites dos campos classicos de radioterapia em pacientes portadoras de neoplasia maligna de colo uterino

    Freire, Geison Moreira; Dias, Rodrigo Souza; Giordani, Adelmo Jose; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo, E-mail: segreto.dmed@epm.b [Universidade Federal de Sao Paulo (UNIFESP-EPM), SP (Brazil). Unit of Radioterapy; Ribalta, Julisa Chamorro Lascasas [Universidade Federal de Sao Paulo (UNIFESP-EPM), SP (Brazil). Dept. de Gynecology

    2010-05-15

    Objective: to evaluate, by means of magnetic resonance imaging, the standardized field borders in radiotherapy for malignant neoplasm of uterine cervix, and to determine the role of this method in the reduction of possible planning errors related to the conventional technique. Materials and methods: magnetic resonance imaging studies for planning of treatment of 51 patients with uterine cervix cancer were retrospectively analyzed. The parameters assessed were the anterior and posterior field borders on sagittal section. Results: The anterior field border was inappropriate in 20 (39.2%) patients and geographic miss was observed in 37.3% of cases in the posterior border. The inappropriateness of both field borders did not correlate with clinical parameters such as patients' age, tumor staging, histological type and degree. Conclusion: the evaluation of standardized field borders with the use of magnetic resonance imaging has demonstrated high indices of inappropriateness of the lateral field borders, as well as the relevant role of magnetic resonance imaging in the radiotherapy planning for patients with uterine cervix cancer with a view to reduce the occurrence of geographic miss of the target volume. (author)

  19. Spectrum of rectal radiation lesions in cases of cancer cervix

    Srivastava, V.K.; Rohatgi, V.K.; Gupta, J.C.

    1978-01-01

    The study was carried out in 70 cases of carcinoma cervix uteri, showing varying degree of proctitis following radiotherapy treatment for cervical cancer. Grossly, the rectal mucosa showed oedema, congestion, granular proctitis, ulceration, and microscopically stromal connective tissue as well as epithelial changes. The stromal changes have been emphasised as useful diagnostic criteria of radiation reaction. The familarity of these changes is considered necessary because it is imperative to know categorically that a given lesion is entirely or in part due to radiation or due to extension of adjacent tumour in the cervix. Further, this issue is very important in management of cases of cancer cervix. The criteria of distinguishing the lesions in the rectal tissue have been laid down. (auth.)

  20. Positron emission tomography in the management of cervix cancer patients; Tomographie par emission de positons dans la prise en charge des cancers du col de l'uterus

    Bonardel, G.; Gontier, E.; Soret, M.; Dechaud, C.; Fayolle, M.; Foehrenbach, H. [Hopital d' Instruction des Armees du Val-de-Grace, Service de Medecine Nucleaire, 75 - Paris (France); Chargari, C.; Bauduceau, O. [Hopital d' Instruction des Armees du Val-de-Grace, Service de Radiotherapie, 75 - Paris (France)

    2009-10-15

    Since its introduction in clinical practice in the 1990 s, positron emission tomography (PET), usually with {sup 18}F-fluoro-2-deoxy-D-glucose ({sup 18}F-F.D.G.), has become an important imaging modality in patients with cancer. For cervix carcinoma, F.D.G.-PET is significantly more accurate than computed tomography (CT) and is recommended for loco-regional lymph node and extra pelvic staging. The metabolic dimension of the technique provides additional prognostic information. Ongoing studies now concentrate on more advanced clinical applications, such as the planning of radiotherapy, the response evaluation after the induction of therapy, the early detection of recurrence. Technical innovations, such as PET cameras with better spatial resolution and hybrid positron emission tomography/computed tomography (PET-CT), available now on the whole territory, provide both anatomic and metabolic information in the same procedure. From the point of view of biological metabolism, new radiopharmaceutical probes are being developed. Those hold promise for future refinements in this field. This article reviews the current applications of F.D.G.-PET in patients with cervix cancer. (authors)

  1. The clinical value of squamous cell carcinoma antigen in cancer of the uterine cervix

    de Bruijn, HWA; Duk, JM; van der Zee, AGJ; Pras, E; Willemse, PHB; Hollema, H; Mourits, MJE; de Vries, EGE; Aalders, JG; Boonstra, J.

    1998-01-01

    A review is given of the clinical use and interpretation of serum tumor marker levels during the treatment of patients with cancer of the uterine cervix, Pretreatment serum squamous cell carcinoma (SCC) antigen provides a new prognostic factor in early stage squamous cell carcinoma of the uterine

  2. Comparison of the efficacy among multiple chemotherapeutic interventions combined with radiation therapy for patients with cervix cancer after surgery: A network meta-analysis.

    Chang, Lei; Guo, Ruixia

    2017-07-25

    Cervix cancer was the second most common cancer in female. However, there was no network meta-analysis (NMA) comparing the efficacy of the multiple chemotherapeutic interventions combined with radiation therapy in patients after operation. Randomized controlled trials were retrieved from PubMed, Embase and Cochrane Library. Overall survival (OS), recurrence-free survival (RFS), incidence of recurrence and distant metastasis were the main outcomes, particularly 5-year OS and PFS were considered as primary outcomes. Furthermore, the hazard ratio (HR) or odds ratio (OR) and their 95% credible intervals (CrIs) were extracted. The surface under cumulative ranking curve (SUCRA) was also used in this NMA. A total of 39 eligible trials with 8,952 patients were included and 22 common chemotherapies were evaluated in this meta-analysis. For OS, cisplatin+fluorouracil+hydroxyurea, fluorouracil+mitomycin C, cisplatin and cisplatin+fluorouracil were better than placebo. As for RFS, cisplatin+fluorouracil, fluorouracil+mitomycin C, and cisplatin alone had the significant superiority compared with placebo. In terms of incidence of recurrence, the optimal drug combination was cisplatin+ifosfamide (0.93) based on SUCRA. Moreover, epirubicin (OR = 0.28, 95% CrI: 0.08-0.91) was the only one had the distinguished potency in reducing the occurrence of distant metastasis with a SUCRA rank probability of 0.88. We recommended cisplatin+fluorouracil+hydroxyurea and cisplatin+docetaxel for their good efficacy in long term survival. Meanwhile, the combination of multiple drugs with different mechanisms worked better.

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

    Chaudary, Naz; Mujcic, Hilda; Wouters, Bradly G.; Hill, Richard P.

    2013-01-01

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

  4. Isotope applications on uterine cervix cancer

    Pinto, A.C.L.C.; Vigna Filho, E. del

    1978-01-01

    Techniques for the treatment of uterine cervix carcinoma are presented with isotopes used in the Instituto de Radioterapia Geral e Megavoltagem de Minas Gerais - Belo Horizonte (Brazil). Gynecological applicators, dosimetry care, diagnostic methods, stage and treatment are described that are the same as in the M.D. Anderson Hospital and Tumor Institute, Houston, Texas. The need for the use of 'After-loading' methods is emphasized, as well as radium substitutes, mainly Cs-137 and accurate dosimetry [pt

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

    Cho, Jung Kun; Lee, Du Hyun; Si, Chang Kun; Choi, Yoon Kyung; Kim, Tae Yoon

    2004-01-01

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

  6. Treatment results of radical radiotherapy in uterine cervix cancer

    Huh, Seung Jae; Kim, Bo Kyong; Lim, Do Hoon; Shin, Seong Soo; Lee, Jeong Eun; Kang, Min Kyu; Ahn, Yong Chan [Samsung Medical center, sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-09-15

    This study was conducted to evaluate the treatment results, prognostic factors, and complication rates after high dose rate (HDR) brachytherapy in patients with uterine cervix cancer who were treated with curative aim. Of 269 cervix cancer patients treated at the department of radiation oncology, Samsung Medical Center from September 1994 to July 1998, the 106 who were treated with radical radiotherapy were analyzed. The median age was 61 years (range 22 to 89). All patients except 4 with carcinoma in situ (CIS) were given external beam radiotherapy (range 30.6 {approx} 50.4 Gy to whole pelvis) and HDR brachytherapy. The common regimens of HDR brachytherapy were a total dose of 24 {approx} 28 Gy with 6 {approx} 7 fractions to point A at two fractions per week. The median overall treatment time was 55 days (range 44 to 104) in patients given both external beam radiotherapy and HDR brachytherapy. Early response of radiotherapy were evaluated by gynecologic examination and follow-up MRI 1 month after radiotherapy. Treatment responses were complete remission in 72 patients, partial response in 33 and no response in 1. The overall survival (OS) rate of all patients was 82%, and 73%, and the disease free survival (DFS) rate was 72%, and 69%, at 3, and 5 years, respectively. The pelvic control rate (PCR) was 79% at both 3 and 5 years. According to the FIGO stage, 3 and 5 year OS were 100% and 50% in CIS/IA, 100% in 100% in IB, 83% and 69% in IIA, 87% and 80% in IIB, and 62% and 62% in III, respectively. The 3 year OS in 4 patients with stage IVA was 100%. Three-year DFS were 80% in CIS/IA, 88% in IB, 100% in IIA, 64% in IIB, 58% in III, and 75% in IVA. Three-year PCR were 100% in CIS/IA, 94% in IB, 100% in IIA, 84% in IIB, 69% in III, and 50% in IVA. By univariate analysis, FIGO stage and treatment response were significant factors for OS. The significant factors for DFS were age, FIGO stage, treatment response and overall treatment time (OTT). For pelvic control rate

  7. Treatment of the uterus cervix cancer with the JINR phasotron proton beam

    Astrakhan, B.V.; Kiseleva, V.N.; Pojdenko, V.K.; Klochkov, I.I.; Molokanov, A.G.; Mitsin, G.V.; Savchenko, O.V.; Zorin, V.P.

    1995-01-01

    The methods of the uterus cervix cancer proton-and-gamma treatment for the first time were elaborated in the CRC RAMS and ITEP in Moscow and then developed for the JINR proton beam in Dubna. The results of the clinical probation of the methods for the uterus cervix cancer treatment have confirmed the advantage of the proton irradiation. The most important advantage of the proton beam treatment is absence of postradiation reactions and complications in the critical organs (bladder and rectum). Up to now 31 patients with the uterus cervix cancer have been treated at the JINR phasotron. 6 of them had proton-and-gamma treatment combined with surgical operation and 22 patients received a radical proton-and-gamma treatment (without surgery). The clinical results are in good agreement with the preceding results of the ITEP group. After receiving proton-and-gamma radiotherapy of the uterus cervix, 83% of the patients are alive without recurrences, metastases and complications. 10 refs., 4 figs., 2 tabs

  8. Lymphoscintigraphy and identification of lymph nodes in patients with cervix carcinoma undergoing radical hysterectomy

    Alonso, Omar; Lago, Graciela; Juri, Cecilia; Touya, Eduardo; Arribeltz, Gualberto; Dabezies, Luis; Alvarez, Carmen; Sotero, Gonzalo; Martinez, Jorge

    2003-01-01

    One of the most important prognostic features of early cervix cancer is the involvement of regional lymph nodes (LN). Although not fully studied, the sentinel node (SN) strategy has the potential of preventing unnecessary extensive LN dissections in these patients. The aim of this study was to determine the feasibility of SN identification by means of preoperative lymphoscintigraphy (PL) and intraoperative gamma probe detection (IGPD) in patients undergoing radical hysterectomy and pelvic/para-aortic lymphadenectomy for the treatment of early cervix carcinoma. (author)

  9. Mid-dose rate intracavitary therapy for uterine cervix cancer with a Selectron; An early experience of Osaka University

    Teshima, Teruki; Inoue, Takehiro; Sasaki, Shigeru; Ohtani, Masatoshi; Kozuka, Takahiro; Inoue, Toshihiko; Ikeda, Hiroshi; Yamazaki, Hideya (Osaka Univ. (Japan). Faculty of Medicine); Murayama, Shigeyuki

    1993-05-01

    From May 1991 through September 1992, a total of 17 previously untreated patients with invasive uterine cervix cancer and with intact uterus were treated with mid-dose rate intracavitary therapy administered with a Selectron. Early primary tumor responses for all patients were complete. No acute or subacute radiation injury was observed except one patient with aplastic anemia who developed rectal ulcer. Two patients of Stage IIIb died from tumor because of local, paraaortic lymph node and distant metastases. Our early experience concluded that Selectron MDR can be used for cervix cancer patients as safely and effectively as our previously used high-dose rate machine. (author).

  10. The more frequent types of human papillomavirus in Cuban samples of cervix cancer

    Rios Hernandez, Maria de los Angeles; Hernandez Menendez, Maite; Aguilar Vela de Oro, Francisco Orlando

    2010-01-01

    Cervix cancer (UCC) is considered a sexually transmitted disease due to factors involved in its appearance and development and this infection is recognized as the main etiological agent of this entity. In Cuba this type of tumor is placed in 2nd category in incidence and in 4th place in mortality among the malignant disease affecting the female sex. The objective of present study is to determine the types of human virus papilloma (HVP) present in samples of cervix tumors in Cuban women, as well as to describe the behavior of different risk factors associated with this disease. Forty five samples of cervix cancer were analyzed and the presence of 20 types of HVP was determined by polymerase chain reaction with specific primers founding in them a 91,1% of positivity. Genotype 16 was the more prevalent, followed by the 18, 45, 31, 39, 51, 56, 59, PAP23A. The low risk type 6 and 11 weren't founded in samples. Promiscuity was the more interesting risk factor in our study. Knowledge of the viral types present in cervix cancer in our patients is very important when we approach the development and the use of prophylactic and therapeutical vaccines

  11. Cancer of the Uterine Cervix: Late Diagnosis. Case Presentation

    Miguel Ángel Serra Valdés

    2017-01-01

    Full Text Available Cancer is an important health problem due to the high morbidity and mortality which it produces. The first cause of women death between 30 and 44 years old in Cuba is cervix carcinoma. This is a case of a 39 year old woman who presented to the secondary health care level with a stage IV cervix tumor where it was diagnosed, it simulated an anaemic syndrome due to another cause. The histological and imaging studies were concluding. Primary prevention of this kind cancer by means of health education and searching in the risk population are paramount. The program of early detection still has difficulties. The presentation of this case is aimed at teaching so as documentary exposition for professionals of primary health care attention, gyneco-obstetricians, internists and any other clinical specialty derived.

  12. Utilizing 3-D and 4-D ultrasound systems to improve radiation treatment of cervix and prostate cancer patients

    Baker, Mariwan

    Radiotherapy plays an important role in modern treatment for cancer, such as cervical and prostate radiation treatment. One of the major issue in radiotherapy is that the target should be aligned to the planned target volume prior to each treatment fraction, for which different kilovoltage (k...

  13. Biorhythm theory and primary irradiation of inoperable cancer of the cervix

    Kucera, H.; Riss, P.; Weghaupt, K.

    1980-01-01

    Hundred patients with inoperable cancer of the cervix, who had been treated by primary irradiation, were reviewed with regard to biorhythm on the days of radium application. 5-year survival was lower in patients with unfavorable biorhythm; the differences, however, were not significant. It is concluded that the calculation of biorhythm for the day of radiotherapy has little or no influence on the results of therapy. (orig.) [de

  14. Cervix Motion in 50 Cervical Cancer Patients Assessed by Daily Cone Beam Computed Tomographic Imaging of a New Type of Marker

    Langerak, Thomas, E-mail: t.langerak@erasmusmc.nl; Mens, Jan Willem; Quint, Sandra; Bondar, Luiza; Heijkoop, Sabrina; Heijmen, Ben; Hoogeman, Mischa

    2015-11-01

    Purpose: To evaluate a new type of marker and a new method of marker implantation and to assess interfraction cervix motion for a large population of patients with locally advanced cervical cancer by daily cone beam computed tomographic (CBCT) imaging. Methods and Materials: We investigated the position of markers in 50 patients treated in prone position during at least 23 fractions. To reduce streaking artifacts in the planning CT scan, a new type of polymeric marker was used and compared with conventional gold markers. In addition, a new method of implantation was used in an attempt to reduce marker loss. In each fraction, a CT scan was acquired before dose delivery and aligned to the bony anatomy of the planning CT scan, simulating the clinical setup protocol. First, sufficient visibility of the markers was verified. Then, systematic and random displacement of the marker centroids was recorded and analyzed in 3 directions with regard to the planning CT and the first CBCT (to evaluate the presence of a vaginal catheter in the planning CT). Streaking artifacts were quantified with the standard deviation of the mean squared intensity difference in a radius around the marker. Results: Marker loss was minimal during treatment: in only 3 of the 50 patients 1 marker was lost. Streaking artifacts for the new markers were reduced compared with conventional gold markers. For the planning CT, M/Σ/σ were 0.4/3.4/2.2 mm, 1.0/5.5/4.5 mm, and −3.9/5.1/3.6 mm for the left-right, anterior-posterior, and cranial-caudal directions, respectively. With regard to the first CBCT scan, M/Σ/σ were 0.8/2.8/2.1, 0.6/4.4/4.4, and −1.3/4.5/3.6 mm. Conclusions: A new type of marker and implantation method was shown to have significantly reduced marker loss and streaking artifacts compared with gold fiducial markers. The recorded marker displacement confirms results reported in the existing literature but for a larger dataset.

  15. Regional lymphadonectomy in uterine cervix carcinoma patients after radiotherapy

    Bokhman, Ya.V.; Kuznetsov, V.V.

    1981-01-01

    A group of patients with uterine cervix carcinoma with metastatic indices in regional lymphatic vessels detected on lymphograms is studied. It is established that after radiation treatment the relative resistance of lymphogenic metastases to the ionizing radiation is found in 14.9% patients. Extraperitoneal removal of regional lymphatic collectors after a complete course of combined radiation therapy in patients with uterine cervix carcinoma with histologically proved metastases improves 3-year results of survival up to 40%. In the case of multiple and bilateral metastatic injury of regional lymph nodes the therapeutic value of extraperitoneal lymphadenectomy reduces sharply. The diagnostic value of X-ray contrast lymphography not only for defining regional metastases, but for planning and carrying out the treatment of patients with uterine cervix carcinoma is pointed out [ru

  16. Peculiarities of immune status in uterine cervix carcinoma patients

    Dekster, L.I.

    1981-01-01

    On the basis of investigating the peripheral blood lymphocytes the immunologic state in 81 patients with uterine cervix carcinoma is estimated. It is established that there is a considerable decrease of indices in the T-immune system in patients with uterine cervix carcinoma. The detection of reductions in the immunogram indices in the initial stage plays a definte diagnostic role in the detection of metastases, permits to forecast the process generalization, and consequently, to determine the treatment tactics. It is established that under the effect of combined radiation treatment the T-system is mostly injured. Consequently, pronounced postradiation depression is prognostically unfavourable. The examination of another group of patients has shown that the probability of development of lymphogenic metastases in uterine cervix carcinoma is mainly determined by immuno-morphological peculiarities of regional lymph nodes [ru

  17. Dissection of the sentry ganglion by laparoscopic boarding in patients with cervix uterine cancer clinical stages IA2 at IIB; Diseccion de ganglio centinela por abordaje laparoscopico en pacientes con cancer cervicouterino etapas clinicas IA2 a IIB

    Valdez U, J J; Pichardo M, P A; Cortes M, G; Escudero de los Rios, P. [Hospital de Oncologia. Centro Medico Nacional Siglo XXI. IMSS, Mexico D.F. (Mexico)

    2005-07-01

    The obtained results in presently study demonstrate that the feasibility of the detection of the sentry ganglion in cervix uterine cancer using a boarding by laparoscopic via, being necessary the use of twice labelled as much with patent blue and radioisotope (colloid of labelled rhenium with {sup 99m}Tc, total dose of 3 MCi) to achieve the identification of the ganglion. (Author)

  18. Radiotherapy of cancer of the cervix

    Taggart, C.H.

    1975-01-01

    This new section in Arizona Medicine is specifically targeted to the subject of cancer care in the state of Arizona. Recognition of the importance of cancer management has been underscored by the establishment of the conquest of cancer as a national goal. In this column, current concepts in cancer management and recent advances in cancer research that are relevant to Arizona will be discussed each month. Cancer therapy is currently changing at an extraordinarily rapid rate, and the views expressed on this page should not be considered as static recommendations. The editors of this column will select key topics and invite interested physicians and allied health professionals from Arizona to write components related to areas of their expertise in cancer. (auth)

  19. CCDB: a curated database of genes involved in cervix cancer.

    Agarwal, Subhash M; Raghav, Dhwani; Singh, Harinder; Raghava, G P S

    2011-01-01

    The Cervical Cancer gene DataBase (CCDB, http://crdd.osdd.net/raghava/ccdb) is a manually curated catalog of experimentally validated genes that are thought, or are known to be involved in the different stages of cervical carcinogenesis. In spite of the large women population that is presently affected from this malignancy still at present, no database exists that catalogs information on genes associated with cervical cancer. Therefore, we have compiled 537 genes in CCDB that are linked with cervical cancer causation processes such as methylation, gene amplification, mutation, polymorphism and change in expression level, as evident from published literature. Each record contains details related to gene like architecture (exon-intron structure), location, function, sequences (mRNA/CDS/protein), ontology, interacting partners, homology to other eukaryotic genomes, structure and links to other public databases, thus augmenting CCDB with external data. Also, manually curated literature references have been provided to support the inclusion of the gene in the database and establish its association with cervix cancer. In addition, CCDB provides information on microRNA altered in cervical cancer as well as search facility for querying, several browse options and an online tool for sequence similarity search, thereby providing researchers with easy access to the latest information on genes involved in cervix cancer.

  20. [Cervix uteri cancer: a critical approach to its prevention].

    de Oliveira, Michele Mandagara; da Silva, Emilia Nalva Ferreira; Pinto, Ione Carvalho; Coimbra, Valéria Cristina Christello

    2004-08-01

    This article is a pilot study of one of the authors master dissertation about problems related to the preventive measures of cervix cancer. Four women with cancer that were hospitalized at the gynecological ward or under chemotherapy treatment at a hospital in the city of Pelotas, RS, Brazil, were interviewed. Data were collected from April to June 2001, and of the women interviewed only one was examined preventively according to the guidelines of the Ministry of Health. Therefore, health professionals should be urged to promote care as well as health education.

  1. Pathological problems of cancer of the uterine cervix

    Ohmi, Kazuo

    1981-01-01

    Cancers of the uterine cervix were classified for prediction of radiosensitivity. They were classified into two types: radioresistant type (R-type), in which the cancer was predominated by the properties of adenocarcinoma and was radioresistant, and radiosensitive type (S-type) in all others. In preoperatively irradiated cases of stage IIb cancer of uterine cervix, 84% of R-type cases showed viable cancer cells, and 84% of S-type cases showed tumor disappearance. In cases of radiotherapy in a period 1965 - 70, 69% of stage II cases and 70% of stage III cases of R-type showed disease progress; for S-type, 88% of stage II and 77% of stage III cases had tumor control. In stage III cases given radiotherapy alone in 1971 and 1972 after the histological features were examined, 82% of R-type cases showed tumor recurrence and 77% of S-type cases had disease control. Problems in the classification and assessment were discussed. (Chiba, N.)

  2. Radiation with cisplatin or carboplatin for locally advanced cervix cancer: the experience of a tertiary cancer centre

    Au-Yeung, George; Mileshkin, Linda; Rischin, Danny; Bernshaw, David M.; Kondalsamy-Chennakesavan, Srinivas; Narayan, Kailash

    2013-01-01

    Definitive treatment with concurrent cisplatin and radiation is the standard of care for locally advanced cervix cancer. The optimal management of patients with a contraindication to cisplatin has not been established. We conducted a retrospective audit of concurrent chemotherapy in a cohort of patients with locally advanced cervix cancer. All patients with locally advanced cervix cancer treated with definitive radiation were entered into a prospective database. Information regarding their demographics, stage, histology, recurrence and survival were recorded. Pharmacy records were reviewed to determine concurrent chemotherapy use. A total of 442 patients were included in the audit. Two hundred sixty-nine patients received cisplatin, 59 received carboplatin and 114 received no concurrent chemotherapy. Overall survival was significantly improved with the use of concurrent cisplatin compared with radiation alone (adjusted hazard ratio 0.53, P=0.001), as was disease-free survival and rate of distant failure. The use of carboplatin was not associated with any significant benefit in terms of overall survival or disease-free survival. The results of this audit are consistent with the known significant survival benefit with concurrent cisplatin chemotherapy. However, there did not appear to be any significant benefit with carboplatin although there were potential confounding factors. The available evidence in the literature would favour the use of non-platinum chemotherapy rather than carboplatin in patients with contraindications to cisplatin.

  3. Locally advanced cervix cancer: chemotherapy prior to definitive surgery or radiotherapy. A single institutional experience

    MacLeod, C.; O'Donnell, A.; Tattersall, M.H.N.; Dalrymple, C.; Firth, I.

    2001-01-01

    Primary or neoadjuvant chemotherapy prior to definitive local therapy has potential advantages for locally advanced cervix cancer. It can down stage a cancer and allow definitive local therapy to be technically possible (surgery), or potentially more effective (radiotherapy). It can also eradicate subclinical systemic metastases. This report reviews a single institution's experience of neoadjuvant chemotherapy prior to definitive local therapy for cervix cancer over a 13-year period. One hundred and six patients were treated with this intent. The patients were analysed for their response to chemotherapy, treatment received, survival, relapse and toxicity. The chemotherapy was feasible and the majority of patients had a complete or partial response (58.5%). Eight patients did not proceed to local treatment. Forty-six patients had definitive surgery and 52 had definitive radiotherapy. The 5-year overall survival was 27% and the majority of patients died with disease. The first site of relapse was usually in the pelvis (46.2%). Late complications that required ongoing medical therapy (n = 6) or surgical intervention (n = 2) were recorded in eight patients (7.5%). On univariate analysis stage (P= 0.04), tumour size (P = 0.01), lymph node status (P=0.003), response to chemotherapy (P = 0.045) and treatment (P = 0.003) were all significant predictors of survival. On multivariate analysis, tumour size (P < 0.0001) and nodal status (P = 0.02) were significant predictors of survival. Despite the impressive responses to chemotherapy of advanced cervix cancer, there is evidence from randomized trials that it does not improve or compromise survival prior to radiotherapy. As its role prior to surgery remains unclear, it should not be used in this setting outside a prospective randomized trial. Copyright (2001) Blackwell Science Pty Ltd

  4. Cancer of the cervix in Ilorin, Nigeria

    grandmultiparous patients constituting 119 (79.9%) of the cases. Irregular vaginal bleeding 109 (73.2 %), vagi- nal discharge 58 (38.9 %) and postcoita] bleeding. 31(20.5 %) were the common symptoms. Nineteen. (12.8%) patients reported at the hospital within one month of onset of symptoms. About three quarter of the.

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

    Naganawa, Shinji; Sato, Chiho; Ishigaki, Takeo; Kumada, Hisashi; Miura, Shunichi; Takizawa, Osamu

    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 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 -3 mm 2 /s, and that of normal cervix tissue was 1.79±0.24 x 10 -3 mm 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.)

  6. Sigmoid Colon is an Unexpected Organ at Risk in Brachytherapy for Cervix Cancer

    Ffrrcsi, H.F.; Mrcpfrcr, I.B.; Appleby, H.

    2006-01-01

    Purpose: To identify organs at risk (OAR) and analyze the dose volume histograms (DVHs) for intracavitary brachytherapy in cancer of the cervix. Late toxicities are our concern in treatment of cancer cervix especially as it is presenting in younger age population. Material and Methods: Patients with cancer of the cervix were treated using CT and MRI compatible, high dose rate, (HDR) applicators. CT images were acquired with the intra-uterine tube and colpostats in place and subsequently imported into Varian Brachyvision planning software. We identified the gross tumour volume (GTV) and organs at risk (OARs) and analyzed the dose distribution using dose volume histograms (DVHs). Doses were calculated according to ICRU 38. Critical tissue DVHs were analysed following the American Brachytherapy Society rules. Dose points are recorded as the dose encompassed by the greatest contiguous I cm3, 2 cm3, and 5 cm3 volumes in the plan. Results: We found the sigmoid colon to be a relatively immobile structure that repeatedly received doses in excess of 70% of the intended point A dose. The only solution in order to bring sigmoid DVHs within 5% toxicity limits was to reduce the dose to point A. Planning images and DVHs for the OARs are shown as an example of our work. Conclusion: The recto-sigmoid colon is identified as an unexpected OAR in a majority of cervix brachytherapy plans. A new consensus on the DVH limit of this structure will be needed in the era of CT planned brachytherapy, if arbitrary dose reductions to point A are to be the solution to the problem of sigmoid DVHs that exceed conventional tolerance limits

  7. Adenoid cystic carcinoma of uterine cervix in a young patient

    Seth Ankit

    2009-10-01

    Full Text Available Adenoid cystic carcinoma of uterine cervix is a rare tumor. Its origin is debatable. It has a high incidence in postmenopausal women but rarely can develop in patients under 40. An association with squamous cell carcinoma has been described. We report a case of adenoid cystic carcinoma of the endocervical canal with foci of squamous cell carcinoma in a 34-year-old suffering from menorrhagia associated with blood-stained vaginal discharge. Per vaginum and per speculum examination revealed a growth. Cervical biopsy showed bits of tissue, suggesting adenoid cystic carcinoma. Patient was operated upon and uterus with cervix sent for histopathological examination. We report this case because of its rarity, particularly in young patients, with description of illustrative pathology and discussion on the histological diagnosis.

  8. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Herrera, Higmar; Yañez, Elvia; López, Jesús

    2012-01-01

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerología de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  9. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Herrera, Higmar; Yañez, Elvia; López, Jesús

    2012-10-01

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerología de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  10. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Herrera, Higmar; Yanez, Elvia; Lopez, Jesus [Centro Estatal de Cancerologia de Durango, Victoria de Durango, Durango (Mexico); ISSSTE General Hospital Dr. Santiago Ramon y Cajal, Victoria de Durango, Durango (Mexico)

    2012-10-23

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerologia de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  11. Significance of cytology in the evaluation of radiation therapy for cancer of the uterine cervix

    Tsukahara, Yoshiharu; Kato, Junzo; Nakayama, Akiko; Fukamatsu, Yoshito; Shiozawa, Isao; Tomita, Kazuhiko; Noguchi, Hiroshi; Fukuta, Toru.

    1986-01-01

    Cytologic and histologic diagnoses were made on 184 patients with cancer of the uterine cervix treated with radiation therapy. In 125 patients examined at the 8th day after completion of external irradiation, 73 and 52 patients were cytologically positive and negative, respectively, for persistent cancer. Histologically, 74 and 51 patients were positive and negative, respectively. Fifty-eight and 36 patients showed an agreement between the two procedures for positive and negative findings, respectively. In 159 patients examined at the 8th day after both external and intracavitary irradiation, 17 were cytologically diagnosed as positive and 142 as negative: histologically, 53 were positive and 106 were negative. Thirteen and 102 patients showed an agreement between the procedures for positive and negative findings, respectively. Using histological findings as the standard, false negative cases of cytology increased after doing intracavitary irradiation than after external irradiation (25 % vs 13 %). (Namekawa, K.)

  12. Evaluation of radiation doses on critical organs in the treatment of cancer of the cervix using HDR-brachytherapy

    Soares, Taciana; Jansem, Teresa

    2000-01-01

    High dose-rate (HDR) brachytherapy is one type of treatment of the cervix carcinoma. During the planning for this therapy, especial attention is given to proximal normal organs such as bladder and rectum. In fact, due to their radiosensibility and localization, bladder and rectum are considered as critical organs. In this work we have studied the influence of the positioning of patient legs in the dose delivered to these critical organs in the treatment of cancer of the cervix using HDR-brachytherapy. (author)

  13. Effect of radiotherapy on lymphocyte subpopulations in patients with carcinoma of the breast and uterine cervix

    Guha Thakurta, S.; De, M.; Roy Chowdhury, J.

    1983-01-01

    Immune competence was evaluated in 43 patients of carcinoma breast, 77 patients of cancer cervix, as compared to 30 normal healthy women. The study also included 25 women from the two carcinoma groups, who had undergone radiotherapy. A reduction in the white blood cell count, absolute lymphocyte count, active T-cell count and absolute T-cell count were observed in patients with carcinoma of the breast and cervix prior to irradiation. Radiation therapy resulted in a striking reduction of all the three parameters in both the carcinoma groups. Substantial recovery was observed within a year after cessation of therapy. Increased number of peripheral B lymphocytes was observed in carcinoma of the breast as well as the cervix prior to irradiation. At completion of radiation, the number decreased markedly in both groups of patients. Gradual recovery took place within a year. The reduction in lymphocyte numbers and its subpopulations could not be attributed to thymic irradiation, since patients receiving pelvic and mediastinal (including thymic) radiotherapy showed similar changes. (author)

  14. Rectal bleeding and its management after irradiation for cervix cancer

    Chun, Mi Son; Kang, Seung Hee; Kil, Hoon Jong; Oh, Young Taek; Sohn, Jeong Hye; Ryu, Hee Suk; Lee, Kwang Jae; Jung, Hye Young

    2002-01-01

    Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. The study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. A total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The point A dose from the HDR brachytherapy was 28 Gy to 30 Gy (4 Gy x 7, or 5 Gy x 6). The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months (12 ∼ 86 months). The incidence of rectal bleeding was 12.7% (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was 8.5%. Most complications (92.6%) developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding: an icruCRBED greater than 100 Gy (19.7% vs. 4.2%), an EBRT dose to the parametrium over 55 Gy (22.1% vs. 5.1%) and higher stages of III and IV (31.8% vs. 10.5%). In the multivariate analysis, the icruCRBED was the only significant factor (ρ > 0.0432). The total

  15. Dose dependence of complication rates in cervix cancer radiotherapy

    Orton, C.G.; Wolf-Rosenblum, S.

    1986-01-01

    The population selected for this study was a group of 410 Stage IIB and III squamous cell Ca cervix patients treated at the Radiumhemmet between the years 1958-1966. A total of 48 of these patients developed moderate-to-severe rectal and/or bladder complications. Of these, 33 were evaluable with respect to dose-dependence of complications, that is, complete intracavitary dose measurements and external beam dose calculations, no chemotherapy or electrocautery, and complete clinical radiotherapy records. A group of 57 randomly selected uninjured patients were used as controls. Results show good correlation between dose, expressed in TDF units, and complication rates for both rectal and bladder injuries. Severity of rectal injury was observed to increase with increase in dose, although no such correlation was observed for bladder injuries. Mean delays in the expression of symptoms of injury were 10 months for the rectum and 22 months for the bladder

  16. Dose dependence of complication rates in cervix cancer radiotherapy

    Orton, C.G.; Wolf-Rosenblum, S.

    1986-01-01

    The population selected for this study was a group of 410 Stage IIB and III squamous cell Ca cervix patients treated at the Radiumhemmet between the years 1958-1966. A total of 48 of these patients developed moderate-to-severe rectal and/or bladder complications. Of these, 33 were evaluable with respect to dose-dependence of complications, that is, complete intracavitary dose measurements and external beam dose calculations, no chemotherapy or electrocautery, and complete clinical radiotherapy records. A group of 57 randomly selected uninjured patients were used as controls. Results show good correlation between dose, expressed in TDF units, and complication rates for both rectal and bladder injuries. Severity of rectal injury was observed to increase with increase in dose, although no such correlation was observed for bladder injuries. Mean delays in the expression of symptoms of injury were 10 months for the rectum and 22 months for the bladder.

  17. HPV epigenetic mechanisms related to Oropharyngeal and Cervix cancers.

    Di Domenico, Marina; Giovane, Giancarlo; Kouidhi, Soumaya; Iorio, Rosamaria; Romano, Maurizio; De Francesco, Francesco; Feola, Antonia; Siciliano, Camilla; Califano, Luigi; Giordano, Antonio

    2017-03-31

    Human Papilloma Virus infection is very frequent in humans and is mainly transmitted sexually. The majority of infections are transient and asymptomatic, however, if the infection persists, it can occur with a variety of injuries to skin and mucous membranes, depending on the type of HPV involved. Some types of HPV are classified as high oncogenic risk as associated with the onset of cancer. The tumors most commonly associated with HPV are cervical and oropharyngeal cancer, epigenetic mechanisms related to HPV infection include methylation changes to host and viral DNA and chromatin modification in host species. This review is focused about epigenethic mechanism, such as MiRNAs expression, related to cervix and oral cancer. Specifically it discuss about molecular markers associated to a more aggressive phenotype. In this way we will analyze genes involved in meiotic sinaptonemal complex, transcriptional factors, of orthokeratins, sinaptogirin, they are all expressed in cancer in a way not more dependent on cell differentiation but HPV-dependent.

  18. Studies on evaluation of staging of cancer of the uterine cervix by means of CT

    Kakizaki, D

    1987-03-01

    The present study was undertaken to evaluate the stage classification (FIGO) by using CT in 50 cases with cancer of the uterine cervix in which the final stage had been diagnosed. An accurate diagnosis was obtained in 6 of 14 Ib cases, 14 of 21 IIa cases, 5 of 6 IIb cases, 2 of 3 IIIa cases, 3 of 3 IIIb cases and 3 of 3 IVa cases, for a total of 33 of 50 (66 %). The diagnostic rate for Ib and IIa staging was 57 %, while that for IIb or more was 87 %, but the accuracy rate in IIIb and IVa was 100 %. As the equipment, a high resolutional GE 9800 CT using a special technique was employed. Employing special pretreatment for the patient, it became possible to accurately grasp the pelvic condition of the patients. CT evaluation was related to the extent of the cervical cancer and the presence of infiltration into the vaginal wall. According to a 4-stage classification of the CT image, the extent of infiltration to surrounding parametrium and the bladder was determined. As a result, the sensitivity for evaluating invasion into surrounding tissue raised 92 %, and it showed 100 % for cases with adhesion or invasion of the bladder. Therefore, CT can an extremely effective method to determine the clinical staging of cancer of the uterine cervix.

  19. Cancer of the Cervix in Nigeria: A Case – Control Study of some ...

    A case –control study to establish possible aetiological factor of carcinoma of the cervix was undertaken. Data were collected from 206 patients with carcinoma of cervix and 206 controls using a standardized questionnaire. Risk factors assessed included sociodemographic characteristics, sexual history, personal habit and ...

  20. Multidisciplinary treatment of cancer of uterine cervix, (2)

    Kasamatsu, Tatsuhiro; Sonoda, Takahiko; Tanemura, Kenjiro; Ohmi, Kazuo; Matsumoto, Yoshi

    1981-01-01

    Okabayashi's extensive panhysterectomy is used for cancer of uterine cervix in Japan, and the rate of its practice was 45.6% at the National Cancer Center (1962 - 73, stage 1 - 4 cases). Cancer death within 5 years occurred in 92.3% of the total deaths, and the total surgical deaths did not exceed 1%. Postoperative irradiation was performed in cases with lymph node metastasis, those with parametrial invasion and those with deep primary lesions. Intravaginal irradiation was sometimes performed in cases of insufficient vaginal excision. Therefore, the 5-year survival rate of postoperatively irradiated cases was 71.4%, and that of non-irradiated cases 93.7%. The 5-year survival rate of all cases of adenocarcinoma including irradiated cases was 44.7%. Since the effect of irradiation was not so promising, postoperative irradiation with fast neutrons is performed in adenocarcinoma cases with metastasis and/or infiltration. Effect of combination with chemotherapy has been poor. The indication of less surgery for early cases is under examination. (Chiba, N.)

  1. Effects of major geometric variations between intracavitary applications on pear-shaped isodose dimension in cancer of the cervix

    Kim, R. Y.

    1996-01-01

    PURPOSE: The basic principal of intracavitary brachytherapy for cancer of the cervix is based on specific loading rules to achieve a pear-shaped isodose distribution centered around the cervix. Recently, ICRU Report 38 recommends a dose reference volume for reporting. Our previous studies have confirmed that there is considerable variations of geometry between applications. This study is to evaluate the effect of major geometric variations on pear-shaped isodose dimension in manual afterloading low-dose-rate system. MATERIAL AND METHODS: One hundred orthogonal films of 50 patients with cancer of the cervix (2 applications/patient) were reviewed for comparative measurements of geometric variations between applications. Major geometric variations were found for 13 patients in lengths of tandem, 7 patients in colpostats separation and 16 patients in vaginal packing. The direct measurement of these geometric variations were compared with the three-dimensional measurement of the pear-shaped isodose enclosed by the point A between the two applications. RESULTS: The geometric variations in the width of colpostats separation and length of tandem were directly related to the width and height of the pear-shaped isodose dimension. The geometric relationship between the colpostats and distal tandem had an important effect on the thickness of the pear-shape. In optimization of poor geometry for rectum or bladder wall, high dose volume centered around the cervix is reduced without changing the overall pear-shaped volume due to changing configuration of the pear-shaped isodose. In our selected patients with two applications, variations in vaginal packing had no direct effect on the width and thickness of the pear-shape due to other variables. CONCLUSION: Major geometric variations between applications greatly affect the dimension of the pear-shaped isodose distribution. Optimization of poor geometry is quite limited without compromising the high-dose volume centered around the

  2. The value of the hysterectomy of rescue in uterine cervix cancer. An experience in SOLCA Guayaquil

    Panchana, Guido; Jimenez, Jorge

    2005-01-01

    By way of obtaining results on treatment in advanced stages II b - II a and III b of uterine cervix cancer; we realized study of retrospective accomplished in course of years 1997 and 1998, reviewing clinical charts of statistical department of ION SOLCA. We reviewed 829 clinical charts diagnosed of uterine cervix cancer; of this group 316 patients were chosen in stages II b III a and II b. 148 cases in this group (46.8%) received treatment, on the meanwhile 168 (53.2%) left treatment at beginning. 70.27% had been received treatment with exclusivity radiotherapy and 29.73% had been treated with radiotherapy plus rescue surgery. Middle age was 53.11 years. 88.5% in histological finding was predominant squamous cell carcinoma. The majority of cases stage II-b the most frequent was over stages III a, and III b. The patients treated with exclusivity radiotherapy, 47% showed a good response. The group treated with radiotherapy plus rescue surgery; 54% showed preoperative residual tumor and near of 55.5% of this group that went through surgical procedure showed tumor persistence after surgery. In this study survival result founded in treated patients of both groups when we stop gathering of data they not showed a consistent difference according to the type's treatment. (The author)

  3. Blood-ACTH, cortisole and aldosterone levels following complex radiation treatment for cancer of the uterine cervix

    Modnikov, O.P.

    1984-01-01

    Blood-ACTH, cortisole and aldosterone levels in patients with cancer of the uterine cervix were measured radioimmunologically prior to complex radiotherapy, following a half-dose exposure of tumor focus and immediately on completion of the treatment course. Patients showed a rise in cortisole and aldosterone levels and a slight increase in ACTH. Radiation therapy inhibited production of cortisole and aldosterone matched by a rise in ACTH output

  4. Cervix cancer: clinical aspects of tumoral control and radiotherapy treatment time

    Petitto, J.V.

    1994-01-01

    The author analyzed 35 patients with recurrence or residual tumor at the end of the radiotherapy program. These patients were selected out of a group of 338 patients cervix cancer who had also undergone on the same radiotherapy program. Those patients were compared with control group of 30 patients without clinical evidence of the disease, from the same group of 338 patients. It has studied the clinical results considering the total radiotherapy time to developed the radiation program and factors that could modify the time for a longer program, and also modify the final survival results. No significant difference was shown in this study, but it should be taken in consideration the total radiotherapy time, because this is a factor that could change the final results if the time would be longer than what was shown in this work. (author). 26 refs, 10 tabs

  5. Computer-assisted dosimetry in the radiotherapy of cancer of the cervix

    Calaguas, M.J.C.; Rodriguez, L.V.; Vito Cruz, E.Q.; Legaspi, G.C.; De Luna, R.M.; Hermoso, T.M.; Razon, E.C.; Madrid, E.T.; Viray, R.G.

    1992-01-01

    Cancer of the cervix is the third leading cause of cancer in the Philippines. The Department of Radiotherapy of the Jose R. Reyes Memorial Medical Center has participated in the Regional Coordinated Research project sponsored by the International Atomic Energy Agency (IAEA) to undertake a study to compare computer treatment planning and manual calculations in radiotherapy of the cancer of the cervix; and to perform actual measurements on bladder and rectal points using TLDs. Twenty-seven patients with Stage II-B to III-B were included in the study. External beam teletherapy of 40 Gy without shielding for 4 weeks and 50 Gy with blocks plus brachytherapy of 20-40 Gy were given using LDR or HDR machine. Point A, bladder and rectal points were defined following ICRU 38 recommendations. The results showed dose calculations between commercially available computers and IAEA - provided computers agree to within 20%. Results of TLD measurement in bladder and rectum have shown wide range of variation. (author). 3 refs.; 4 tabs.; 8 figs

  6. Feasibility and safety of same-day discharge after laparoscopic radical hysterectomy for cervix cancer.

    Philp, Lauren; Covens, Allan; Vicus, Danielle; Kupets, Rachel; Pulman, Katherine; Gien, Lilian T

    2017-12-01

    To evaluate the safety and feasibility of same day-discharge (SDD) after laparoscopic radical hysterectomy for cervix cancer by determining complication rates and factors associated with post-operative admission. In this retrospective cohort study, patients undergoing laparoscopic radical hysterectomy for cervix cancer at a single institution from January 2006 to November 2015 were identified. Admitted patients were compared to same-day discharge patients. Rates of post-operative complications and readmission were analyzed and regression analysis used to determine factors associated with admission. 119 patients were identified. 75 (63%) were SDD patients (mean stay 156.7±50.2min) and 44 (37%) were admitted patients (mean stay 1.2±0.6days). Ten (13%) SDD patients sought medical attention within 30days post-operatively vs. nine (20%) admitted patients (p=0.17). Reasons SDD patients sought attention included pain (n=1), wound concerns (n=2), vaginal bleeding (n=2), DVT/VTE (n=1), fever (n=2) and fistula (n=2). All patients developed symptoms and presented between 5 and 13days post-operatively thus no complications could have been detected or prevented through initial admission. Four SDD patients were readmitted within 30days of surgery (p=0.25), two required re-operation (p=0.16). Admitted patients were older (p=0.049), had longer operations (p=0.02), increased blood loss (p=0.0004), increased intra-operative complications (p=0.001), surgery later in the day (p=0.004) and before April 2010 (p=0.001). On multivariate analysis, older age (OR1.05, p=0.03), surgery later in the day (OR 7.22, p=0.002) and presence of an intra-operative complication (OR 10.25, p=0.02) were significantly associated with admission. Same-day discharge after laparoscopic radical hysterectomy for cervix cancer is safe, with a low risk of post-operative morbidity and hospital readmission. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Mohammed Osman

    2014-09-01

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

  8. Cellular immune response in patients presenting with benign and malignant lesions of cervix

    Leon Cruz, Grettell; Arango Prado, Maria del Carmen; Faxas Garcia, Maria Elena

    2012-01-01

    To study the immunologic parameters in patients presenting with intraepithelial lesions (IEL) and carcinoma in situ of cervix in the National Institute of Oncology and Radiotherapy over 2009. The alterations in the immune system in patients with cervix pathology are associated with the progress of lesions

  9. Brachytherapy for treatment of cervix cancer in Madagascar

    Pignon, T.; Ratovonarivo, H.; Rafaramino, F.; Ruggieri, S.

    1993-01-01

    From March 1986 to June 1988, 60 patients with carcinoma of the uterine cervix were treated by radiotherapy alone or combined radiotherapy and surgery at the only radiotherapy-oncology department of Madagascar in Antananarivo. There were 20 stage IB, 28 stage II, 5 stage III and 7 cases where initial stage before surgery was unknown. After a limited pre-therapeutic investigation, treatment for stage IB consisted of utero-vaginal brachytherapy followed by a colpo-hysterectomy and external iliac lymphadenectomy. Others received combined external radiotherapy and brachytherapy according to the Fletcher guidelines, although 30 patients also received surgery. An obsolete and inefficient cobalt unit with lack of computerized dosimetry made the management of therapeutic schemas difficult. Nineteen patients (31.6%) were not available for follow-up immediately after the end of the treatment and one patient died from intestinal occlusion during brachytherapy. The overall rate of severe complications was 4.8%. There were 12 recurrences which occurred in stage II or in patients with unknown initial staging. At the time of analysis, 25 patients were alive: 15 stage I and 10 stage II. In this country, cervical carcinomas are the most frequent tumors: only the rehabilitation of radiotherapy facilities will allow results to be improved

  10. Patterns of care study of radiation therapy for uterine cervix cancer in Japan. The influence of age on the process

    Teshima, Teruki; Ikeda, Hiroshi; Abe, Mitsuyuki

    1999-01-01

    To improve the quality of radiation oncology in Japan, a Patterns of Care Study (PCS), a quality assurance program widely known in the United States, was introduced to Japan. In this study, the process, including work-up and treatment for uterine cervix cancer patients, was investigated to show nationwide variation by age. From July 1996 through February 1997, PCS extramural audits were performed for 29 institutions nationwide. Medical charts for 432 patients with uterine cervix cancer treated between 1992 and 1994 were reviewed based on the PCS data format used in the US. The processes of radiation therapy for these patients were compared in two age groups those aged ≥75 years (n=132) and those aged <75 years (n=300). There were significant differences by age group in medical background, indicating the fragility of the elderly and a relatively higher incidence of early-stage disease in the elderly by patient selection. Lower pelvic radiation doses were used for the elderly with advanced stage disease. There were no significant differences in unplanned breaks in external irradiation between the two age groups. Brachytherapy was used less commonly in the elderly group than in younger group (p=0.0187). The dose range for brachytherapy did not show any significant difference between the two groups. Preliminary survival rates for the elderly were similar to those for the younger group. Radiation therapy was found to play an important role in the treatment of uterine cervix cancer in elderly as well as younger patients. (author)

  11. Literature analysis of radiotherapy in uterine cervix cancer for the processing of the patterns of care study in Korea

    Choi, Doo Ho; Kim, Eun Seog; Kim, Yong Ho; Kim, Jin Hee; Yang, Dae Sik; Kang, Seung Hee; Wu, Hong Gyun; Kim, Il Han

    2005-01-01

    Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into 3 ∼ 4 categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors. Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wall invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (8) and unconventional fractionation. By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication

  12. Overall major histocompatibility complex class I expression is not downregulated in cervix cancer, as detected by immunoelectron microscopy

    van Eijkeren, MA; Roovers, JP; Oorschot, [No Value; Geuze, HJ

    2004-01-01

    Downregulation of major histocompatibility complex (MHC) class I molecules in cervix cancer has been proposed as a mechanism for cancer cells to escape immunodetection. By means of light microscopic immunohistochemistry, it has been shown that in 20-70% of cervix cancers MHC class I is

  13. Prevalence of codon 72 P53 polymorphism in Brazilian women with cervix cancer

    Sylvia Michelina Fernandes Brenna

    2004-01-01

    Full Text Available The p53 codon 72 polymorphism seems to be associated with HPV-carcinogenesis, although controversial data have been reported. A series of Brazilian women with cervix carcinomas were analyzed. Ninety-nine (67% of 148 women were found to be homozygous (arg/arg for the arginine polymorphism, and 49 (33% were heterozygous (arg/pro. This polymorphism may be an important determinant of the risk for cervix cancer, but does not seem to be sufficient for carcinogenesis.

  14. Five-year healing results of radiotherapy in 4347 uterine cervix cancers treated within the period of 1928 to 1977

    Tschakert, H.

    1986-01-01

    The author presents the five-year healing results of 4347 uterine cervix cancers treated at our Radiotherapeutic Institute within the years of 1928 to 1977. The part of patients irradiated postoperatively increased by 30% during this period, and the average age of patients at the beginning of their disease increased by almost seven years. The overall five-year healing results increased from 47 to 60% during this half of a century, especially the prognosis of stage II and III was considerably improved. With almost the same rate of radiogenic side effects, the incidence of recurrences could be reduced by 50%. The healing results achieved by us in uterine cervix cancer during the last ten years under report correspond well with the healing results of other radiotherapeutic hospitals. Even when compared to the most recent reports on the success achieved by afterloading techniques, there is not much difference to our recent results obtained with radium brachytherapy. (orig.) [de

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

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

    2011-04-15

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

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

    Stenstedt, Kristina; Hellstroem, Ann-Cathrin; Fridsten, Susanne; Blomqvist, Lennart

    2011-01-01

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

  17. Effect of troglitazone on radiation sensitivity in cervix cancer cells

    An, Zheng Zhe; Liu, Xian Guang; Song, Hye Jin; Choi, Chi Hwan; Kim, Won Dong; Park, Woo Yoon; Yu, Jae Ran

    2012-01-01

    Troglitazone (TRO) is a peroxisome proliferator-activated receptor γ (PPARγ ) agonist. TRO has antiproliferative activity on many kinds of cancer cells via G1 arrest. TRO also increases Cu 2+ /Zn 2+ -superoxide dismutase (CuZnSOD) and catalase. Cell cycle, and SOD and catalase may affect on radiation sensitivity. We investigated the effect of TRO on radiation sensitivity in cancer cells in vitro. Three human cervix cancer cell lines (HeLa, Me180, and SiHa) were used. The protein expressions of SOD and catalase, and catalase activities were measured at 2-10 μM of TRO for 24 hours. Cell cycle was evaluated with flow cytometry. Reactive oxygen species (ROS) was measured using 2',7'-dichlorofluorescin diacetate. Cell survival by radiation was measured with clonogenic assay. By 5 μM TRO for 24 hours, the mRNA, protein expression and activity of catalase were increased in all three cell lines. G0- G1 phase cells were increased in HeLa and Me180 by 5 μM TRO for 24 hours, but those were not increased in SiHa. By pretreatment with 5 μM TRO radiation sensitivity was increased in HeLa and Me180, but it was decreased in SiHa. In Me180, with 2 μM TRO which increased catalase but not increased G0-G1 cells, radiosensitization was not observed. ROS produced by radiation was decreased with TRO. TRO increases radiation sensitivity through G0-G1 arrest or decreases radiation sensitivity through catalasemediated ROS scavenging according to TRO dose or cell types. The change of radiation sensitivity by combined with TRO is not dependent on the PPAR γ expression level.

  18. Prevalence of prognostic factors for cancer of the uterine cervix after radical hysterectomy

    Marília Buenos Aires Cabral Tavares

    Full Text Available CONTEXT AND OBJECTIVE: Cancer of the uterine cervix is still very common in Brazil. It is important to evaluate factors that influence its prognosis. The aim here was to analyze the prevalence of prognostic anatomoclinical factors among patients with carcinoma of the uterine cervix undergoing radical hysterectomy. DESIGN AND SETTING: Cross-sectional study on 301 patients with invasive carcinoma of the uterine cervix who underwent Level III Piver-Rutledge hysterectomy surgery at São Marcos Hospital. METHODS: The following variables were analyzed: age, histological type, degree of differentiation, invasion of lymphatic, vascular and perineural space, lymph node metastasis, distance to nearest margin, tumor invasion depth, vaginal cuff size, largest diameter of the tumor, presence of necrosis and surgical margin involvement. Descriptive statistics, multiple regression analysis, Kaplan-Meier survival curves and the log-rank test were performed. A significance level of 5% was used. RESULTS: The mean age was 48.27 years. The following were not important for the prognosis, in relation to survival analysis: degree of differentiation and tumor invasion depth; presence of lymphatic, blood and perineural invasions; distance to nearest margin; and vaginal cuff size. Tumor size (P < 0.036, presence of lymph node metastasis (P < 0.0004, necrosis (P < 0.05 and surgical margin involvement (P < 0.0015 presented impacts on survival. The overall survival with 98 months of follow-up was 88.35%. CONCLUSION: The most prevalent prognostic factors were the presence of lymph node metastasis, tumor size and surgical margin involvement.

  19. The Results of Radiation Therapy Alone vs Radiation Plus Chemotherapy of Uterine Cervix Cancer

    Lee, Myung Za; Choi, Suk Young; Chun, Ha Jeong

    1995-01-01

    Purpose : Radiation therapy(RT) is conventionally standard treatment for locally advanced stage for uterine cervix cancer. Recently to improve treatment results, combined chemotherapy and radiation therapy was tried. We retrospectively analysed our experience of 122 patients. Comparison of the results in 45 patients treated with RT alone and 77 patients treated with RT plus chemotherapy was made. Materials and Methods : from January 1985 to December 1991, 122 patients with cervix cancer were treated with whole pelvic external RT and ICR(34 1 ICR, 77 2 ICR, 11 high dose rate ICR) in our department. Forty five patients were treated with RT alone, and 77 patients were treated with combined plus chemotherapy. Mean age was 58 years(range:29-81). Histologic types were 111 squamous cell carcinoma, large cell carcinoma, 3 adenocarcinoma, and 2 adenosquamous cell carcinoma. According to the FIGO stage 6 had stage IA94.9%, 11 had IIA(9.0%), 37 had IIB(30.3%), 3 had IIA(2.5%), 63 had IIB(51.6%), and 2 had stage IV(1.6%). In 77 patients with RT plus chemotherapy, 36 patients were treated with VBP(vinblastin, bleoycin, cisplainum), 39 patients with cisplatinum plus 5-FU and 2 patients with 5-FU. Results : Complete response after external RT(3960cGy-5500cGy)was achieved in 61 patients(50%). He actuarial 5 year and 9 year survival rate was 57.8% and 53.9%, respectively. Five year actuarial survival rate was 63.1% with RT alone(n=45) and 55.9% with RT plus chemotherapy(n=77). Their 5 year survival rate was 35.5% for 1 course of ICR and 67% for 2 courses of ICR. There was statistically significant advantage of survival with RT alone group who were treated with 2 coursed of ICR and dose to the A point≥8000cGy(4/25 died). In RT plus chemotherapy group, dose response was not seen and there was no difference in 5 year survival between 1 course and 2 course of ICR(50% vs 56.8%), and dose to point A less than 8000cGy and more than 8000 cGy(55.6% vs 55.7%). There was no significant

  20. IMPROVING THE DIAGNOSIS AND TREATMENT OF RETENTION DISORDERS OF THE UPPER URINARY TRACT IN PATIENTS WITH STAGES IIB–III CANCER OF THE CERVIX UTERI

    A. D. Kaprin

    2012-01-01

    Full Text Available Study investigates the prevalence, diagnosis and treatment in patients with retention disorders upper urinary tract cervical cancer stage IIB III after more than 3 months after combined radiotherapy. In the apartment complex to the diagnosis of renal ultrasound and radioisotope study of renal excretory function added to the study ureteral emissions by color Doppler sonography. Information on ureteral emissions revealed a violation of the early passage of urine in 23.1 % of patients with renal ultrasound revealed no pathology. On the basis of violations ureteral emissions increase in the number of patients, respectively, are assigned to nonoperative treatment (anti-inflammatory, spasmolytic therapy. As a result, decreased by 14.2 % (p = 0.034, female patients, which showed drainage of the upper urinary tract.

  1. Pelvic Radiotherapy for Cancer of the Cervix: Is What You Plan Actually What You Deliver?

    Lim, Karen; Kelly, Valerie; Stewart, James; Xie, Jason; Cho, Young-Bin; Moseley, Joanne B.; Brock, Kristy; Fyles, Anthony; Lundin, Anna; Rehbinder, Henrik; Milosevic, Michael

    2009-01-01

    Purpose: Whole pelvic intensity-modulated radiotherapy (IMRT) is increasingly being used to treat cervix cancer and other gynecologic tumors. However, tumor and normal organ movement during treatment can substantially detract from the benefits of this approach. This study explored the effect of internal anatomic changes on the dose delivered to the tumor and organs at risk using a strategy integrating deformable soft-tissue modeling with simulated dose accumulation. Methods and Materials: Twenty patients with cervix cancer underwent baseline and weekly pelvic magnetic resonance imaging during treatment. Interfraction organ motion and delivered (accumulated) dose was modeled for three treatment scenarios: four-field box, large-margin whole pelvic IMRT (20-mm planning target volume, but 10 mm inferiorly) and small-margin IMRT (5-mm planning target volume). Results: Individually, the planned dose was not the same as the simulated delivered dose; however, when taken as a group, this was not statistically significant for the four-field box and large-margin IMRT plans. The small-margin IMRT plans yielded adequate target coverage in most patients; however, significant target underdosing occurred in 1 patient who displayed excessive, unpredictable internal target movement. The delivered doses to the organs at risk were significantly reduced with the small-margin plan, although substantial variability was present among the patients. Conclusion: Simulated dose accumulation might provide a more accurate depiction of the target and organ at risk coverage during fractionated whole pelvic IMRT for cervical cancer. The adequacy of primary tumor coverage using 5-mm planning target volume margins is contingent on the use of daily image-guided setup.

  2. Cervix uteri. Strategy for the management of cancer of the cervix uteri

    Takahashi, S.

    1984-01-01

    In our department external irradiation is given priority over intracavitary (radium) therapy for the treatment of carcinoma of the cervix uteri. Our policy is to irradiate the volume containing the primary lesion, parametrium and pelvic lymph nodes to a dose of 40.0 Gy in about 4 weeks for stages I and IIa, or 50.0 Gy over 5 weeks for stages IIb and III. For stages I and IIa, intracavitary radium therapy is additionally given to a dose of 28.0-30.0 Gy at ''point A'', 7-10 days after the external irradiation, by means of two fractions with an interval of 7-10 days. For stages IIb and III, further external irradiation is carried out to give an additional dose of 20.0 to 25.0 Gy to the cervix and parametrium over 2 weeks by means of radiation fields of reduced size. If the size of the tumour in stages IIb and III is considerably reduced after the initial dose of 50.0 Gy, and the dose to point A is 40.0 Gy, intracavitary therapy is carried out without the additional small field irradiation. The intracavitary therapy is given twice with an interval of 8 days. For stage IV without distant metastases the treatment policy is the same as that in stage III; for stage IV with distant metastases, only whole pelvis irradiation is performed, to a dose of 50.0 Gy over 5 weeks

  3. Comparison of {sup 18}F-FDG PET/MRI and MRI for pre-therapeutic tumor staging of patients with primary cancer of the uterine cervix

    Sarabhai, Theresia; Wetter, Axel; Forsting, Michael; Umutlu, Lale; Grueneisen, Johannes [University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schaarschmidt, Benedikt M.; Kirchner, Julian [University Dusseldorf, Department of Diagnostic and Interventional Radiology, Medical Faculty, Dusseldorf (Germany); Aktas, Bahriye [University Hospital Essen, University of Duisburg-Essen, Department of Obstetrics and Gynecology, Essen (Germany); Ruhlmann, Verena; Herrmann, Ken [University Hospital Essen, University of Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany)

    2018-01-15

    The aim of the present study was to assess and compare the diagnostic performance of integrated PET/MRI and MRI alone for local tumor evaluation and whole-body tumor staging of primary cervical cancers. In addition, the corresponding impact on further patient management of the two imaging modalities was assessed. A total of 53 consecutive patients with histopathological verification of a primary cervical cancer were prospectively enrolled for a whole-body 18F-FDG PET/MRI examination. Two experienced physicians analyzed the MRI data, in consensus, followed by a second reading session of the PET/MRI datasets. The readers were asked to perform a dedicated TNM staging in accordance with the 7th edition of the AJCC staging manual. Subsequently, the results of MRI and PET/MRI were discussed in a simulated interdisciplinary tumor board and therapeutic decisions based on both imaging modalities were recorded. Results from histopathology and cross-sectional imaging follow-up served as the reference standard. PET/MRI allowed for a correct determination of the T stage in 45/53 (85%) cases, while MRI alone enabled a correct identification of the tumor stage in 46/53 (87%) cases. In 24 of the 53 patients, lymph node metastases were present. For the detection of nodal-positive patients, sensitivity, specificity and accuracy of PET/MRI were 83%, 90% and 87%, respectively. The respective values for MRI alone were 71%, 83% and 77%. In addition, PET/MRI showed higher values for the detection of distant metastases than MRI alone (sensitivity: 87% vs. 67%, specificity: 92% vs. 90%, diagnostic accuracy: 91% vs. 83%). Among the patients with discrepant staging results in the two imaging modalities, PET/MRI enabled correct treatment recommendations for a higher number (n = 9) of patients than MRI alone (n = 3). The present results demonstrate the successful application of integrated PET/MRI imaging for whole-body tumor staging of cervical cancer patients, enabling improved treatment

  4. Hybrid adaptive radiotherapy with on-line MRI in cervix cancer IMRT

    Oh, Seungjong; Stewart, James; Moseley, Joanne; Kelly, Valerie; Lim, Karen; Xie, Jason; Fyles, Anthony; Brock, Kristy K.; Lundin, Anna; Rehbinder, Henrik; Milosevic, Michael; Jaffray, David

    2014-01-01

    Purpose: Substantial organ motion and tumor shrinkage occur during radiotherapy for cervix cancer. IMRT planning studies have shown that the quality of radiation delivery is influenced by these anatomical changes, therefore the adaptation of treatment plans may be warranted. Image guidance with off-line replanning, i.e. hybrid-adaptation, is recognized as one of the most practical adaptation strategies. In this study, we investigated the effects of soft tissue image guidance using on-line MR while varying the frequency of off-line replanning on the adaptation of cervix IMRT. Materials and method: 33 cervical cancer patients underwent planning and weekly pelvic MRI scans during radiotherapy. 5 patients of 33 were identified in a previous retrospective adaptive planning study, in which the coverage of gross tumor volume/clinical target volume (GTV/CTV) was not acceptable given single off-line IMRT replan using a 3 mm PTV margin with bone matching. These 5 patients and a randomly selected 10 patients from the remaining 28 patients, a total of 15 patients of 33, were considered in this study. Two matching methods for image guidance (bone to bone and soft tissue to dose matrix) and three frequencies of off-line replanning (none, single, and weekly) were simulated and compared with respect to target coverage (cervix, GTV, lower uterus, parametrium, upper vagina, tumor related CTV and elective lymph node CTV) and OAR sparing (bladder, bowel, rectum, and sigmoid). Cost (total process time) and benefit (target coverage) were analyzed for comparison. Results: Hybrid adaptation (image guidance with off-line replanning) significantly enhanced target coverage for both 5 difficult and 10 standard cases. Concerning image guidance, bone matching was short of delivering enough doses for 5 difficult cases even with a weekly off-line replan. Soft tissue image guidance proved successful for all cases except one when single or more frequent replans were utilized in the difficult cases

  5. Risk of cervical intra-epithelial neoplasia and invasive cancer of the cervix in DES daughters

    H. Verloop (Herman); F.E. van Leeuwen (F.); T.J.M. Helmerhorst (Theo); I.M.C.M. de Kok (Inge); van Erp, E.J.M.; H.H. van Boven (Hester); M.A. Rookus (Matti)

    2017-01-01

    textabstractObjective: Women exposed to diethylstilbestrol in utero (DES) have an increased risk of clear cell adenocarcinoma (CCA) of the vagina and cervix, while their risk of non-CCA invasive cervical cancer is still unclear. Methods: We studied the risk of pre-cancerous (CIN) lesions and non-CCA

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

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

    2013-01-01

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

  7. A quality indicator to evaluate high-dose-rate intracavitary brachytherapy for cancer of the cervix

    Morales, Francisco Contreras; Soboll, Daniel Scheidegger

    2000-01-01

    The aim of this report is to prevent a simple quality indicator (QI) that can be promptly used to evaluate the high-dose-rate (HDR) intracavitary brachytherapy for the treatment of cancer of the cervix, and if necessary, to correct applicators' geometry before starting the treatment. We selected 51 HDR intracavitary applications of brachytherapy of patients with carcinoma of the cervix treated with 60 mm uterine tandem and small Fletcher colpostat, according to the Manchester method (dose prescription on point A). A QI was defined as the ratio between the volume of 100% isodose curve of the study insertion and the volume of the 100% isodose curve of an insertion considered to be ideal. The data obtained were distributed in three groups: the group with tandem placement slippage (67,5%), a group with colpostat placement slippage (21,9%), and a third group, considered normal (10,6%). Each group showed particular characteristics (p < 0.0001). QI can be the best auxiliary method to establish the error tolerance (%) allowed for HDR intracavitary brachytherapy. (author)

  8. Dependence of radiotherapeutic results on tumor size in patients with cervix uteri carcinoma

    Gabelov, A.A.; Zharinov, G.M.

    1981-01-01

    A method is suggested that permits specifying the primary tumor size on the basis of clinical examination of patients with cervix uteri carcinoma. The values of tumor size have been correlated with long-term results of concomitant radiotherapy in 1358 patients with cervix uteri carcinoma. The data obtained have shown that the primary tumor size is a factor that determines to a large extent radiotherapeutic results in patients with cervix uteri carcinoma. The specification of tumor size values makes it possible to considerably lessen prognostic uncertainty of present-day staging classifications. The structure of radiotherapeutic failures also turned out to be closely associated with the primary tumor size

  9. Prognostic significance of pretherapeutic and therapeutic factors in patients with advanced cancer of the uterine cervix treated with radical radiotherapy alone

    Karolewski, K.; Korzeniowski, S.; Urbanski, K.; Kojs, Z. [Centre of Oncology, Maia Sklodowska-Curie Memorial Inst., Krakow (Poland); Sokolowski, A. [Dept. of Statistics, Cracow Univ. of Economics (Poland)

    1999-11-01

    The prognostic importance of various pretherapeutic and therapeutic factors was analysed in a group of 413 cervical cancer patients with stage IIB (183 pts) and IIIB (230 pts) treated with radical radiotherapy, which consisted of external irradiation and intracavitary brachytherapy. Univariate analysis of pretherapeutic factors revealed the prognostic significance of patient age, history of abortion, stage, haemoglobin and hematocrit levels. Five-year overall survival rate in stage IIB patients was 51% in stage IIIB 40% and the respective rates for local control at each stage were 61%, and 46%. Univariate analysis of therapeutic factors showed that survival and local control rates increased with the dose, but a significant difference was found only in the case of a paracentral (point A) dose. In a multivariate analysis only patient age, abortions, and clinical stage appeared to have a significant and independent impact on survival. Linear regression analysis results indicated that prolongation of treatment time between 33 and 108 days caused a loss of local control of 0.36% per day. (orig.)

  10. Cancer of the cervix - from bleak past to bright future; a review, with an emphasis on cancer of the cervix in malaysia.

    Nor Hayati, Othman

    2003-01-01

    Cancer of the cervix has the potential to be eradicated since the initiating cause is known. There was not much known about this cancer until the time of the Renaissance. In Malaysia, it is the second most common cancer among females after breast cancer. The strategies on prevention in this country are still not optimal. This article highlights the problems and also discusses the pathogenesis of this disease. The key to prevention is screening and the future is the era of molecular pap smear.

  11. Impact of viral E2-gene status on outcome after radiotherapy for patients with human papillomavirus 16-positive cancer of the uterine cervix

    Lindel, Katja; Villiers, Ethel-Michele de; Burri, Philipp; Studer, Ueli; Altermatt, Hans J.; Greiner, Richard H.; Gruber, Guenther

    2006-01-01

    Purpose: Integration of high-risk papillomavirus DNA has been considered an important step in oncogenic progression to cervical carcinoma. Disruption of the human papillomavirus (HPV) genome within the E2 gene is frequently a consequence. This study investigated the influence of episomal viral DNA on outcome in patients with advanced cervical cancer treated with primary radiotherapy. Methods and Materials: Paraffin-embedded biopsies of 82 women with locally advanced cervical cancer could be analyzed for HPV infection by multiplex polymerase chain reaction (PCR) by use of SPF1/2 primers. E2-gene intactness of HPV-16-positive samples was analyzed in 3 separate amplification reactions by use of the E2A, E2B, E2C primers. Statistical analyses (Kaplan-Meier method; log-rank test) were performed for overall survival (OS), disease-free survival (DFS), local progression-free survival (LPFS), and distant metastases-free survival (DMFS). Results: Sixty-one (75%) of 82 carcinomas were HPV positive, 44 of them for HPV-16 (72%). Seventeen of the 44 HPV-16-positive tumors (39%) had an intact E2 gene. Patients with a HPV-16-positive tumor and an intact E2 gene showed a trend for a better DFS (58% vs. 38%, p = 0.06) compared with those with a disrupted E2 gene. A nonsignificant difference occurred regarding OS (87% vs. 66%, p = 0.16) and DMFS (57% vs. 48%, p = 0.15). Conclusion: E2-gene status may be a promising new target, but more studies are required to elucidate the effect of the viral E2 gene on outcome after radiotherapy in HPV-positive tumors

  12. Radiation-induced changes in cell proliferation kinetics in uterine cervix cancer

    Siracka, E; Siracky, J; Pappova, N [Slovenska Akademia Vied, Bratislava (Czechoslovakia). Cancer Research Inst.; Schreiner, P [Komenskeho Univ., Bratislava (Czechoslovakia). Chair of Oncology and Radiology

    1979-06-01

    In vitro double labeling autoradiography for measuring the labeling index, duration of S phase and potential doubling time has been used to assess the effect of a single and fractionated test dose of irradiation in uterine cervix cancer applied in 21 patients. Tumor-labeling index fell significantly in those tumors which had a high labeling index before irradiation, and these cases were found later to exhibit a good radiation response. Duration of S phase which ranged between 9 and 27 hours prior to irradiation was increased. Differences between the potential doubling time and the actual doubling time suggest a massive cell loss in tumors which were, for the most part, of exophytic type. Fractionated irradiation provides more reliable informations than a single dose and is useful for investigation of dynamic changes in the kinetics of an asynchronous cell population.

  13. Effect of blood transfusion during radiotherapy on the immune function of patients with cancer of the uterine cervix: role of interleukin-10

    Santin, Alessandro D.; Bellone, Stefania; Palmieri, Michela; Bossini, Barbara; Dunn, Donna; Roman, Juan J.; Pecorelli, Sergio; Cannon, Martin; Parham, Groesbeck P.

    2002-01-01

    Purpose: To analyze prospectively the effects of blood transfusion administered during radiotherapy (RT) on the immune function of patients with locally advanced cervical cancer. Methods and Materials: In a total of 15 patients, 7 transfused and 8 untransfused, lymphocyte populations, including CD3+, CD4+, and CD8+ T-cell subsets, B cells (CD19+), and natural killer (NK) cells (CD56+, CD16+, CD3-) were studied before (i.e., time 0), during (i.e., times 1 and 2), and after (i.e., time 3) therapy. Expression of the early (CD25) and late (HLA-DR) activation markers on CD3+ T cells, the intracellular levels of perforin in CD8+ and CD56+ cells, and interferon (IFN)-γ, interleukin (IL)-2, and IL-4 in CD4+ and CD8+ T cells were also measured. NK cell cytotoxicity against the NK-sensitive target K-562 cells and CD8+ T-cell-directed cytotoxicity against OKT3 hybridoma cells were also assessed. Finally, the plasma levels of the immunoregulatory cytokine IL-10 were analyzed by enzyme-linked immunosorbent assay. Results: The mean absolute number of all lymphocyte subsets compared with pretreatment levels decreased significantly during RT of both transfused and untransfused patients (p>0.001), with no detectable differences between the two groups in terms of total lymphocytes or relative numbers of CD3+ and CD4+ T cells, CD56+ NK cells, or CD19+ B cells. In contrast, concomitant with an inversion of the CD4/CD8 ratio, a significant increase in the number of CD8+ T cells at time 2 and CD3+ T cells, CD8+ T cells, and NK cells at time 3 was found in the transfused patients compared with the untransfused group. The percentages of CD25+/CD3+ T cells and HLA-DR+/CD3+ T cells increased during RT of the untransfused patients, but CD3+ T cells showed decreased CD25 expression and increased HLA-DR expression in the transfused group. An increase of CD8+ IFN-γ+ T cells with a concomitant decrease in CD8+ IL-2+ T cells was found in the transfused vs. untransfused group, and no differences

  14. Cervical Cancer in Women with Unhealthy Cervix in a Rural ...

    Mubeen

    women with grossly unhealthy cervix in a rural population and to get an overview of ... to be implemented with immediate effect to early diagnose cases to decrease the ... hygiene and early marriage are closely related to the ... and incidence of cervicitis is high. .... other factors such as smoking, diet, oral contraceptives,.

  15. Clinical experience of Scheriproct suppository to rectal hemorrhage following radiotherapy for cancer of the cervix uteri

    Kasamatsu, Tatsuhiro

    1977-01-01

    Scheriproct suppository was used in 25 cases of radiation rectal hemorrhage induced after a little while from irradiation to the patients with cancer of the cervix uteri. As to the stage of cancer of the cervix uteri at the first administration of this drug, the first stage was 2 cases, the second stage, 10, and third stage, 13. The age of the patients ranged from 30 to 70 years old. The administration to severe cases was performed 1-2 times per a day, and, when severe cases were improved, the administration was performed once per a day. When the stage of disease was improved further, this drug was used only for hemorrhage. With respect to the degree of hemorrhage when the administration started, 17 cases did not induce anemia (+), and 8 cases needed to be administered iron (++). As a result of administration of this drug, 20 cases showed decrease of the amount of hemorrhage, 4 cases did not show any change, and one case showed aggravation. In 17 cases of (+), 14 cases showed decrease of hemorrhage, 2 cases showed no change, and one case showed aggravation. In 8 cases of (++), 6 cases showed decrease of hemorrhage, and 2 cases were unchanged. 11 cases showed decrease of hemorrhage within 3 months after the administration, 7 cases, within 3 to 6 months, 1 case, within 6 to 9 months, and 1 case, within 9 to 12 months. One case of aggravation changed from (+) to (++) after five months of the administration, but further aggravation was not recognized. (Kanao, N.)

  16. Long-term performance of interstial fluid pressure and hypoxia as prognostic factors in cervix cancer

    Fyles, Anthony; Milosevic, Michael; Pintilie, Melania; Syed, Ami; Levin, Wilf; Manchul, Lee; Hill, Richard P.

    2006-01-01

    Objectives: Hypoxia and high interstitial fluid pressure (IFP) have been shown to independently predict for nodal and distant metastases, as well as survival, in patients with cervix cancer. Using data from our prospective trial, we updated a cohort of patients treated with definitive radiation alone without chemotherapy, to assess the long-term prognostic impact of these microenvironmental features. Methods: Between April 1994 and January 1999, 107 eligible patients with cervix cancer were entered into a prospective study of tumor oxygenation and IFP prior to primary radiation therapy. Oxygenation data are presented as the hypoxic proportion, defined as the percentage of pO 2 readings 5 ). Patients with HP 5 values >50% were considered to have hypoxic tumors. IFP is presented in mm Hg, divided into high and low IFP groups by the median value. Patients ranged in age from 23 to 78 years with a mean of 53 years. The maximum tumor size ranged from 2 to 10 cm, with a median diameter of 5 cm. FIGO stage was IB in 28 patients, IIA in 4, IIB in 42 and IIIB in 33 patients. Twenty-two patients (21%) had evidence of pelvic lymph node involvement on staging CT abdomen/pelvis or MR pelvis. HP 5 ranged from 0% to 99% with a median of 48%. IFP ranged from -3 to 48 mm Hg (median 19 mm Hg). Median follow-up was 6.7 years (range 0.9-10.6). Results: Disease-free survival (DFS) at 5 years was 50%. Five year DFS was 42% for patients with hypoxic tumors (HP 5 > 50%), and 58% in patients with oxygenated tumors (HR 1.01 per %, p = 0.05). DFS at 5 years was 42% for patients with interstitial hypertension (IFP >19 mm Hg), and 63% in patients with IFP ≤19 mm Hg (HR 1.05 per mm Hg, p = 0.001). In a multivariate analysis only tumor size (HR 1.2, p = 0.009) pelvic nodal metastases (HR 3.3, p = 0.0004) and IFP (HR 1.06, p = 0.0005) were predictive of DFS. Because an interaction between nodal status and oxygenation was observed (p = 0.03), further analysis indicated a borderline significant

  17. Dependence of early therapy results and complications on radiation dose values and their fractionation in pre-operative ''afterloading'' technique brachyradiotherapy applied to cervix uteri carcinoma patients

    Kaminska, G.; Kawczynska, M.

    1984-01-01

    The ''afterloading'' technique with use of Curietron (41 cases) or Selectron (43 cases) apparatus was applied in 83 cervix uteri carcinoma patients in phase 1b (79 cases) and 2a (4 cases). The Wertheim-Magis operation was performed after several weeks. Post-operative histologic investigation showed complete destruction of the tumour in 72% cases; persistent cancer cells in cervix uteri were stated in 11 patients (13%), while lymphatic node metastasis was seen in 14 patients (17%). Supplementary teleradiotherapy was performed in those cases. 39 patients (95%) of the 41 observed during 3 years survived without any cancer symptoms. No explicit relationship between dose administered to vaginal disc and cancer persistence frequency in the cervix uteri was stated. However, such relationship was stated for the dose in point A. In the group of 19 patients who received point A dose of the least 6000 rads, with average TDF value of 135, presence of cancer cells in cervix uteri was not stated in any of the cases. In 7 patients (17%) observed for over 3 years light and medium heavy postradiation complications were stated; in that 5 rectum side complications were stated in patients additionally irradiated from external fields, where the dose absorbed by rectum wall exceeded 8000 rads, with TDF - 150. No complications were observed when the dose was less than 5000 rads and TDF below 100. 16 refs., 1 fig. (author)

  18. Can reduction of uncertainties in cervix cancer brachytherapy potentially improve clinical outcome?

    Nesvacil, Nicole; Tanderup, Kari; Lindegaard, Jacob C

    2016-01-01

    AIM: The aim of this study was to quantify the impact of different types and magnitudes of dosimetric uncertainties in cervix cancer brachytherapy (BT) on tumour control probability (TCP) and normal tissue complication probability (NTCP) curves. MATERIALS AND METHODS: A dose-response simulation...

  19. Cancer of the cervix in Ilorin, Nigeria | Ijaiya | West African Journal of ...

    Objective: The purpose of this study is to review our experience with carcinoma of the cervix in Ilorin, Nigeria. Method: From 1st January 1990 to 31st December 1999, a total of 169 cases of invasive cervical cancer were seen at the Department of Obstetrics and Gynaecology of the University of Ilorin Teaching Hospital, Ilorin ...

  20. The results of isotope renography and intravenous pyelography in 420 patients with carcinoma of the uterine cervix

    Leodolter, S.; Philipp, K.; Szalay, S.

    1979-01-01

    A group of women with carcinoma of the cervix was studied by renography and i.v. pyelography. The incidence of renal and urinary tract disorders detected by these tests increased as did the stage of the disease, being 17.1% with Stage I carcinoma of the cervix, 27.8% with Stage II carcinoma of the cervix, 47% with Stage III carcinoma of the cervix, and 83.3% in Stage IV carcinoma of the cervix. In patients with Stage I and Stage II carcinoma of the cervix, those selected for radiotherapy had twice the incidence of abnormal renograms as those selected for surgery. This difference probably reflected a higher incidence of medical disorders affecting renal and urinary tract function in those considered unfit for surgery. We believe that renograms should be used routinely as a screening test in patients with carcinoma of the cervix. (orig.) [de

  1. Prognostic Significance of Pre-treatment Serum C-Reactive Protein Level in Patients with Adenocarcinoma of the Uterine Cervix.

    Bodner-Adler, Barbara; Kimberger, Oliver; Schneidinger, Cora; Kölbl, Heinz; Bodner, Klaus

    2016-09-01

    To evaluate pre-treatment serum C-reactive protein (CRP) level as a prognostic parameter in patients with adenocarcinoma of the uterine cervix. Pre-treatment CRP levels were analyzed to determine potential associations with clinicopathological parameters and to assess prognostic value in 46 patients with sole adenocarcinoma of the uterine cervix. The mean (±SD) pre-treatment serum CRP level was 5.82 (7.21) mg/l. Serum CRP concentration significantly correlated positively with age at diagnosis (p=0.001), lymphovascular space invasion (p=0.0026), recurrent disease (p=0.0001) and International Federation of Gynecology and Obstetrics (FIGO) stage (p=0.0002). In multivariate Cox regression models with age, FIGO stage, histological grade and lymph node status, elevated CRP and cancer antigen 125 levels were associated with shortened survival (pcervix. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. CLINICOPATHOLOGICAL STUDY OF CARCINOMA CERVIX IN A TERTIARY CARE CENTRE

    Kartheek Botta Venkata Satya

    2017-12-01

    Full Text Available BACKGROUND Cancer cervix is the second most commonly-diagnosed cancer among women worldwide. The aim of the study is to evaluate the histopathological diagnosis of cancer cervix and to determine the incidence of the various types of cancerous lesions. MATERIALS AND METHODS It was a prospective study in the Department of Pathology, Andhra Medical College/King George Hospital over a period of one year. 152 women with carcinoma cervix were included in the study. RESULTS 152 cases of carcinoma of cervix were in the age group of 28-76 years. The mean age of the patients with carcinoma cervix is 52.97. Histologically, Large Cell Non-Keratinising Squamous Cell Carcinoma (LCNKSCC constituted the majority of carcinoma cervix cases, i.e. 134 cases (88.15%. 3 (1.97% cases of adenocarcinoma of cervix were diagnosed in the present study. Majority of cases of carcinoma cervix were in stage III, i.e. 64 cases (64%, followed by stage II in 24 cases (24% and stage IB in 8 cases (8%. CONCLUSION Large Cell Non-Keratinising Squamous Cell Carcinoma (LCNKSCC is the most common histological type of carcinoma cervix. A relatively large proportion of patients presented in stages IIIA and IIIB. There is a need to reinforce the early detection of carcinoma cervix and its precursor lesions, especially in developing countries.

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

    Hong, J.-H.; Tsai, C.-S.; Lai, C.-H.; Chang, T.-C.; Wang, C.-C.; Chou, H.-H.; Lee, Steve P.; Lee, C.-C.; Tang, Simon G.; Hsueh Swei

    2005-01-01

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

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

    Yokoyama, Takashi; Beppu, Michiko; Kawakami, Yousuke; Nogawa, Takayoshi; Chiba, Take; Hiura, Masamichi

    2000-01-01

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

  5. Magnetic Resonance Imaging-Guided Intracavitary Brachytherapy for Cancer of the Cervix

    Zwahlen, Daniel; Jezioranski, John; Chan, Philip; Haider, Masoom A.; Cho, Young-Bin; Yeung, Ivan; Levin, Wilfred; Manchul, Lee; Fyles, Anthony; Milosevic, Michael

    2009-01-01

    Purpose: To determine the feasibility and benefits of optimized magnetic resonance imaging (MRI)-guided brachytherapy (BT) for cancer of the cervix. Methods and Materials: A total of 20 patients with International Federation of Gynecology and Obstetrics Stage IB-IV cervical cancer had an MRI-compatible intrauterine BT applicator inserted after external beam radiotherapy. MRI scans were acquired, and the gross tumor volume at diagnosis and at BT, the high-risk (HR) and intermediate-risk clinical target volume (CTV), and rectal, sigmoid, and bladder walls were delineated. Pulsed-dose-rate BT was planned and delivered in a conventional manner. Optimized MRI-based plans were developed and compared with the conventional plans. Results: The HR CTV and intermediate-risk CTV were adequately treated (the percentage of volume treated to ≥100% of the intended dose was >95%) in 70% and 85% of the patients with the conventional plans, respectively, and in 75% and 95% of the patients with the optimized plans, respectively. The minimal dose to the contiguous 2 cm 3 of the rectal, sigmoid, and bladder wall volume was 16 ± 6.2, 25 ± 8.7, and 31 ± 9.2 Gy, respectively. With MRI-guided BT optimization, it was possible to maintain coverage of the HR-CTV and reduce the dose to the normal tissues, especially in patients with small tumors at BT. In these patients, the HR percentage of volume treated to ≥100% of the intended dose approached 100% in all cases, and the minimal dose to the contiguous 2-cm 3 of the rectum, sigmoid, and bladder was 12-32% less than with conventional BT planning. Conclusion: MRI-based BT for cervical cancer has the potential to optimize primary tumor dosimetry and reduce the dose to critical normal tissues, particularly in patients with small tumors.

  6. Angiogenesis of cancer of the cervix. Contrast-enhanced dynamic MRT, histological quantification of capillary density and lymph system infiltration

    Hawighorst, H.; Knoop, M.V.; Zuna, I.; Schoenberg, S.O.; Essig, M.; Hoffmann, U.; Brix, G.; Kaick, G. van; Knapstein, P.G.; Weikel, W.; Schaeffer, U.

    1998-01-01

    Purpose: It was the aim of this project to examine (i) the relationships between contrastenhanced dynamic MR imaging derived characteristics and histologic microvessel density counts - a recognized surrogate of tumor angiogenesis - from tumors in patients with primary or recurrent cancer of the uterine cervix, and (ii) to correlate these parameters with lymphatic involvement (i.e. lymphatic channels) to assess tumorbiological aggressiveness in terms of lymphatic spread. Results: Pharmacokinetic MR imaging derived parameters (A, k 21 ) showed a weak but signifikant (p 21 compared with histologic microvessel density, resulting in a significantly (p [de

  7. Effect of quercetin on radiosensitivity of human uterine cervix cancer HeLa cells

    Liang Xiaofang; Hong Chengjiao; Zhang Baoguo

    2009-01-01

    In order to investigate the effects of Quercetin on radiosensitivity of human Uterine Cervix Cancer HeLa cells, MTT assay and clonogenic assay were performed to evaluate the cytotoxicity of Quercetin on the cells. Clonogenic assay was used to observe its effects on the radiosensitivity of the cells. MTT result shows that the inhibition of Quercetin on the cells is in the dose-dependent and time-dependent. And the clonogenic assay result shows that the effect of Quercetin on HeLa cells can be divided into two parts, one for the inhibition of HeLa cells and another for the induction of HeLa cell death. The other clonogenic assay result also shows Quercetin can decrease clonogenic survival rate of HeLa cells exposed to X rays. The study shows Quercetin might enhance the radiosensitivity of the HeLa cell line. And it may provide a useful evaluation to combination of ionizing radiation and Quercetin for cancer patients. (authors)

  8. Studies on MRI diagnostic accuracy of invasion to body muscular layer and cervix of endometrial cancer

    Takemoto, Yumi; Fujiyoshi, Keizou; Takemoto, Shuji; Kawano, Kouichirou; Ohta, Shunichirou; Murakami, Fumihiro; Komai, Kan; Ushijima, Kimio; Kamura, Toshiharu

    2008-01-01

    This study was conducted to know usefulness of preoperative MRI to detect invasions of endometrial cancer to uterine body muscular layer and cervix. Subjects were 132 patients (median age of 57 y, pre- and post-menopause, 11.2 and 78.8%, respectively) with the cancer at stage I (66 cases) and >II in authors' facility, who had undergone the preoperative MRI with 1.5T Siemens machine by imaging with T1 and T2 weighted, Gd-enhanced T1 weighted, dynamic study and STIR. Imaging findings were compared with histopathological ones to assess the accuracy of imaging diagnosis. Positive predictive accuracy for muscular invasion was found to be as high as 95.5% and negative one, as low as 29.5%: especially, in pre-menopause group, tendency of underestimation for the invasion was thought notable. In contrast, negative accuracy was found low for cervical invasion and positive one, high: overestimation was possibly occurring. Thus, MRI diagnosis of those invasions should be seriously judged with careful consideration of menopause state. (R.T.)

  9. FDG-PET imaging for the assessment of physiologic volume response during radiotherapy in cervix cancer

    Lin, Lilie L.; Yang Zhiyun; Mutic, Sasa; Miller, Tom R.; Grigsby, Perry W.

    2006-01-01

    Purpose: To evaluate the physiologic tumor volume response during treatment in cervical cancer using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Patients and Methods: This was a prospective study of 32 patients. Physiologic tumor volume in cubic centimeters was determined from the FDG-PET images using the 40% threshold method. Results: The mean pretreatment tumor volume was 102 cm 3 . The mean volume by clinical Stages I, II, and III were 54, 79, and 176 cm 3 , respectively. After 19.8 Gy external irradiation to the pelvis, the reduction in tumor volume was 29% (72 cm 3 ). An additional 13 Gy from high-dose-rate (HDR) brachytherapy reduced the mean volume to 15.4 cm 3 , and this was subsequently reduced to 8.6 cm 3 with 13 Gy additional HDR brachytherapy (26 Gy, HDR). Four patients had physiologic FDG uptake in the cervix at 3 months after the completion of therapy. The mean time to the 50% reduction in physiologic tumor volume was 19.9 days and after combined external irradiation and HDR to 24.9 Gy. Conclusion: These results indicate that physiologic tumor volume determination by FDG-PET is feasible and that a 50% physiologic tumor volume reduction occurs within 20 days of starting therapy

  10. The Cervix Cancer Research Network (CCRN: Increasing access to cancer clinical trials in low- and middle-income countries

    Gita eSuneja

    2015-02-01

    Full Text Available Introduction: The burden of cervical cancer is large and growing in developing countries, due in large part to limited access to screening services and lack of human papillomavirus (HPV vaccination. In spite of modern advances in diagnostic and therapeutic modalities, outcomes from cervical cancer have not markedly improved in recent years. Novel clinical trials are urgently needed to improve outcomes from cervical cancer worldwide. Methods: The Cervix Cancer Research Network (CCRN, a subsidiary of the Gynecologic Cancer InterGroup (GCIG, is a multi-national, multi-institutional consortium of physicians and scientists focused on improving cervical cancer outcomes worldwide by making cancer clinical trials available in low-, middle-, and high-income countries. Standard operating procedures for participation in CCRN include a pre-qualifying questionnaire to evaluate clinical activities and research infrastructure, followed by a site visit. Once a site is approved, they may choose to participate in one of four currently accruing clinical trials.Results: To date, 13 different CCRN site visits have been performed. Of these 13 sites visited, 10 have been approved as CCRN sites including Tata Memorial Hospital, India; Bangalore, India; Trivandrum, India; Ramathibodi, Thailand; Siriaj, Thailand; Pramongkutklao, Thailand; Ho Chi Minh, Vietnam; Blokhin Russian Cancer Research Center; the Hertzen Moscow Cancer Research Institute; and the Russian Scientific Center of Roentgenoradiology. The four currently accruing clinical trials are TACO, OUTBACK, INTERLACE, and SHAPE.Discussion: The CCRN has successfully enrolled 10 sites in developing countries to participate in four randomized clinical trials. The primary objectives are to provide novel therapeutics to regions with the greatest need and to improve the validity and generalizability of clinical trial results by enrolling a diverse sample of patients.

  11. Sensitivity of T lymphocytes to gamma rays in patients with cervix tumor

    Oueslati, R; Kdous, CH; Chouikha, M [Lab. Immunology, Hopital de Tunis, (Tunisia); Maalej, M; Kochbati, N [Service Radiotherapy, Institut Salah Azeiz, (Tunisia)

    1995-10-01

    In this work we studied the effect of radiotherapy on normal cells in patients with cervix tumors treated only by gamma rays. In our laboratory, after lymphocytes separation, we tested the proliferation system of these cells against the phytohemagglutinin and the concanavalin a antigens; at the same time we tested their sensitivity to lys the erythroid tumor cells line K 562. According to the clinical stage of disease the 25 patients studied were divided in two groups; group I composed of 14 patients at stage I and II proximal, received 50 Gy from a cesium 137 source, in intrauterine and in continuous treatment during 4 days. The second group composed of 11 patients at stage II distal and III, received 50 Gy from a cobalt-60 source in extra uterine, the treatment is fractioned in 3 to 5 times per week, at each time the patient received 1,5 - 3 Gy. To compare with their immunological status before treatment, until 1 month after total dose received, all of our patients lost transitory their capacity to prolifere in vitro. Although the capacity to lys the tumor cells is diminished in cancer patients, the drop of this activity is principally. The selective recuperation of T lymphocytes stimulated by concanavalin A is also observed. 3 figs., 2 tabs.

  12. Sensitivity of T lymphocytes to gamma rays in patients with cervix tumor

    Oueslati, R.; Kdous, CH.; Chouikha, M.; Maalej, M.; Kochbati, N.

    1995-01-01

    In this work we studied the effect of radiotherapy on normal cells in patients with cervix tumors treated only by gamma rays. In our laboratory, after lymphocytes separation, we tested the proliferation system of these cells against the phytohemagglutinin and the concanavalin a antigens; at the same time we tested their sensitivity to lys the erythroid tumor cells line K 562. According to the clinical stage of disease the 25 patients studied were divided in two groups; group I composed of 14 patients at stage I and II proximal, received 50 Gy from a cesium 137 source, in intrauterine and in continuous treatment during 4 days. The second group composed of 11 patients at stage II distal and III, received 50 Gy from a cobalt-60 source in extra uterine, the treatment is fractioned in 3 to 5 times per week, at each time the patient received 1,5 - 3 Gy. To compare with their immunological status before treatment, until 1 month after total dose received, all of our patients lost transitory their capacity to prolifere in vitro. Although the capacity to lys the tumor cells is diminished in cancer patients, the drop of this activity is principally. The selective recuperation of T lymphocytes stimulated by concanavalin A is also observed. 3 figs., 2 tabs

  13. Randomized Trial of Oral Misoprostol Treatment for Cervical Ripening Before Tandem Application in Cervix Cancer

    Cepni, Kimia; Gul, Sule; Cepni, Ismail; Gueralp, Onur; Sal, Veysel; Mayadagli, Alpaslan

    2011-01-01

    Purpose: To investigate the efficacy of oral misoprostol administered to facilitate tandem application to the cervix as a part of brachytherapy in patients with cervical cancer. Methods and Materials: Eighty patients with cervical cancer who had been planned to undergo brachytherapy at Dr. Luetfi Kirdar Kartal Training and Research Hospital were evaluated in a double-blind, prospective, randomized trial. Patients were divided randomly into two groups of 40 patients. The first and second groups received 400 μg of misoprostol orally and placebo, respectively, 3 h before tandem application. The two groups were compared in terms of age, diameter of tumor, parity, age at first intercourse, amount of bleeding and pain at first tandem application, length of endometrial cavity measured by hysterometer, and size of Hegar dilators used for cervical dilatation. Results: Of all cases, 63.6%, 16.3%, 10%, 6.3%, 2.5%, and 1.3% were Stage IIB, IIIB, IIIA, IVA, IIA and IIC, respectively. Mean (±SD) age (range) was 49.3 ± 13.1 (25-83) years and 56.6 ± 13.2 (30-78) years in the study and control groups, respectively (p = 0.015). Age at first intercourse, diameter of tumor, parity, amount of bleeding at first tandem application, and length of endometrial cavity measured by hysterometer were not significantly different between the two groups. Pain score was significantly higher in the control group (p < 0.001). Application was significantly easier in the study group compared with controls (p < 0.001). Average size of initial Hegar dilators used for cervical dilatation was significantly higher in the study group compared with controls (p = 0.017). Conclusion: Administration of misoprostol 400 μg orally for cervical ripening before tandem application facilitates the procedure, increases patient tolerability and comfort, and may decrease complication rates.

  14. Correlation between CT findings and prognosis of patients with carcinoma of the cervix

    Kubota, Susumu; Ohara, Kiyoshi; Okumura, Toshiyuki; Gomi, Hiromichi; Nakano, Takashi; Arai, Tatsuo.

    1986-01-01

    Ninety-one patients with carcinoma of the cervix received radical radiation therapy from May 1981 through August 1983 at NIRS hospital. The correlation between eight CT findings and the prognosis was analysed in 75 patients, performed CT scan within 15 days form the admision. Among these CT findings, area of uterine cervix correlates well with recurrence, and enlargement of para-aortic lymph nodes showed the strong correlation between metastasis. We also analized these data by a multivariate analytical method (quantification method II). There exists a correlation between the prognosis and the score of quantification method II, and this score will be a good index of the prognosis of patients with carcinoma of the cervix. (author)

  15. Impact of organ shape variations on margin concepts for cervix cancer ART.

    Seppenwoolde, Yvette; Stock, Markus; Buschmann, Martin; Georg, Dietmar; Bauer-Novotny, Kwei-Yuang; Pötter, Richard; Georg, Petra

    2016-09-01

    Target and organ movement motivate adaptive radiotherapy for cervix cancer patients. We investigated the dosimetric impact of margin concepts with different levels of complexity on both organ at risk (OAR) sparing and PTV coverage. Weekly CT and daily CBCT scans were delineated for 10 patients. The dosimetric impact of organ shape variations were evaluated for four (isotropic) margin concepts: two static PTVs (PTV 6mm and PTV 15mm ), a PTV based on ITV of the planning CT and CBCTs of the first treatment week (PTV ART ITV ) and an adaptive PTV based on a library approach (PTV ART Library ). Using static concepts, OAR doses increased with large margins, while smaller margins compromised target coverage. ART PTVs resulted in comparable target coverage and better sparing of bladder (V40Gy: 15% and 7% less), rectum (V40Gy: 18 and 6cc less) and bowel (V40Gy: 106 and 15cc less) compared to PTV 15mm . Target coverage evaluation showed that for elective fields a static 5mm margin sufficed. PTV ART Library achieved the best dosimetric results. However when weighing clinical benefit against workload, ITV margins based on repetitive movement evaluation during the first week also provide improvements over static margin concepts. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Radiation therapy alone in stage III-B cancer of the uterine cervix - a 17-year experience in Southern Brazil

    Ferreira, Paulo R.F.; Braga-Filho, Aroldo; Barletta, Antonio; Ilha, Ligia A.

    1999-01-01

    Purpose: External irradiation followed by intracavitary therapy (EBIC) has been considered the standard treatment for stage III-B cancer of the uterine cervix. For different reasons, some patients are not suited for intracavitary therapy (ICT), and the treatment may be given entirely by external beam irradiation alone (EBRTA). The purpose of our study is to discuss treatment results and complications for patients undergoing EBIC or EBRTA. Methods and Materials: A retrospective study was carried out on 202 eligible patients with stage III-B cancer of the uterine cervix admitted for radiotherapy from 1980-1997. Ninety-three patients were able to receive EBIC (50 Gy, 8 MV RX whole pelvis followed by one session of 38-45 Gy ICT to point A). The remaining received EBRTA (50-70 Gy for 5-9 or more weeks). Median follow-up procedure was 18.5 months (range: 4-182) for all patients and 26 months (range 4-147) for the patients at risk. Results: The most frequent reason for precluding ICT was large residual tumor volume (32.1%). Ten-year overall survival rates, relapse free survival, and pelvic failure rate for the EBIC and EBRTA patients were, respectively, 22.5% x 15.6% (p = 0.0087), 23.5% x 14.8% (p = 0.005), and 51.6% x 68.8% (p = 0.005). However, when the same comparisons were performed with EBIC patients x EBRTA patients receiving a high dose schedule (60 Gy/6-8 wk to 70 Gy/7-9 wk), the results of the EBIC group remained higher, but the differences became insignificant: respectively, 22.5% x 18.9% (p = 0.17), 23.5% x 15.3% (p = 0.052), and 51.6% x 60.0% (p = 0.10). The distribution of complications was similar in both groups. Conclusions: We found that EBIC was the best treatment modality in our patients with stage III-B cancer of the uterine cervix, whereas for patients who were not candidates for ICT, EBRTA with a high dose schedule appears to be an efficient and safe alternative

  17. Brachytherapy in cervix cancers: techniques and concepts evolution

    Haie-Meder, C.; Crevoisier, R. de; Petrow, P.; Fromm, S.; Delapierre, M.; Albano, M.; Petit, C.; Briot, E.

    2003-01-01

    Brachytherapy plays an important role in the treatment of patients with cervical carcinoma. Technical modalities have evolved during the last years and have benefited from imaging modalities development, specially MRI. Imaging modalities contribute to a better knowledge of tumoral extension and critical organs. Ultrasound during brachytherapy has led to the almost complete eradication of uterine perforation. In the future, a more systematic use of systems allowing optimization may induce a better dose distribution in the tumor as well as in the critical organs. Recent data provided information in favor of a better analysis in the relative role of dose-rate, total dose and treated volume and their influence on the local control and complication incidence. Concomitant radio-chemotherapy represents a standard in the treatment of patients with tumoral size exceeding 4 cm. Some questions still remain: is concomitant chemotherapy of benefit during brachytherapy? Is there any place for complementary surgery, specially in patients with complete response after external irradiation with concomitant chemotherapy and brachytherapy? In order to answer the former question, a phase III randomized trial is going to start, with the Federation Nationale des Centres de Lutte Contre le Cancer as a promoter. (authors)

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

    Ngoma Twalib

    2008-07-01

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

  19. Metastatic Small Cell Carcinoma of the Breast from Cancer of the Uterine Cervix: A Case Report

    Beom Seok Kwak

    2018-01-01

    Full Text Available We report here on a case of 51-year-old woman with metastatic small cell carcinoma of the breast that came from her cancer of the uterine cervix. She underwent radical hysterectomy with bilateral salpingo-oophorectomy due to small cell carcinoma of the uterine cervix, and adjuvant radiotherapy was administered to the pelvis. Breast metastasis with a palpable mass then occurred 3 months after the primary surgery. Simple mastectomy and adjuvant chemotherapy were performed. She initially showed a good response to the therapy, yet she ultimately died of multiple metastases with a fulminating disease course. This is an extremely rare case, and only 1 similar case has been reported earlier, so we report on this case along with a review of the relevant literature.

  20. DCE-MRI of patient-derived xenograft models of uterine cervix carcinoma: associations with parameters of the tumor microenvironment

    Anette Hauge

    2017-11-01

    Full Text Available Abstract Background Abnormalities in the tumor microenvironment are associated with resistance to treatment, aggressive growth, and poor clinical outcome in patients with advanced cervical cancer. The potential of dynamic contrast-enhanced (DCE MRI to assess the microvascular density (MVD, interstitial fluid pressure (IFP, and hypoxic fraction of patient-derived cervical cancer xenografts was investigated in the present study. Methods Four patient-derived xenograft (PDX models of squamous cell carcinoma of the uterine cervix (BK-12, ED-15, HL-16, and LA-19 were subjected to Gd-DOTA-based DCE-MRI using a 7.05 T preclinical scanner. Parametric images of the volume transfer constant (K trans and the fractional distribution volume (v e of the contrast agent were produced by pharmacokinetic analyses utilizing the standard Tofts model. Whole tumor median values of the DCE-MRI parameters were compared with MVD and the fraction of hypoxic tumor tissue, as determined histologically, and IFP, as measured with a Millar catheter. Results Both on the PDX model level and the single tumor level, a significant inverse correlation was found between K trans and hypoxic fraction. The extent of hypoxia was also associated with the fraction of voxels with unphysiological v e values (v e > 1.0. None of the DCE-MRI parameters were related to MVD or IFP. Conclusions DCE-MRI may provide valuable information on the hypoxic fraction of squamous cell carcinoma of the uterine cervix, and thereby facilitate individualized patient management.

  1. Dosimetric evaluation of a combination of brachytherapy applicators for uterine cervix cancer with involvement of the distal vagina

    Guimaraes, Roger Guilherme Rodrigues

    2009-01-01

    Objective: To evaluate an alternative brachytherapy technique for uterine cervix cancer involving the distal vagina, without increasing the risk of toxicity. Materials And Methods: Theoretical study comparing three different high-dose rate intracavitary brachytherapy applicators: intrauterine tandem and vaginal cylinder (TC); tandem/ring applicator combined with vaginal cylinder (TR+C); and a virtual applicator combining both the tandem/ring and vaginal cylinder in a single device (TRC). Prescribed doses were 7 Gy at point A, and 5 Gy on the surface or at a 5 mm depth of the vaginal mucosa. Doses delivered to the rectum, bladder and sigmoid colon were kept below the tolerance limits. Volumes covered by the isodoses, respectively, 50% (V50), 100% (V100), 150% (V150) and 200% (V200) were compared. Results: Both the combined TR+C and TRC presented a better dose distribution as compared with the TC applicator. The TR+C dose distribution was similar to the TRC dose, with V150 and V200 being about 50% higher for TR+C (within the cylinder). Conclusion: Combined TR+C in a two-time single application may represent an alternative therapy technique for patients affected by uterine cervix cancer involving the distal vagina. (author)

  2. SEXUALITY AND COUPLE COMMUNICATION IN WOMEN WITH CERVIX CANCER

    DENNYS DEL ROCÍO GARCÍA PADILLA

    2003-07-01

    Full Text Available The aim of this quasiexperimental research of single case with n replications was to evaluate a psychologicalintervention with emphasis on sexuality and marital communication for women diagnosed withcervical cancer under treatment. Four women patients of the Javeriano Oncology Centre participatedvoluntarily. The instrument was a semi-structured interview validate by experts judgement and wasapplied individually in order to collect relevant and pertinent data according to the objectives. Based onthe information from the interview special patient’s needs were detected which guided the selection ofthe intervention program contents. Intervention was applied and evaluated in different moments, as isrequired to decrease threatens to internal validity (Kazdin 2001. The intervention program consistedof three-session psycho-educational workshop with pre-post-test measures specially designed for eachoccasion. Evaluations were applied immediately after each session, 15 days after, 30 days after the lastsession. Results were presented graphically and in tables and were analysed descriptively without statisticsthrough categories derived from the answers. The intervention effectivity was demonstrated in positivechanges in each participant, especially in general information and beliefs; there were changes respect tosexuality favourable to couple relation, however some deficits in communication and sexual relationpersisted. Practical and theoretical implications were analysed in different moments during the research.

  3. The role of polymorphisms of genes repair pathway to the radiotoxicity in patients with cancer of the cervix; O papel dos polimorfismos de genes da via de reparo com a radiotoxidade em pacientes com cancer de colo uterino

    Carvalho, Ana Terra Silva

    2012-07-01

    Background: In Brazil, cervical cancer is the second most common among women. Radiation therapy is part of its interdisciplinary management, playing an important role in their loco regional control. The major challenge of modern medicine in radiotherapy is to develop predictive methods that can determine the level of radiosensitivity of the patient and the healthy surrounding tissue in order to individualize the prescribed radiation dose, to prevent severe side effects and promoting better local tumor control. This study evaluated the acute and chronic adverse effects on the skin, lower gastrointestinal tract and urinary tract of radiotherapy in 47 cervical cancer patients. Methods and Materials: Biological material was collected and DNA from peripheral blood was extracted of ali patients studied. The fragments of TP53 and ATM were amplified to be sequenced, to verify if there are any polymorphisms witch could be responsible to the radiosensitivity of the patients. Results and Discussion: In a univariate analysis, the variable age was strongly associated with a risk of acute toxicity skin (p=O,023). Patients that received a high dose of external beam radiation and patients who have undergone brachytherapy, showed a significantly higher incidence of chronic urinary tract toxicity (p=O,031) and (p=O,019), respectively. The exchange G>A in the position 5557 of the A TM gene was significantly associated with the risk of acute lower gastrointestinal tract (p=O,008). There wasn't association between the other TP53 polymorphisms analyzed and the frequency of side effects (p>O,05). Our data revealed that patients who evolved significant association presented death (p=O,019) with the increase of chronic skin radiossensitivity. Conclusions: These observations corroborate the importance of investigating the genetic profile to predict adverse side effects in cervical cancer patients undergoing radiotherapy. These genes have an important role in DNA repair pathways and

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

    Lim, Karen Siah Huey

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

  5. Biatrial Cardiac Metastases in a Patient with Uterine Cervix Malignant Melanoma

    Caglayan Geredeli

    2015-01-01

    Full Text Available Primary malignant melanomas of uterine cervix are quite rarely seen neoplasms, and long-life prognosis of patients with this disease is poor. Immunohistochemical methods and exclusion of other primary melanoma sites are used to confirm the diagnosis. As with other melanomas, cervix malignant melanomas may also cause cardiac metastases. Cardiac metastases are among rarely seen but more commonly encountered cases, compared to primary cardiac tumors. Here, we present a case of biatrial cardiac metastases in a 73-year-old patient with uterine cervix malignant melanomas. The patient underwent echocardiography, cardiac magnetic resonance imaging, and computed tomography. Our report shows the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but for a better anatomic definition and tissue characterization. Although the cases of malignant melanomas leading to multiple cardiac metastasis were reported in literature, the metastatic concurrence of malignant melanomas in both right and left atriums is quite rarely encountered as metastatic malignant melanomas. Also, another intriguing point in our case is that the primary lesion of our case was stemmed from uterine cervix, but not skin.

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

    Wolna, M.; Pisarski, T.; Kedzia, H.

    1993-01-01

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

  7. Dose specification and normal tissue reference points in the treatment of cancer cervix

    Ray, D.K.; Kumar, P.; Misra, D.K.; Das, R.; Kumar, A.; Maji, T.; Chaudhuri, P.; Sinha, T.P.

    2007-01-01

    Carcinoma of uterine cervix is one of the most common diseases among the women in India where radiotherapy is the mainstay of treatment. Most common practice of dose prescription point is the Manchester Point A. American Brachytherapy Society (ABS) recommends a point H equivalent to that used in the classical Manchester system. Many centre practices Madison point M as dose specification point which is 20 mm cephaled along the tandem from a line joining the mid dwell positions in the ovoids/ring and 20 mm lateral to the tandem. In the present study has compared the dose prescription points between Manchester Point A and Madison Point M for ring applicators and their implication in the assessment of rectal and bladder doses in patients of Carcinoma of uterine cervix

  8. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology

    Brenot-Rossi, I.

    2008-01-01

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid 99m Tc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

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

    Inoue, Takehiro; Inoue, Toshihiko; Suzuki, Takaichiro

    1983-01-01

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

  10. Phase I clinical trial of parenteral hydroxyurea in combination with pelvic and para-aortic external radiation and brachytherapy for patients with advanced squamous cell cancer of the uterine cervix

    Beitler, Jonathan J.; Anderson, Patrick; Haynes, Hilda; Sood, Brij; Fields, Abbi; Goldberg, Gary; Vikram, Bhadrasain; Runowicz, Carolyn D.; Wadler, Scott

    2002-01-01

    Purpose: Oral hydroxyurea (HU) is a potent radiation sensitizer, but in vitro studies have suggested that prolonged exposure to HU by way of continuous parenteral infusion would enhance clinical efficacy. The objective of this study was to determine the maximal tolerated dose and identify the toxicities of continuous infusion HU in combination with pelvic and para-aortic external beam radiotherapy (RT) and intrauterine brachytherapy in patients with locally advanced carcinoma of the uterine cervix. Methods: This Phase I study of concomitant RT was designed with an escalating dose schedule of HU administered by continuous infusion. HU was administered parenterally as a continuous infusion, 5 d/wk, during the first 21 days of external radiation, during the final 5 days of external beam RT, followed by another 5-day infusion schedule bracketing the single fraction of brachytherapy. The maximal tolerated dose was defined as the highest dose level at which 3 of 3 or 5 of 6 patients could be treated without dose-limiting toxicity. Results: At dose level 1 (0.25 mg/m 2 /min), 0 of 4 patients experienced Grade 4 toxicities and 2 patients experienced Grade 3 hematologic toxicities that were not considered dose-limiting. One of the first 4 patients at level 2 (0.375 mg/m 2 /min) had Grade 3 diarrhea, but the 3 subsequent patients tolerated the dose. At level 3 (0.5 mg/m 2 /min), 4 of 5 patients failed to complete therapy without a >7-day interruption in HU. Conclusions: The maximal tolerated dose of parenteral HU was 0.375 mg/m 2 /min when administered with concomitant RT. The most common toxicities were hematologic. A new trial, incorporating concurrent cisplatin, HU, and RT is planned

  11. Measurement of Rectal Radiation dose in the Patients with Uterine Cervix fencer using In Vivo Dosimetry(Diode Detector)

    Kim, Sung Kee; Kim, Wan Sun

    2004-01-01

    A rectum and a bladder should be carefully considered in order to decrease side effects when HDR patient of uterine cervix cancer. Generally speaking, the value of dosimeter at a rectum and a bladder only depends on the value of a planning equipment, while some analyses of the value of dosimetry at rectum with TLD has been reported Or the contrary, it is hardly to find a report with in vivo dosimetry(diode detector). On this thesis, we would like to suggest the following. When a patient of uterine cervix cancer is in therapy, it is helpful to put a diode detector inside of a rectum in order to measure the rectal dose Based upon the result of the dosimetry, the result can be used as basic data at decreasing side effects. Six patients of uterine cervix cancer(four with tandem and ovoid, one with cylinder, and the other one with tandem and cylinder) who had been irradiated with HDR. Ir-192 totally 28 times from February 2003 to June 2003. We irradiated twice in the same distant spots with anterior film and lateral film whenever we measured with a diode detector. Then we did planning and compared each film. The result of the measurement 4 patients with a diode detector is the following. The average and deviation from 3 patients with tandem and ovoid were 274±13.4 cGy, from 1 patient with tandem and ovoid were 126.1±7.2 cGy, from 1 patient with cylinder were 99.7±7.1 cGy, and from 1 patient with tandem and cylinder were 77.7±11.5 cGy. It is difficult to predict how the side effect of a rectum since the result of measurement with a diode detector depends on the state of a rectum. According to the result of the study, it is effective to use a TLD or an in vivo dosimetry and measure a rectum in order to consider the side effect. It is very necessary to decrease the amount of irradiation by controlling properly the duration of the irradiation and gauze packing, and by using shield equipment especially when side effects can be expected.

  12. Advanced Cancer Of The Cervix Coexisting With Multiple Fibroids In ...

    A case of a 47 year old nulliparous woman with advanced cervical cancer coexisting with uterine fibroid is presented. The nulliparity and the presence of Fibroids presented diagnostic challenges especially because epidemiologically the factors present are not commonly associated. Diagnosis was assisted by a thorough ...

  13. A novel method to quantify and compare anatomical shape: application in cervix cancer radiotherapy

    Oh, Seungjong; Jaffray, David; Cho, Young-Bin

    2014-06-01

    Adaptive radiation therapy (ART) had been proposed to restore dosimetric deficiencies during treatment delivery. In this paper, we developed a technique of Geometric reLocation for analyzing anatomical OBjects' Evolution (GLOBE) for a numerical model of tumor evolution under radiation therapy and characterized geometric changes of the target using GLOBE. A total of 174 clinical target volumes (CTVs) obtained from 32 cervical cancer patients were analyzed. GLOBE consists of three main steps; step (1) deforming a 3D surface object to a sphere by parametric active contour (PAC), step (2) sampling a deformed PAC on 642 nodes of icosahedron geodesic dome for reference frame, and step (3) unfolding 3D data to 2D plane for convenient visualization and analysis. The performance was evaluated with respect to (1) convergence of deformation (iteration number and computation time) and (2) accuracy of deformation (residual deformation). Based on deformation vectors from planning CTV to weekly CTVs, target specific (TS) margins were calculated on each sampled node of GLOBE and the systematic (Σ) and random (σ) variations of the vectors were calculated. Population based anisotropic (PBA) margins were generated using van Herk's margin recipe. GLOBE successfully modeled 152 CTVs from 28 patients. Fast convergence was observed for most cases (137/152) with the iteration number of 65 ± 74 (average ± STD) and the computation time of 13.7 ± 18.6 min. Residual deformation of PAC was 0.9 ± 0.7 mm and more than 97% was less than 3 mm. Margin analysis showed random nature of TS-margin. As a consequence, PBA-margins perform similarly to ISO-margins. For example, PBA-margins for 90% patients' coverage with 95% dose level is close to 13 mm ISO-margins in the aspect of target coverage and OAR sparing. GLOBE demonstrates a systematic analysis of tumor motion and deformation of patients with cervix cancer during radiation therapy and numerical modeling of PBA-margin on 642 locations of CTV

  14. The Creteil method of intracavitary brachytherapy for cancer of the cervix

    Pierquin, B.; Marinello, G.

    1981-01-01

    This system is based on a principle of direct proportionality between the dimensions of the uterine cervix and the length of the vaginal sources. The system defines a reference isodose of fixed value encompassing a target volume of constant anatomic structures. The target volume always contains the same anatomic structures, independent of the tumor extent. The technique for doing the application is based upon certain practical principles: - the use of a cervical-vaginal plastic mould with a semi-rigid uterine tandem; - the use of 192 Ir wires; - the same uniform linear exposure rate for each source used in the application; - a single application for each patient; - the source in the uterus and the sources in the vagina are left in place for the same time. The maximum total dose is 60 Gy, calculated at the reference isodose of 4 Gy/day, assuming a linear nominal exposure rate of 1 mR x h -1 x m 2 x cm -1 . This corresponds to an effective dose rate which varies between 8 and 16 Gy/day, when the actual linear exposure rate of the 192 Ir wires is taken into account. The cervical dose, calculated at the level of the mucosa, is approximately twice the reference dose. It depends upon the size of the cervix, being 2.1 times the reference dose when the cervix is greater than 4 cm in diameter and 2.6 times when the cervix is less than 2.5 cm in diameter. The vaginal dose, calculated at the ''Cap Sassal point'', on the anterior part of the rectum, is always less than the reference dose [fr

  15. Treatment of cancer of cervix stages IB1 and IB2 in the Hospital Calderon Guardia (2000-2003)

    Saenz, Oscar; Picans, Serafin

    2004-01-01

    The types of treatment applied in patients with stages of cancer of cervix IB1 and IB2, your evolution and prognosis were determined. Different methods of treatment were compared. It was a prospective descriptive and observational study of the patients of Servicio de Ginecologia Oncologica of the Hospital Calderon Guardia, San Jose, Costa Rica. It was carried out from August 2000 to November 2002. The study included all female patients with proved histological diagnosis of cervical cancer IB1 and IB2. All of them had pre-operative studies: plate of thorax, abdomen ultrasound, computerized axial tomography of pelvis and abdomen, at least received primary treatment (surgery) and the following monitoring. The statistical analysis was realized with chi-square evidences, through epi-info software. Of 24 patients only 19 got complete information. It was found a 22% of patients with positives adenopatias to level of histological study with a ganglionic compromise of 32% in general form, a 36% in the stages IB1 and a 25% in stages IB2. Of all the patients that presented ganglionic metastasis illness, did not get to show with the computerized axial tomography and it is concluded that TAC is a bad method for detection of the microscopic metastasis illness, or at least to 2 cm. None of the patients in stages IB1 presented relapse data in the observed period, founding a 100% of survival to 24 months. The patients in stages IB2 presented relapses, with a 75% of survival [es

  16. Possible role of glutathione in predicting radiotherapy response of cervix cancer

    Jadhav, Ganesh Krishna R.; Bhanumathi, Pullara; Devi, Pathirissery Uma; Seetharamaiah, Tattikonda; Vidyasagar, Mamudipudi S.; Rao, Kilari Koteshwer; Hospet, Chandrashekhar S.; Solomon, Johnson Gilbert R.

    1998-01-01

    Purpose: To see if changes in tumor/blood glutathione (GSH) levels after one fraction of radiotherapy can be correlated with the treatment response in patients with carcinoma of the uterine cervix. Methods and Materials: The study was done on 45 patients with squamous cell carcinoma of the uterine cervix, FIGO Stages IIB (17 patients) and IIIB (28 patients). Stage IIB patients received 35 Gy of cobalt-60 external radiotherapy (RT) in 16 fractions over 4 weeks with a concurrent high-dose-rate intracavitary dose of 8.5 Gy to point A once a week. Stage IIIB patients were given 45 Gy of RT in 20 fractions over 5 weeks, followed by two doses of intracavitary therapy once a week. Blood and tumor samples were collected before and after one dose of RT and GSH was estimated. Tumor response was assessed clinically at 1 month after treatment. Results: Glutathione levels in both blood and tumor showed a significant decrease after one fraction of RT, but the degree of decrease varied among patients. There was a good correlation between the extent of GSH decrease and the tumor response. All patients who had complete response (CR) (seven Stage IIB and eight Stage IIIB) showed ≥70% decrease in both tumor and blood GSH, while those who had <50% regression (NR) (five Stage IIB and 13 Stage IIIB) showed <50% decrease in GSH. The partial responders recorded an intermediate level (50-70%) of depletion in blood and tumor GSH. Conclusions: The results indicate that the changes in tumor/blood GSH levels after one fraction of RT could serve as an index of tumor response to therapy and may help in identifying radioresistant tumors, at least in the case of cervix carcinoma

  17. Spectropolarimetry biopsies of the cervix at an early cancer and dysplasia

    Yermolenko, S. B.; Peresunko, O. P.; Babechko, N. J.

    2015-11-01

    The analysis of the spectral anisotropic properties of layers of oncologic modified biological tissues with precancerous condition (CIN) and with cancer formation (G) of cervix according to linear dichroism determined in the wavelength range 300-800 nm was conducted. Comparison of results of animal testing of samples of biological samples oncologic modified human tissue was conducted, introduction of differentiation criterion spectropolarimetric precancerous condition and the stage cancer formation in the spectral band of 390-410 nm was proposed. Appropriate diagnostically important changes in the value ranges of linear dichroism at each stage of cancer formation (high- and low-grade dysplasia, high and low-grade adenocarcinoma) was determined. A differential method for diagnosis of epithelial cells in the above diseases was suggested.

  18. Cervical digital photography for screening of uterine cervix cancer and its precursor lesions in developing countries.

    Hillmann, Elise de Castro; Dos Reis, Ricardo; Monego, Heleusa; Appel, Márcia; Hammes, Luciano Serpa; Rivoire, Waldemar Augusto; Capp, Edison

    2013-07-01

    This study aims to evaluate and to compare the performance of cervical digital photography (CDP) to the visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI) methods for screening the uterine cervix cancer and its precursor lesions in developing countries. A cross-sectional study was performed in Brazil. 176 women were evaluated by VIA, VILI, CDP with acetic acid and CDP with Lugol's iodine. Kappa statistic was used to estimate the interobserver and intermethod agreement. Sensitivity, specificity and diagnostic accuracy of the four methods (VIA, VILI, CDP with acetic acid, CDP with Lugol's iodine) was calculated. Interobserver agreement for CDP with acetic acid was K = 0.441 and for CDP with Lugol's iodine was K = 0.533; intermethod agreement of VIA and CDP with acetic acid, K = 0.559; and of VILI and CDP with Lugol's iodine, K = 0.507. Sensitivity and specificity of CDP with acetic acid were 84.00 and 95.83 %, and of CDP with Lugol's iodine were 88.00 and 97.26 %, respectively. The diagnostic accuracy of CDP with acetic acid and CDP with Lugol's iodine was 92.78 and 94.90 %, respectively. This was the first study to assess the CDP with Lugol's iodine performance, which had similar performance to the CDP with acetic acid. CDP is considered a promising method for screening the uterine cervix cancer and its precursor lesions in developing countries.

  19. Cervix carcinomas: place of intensity-modulated radiotherapy; Les cancers du col uterin: place de la radiotherapie avec modulation d'intensite

    Barillot, I. [Centre Regional Universitaire de Cancerologie H.S.-Kaplan, Hopital Bretonneau, CHU de Tours, 37 - Tours (France); Universite Francois-Rabelais, 37 - Tours (France)

    2009-10-15

    While indications of modulated intensity radiation therapy (I.M.R.T.) are perfectly defined in head and neck and prostate cancer patients, this technique remains under evaluation for gynecologic tumours. The implementation of conformal three dimensional radiotherapy in the late 1990 has been the first important step for optimisation of treatment of cervix carcinomas, as it permitted a better target coverage with a significant reduction of the bladder dose. However, this technique often leads to an irradiation of a larger volume of rectum in locally advanced stages and could only spare a limited amount of intestine. I.R.M.T. is one of the optimisation methods potentially efficient for a better sparing of digestive tract during irradiation of cervix carcinomas. The aim of this literature review is to provide the arguments supporting this hypothesis, and to define the place of this technique for dose escalation. (authors)

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

    Kim, Eun Seog; Choi, Doo Ho [Soonchunhyang Univ. College of Medicine, Asan (Korea, Republic of); Huh, Seung Jae [Samsung Medical Center, Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-03-01

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

  1. A limited role for adjuvant radiotherapy after the Wertheim/Okabayashi radical hysterectomy for cervical cancer confined to the cervix

    van der Velden, J.; Samlal, R.; Schilthuis, M. S.; Gonzalez, D. G.; ten Kate, F. J.; Lammes, F. B.

    1999-01-01

    The indications for radiotherapy after radical hysterectomy for early stage cervical cancer are changing. In the past only tumor outside the cervix was considered an indication for radiotherapy. Today adjuvant radiotherapy is also considered for an "intermediate-risk" group with tumor confined to

  2. Total reference air kerma can accurately predict isodose surface volumes in cervix cancer brachytherapy. A multicenter study

    Nkiwane, Karen S; Andersen, Else; Champoudry, Jerome

    2017-01-01

    PURPOSE: To demonstrate that V60 Gy, V75 Gy, and V85 Gy isodose surface volumes can be accurately estimated from total reference air kerma (TRAK) in cervix cancer MRI-guided brachytherapy (BT). METHODS AND MATERIALS: 60 Gy, 75 Gy, and 85 Gy isodose surface volumes levels were obtained from treatm...

  3. Regulation of Inflammatory Pathways in Cancer and Infectious Disease of the Cervix

    Anthonio Adefuye

    2012-01-01

    Full Text Available Cervical cancer is one of the leading gynaecological malignancies worldwide. It is an infectious disease of the cervix, associated with human papillomavirus infection (HPV, infection with bacterial agents such as Chlamydia trachomatis and Neisseria gonorrhoea as well as human immunodeficiency virus (HIV. Furthermore, it is an AIDS-defining disease with an accelerated mortality in HIV-infected women with cervical cancer. With the introduction of robust vaccination strategies against HPV in the developed world, it is anticipated that the incidence of cervical cancer will decrease in the coming years. However, vaccination has limited benefit for women already infected with high-risk HPV, and alternative therapeutic intervention strategies are needed for these women. Many pathological disorders, including cervical cancer, are characterised by the exacerbated activation and maintenance of inflammatory pathways which are considered to be regulated by infectious agents. In cervical cancer, hyperactivation of these inflammatory pathways and regulation of immune infiltrate into tissues can potentially play a role not only in tumorigenesis but also in HIV infection. In this paper we will discuss the contribution of inflammatory pathways to cervical cancer progression and HIV infection and the role of HIV in cervical cancer progression.

  4. Regulation of Inflammatory Pathways in Cancer and Infectious Disease of the Cervix

    Adefuye, Anthonio; Sales, Kurt

    2012-01-01

    Cervical cancer is one of the leading gynaecological malignancies worldwide. It is an infectious disease of the cervix, associated with human papillomavirus infection (HPV), infection with bacterial agents such as Chlamydia trachomatis and Neisseria gonorrhoea as well as human immunodeficiency virus (HIV). Furthermore, it is an AIDS-defining disease with an accelerated mortality in HIV-infected women with cervical cancer. With the introduction of robust vaccination strategies against HPV in the developed world, it is anticipated that the incidence of cervical cancer will decrease in the coming years. However, vaccination has limited benefit for women already infected with high-risk HPV, and alternative therapeutic intervention strategies are needed for these women. Many pathological disorders, including cervical cancer, are characterised by the exacerbated activation and maintenance of inflammatory pathways which are considered to be regulated by infectious agents. In cervical cancer, hyperactivation of these inflammatory pathways and regulation of immune infiltrate into tissues can potentially play a role not only in tumorigenesis but also in HIV infection. In this paper we will discuss the contribution of inflammatory pathways to cervical cancer progression and HIV infection and the role of HIV in cervical cancer progression. PMID:24278714

  5. Prediction of late rectal complication following high-dose-rate intracavitary brachytherapy in cancer of the uterine cervix

    Lee, Jeung Eun; Huh, Seung Jae; Park, Won; Lim, Do Hoon; Ahn, Yong Chan

    2003-01-01

    Although high-dose-rate intracavitary radiotherapy (HDR ICR) has been used in the treatment of cervical cancer, the potential for increased risk of late complication, most commonly in the rectum, is a major concern. We have previously reported on 136 patients treated with HDR brachytherapy between 1995 and 1999. The purpose of this study is to upgrade the previous data and confirm the correlation between late rectal complication and rectal dose in cervix cancer patients treated with HDR ICR. A retrospective analysis was performed for 222 patients with cervix cancer who were treated for curative intent with extemal beam radiotherapy (EBRT) and HDR ICR from July 1995 to December 2001. The median dose of EBRT was 50.4 (30.6-56.4) Gy with a daily fraction size 1.8 Gy. A total of six fractions of HDR ICR were given twice weekly with fraction size of 4 (3-5.5) Gy to A point by Iridium-192 source. The rectal dose was calculated at the rectal reference point using the barium contrast criteria in vivo measurement of the rectal dose was performed with thermoluminescent dosimeter (TLD) during HDR ICR. The median follow-up period was 39 months, ranging from 6 to 90 months. Twenty-one patients (9.5%) experienced late rectal bleeding, from 3 to 44 months (median, 13 months) after the completion of RT. The calculated rectal doses were not different between the patients with rectal bleeding and those without, but the measured rectal doses were higher in the complicated patients. The differences of the measured ICR rectal fractional dose, ICR total rectal dose, and total rectal biologically equivalent dose (BED) were statistically significant. When the measured ICR total rectal dose was beyond 16 Gy, when the ratio of the measured rectal dose to A point dose was beyond 70%, or when the measured rectal BED was over 110 GY 3 , a high possibility of late rectal complication was found. Late rectal complication was closely correlated with measured rectal dose by in vivo dosimetry using

  6. Preoperative brachyradiotherapy in the treatment of uterine cervix cancer in its first stage of clinical development

    Kietlinska, Z.; Haruppa, J.; Zielinski, J.; Kawczynska, M.

    1981-01-01

    In 58 women with diagnosed stage 1 uterine cervix cancer radium (27 women) or cesium (31 women) were applied into the vagina or in the uterine cavity, then after about 7 weeks they were submitted to surgical treatment - radical hysterectomy with adnexectomy and excision of the obturatory and iliac lymphnodes (Wertheim Meigs operation). In 16 of these women, considering the marked dimensions of the neoplasm teletherapy in a decreased dose preceded the brachytherapy. Total destruction of the neoplasmatic outgrowth as a result of preoperative radiotherapy was met in 44 women (76%). In 8 women the excised tissues revealed neoplasmatic cells persisting in the uterine cervix and in 6 - in the lymphnodes. These women underwent subsequent post-operative teletherapy. The complications of the adapted technique were analysed and found to fall close within limits of those, accepted in cases of classic primary surgical treatment. No exits and no fistulas were met in the material. The value of brachytherapy applied before surgery is evident as it permitted to evade the post-operative teletherapy in 55% of women and to reduce the external irradiation dose in further 21% of women. (author)

  7. Diagnosis of uterine cervix cancer using Müller polarimetry: a comparison with histopathology

    Rehbinder, Jean; Deby, Stanislas; Haddad, Huda; Teig, Benjamin; Nazac, André; Pierangelo, Angelo; Moreau, François

    2015-07-01

    Today around 275000 women a year in the world keep dying from the cancer of uterine cervix due to the difficulty to meet the logistic requirements of an organized screening in the developing world. Polarimetric imaging is a new promising technique with a tremendous potential for applications in biomedical diagnostics: it is sensitive to slight morphological changes in tissues, can provide wide field images for the screening and requires light sources such as a LED for example. This work intends to characterize the polarimetric response of the uterine cervix in its healthy and pathological states. An extensive series of ex-vivo measurements is in progress the Kremlin Bicêtre hospital near Paris using an imaging multispectral Mueller polarimeter in backscattering configuration. The goal of this study is to evaluate the performances of polarimetric imaging technique in terms of sensitivity and specificity for the detection of healthy epithelia (Healthy Squamous epithelium and Malpighian Metaplasia) with respect to the diagnosis provided by pathologists from histology slides as the "gold standard". We show that, at λ=550nm, performances as high as 62% sensitivity and 64% specificity are achieved by optimizing a simple threshold on the scalar retardance values.

  8. Comparison of visual inspection of cervix and pap smear for cervical cancer screening

    Tayyeb, R.; Khawaja, N.P.; Malik, N.

    2003-01-01

    Objective: To evaluate the performance of visual inspection of cervix (VIA) after application of 3% acetic acid in cervical cancer screening in comparison with PAP smear. Results: Out of 540 subjects, 356 were negative with both screening techniques. One hundred and fifty-six subjects were positive with VIA (28.9%) while PAP smear was positive in seventy-eight subjects (14.4%). The sensitivity of VIA was 93.9% and of PAP smear was 46.9%. Corresponding specificities were 30.4% and 69.5%. There was no significant difference between the positive predictive value (PPV) of both test (p<0.05). The accuracy of VIA was 77.5% compared to 52.8% of PAP smear. The difference was highly significant (p < 0.01). Conclusion: These results indicate that VIA is more sensitive and has a higher accuracy as compared to PAP smear. It could, therefore, be valuable in detection of precancerous lesions of cervix. Low cost, easy applicability and immediate results make VIA a useful screening test in developing countries like Pakistan as compared to PAP smear. (author)

  9. Cervix-to-rectum measuring device in a radiation applicator for use in the treatment of cervical cancer

    Fischell, D.R.; Mazique, J.C.

    1981-10-01

    A cervix-to-rectum measuring device to be used in the treatment of cervical cancer is described. It includes a handle and a probe pivotably connected to the handle for insertion in the rectum. The measuring device further includes means for coupling the handle to an intrauterine radiation applicator when the latter is positioned in the uterine cervix and the probe is inserted in the rectum to pivot the handle about the probe. A gear is provided which is adapted to pivot with the probe. A pinion pivotably connected to the handle meshes with the gear. A pointer fixed to the pinion is displaced in response to the pivoting of the handle about the probe, and this displacement can be read from a scale on the handle, providing an indication of the cervix-to-rectum distance. Official Gazette of the U.S. Patent and Trademark Office

  10. MR imaging of endometrial cancer that occurs after radiation therapy for cervix cancer

    Kim, Youn Jeong; Jeong, Yong Yeon; Lim, Nam Yeol; Ko, Seok Wan; Kim, Bo Hyun

    2007-01-01

    We wanted to describe the MR imaging findings of endometrial cancer in patients with a history of prior radiation therapy for cervical cancer (ECRT) and we compare them to the MR imaging findings of patients with spontaneously occurring endometrial cancer (SEC). Twenty-two patients with endometrial cancer that was diagnosed by operation or endometrial biopsy were included in the study. The patients were divided into two groups according to the presence of past RT for cervical cancer: ECRT (n = 4) and SEC (n = 18). The MR images were retrospectively analyzed by consensus of two experienced radiologists. The MR imaging findings were analyzed by the size, shape and signal intensity of the mass, distension of the uterine cavity, the presence of cervical stenosis and the nature of the fluid collection. For the mass shape, all the ECRT lesions were polypoid masses. However, the SEC patients had 5 polypoid masses and 13 wall thickenings. The maximal diameter, signal intensity and enhancement pattern of the masses were not different between the ECRT and SEC patients. The width of the endometrial cavity varied between 3.9 cm in the ECRT patients and 0.4 cm in the SEC patients (ρ = 0.002). All the ECRT patients had cervical stenosis. However, none of the SEC patients had cervical stenosis. MR imaging of ECRT patients demonstrated prominent distension of their uterine cavity and cervical stenosis, which may be the result of radiation fibrosis in the uterus

  11. Brachytherapy for cervix cancer: low-dose rate or high-dose rate brachytherapy – a meta-analysis of clinical trials

    Stefano Eduardo J

    2009-04-01

    Full Text Available Abstract Background The literature supporting high-dose rate brachytherapy (HDR in the treatment of cervical carcinoma derives primarily from retrospective series. However, controversy still persists regarding the efficacy and safety of HDR brachytherapy compared to low-dose rate (LDR brachytherapy, in particular, due to inadequate tumor coverage for stage III patients. Whether LDR or HDR brachytherapy produces better results for these patients in terms of survival rate, local control rate and the treatment complications remain controversial. Methods A meta-analysis of RCT was performed comparing LDR to HDR brachytherapy for cervix cancer treated for radiotherapy alone. The MEDLINE, EMBASE, CANCERLIT and Cochrane Library databases, as well as abstracts published in the annual proceedings were systematically searched. We assessed methodological quality for each outcome by grading the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE methodology. We used "recommend" for strong recommendations, and "suggest" for weak recommendations. Results Pooled results from five randomized trials (2,065 patients of HDR brachytherapy in cervix cancer showed no significant increase of mortality (p = 0.52, local recurrence (p = 0.68, or late complications (rectal; p = 0.7, bladder; p = 0.95 or small intestine; p = 0.06 rates as compared to LDR brachytherapy. In the subgroup analysis no difference was observed for overall mortality and local recurrence in patients with clinical stages I, II and III. The quality of evidence was low for mortality and local recurrence in patients with clinical stage I, and moderate for other clinical stages. Conclusion Our meta-analysis shows that there are no differences between HDR and LDR for overall survival, local recurrence and late complications for clinical stages I, II and III. By means of the GRADE system, we recommend the use of HDR for all clinical stages of cervix

  12. Brachytherapy for cervix cancer: low-dose rate or high-dose rate brachytherapy – a meta-analysis of clinical trials

    Viani, Gustavo A; Manta, Gustavo B; Stefano, Eduardo J; de Fendi, Ligia I

    2009-01-01

    Background The literature supporting high-dose rate brachytherapy (HDR) in the treatment of cervical carcinoma derives primarily from retrospective series. However, controversy still persists regarding the efficacy and safety of HDR brachytherapy compared to low-dose rate (LDR) brachytherapy, in particular, due to inadequate tumor coverage for stage III patients. Whether LDR or HDR brachytherapy produces better results for these patients in terms of survival rate, local control rate and the treatment complications remain controversial. Methods A meta-analysis of RCT was performed comparing LDR to HDR brachytherapy for cervix cancer treated for radiotherapy alone. The MEDLINE, EMBASE, CANCERLIT and Cochrane Library databases, as well as abstracts published in the annual proceedings were systematically searched. We assessed methodological quality for each outcome by grading the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. We used "recommend" for strong recommendations, and "suggest" for weak recommendations. Results Pooled results from five randomized trials (2,065 patients) of HDR brachytherapy in cervix cancer showed no significant increase of mortality (p = 0.52), local recurrence (p = 0.68), or late complications (rectal; p = 0.7, bladder; p = 0.95 or small intestine; p = 0.06) rates as compared to LDR brachytherapy. In the subgroup analysis no difference was observed for overall mortality and local recurrence in patients with clinical stages I, II and III. The quality of evidence was low for mortality and local recurrence in patients with clinical stage I, and moderate for other clinical stages. Conclusion Our meta-analysis shows that there are no differences between HDR and LDR for overall survival, local recurrence and late complications for clinical stages I, II and III. By means of the GRADE system, we recommend the use of HDR for all clinical stages of cervix cancer. PMID:19344527

  13. Adjuvant postoperative radiation therapy following simple hysterectomy and radical hysterectomy in stage IB cancer of the cervix: Analysis of risk factors and patterns of failure

    Kim, R.Y.; Weppelmann, B.; Sanford, S.P.; Salter, M.M.; Brascho, D.J.

    1986-01-01

    Between 1969 and 1980, 242 cases of stage IB cancer of the cervix were referred to the department of radiation oncology for curative radiation therapy. In 186 cases treatment was with radiation therapy alone. In 56 cases treatment included adjuvant postoperative radiation therapy; a minimum follow-up of 5 years has been carried out in this group. In 17 cases radiation therapy followed a simple hysterectomy for an unexpected stage IB cancer of the cervix. In 39 cases radiation therapy was given after a radical hysterectomy for stage IB cancer of the cervix because of positive margins and/or positive pelvic lymph nodes

  14. Carcinoma of the cervix

    Eifel, Patricia J.

    1997-01-01

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

  15. A pilot study of accelerated superfractionated radiotherapy for locally advanced cancer of the uterine cervix

    Gieschen, H; Kavanagh, B; Kaufman, N; West, R; Goplerud, D; Schmidt-Ullrich, R

    1995-07-01

    Purpose: Retrospective studies have suggested that overall treatment time is an important determinant of outcome for locally advanced squamous carcinoma of the cervix managed with definitive radiotherapy. We initiated a prospective clinical trial to test the hypothesis that minimizing treatment time can prevent tumor cell repopulation in squamous cell carcinoma of the cervix. Materials and Methods: Between 1989 and 1994 twenty two patients with FIGO stage IIIA to IVA squamous cell carcinoma of the cervix were treated as follows: Forty-five Gy was delivered to the whole pelvis in 25 fractions in 5 weeks using photon energies of 6 MV or greater. On Monday, Wednesday, and Friday of each of the last three weeks of treatment, a boost treatment of 1.6 Gy was given via small lateral parallel opposed fields, six hours after the first fraction. Thus, the total dose to the tumor and parametrial region was 59.4 Gy. A single brachytherapy procedure (Standard Tandem and Ovoids or Interstitial Template) was performed one week after the completion of external beam radiotherapy to bring the point A dose to 90 Gy in 6 weeks. Results: With a median follow-up of 30 months, (range: 5 to 42 months) the actuarial 3 year overall survival is 61.5% and the disease-free survival is 51.4%. Two out of twenty two patients (9.1%) had loco-regional failure alone, (5(22)) (22.7%) had distant failure only, and (4(22)) (18.2%) had both. The actuarial loco-regional control at 3 years is 69.5% with a distant metastasis-free survival of 57.5%. The median length of treatment was 46 days with a range of 35 to 107 days Most of the patients had only mild acute reactions, mainly diarrhea. There were no severe acute reactions. Thirteen of 22 patients (59.1%) had no late complications. Three patients had chronic proctitis, one with intermittent bleeding. Six (27.3%) patients experienced severe late complications consisting of vesico-vaginal fistulas, recto-vaginal fistulas and small bowel obstruction. One

  16. High-dose-rate brachytherapy in the treatment of uterine cervix cancer. Analysis of dose effectiveness and late complications

    Ferrigno, Robson; Novaes, Paulo Eduardo Ribeiro dos Santos; Pellizzon, Antonio Cassio Assis; Maia, Maria Aparecida Conte; Fogarolli, Ricardo Cesar; Gentil, Andre Cavalcanti; Salvajoli, Joao Victor

    2001-01-01

    Purpose: This retrospective analysis aims to report results of patients with cervix cancer treated by external beam radiotherapy (EBR) and high-dose-rate (HDR) brachytherapy. Methods and Materials: From September 1992 to December 1996, 138 patients with FIGO Stages II and III and mean age of 56 years were treated. Median EBR to the whole pelvis was 45 Gy in 25 fractions. Parametrial boost was performed in 93% of patients, with a median dose of 14.4 Gy. Brachytherapy with HDR was performed during EBR or following its completion with a dose of 24 Gy in four weekly fractions of 6 Gy to point A. Median overall treatment time was of 60 days. Patient age, tumor stage, and overall treatment time were variables analyzed for survival and local control. Cumulative biologic effective dose (BED) at rectal and bladder reference points were correlated with late complications in these organs and dose of EBR at parametrium was correlated with small bowel complications. Results: Median follow-up time was 38 months. Overall survival, disease-free survival, and local control at 5 years was 53.7%, 52.7%, and 62%, respectively. By multivariate and univariate analysis, overall treatment time up to 50 days was the only statistically significant adverse variable for overall survival (p=0.003) and actuarial local control (p=0.008). The 5-year actuarial incidence of rectal, bladder, and small bowel late complications was 16%, 11%, and 14%, respectively. Patients treated with cumulative BED at rectum points above 110 Gy 3 and at bladder point above 125 Gy 3 had a higher but not statistically significant 5-year actuarial rate of complications at these organs (18% vs. 12%, p=0.49 and 17% vs. 9%, p=0.20, respectively). Patients who received parametrial doses larger than 59 Gy had a higher 5-year actuarial rate of complications in the small bowel; however, this was not statistically significant (19% vs. 10%, p=0.260). Conclusion: This series suggests that 45 Gy to the whole pelvis combined with

  17. Radiation therapy alone in the treatment of cervix cancer stages IIB and IIB. Results from Hospital Mario Gatti, Pontificia Universidade Catolica de Campinas

    Ferrigno, Robson; Oliveira Faria, Sergio Luis Campos de

    1995-01-01

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

  18. Preoperative radiotherapy with high dose rate brachytherapy in the treatment of stage IIB cervix cancer. A retrospective analysis of histological specimens

    Ferrigno, Robson; Trippe, N; Novaes, P.E.; Brandani, I.B.; Hanriot, R.; Souza, L.M.; Pellizzon, A.C.; Salvajoli, J.V.; Baraldi, H.E.; Maia, M.A.; Fogaroli, R.C.

    1996-01-01

    Purpose/Objective: To evaluate the histological specimens of the stage IIB cervix cancer patients who were treated by preoperative radiotherapy with external beam radiotherapy (EBRT) and high dose rate (HDR) brachytherapy. Materials and Methods: From August 1992 to August 1995, 32 patients with stage IIB cervix cancer were underwent to preoperative radiotherapy. All patients received EBRT at the whole pelvis with total dose of 45Gy in 25 fractions of 1,8Gy through a 4 MV linear accelerator. The HDR brachytherapy was realized through a Micro-Selectron device, working with Iridium-192 with initial activity of 10 Ci. The prescribed dose was 6,0Gy at point A, defined by the Manchester, system in 2 weekly insertions during the course of EBRT. The insertions were done by the Fletcher colpostats in association with intrauterine tandem. Four to six weeks after the end of radiotherapy, the patients were underwent to Total Hysterectomy and Salpingoforectomy through Piver second level technique. The uterine specimens were histologically analysed with attention to residual disease at the cervix and lymph nodes status. Results: The histological analysis showed that 19 (59,4%) patients had no residual tumor at the cervix while 13 (40,6%) had microscopic residual tumor. The lymph nodes were negative in 30 (93,8%) patients and positive in 2 (6,3%). All positive lymph nodes patients also had microscopic residual tumor at the cervix. With the follow up ranging from six to 42 months and medium of 21 months, 29 (90,6%) patients are alive with no evidence of disease, one (5,6%) is alive with local recurrence and two (6,2%) have died due to the progression of local disease. Of the 19 patients with negative specimens, 18 (94,7%) are alive with no evidence of disease and of the 13 patients with positive specimens, 11 (84,6%) are alive with no evidence of disease. Local recurrence occurred in two patients with positive specimens and in one with negative. These differences are not

  19. [Multiparameter magnetic resonance imaging in the diagnosis of cancer of the cervix uteri].

    Tarachkova, E V; Strel'tsova, O N; Panov, V O; Bazaeva, I Ya; Tyurin, I E

    2015-01-01

    Cancer of the cervix uteri (CCU) ranks third in the incidence of malignancies in women. The choice of CCU treatment mainly depends on the extent of the tumor process, i.e., the stage of the disease. Determining the stage of CCU is based on the clinical classification of the International Federation of Gynecology and Obstetrics (FIGO) (2009) and has a number of substantial limitations in evaluating parametrial invasion, tumor spread to the pelvic wall, and involvement of regional lymph nodes and in determining the true tumor sizes. Magnetic resonance imaging (MRI) is now the method of choice in staging invasive CCU. Multiparameter MRI will be able to enhance the efficiency of diagnosing microinvasive CCU as well (FIGO 2009), to plan surgical and/or chemoradiation treatment, to evaluate its efficiency, and to diagnose locally recurrent CCU.

  20. Limited vaginal hysterectomy after brachytherapy in patients with early stage cervix carcinoma

    Resbeut, M.; Honnoun-Levi, J.M.; Alzieu, C.; Cowen, D.; Cravello, L.; Agostini, A.

    1998-01-01

    In patients with early cervix carcinoma, both radiotherapy and surgery or combined modalities provide effective therapies. In the two last modalities, recommended surgery is radical hysterectomy. The purpose of this prospective study was to assess the value of a limited vaginal hysterectomy after brachytherapy in patients without any unfavorable prognostic factor. Twenty-two patients (stage la2 with vascular invasion: three patients, stage lb1:19 patients) with 1 cm median maximal tumor size and with previous negative laparoscopic lymphadenectomy (median number of lymph nodes:12) underwent a limited vaginal hysterectomy 6 weeks after utero-vaginal brachytherapy. Two mild intra-operative complications were noted. Venous hemorrhage (100 mL) occurred in one patient during lymphadenectomy and another patient presented bladder injury during hysterectomy. These two complications were successfully controlled with no need for laparotomy. Only one late complication was observed: bladder grade G2(b). With a 29 months follow-up (20-48 months), no recurrence was reported. These results appear promising in patients with very early cervix carcinoma but remain to be confirmed on a larger scale. (authors)

  1. Myeloid Sarcoma of the Uterine Cervix as Presentation of Acute Myeloid Leukaemia after Treatment with Low-Dose Radioiodine for Thyroid Cancer: A Case Report and Review of the Literature

    Anne Sophie Weingertner

    2009-01-01

    Full Text Available The development of acute myeloid leukaemia after low-dose radioiodine therapy and its presentation as a myeloid sarcoma of the uterine cervix are both rare events. We report a case of acute myeloid leukaemia revealed by a myeloid sarcoma of the uterine cervix in a 48-year-old woman, 17 months after receiving a total dose of 100 mCi 131I for papillary thyroid cancer. A strict hematological follow-up of patients treated with any dose of 131I is recommended to accurately detect any hematological complications which might have been underestimated. Unusual presentations, such as chloroma of the uterine cervix, may reveal myeloid malignancy and should be kept in mind.

  2. Successful pregnancy after uterovaginal anastomosis in patients with congenital atresia of cervix uteri.

    Prorocic, M; Vasiljevic, M; Tasic, L; Brankovic, S

    2012-01-01

    We present a case of successful pregnancy after effective uterovaginal anastomosis in a 26-years-old patient with congenital atresia of the cervix uteri. She spontaneously achieved pregnancy after four years of uterovaginal anastomosis. Gestation was at the eighth lunar month and the delivery was done by cesarean section due to rapidly progressing fetal asphyxia. The patient gave birth to a live healthy male, weighing 1,950 g, with an Apgar score of 5 and 8 at 1 and 5 min, respectively. The postoperative course was uneventful, and leakage of lochia was normal.

  3. CARCINOMA-ASSOCIATED MUCIN SERUM MARKERS CA-M26 AND CA-M29 - EFFICACY IN DETECTING AND MONITORING PATIENTS WITH CANCER OF THE BREAST, COLON, OVARY, ENDOMETRIUM AND CERVIX

    YEDEMA, KA; KENEMANS, P; WOBBES, T; VANKAMP, GJ; DEBRUIJN, HW; THOMAS, CM; MASSUGER, LF; SCHIJF, CP; BON, GG; VERMORKEN, JB; VOORHORST, F; HILGERS, J

    1991-01-01

    Two recently developed monoclonal antibody (MAb)-based anti-mucin assays, CA M26 and CA M29, were studied in 250 cancer patients and compared to 3 well-established marker tests, viz., CA 125, CA 15.3 and SCC, in order to assess their clinical usefulness as serum tumor markers. Pre-treatment sera

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

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

    2009-10-15

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

  5. A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer

    Singh Karuna

    2010-04-01

    Full Text Available Purpose: In cervical intracavitary brachytherapy, it is mandatory to evaluate if the doses to bladder and rectum are within tolerance limits. In this study, an effort has been made to evaluate the effect of respiration on the doses to bladder and rectum in patients undergoing brachytherapy.Material and methods: Fifteen patients with cervix cancer treated with concurrent chemoradiation followed by intracavitary brachytherapy were included in this study. At the time of brachytherapy, all patients underwent 4D computed tomography (CT imaging. Five out of fifteen patients were scanned with empty bladder while the rest had full bladder during sectional imaging. Four sets of pelvic CT image datasets with applicators in place were acquired at equal interval in a complete respiratory cycle. Treatment plans were generated for all the CT datasets on a PlatoTM Sunrise planning system. A dose of 7 Gy was prescribed to Point A. Doses to ICRU (Report No.38 bladder (IBRP and rectal (IRRP reference points were calculated in all the CT datasets.Results: The mean of maximum dose to IBRP at four different respiratory phases for full and empty bladder were 53.38 ± 19.20%, 55.75 ± 16.71%, 56.13 ± 17.70%, 57.50 ± 17.48% and 60.93 ± 15.18%, 60.29 ± 16.28%, 60.86 ± 15.90%, 60.82 ± 15.42% of the prescribed dose respectively. Similarly, maximum dose to IRRP for full and empty bladder were 55.50 ± 18.66%, 57.38 ± 14.81%, 58.00 ± 14.97%, 58.38 ± 17.28% and 71.96 ± 6.90%, 71.58 ± 7.52%, 68.92 ± 6.21%, 71.45 ± 7.16% respectively.Conclusions: Our study shows that respiration affects the dose distribution to the bladder and rectum in intracavitary brachytherapy of cervix cancer. It is advisable to reduce the critical organ dose to account for the dose variation introduced by respiratory motion.

  6. Thyroid Gland Metastasis from Cancer of the Uterine Cervix: An Extremely Rare Case Report.

    Celik, Suleyman Utku; Besli, Dilara; Sak, Serpil Dizbay; Genc, Volkan

    The thyroid gland is a relatively uncommon site for a metastatic disease, although it is richly supplied with blood. The metastases may originate from various primary sites, mainly kidney, lung, head and neck, and breast. Thyroid metastasis from cervical carcinomas is extremely rare; and only a few cases have been previously reported in the literature. In patient with thyroid nodules and an oncological history, the possibility of thyroid metastasis should be seriously considered. Despite the rarity of the metastasis of cervical carcinoma to the thyroid, it is difficult to say appropriate treatment approach for these lesions. When managing such patients, decision-making should balance the possibility of gaining long-term survival against estimation of the aggressiveness of the disease and its possible complications. Here, a case of thyroid metastasis from a squamous cell carcinoma of the uterine cervix presenting with cervical mass and difficulty in swallowing and its treatment is reported.

  7. Radiation therapy of cancer of the cervix, corpus uteri and vagina at the 1st University Clinic of Gynaecology in Vienna from 1950 to 1979

    Kucera, H.

    1980-01-01

    On the occasion of the 30th anniversary of the department of radiotherapy of th 1st University-Clinic of Gynaecology and Obstetrics in Vienna, the results obtained in the treatment of gynaecologic malignancy are presented. During this period, more than 10 000 malignant tumors of the female genital tract were treated, including 3605 cases of cancer of the cervix, 1412 endometrial carcinomas and 397 cases of cancer of the vagina. The principal method of irradiation was local application of radium. Dosage was established empirically after measurements on a model. In addition conventional percutaneous roentgen therapy was used until 1972, when telecobalt irradiation equipment was put into use. Five-year survival rates for cervical, endometrial and vaginal cancer are presented for the years from 1950 through 1972. These results are attributed primarily to intracavitary radium application. Of 2687 cases with cervical cancer 1222 (45.5%) were alive after five years, in stage III cervical cancer 535 out of 1321 (40.5%). The latest international tables published in the Annual Report give a five-year survival rate of 31.7% for stage-III cancer of the cervix. Of 994 cases of endometrial cancer 473 were alive after five years (49.8%), while the Annual Report gives a five-year survival rate of 39.0% for primary irradiation in endometrial cancer. For cancer of the vagina, our five-year survival rate was 42.8% (127 patients out of a total of 297), while the Annual Report gives 37.3%. This demonstrates, that the results obtained at the department of radiotherapy of the 1st University Clinic of Gynaecology and Obstetrics in Vienna are better than the international average. Apart from the different methods of treatment the importance of primary radiation therapy in gynaecologic oncology is pointed out, and the side effects and complications are discussed. (orig.) [de

  8. PATIENTS WITH SQUAMOUS-CELL VERSUS ADENO(SQUAMOUS) CARCINOMA OF THE CERVIX, WHAT FACTORS DETERMINE THE PROGNOSIS

    TINGA, DJ; BOUMA, J; AALDERS, JG

    1992-01-01

    Patients with squamous cell carcinoma of the cervix FIGO stages IB to IV (n = 306) were compared to patients with adeno(squamous) carcinoma (n = 70). There was no difference between the mean ages of the groups. In the patients who underwent radical surgical treatment, whether or not in combination

  9. Fatal outcome of pelvic radiotherapy for carcinoma of the cervix in a patient with systemic lupus erythematosis

    Olivotto, I.A.; Fairey, R.N.; British Columbia Univ., Vancouver; Gillies, J.H.; Stein, H.; British Columbia Univ., Vancouver

    1989-01-01

    Although there is an impression that patients with connective tissue disorders tolerate radiotherapy less well than other patients, this is not well documented. The authors present the case of a patient with a 7-year history of systemic lupus erythematosis who developed fatal pelvic necrosis as an unexpectedly severe complication after radiotherapy for carcinoma of the cervix. (author)

  10. Fatal outcome of pelvic radiotherapy for carcinoma of the cervix in a patient with systemic lupus erythematosis

    Olivotto, I A; Fairey, R N; Gillies, J H; Stein, H

    1989-01-01

    Although there is an impression that patients with connective tissue disorders tolerate radiotherapy less well than other patients, this is not well documented. The authors present the case of a patient with a 7-year history of systemic lupus erythematosis who developed fatal pelvic necrosis as an unexpectedly severe complication after radiotherapy for carcinoma of the cervix.

  11. The prediction of candidate genes for cervix related cancer through gene ontology and graph theoretical approach.

    Hindumathi, V; Kranthi, T; Rao, S B; Manimaran, P

    2014-06-01

    With rapidly changing technology, prediction of candidate genes has become an indispensable task in recent years mainly in the field of biological research. The empirical methods for candidate gene prioritization that succors to explore the potential pathway between genetic determinants and complex diseases are highly cumbersome and labor intensive. In such a scenario predicting potential targets for a disease state through in silico approaches are of researcher's interest. The prodigious availability of protein interaction data coupled with gene annotation renders an ease in the accurate determination of disease specific candidate genes. In our work we have prioritized the cervix related cancer candidate genes by employing Csaba Ortutay and his co-workers approach of identifying the candidate genes through graph theoretical centrality measures and gene ontology. With the advantage of the human protein interaction data, cervical cancer gene sets and the ontological terms, we were able to predict 15 novel candidates for cervical carcinogenesis. The disease relevance of the anticipated candidate genes was corroborated through a literature survey. Also the presence of the drugs for these candidates was detected through Therapeutic Target Database (TTD) and DrugMap Central (DMC) which affirms that they may be endowed as potential drug targets for cervical cancer.

  12. A prospective phase I/II trial of the cyclooxygenase-2 inhibitor celecoxib in patients with carcinoma of the cervix - acute toxicity and biomarker response analysis

    Chan, P.; Doll, C.; Oza, A.; Pintilie, M.; Levin, W.; Manchul, L.; Fyles, A.; Milosevic, M.

    2003-01-01

    To evaluate the toxicity and biomarker response of celecoxib (C) as a biologic modifier in combination with definitive chemoradiotherapy (CRT) in women with cervix cancer. Fifteen cervix patients were entered into the first phase of this prospective study between March 2001 and January 2002. FIGO stages included IB(2), IIB(8), IIIB(4), and IVA(1), and median age was 51 years (range 26-62). Celecoxib 400mg orally was given b.i.d. 2 weeks prior to, and during the CRT. Toxicity assessments were performed weekly up to 12 weeks following treatment prior to further accrual using the NCIC-CTC. Hypoxia (HP5) and interstitial fluid pressure (IFP) assays were performed at day 0 and 14. Eleven patients completed the prescribed therapy. Only 2 of 4 patients discontinued C due to GI toxicity. In total there were 6 (40%) with grade 3/4 acute toxicity. Four were related to GI, one to skin reaction while the other was haematological. Although it was difficult to distinguish CRT toxicity from C, the proportion of patients with severe acute toxicity was similar to what we previously reported with CRT alone (8/24 (33%), Rodrigues, IJROBP 2001:Vol 51:(3): (Supp 1): 334). GI toxicity was more common in this study whereas haematologic effects were more frequent in the previous study. Evaluating the most recent measurable data set, 6 of 16 patients showed a decrease in HP5, (3.8 - 89.7%) while 10 of 14 patients had a reduction in IFP, (1.3 - 16.2mmHg). Two grade 4 late GI toxicity developed. Celecoxib is tolerated by patients receiving CRT for cervix cancer. Response of microenvironmental biomarkers to C was seen in the majority, suggesting a role as early markers of treatment outcome. Further follow-up is needed to assess the risk of late toxicity. The trial has been re-opened with C reduced to 300 mg b.i.d

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

    Hancock, B.W.; Bruce, L.; Heath, J.; Sugden, P.; Ward, A.M.

    1979-01-01

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

  14. Radiation therapy in patients with carcinoma of the cervix discovered by simple abdominal hysterectomies

    Nori, D.

    1987-01-01

    Memorial Hospital experience for the subsequent period (1955-1979) is reviewed in order to evaluate the effectiveness of postoperative radiation. The clinical information on 53 patients was carefully studied, and it was determined that 51 patients had epidermoid histology and 2 patients had adenocarcinoma. During this period 87% of the patients underwent simple abdominal hysterectomy and 13% had other types of surgical procedures including supracervical hysterectomy or amputation of the cervix for invasive disease. Pathological specimens were reviewed. In 32 patients margins of resection were reported negative, and 21 patients had positive margins or were noted to have gross residual tumors at the margin of resection. Megavoltage radiation by anterior and posterior pelvic portals was used with total doses ranging from 4,500 to 6,000 rads

  15. Prognosis of patients with stage IIIb-IVa squamous cell carcinoma of the cervix following intra-arterial neoadjuvant chemotherapy

    Fujiwaki, R.; Maede, Y.; Ohnishi, Y.; Watanabe, Y.; Hata, K.; Miyazaki, K.

    1999-01-01

    The aim was to determine the long-term prognosis in patients with stage IIIb-IVa squamous cell carcinoma of the cervix who were treated with intra-arterial neoadjuvant chemotherapy (NAC), and to analyze factors related to prognostic value. The authors assessed the disease-free survival of 21 patients with FIGO stage IIIb-IVa squamous cell carcinoma of the cervix treated with intra-arterial NAC followed by irradiation therapy. Before chemotherapy, five factors (age, clinical stage, histologic type, parametrial involvement and serum level of SCC) were evaluated for their correlation with disease-free survival. Univariate Cox's proportional hazard model also demonstrated that age was a significant prognostic factor as a continuous variable. Intra-arterial NAC thus appeared to be effective in treating older patients with stage IIIb-IVa squamous cell carcinoma of the cervix

  16. SFRO booklets - The radiotherapy of cancers: of anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder for a better understanding of radiotherapy, sarcoma radiotherapy - To better understand your treatment

    Leroy, Thomas; Mornex, Francoise; Peiffert, Didier; Thariat, Juliette; Faivre, Jean-Christophe; Huguet, Florence; Vendrely, Veronique; Barillot, Isabelle; Janoray, Guillaume; Bibault, Jean-Emmanuel; Antoni, Delphine; Crehange, Gilles; Meillan, Nicolas; Pichon, Baptiste; Biau, Julian; Pointreau, Yoann; Mirabel, Xavier; Leysalle, Axel; Claren, Audrey; Cartier, Lysian; Chand, Mari-Eve; Jacob, Julian; Renard-Oldrini, Sophie; Le Pechoux, Cecile; Ducassou, Anne; Moureau-Zabotto, Laurence; Lagrange, Jean Leon; Molina, Sarah

    2016-07-01

    This document gathers several booklets which, for different types of cancers, propose information regarding the anatomy and location of the cancer, its diagnosis, possible treatments, secondary effects during treatment, some practical advices, issues related to the post-treatment period, associations and other resources which can be useful for patient information, and a glossary of the main terms used for this cancer and its treatment. Cancer types are anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder cancers

  17. Radiation therapy for the old aged patient suffered from carcinoma of the uterine cervix

    Arai, Tatsuo; Morita, Shinroku; Fukuhisa, Kenjiro; Wada, Susumu.

    1984-01-01

    Since a majority of old aged patients have the troublesome complications and their physical or mental emaciation is clearly appeared, it is necessary for them to adopt a new treatment method which was considered about thier such conditions. The crude survival rate of old aged, over 71, patients suffered from carcinoma of the uterine cervix were 63.6% (7/11) for stage 1, 60% (36/60) for stage 2, 50% (53/106) for stage 3 and 28.6% (8/28) for stage 4. About 20% of patients in each stages were suffered from the complications. We considered the treatment method for the old aged patients such as follows: the radiation dose must be reduced 10% for 71 to 75 year old and 20% for 76 to 80 year old. In the case of over 81 year old, an intracavitary irradiation is only applied for the palliative aim at the out patient clinic. (author)

  18. Development of the Uterine Cervix and Its Implications for the Pathogenesis of Cervical Cancer

    Hopman, Anton H. N.; Ramaekers, Frans C. S.; Herrington, C. Simon

    2017-01-01

    Normal development of the uterine cervix has been widely studied and the origin of both the columnar and squamous epithelia, as well as the molecular basis of their differentiation, has been established. The process of early carcinogenesis in the uterine cervix has also been described extensively,

  19. Serologic answer to the papillomavirus oncogenic capsid types 16, 18, 31, 33, 39, 58 and 59 in Colombian women with cervix cancer

    Combita, Alba Lucia; Touze, Antoine; Coursaget, Pierre; Bravo, Maria Mercedes

    2003-01-01

    The carcinoma of the uterine cervix is the first cause of cancer mortality among young Colombian women. An etiological association between infection with high risk HPV and cervical cancer has been demonstrated. L1 proteins from HPV have the ability to assemble into virus-like particles (VLP) numerous serologic studies using HPV16 or HPV18 VLP have shown that infection with genital HPV is followed by a serologic immune response to viral capsid proteins. Our results confirm (i) the high rate of HPV infections in Colombia, both in cervical cancer patients and in the general population, and the particularly high rate of infections due to HPV 31 and 58; and (ii) the validity of anti-VLP antibodies as markers of present or past infections. The simultaneous appearance or disappearance of antibodies against multiple HPV VLP suggests that the antibodies detected by ELISA are not always type-specific

  20. Shell feature: a new radiomics descriptor for predicting distant failure after radiotherapy in non-small cell lung cancer and cervix cancer

    Hao, Hongxia; Zhou, Zhiguo; Li, Shulong; Maquilan, Genevieve; Folkert, Michael R.; Iyengar, Puneeth; Westover, Kenneth D.; Albuquerque, Kevin; Liu, Fang; Choy, Hak; Timmerman, Robert; Yang, Lin; Wang, Jing

    2018-05-01

    Distant failure is the main cause of human cancer-related mortalities. To develop a model for predicting distant failure in non-small cell lung cancer (NSCLC) and cervix cancer (CC) patients, a shell feature, consisting of outer voxels around the tumor boundary, was constructed using pre-treatment positron emission tomography (PET) images from 48 NSCLC patients received stereotactic body radiation therapy and 52 CC patients underwent external beam radiation therapy and concurrent chemotherapy followed with high-dose-rate intracavitary brachytherapy. The hypothesis behind this feature is that non-invasive and invasive tumors may have different morphologic patterns in the tumor periphery, in turn reflecting the differences in radiological presentations in the PET images. The utility of the shell was evaluated by the support vector machine classifier in comparison with intensity, geometry, gray level co-occurrence matrix-based texture, neighborhood gray tone difference matrix-based texture, and a combination of these four features. The results were assessed in terms of accuracy, sensitivity, specificity, and AUC. Collectively, the shell feature showed better predictive performance than all the other features for distant failure prediction in both NSCLC and CC cohorts.

  1. Storage container of radium source newly manufactured for trial for intracavitary irradiation of cancer of the uterine cervix, 2

    Yamamoto, Chiaki; Sasaki, Tsuneo; Tanaka, Yoshiaki

    1977-01-01

    To decrease exposure dose from radium source to operators during the treatment of cancer of the uterine cervix, new-type storage container was manufactured and its usefullness was discussed. The new-type container manufactured for trial houses radium source, for intracavitary irradiation of cancer of the cervix, connecting with TAO-type applicator for afterloading. TLD 1200 Type was used for measurement of radiation dose, and radium 50 mCi was used per one case. The obtained results were as follows: Using the new-type container, 45-60% decrease of exposure dose in the hands and fingers and 44% decrease in the body were obtained. The exposure dose of persons engaged in work of radiotherapy for one week was only 2.2% of the maximum permissible exposure dose, The time treating radium source was shortened to 50% by using the new-type container, and the shortening of that time was a great factor of countermeasures for decreasing exposure dose to operators. From above-mentioned results, the new-type storage container can be put sufficiently to practical use as a storage container of radium source for intracavitary irradiation of cancer of the cervix (when using TAO type afterloading method). (Tsunoda, M.)

  2. Interobserver variation in rectal and bladder doses in orthogonal film-based treatment planning of cancer of the uterine cervix

    Raghukumar P

    2008-01-01

    Full Text Available Orthogonal film-based treatment planning is the most commonly adopted standard practice of treatment planning for cancer of the uterine cervix using high dose rate brachytherapy (HDR. This study aims at examining the variation in rectal and bladder doses when the same set of orthogonal films was given to different observers. Five physicists were given 35 pairs of orthogonal films obtained from patients who had undergone HDR brachytherapy. They were given the same instructions and asked to plan the case assuming the tumor was centrally placed, using the treatment-planning system, PLATO BPS V13.2. A statistically significant difference was observed in the average rectal (F = 3.407, P = 0.01 and bladder (F = 3.284, P = 0.013 doses and the volumes enclosed by the 100% isodose curve ( P < 0.01 obtained by each observer. These variations may be attributed to the differences in the reconstruction of applicators, the selection of source positions in ovoids and the intrauterine (IU tube, and the differences in the selection of points especially for the rectum, from lateral radiographs. These variations in planning seen within a department can be avoided if a particular source pattern is followed in the intrauterine tube, unless a specific situation demands a change. Variations in the selection of rectal points can be ruled out if the posterior vaginal surface is clearly seen.

  3. Surgery and postoperative brachytherapy for treatment of small volume uterine cervix cancer: an alternative to the standard association of utero vaginal brachytherapy + surgery

    Gallocher, O.; Thomas, L.; Pigneux, J.; Stocke, E.; Bussieres, E.; Avril, A.; Floquet, A.

    2002-01-01

    Purpose. -Evaluate the results of the treatment of small uterine cervix cancer with the association of surgery and postoperative vaginal brachytherapy, without unfavourable prognostic factors. Patients and methods. -After radical hysterectomy with lymphadenectomy, 29 women (mean age: 44 years) with carcinoma < 25 mm (26 stage IB1, 3 IIA, mean size: 15 mm) were treated by post-operative prophylactic vaginal brachytherapy using low dose rate. Ovarian transposition was performed at the surgical time in 14 young women (mean age 35 years). Results. - The actuarial specific survival rates at 5 and 10 years were 100% and 90% respectively, with a mean follow-up 75 months. Only one local recurrence was observed. The rate of grade 1 post-operative complication was 7%. The conservation rate of the ovarian function was 85% for young women. Conclusion. -Treatment of small volume uterine cervix cancer using first surgery and post-operative vaginal brachytherapy is a reliable therapeutic option. The results in terms of specific survival and complications are the same with those after standard association of preoperative utero-vaginal brachytherapy and surgery. (authors)

  4. Clinical experience of Sheriproct suppository to rectitis due to radiotherapy of cancer of the uterine cervix

    Sakurai, Tomoyasu; Haruyama, Masato; Nishio, Masamichi; Moriya, Hiroshi

    1977-01-01

    The subject was 30 cases of cancer of the uterine cervix, which were composed of 13 cases of acute rectitis and 17 cases of delayed rectitis due to radiotherapy. Out of them, 25 cases were treated with radiation, alone and 5 cases were treated with postoperative irradiation. The acute cases were administered Sheriproct alone twice a day (in the morning and in the evening) until symptoms disappeared. The delayed cases were administered two or three suppositories per a day together with antihemorrhagics for one to three weeks, decreasing the administration dose according to severity of symptoms. In the delayed cases, this suppository showed effectiveness in prolapsed hemorrhoids with a recovery rate of 88.9%, and it showed effectiveness in a pain with that of 71.4%. However, this depository showed ineffectiveness in hemorrhage, inhibition of mucous stool, and inhibition of secrete, and these symptoms were generally resistant to this suppository. On the other hand, in the acute cases, this suppository showed ineffectiveness only in prolapsed hemorrhoids with a recovery rate of 63.3%, and it showed marked effectiveness in hemorrhage with that of 100%. It also showed effectiveness in a pain, inhibition of mucose stool, and inhibition of secrete. These symptoms responded well to this suppository. Consequently, use of this drug seemed to be significant in making it possible to perform radiotherapy. (Kanao, N.)

  5. Prognostic value of pretreatment factors in patients with locally advanced carcinoma of the uterine cervix treated by radiotherapy alone

    Pedersen, D.; Soegaard, H.; Overgaard, J.; Bentzen, S.M.

    1995-01-01

    The prognostic effect of pretreatment patient- and tumor characteristics, and the influence of radiotherapy schedule on local control, distant metastases, and crude survival were analyzed in 424 consecutive patients with FIGO stage IIB (n = 137), IIIA (n = 10), IIIB (n = 211) and IVA (n = 66) cancer of the uterine cervix. All patients were given radiotherapy alone. From 1974 and through 1977, the external and intracavitary combined radiotherapy was given continuously in 4 to 6 weeks. From 1978 and through 1983, the treatment policy was changed to split-course radiotherapy by introducing planned pauses, resulting in an overall treatment time of 10 to 12 weeks. The results were estimated by univariate actuarial- and Cox multivariate regression analyses. Multivariate analysis showed that significant adverse variables for local control were large lateral tumor diameter, young age, low hemoglobin at time of admission, many prognancies, split-course strategy, and high FIGO stage. Risk of metastases increased with decreasing hemoglobin, increasing malignancy grade and split-course treatment. Poor survival probability were related to large lateral tumor diameter, high malignancy grade and FIGO stage, low hemoglobin, split-course therapy, and adeno/adenosquamous tumor type. (orig.)

  6. The influence of bone density on the radiotherapy of cervix cancer

    Soares, M.R. [Departamento de Fisica, Universidade Federal de Sergipe, Av. Marechal Rondon s/n, 49.100-000, Rosa Elze, Sao Cristovao, SE (Brazil); Souza, D.N., E-mail: divanizi@ufs.br [Departamento de Fisica, Universidade Federal de Sergipe, Av. Marechal Rondon s/n, 49.100-000, Rosa Elze, Sao Cristovao, SE (Brazil)

    2011-10-01

    Until the 1970s the irradiated region of a patient undergoing external beam radiotherapy was considered a homogeneous volume and a regular surface, with physical characteristics similar to water. With the improvement of medical imaging equipment, it has become possible to conduct planning in radiotherapy treatment that considers the heterogeneities and irregularities of a patient's anatomy. Consequently, such technological resources have brought greater accuracy to radiotherapy. In this study, we determined the variation in the average amount of absorbed dose on the target volume and at the point of prescription treatment by comparing the doses which were calculated in a planning system considering the patient both as a homogeneous, and as a heterogeneous medium. The results showed that when we take into account the volume of the upper vagina and cervix, and consider the pelvis as a heterogeneous medium, the calculated dose was under-estimated at some points in the studied volume with respect to the dose when this region was considered homogeneous.

  7. Reducing by half the percentage of late-stage presentation for breast and cervix cancer over 4 years: a pilot study of clinical downstaging in Sarawak, Malaysia.

    Devi, B C R; Tang, T S; Corbex, M

    2007-07-01

    The registry of the Oncology Departmental in Sarawak General Hospital showed that 79% of nasopharyngeal, 77% of breast and 70% of cervix cancer patients were diagnosed at an advanced stage (stages III and IV) for year 1993. Hence, a low cost Early Cancer Surveillance Program was started in 1994, with the intent of downstaging these three most common cancers in Sarawak. The program consisted of (i) training health staff in hospital and rural clinics to improve their skills in early cancer detection, (ii) raising public awareness through pamphlets, posters and sensitization by health staff. Data analysis revealed that the program achieved downstaging in two of the cancers. Breast cancer in stage III and IV was reduced from 60% (1994) to 35% (1998) (P < 0.0001) and cervical cancer in stage III and IV from 60% (1994) to 26% (1998) (P < 0.0001). No reduction was observed for nasopharyngeal cancer at 88% (1994) to 91% (1998). The overall cost of this program was

  8. Knowledge and Practices of Nurses Working in an Education Hospital on Early Diagnosis of Breast and Cervix Cancers.

    Ozlem Ozdemir

    2010-12-01

    Full Text Available AIM: This research has aimed to determine knowledge and practice status of nurses about breast self-examination (BSE, clinical breast examination (CBE, mammography and Pap smear and about influencing status of some variables related to these examinations. METHOD: This descriptive study was conducted in an education hospital in Ankara between March 1st and May 30th, 2008. Three hundred-fifty nurses (82.7% have accepted to participate in the study. Data were collected by a questionnaire form including questions about demographics, their knowledge and practice status about BSE, CBE, mammography and Pap smear. Chi-square test, numbers and percentages were used for evaluating the data. RESULTS: Overall, 46.9% of nurses had enough knowledge about early diagnosis of breast and cervix cancer. 60.2% of them can carry BSE, 18.8% can carry out CBE and 7.3% can carry out mammography. Pap smear is carried out by 23.7% of the nurses. Negligence, fear of cancer and thought of finding them unnecessary were determined as reasons for avoidance. Their knowledge and practice were significantly different (p<0.05 according to their age and service where they work. CONCLUSION: It has been concluded that although knowledge and practices of nurses on breast and cervix cancer are at a good level, this isn’t enough when importance of early diagnosis in breast and cervix cancer are taken into consideration, which are among common cancers in women. [TAF Prev Med Bull 2010; 9(6.000: 605-612

  9. Stage 2 carcinoma of the cervix

    Abayomi, O.

    1990-01-01

    This is a retrospective analysis of the results of 24 patients with bulky stage 2 carcinoma of the cervix treated with full course irradiation followed by adjunctive surgery between 1975 and 1980. A review of the surgical specimens following irradiation showed that 12 patients had no residual cancer, five had only microscopic foci of cancer, and five had extensive residual cancer. Two patients had unresectable persistent cancer. Six patients had histological evidence of lymph node metastases prior to irradiation. The surgical-pathological findings following irradiation had important prognostic implications. All five patients with extensive residual cancer in the surgical specimen recurred, 2 of 5 patients with only microscopic foci of residual cancer and, none of the 12 patients with no residual cancer in the resected specimens developed a recurrence. Lymph node involvement was not associated with an increased incidence of recurrence. Most patients with residual cancer following full course irradiation recurred locally. Thus the addition of adjunctive surgery following full course irradiation did not significantly improve the treatment results of patients with bulky stage 2 carcinoma of the cervix. (author). 14 refs.; 2 figs

  10. Radiotherapy alone in the treatment of uterine cervix cancer with telecobalt and low-dose-rate brachytherapy: retrospective analysis of results and variables

    Ferrigno, Robson; Campos de Oliveira Faria, Sergio Luis; Weltman, Eduardo; Salvajoli, Joao Victor; Segreto, Roberto Araujo; Pastore, Ayrton; Nadalin, Wladimir

    2003-01-01

    Purpose: This retrospective analysis aims to report results and variables from patients with cervix cancer treated by radiation therapy alone with telecobalt and low-dose-rate brachytherapy (LDRB). Methods and Materials: Between September 1989 and September 1995, 190 patients with histologic diagnosis of cervix carcinoma were treated with telecobalt for external beam radiotherapy (EBR), followed by one or two insertions of LDRB. Stage distribution according to patients was the following: IB, 12; IIA, 4; IIB, 105; and IIIB, 69. Median dose of EBR at whole pelvis was 40 Gy, and median parametrial doses for Stages II and III patients were 50 Gy and 60 Gy, respectively. Median doses of LDRB at point A for patients treated with one and two insertions were 38 Gy and 50 Gy, respectively. Results: Median follow-up time was 70 months (range: 8-127 months). Overall survival, disease-free survival, and 5-year local control of patients at Stages I, II, and III were 83%, 78%, and 46%; 83%, 82%, and 49%; and 92%, 87%, and 58%, respectively. Overall incidence of late complications in the rectum, small bowel, and urinary tract was 15.3% (19/190), 4.2% (8/190), and 6.8% (13/190), respectively. The actuarial 5-year rectal, small bowel, and urinary incidence of late complications was 16.1%, 4.6%, and 7.6%, respectively. Clinical stage was the only significant variable for overall 5-year survival (p = 0.001), for disease-free survival (p=0.001), and for local control (p=0.001). Stage II patients more than 50 years old had better disease-free survival and local control at 5 years (p=0.004). None of the analyzed variables influenced the actuarial 5-year incidence of late complications. Conclusions: Results of this series suggest that the use of telecobalt equipment for EBR with doses up to 50 Gy at whole pelvis, prior to brachytherapy, is an acceptable technique for radiation therapy alone in the treatment of cervix cancer, especially in developing countries, including Brazil, where

  11. Proliferation, apoptosis and their relationship to clinical outcome in cancer of the uterine cervix

    Shun, Wong; Tsang, Richard; Fyles, Anthony; Levin, Wilfred; Manchul, Lee; Milosevic, Michael; Li, Yu-qing; Chapman, William; Pintilie, Melania

    1997-01-01

    Purpose: To assess the prognostic value of pretreatment tumor proliferation and apoptosis in carcinoma of the cervix. Materials and Methods: Eighty-four patients were studied prospectively from Mar 1991 to Dec 1996. Pre-treatment evaluation included examination under anaesthesia and obtaining a biopsy specimen 4-10 hours following the intravenous administration of BrdUrd (200 mg). Potential doubling time (T pot ) was obtained by deriving the labelling index (LI) and S-phase duration (T s ) using flow cytometry (FC). LI and its staining pattern, mitotic index (MI), and apoptotic index (AI) were also determined on histology slides. Seven patients were excluded: 2 patients had no tumor in the biopsy specimen; 2 had a vaginal primary; and 3 did not receive radiation therapy (RT). The remaining 77 patients (median age 57 years, range 28-83) were treated with radical RT. There were 61 squamous, 11 adeno and 5 adenosquamous carcinomas. FIGO stages were: Ib and IIa, 20; IIb, 29; III and IV, 28, with a median tumor size of 6 cm. The median external beam dose was 50 Gy (range 40-52.8 Gy, 1 pt had 26 Gy and died of progressive disease) in 25 daily fractions, and the intracavitary dose was 40 Gy (single line source) specified at 2 cm lateral of the midline. The median overall treatment time was 45 days (range 38-73 days). Results: To date, 27 patients have died of disease, and the median follow-up for alive patients is 3.2 yr (range 0.4-6.0 yr). Three patients were not evaluable for response. There were 43 diploid and 34 aneuploid tumors. The median/mean LI by FC were (6.7%(7.9%)) (range 1.5-23.9%). The median/mean T pot were (5.0(6.7)) days (range 1.2-42.1 days). The median/mean AI were (1.0%(1.6%)) (range 0-6.8%). Among 64 patients who completely responded to treatment, 25 patients have relapsed (6 pelvic, 17 non-pelvic, and 2 pelvic and distant). Although there was a significant correlation between LI determined by FC vs. by histology (r=0.40), LI by histology was

  12. Conventional four-field pelvic radiotherapy technique without computed tomography-treatment planning in cancer of the cervix: potential geographic miss and its impact on pelvic control

    Kim, Robert Y.; McGinnis, L. Scott; Spencer, Sharon A.; Meredith, Ruby F.; Jennelle, Richard L.S.; Salter, Merle M.

    1995-01-01

    Purpose: To evaluate the impact of inadequate margins on pelvic control using the conventional four-field pelvic portals without computed tomography (CT)-treatment planning. Methods and Materials: Between 1986 and 1991, 34 patients with invasive cancer of the cervix were eligible for outcome study of conventional four-field radiation therapy (10 Stage I, 16 Stage II, 8 Stage III). The eligibility for this study includes four-field pelvic technique, definitive radiation therapy, and diagnostic CT scan of the pelvis. For this study, an inadequate margin is arbitrarily defined as ≤ 1.0 cm of normal tissue around the CT-defined tumor volume. Results: All 34 patients had adequate margins for anterio-posterior/posterio-anterior portals. However, 19 patients had an inadequate margin at the posterior border (S2-S3 interspace) and/or custom-shaped rectal block for lateral pelvic portals. Two patients had inadequate margins at the anterior border (level of symphysis pubis) due to an enlarged uterus. With a median follow-up of 36 months, pelvic control for adequate margins and inadequate margins was 100% and 71% for Stage IB disease and 88% and 50% for Stage IIB disease, respectively. However, pelvic control for Stage IIIB disease was 50% for both groups. There was no difference in total dose to point A or point B between the two groups. Conclusion: Our preliminary data show higher local failure in patients with an inadequate margin. For four-field pelvic radiation therapy, we strongly recommend CT-treatment planning. Otherwise, anterio-posterior/posterio-anterior pelvic therapy is the most reliable treatment for cancer of the uterine cervix

  13. Dosimetric comparison in a cancer of the Cervix with different therapeutic modalities; Comparacion dosimetrica en un cancer de Cervix con distintas modalidades terapeuticas

    Alonso Iracheta, L.; Casa de Julian, M. A. de la; Samper Ots, P.; Penas Cabrera, M. D. de las; Jimenez Gonzalez, J. M.

    2013-07-01

    Cervical cancer is usually treated with radiotherapy composed of 3D (RC3D) and supine position, and is usually not usually outline the small intestine in cases of exclusively pelvic irradiation. In our Center we wanted to check what dose receives the small intestine in these cases and if the positioning of the patient or used irradiation technique influence the distribution of the histogram dose-volume. (Author)

  14. Early diffusion weighted magnetic resonance imaging can predict survival in women with locally advanced cancer of the cervix treated with combined chemo-radiation

    Somoye, Gbolahan; Parkin, David; Harry, Vanessa; Semple, Scott; Plataniotis, George; Scott, Neil; Gilbert, Fiona J.

    2012-01-01

    To assess the predictive value of diffusion weighted imaging (DWI) for survival in women treated for advanced cancer of the cervix with concurrent chemo-radiotherapy. Twenty women treated for advanced cancer of the cervix were recruited and followed up for a median of 26 (range -3 /mm 2 /s), respectively, P = 0.02. The median change in ADC 14 days after treatment commencement was significantly higher in the alive group compared to non-survivors, 0.28 and 0.14 (x 10 -3 /mm 2 /s), respectively, P = 0.02. There was no evidence of a difference between survivors and non-survivors for pretreatment baseline or post-therapy ADC values. Functional DWI early in the treatment of advanced cancer of the cervix may provide useful information in predicting survival. (orig.)

  15. Polyps of the Cervix

    ... it does, a caustic substance, such as silver nitrate, is applied to the affected area with a swab to stop the bleeding. A Papanicolaou (Pap) test or a variation of it ( cervical cytology ) is done to check for cancer of the cervix. If symptoms (bleeding and a ...

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

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

    2008-01-01

    PURPOSE: Although cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) are both caused by human papillomavirus (HPV) infection, they differ in cofactors such as cigarette smoking. We assessed whether these cofactor differences translate into differences in second cancer risk. PATIENTS...... AND METHODS: We assessed second cancer risk among 85,109 cervical SCC and 10,280 AC survivors reported to population-based cancer registries in Denmark, Finland, Norway, Sweden, and the United States. Risks compared to the general population were assessed using standardized incidence ratios (SIR). RESULTS......: Overall cancer risk was significantly increased among both cervical SCC survivors (n = 10,559 second cancers; SIR, 1.31; 95% CI, 1.29 to 1.34) and AC survivors (n = 920 second cancers; SIR, 1.29; 95% CI, 1.22 to 1.38). Risks of HPV-related and radiation-related cancers were increased to a similar extent...

  17. Combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of cervix.

    Zhang, Xuyin; Han, Tiantian; Ding, Jingxin; Hua, Keqin

    2015-01-01

    The aim of this study was to introduce a new technique which is combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of cervix and to evaluate the feasibility and the safety of it. This is a prospective observational study of 10 patients with congenital atresia of cervix who underwent combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft for cervicovaginal reconstruction from February 2013 to August 2014 in our hospital. All of the surgical procedures were carried out by the same operation team. Patient data were collected including operating time, estimated blood loss, hospital stay post-surgery, complications, total cost, and median vaginal length at 3 month, resumption of menstruation, vaginal stenosis and stricture of the cervix postoperatively. The operative procedure lasted 237±46 (175-380) min. The estimated blood loss was 160±76 (50-300) ml. The hospital stay post-surgery was 12±2 (9-18) days. None of the patients had complications or required a blood transfusion. The mean total cost was $3352±1025. The average vaginal length at 3 month was 8.3±1.1 (8-10) cm. All patients had resumption of menstruation. The patients were followed for a mean of 5±2 (1-10) months. Cervical or vaginal stenosis did not occur in any of the patients. Our experiences of combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in10 patients with congenital atresia of cervix were positive, with successful results and without complications, and cervical or vaginal stenosis.

  18. High-dose-rate afterloading brachytherapy in carcinoma of the cervix: an experience of 1992 patients

    Lorvidhaya, Vicharn; Tonusin, Anun; Changwiwit, Witit; Chitapanarux, Imjai; Srisomboon, Jatupol; Wanwilairat, Somsak; Chawapun, Nisa; Sukthomya, Vimol

    2000-01-01

    Purpose: To report the results of radiation therapy in carcinoma of the cervix treated by external irradiation and high-dose-rate (HDR) intracavitary brachytherapy. Methods and Materials: This is a retrospective analysis of 2063 patients with histologically proven carcinoma of the cervix treated by external irradiation and HDR intracavitary brachytherapy between March 1985-December 1991. The Kaplan-Meier method was used for survival and disease-free survival analysis. Late complications in the bowel and bladder were calculated actuarially. Results: There were 71 patients who did not complete the course of irradiation so only 1992 patients were retrospectively analyzed for survival. There were 2 patients (0.1%) in Stage IA, 211 (10.2%) Stage IB, 225 (10.9%) in Stage IIA, 902 (43.7%) in Stage IIB, 14 (0.7%) in Stage IIIA, 675 (32.7%) in Stage IIIB, 16 (0.8%) in Stage IVA, and 16 (0.8%) in Stage IVB. The median follow-up time was 96 months. The actuarial 5-year disease-free survival rate was 79.5%, 70.0%, 59.4%, 46.1%, 32.3%, 7.8%, and 23.1% for Stage IB, IIA, IIB, IIIA, IIIB, IVA, and IVB respectively. The actuarial 5-year disease-free survival rate for Stage IB 1 and IB 2 squamous cell carcinoma was 88.7% and 67.0%. The actuarial 5-year overall survival rate was 86.3%, 81.1%, 73.0%, 50.3%, 47.8%, 7.8%, and 30.8% for Stage IB, IIA, IIB, IIIA, IIIB, IVA, and IVB respectively. Pattern of failure revealed 20.8% local recurrence, 18.7% distant metastases, and 4% in both. The late complication rate Grade 3 and 4 (RTOG) for bowel and bladder combined was 7.0% with 1.9% Grade 4. Conclusion: HDR brachytherapy used in this series produced pelvic control and survival rates comparable to other LDR series

  19. Verification of hyperthermia treatment planning in cervix carcinoma patients using invasive thermometry

    Haaren Van, P.M.A.; Kok, H.P.; Zum Voerde Sive Voerding, P.J.; Oldenborg, S.; Stalpers, L.J.A.; Crezee, J.; Berg Van den, C.A.T; Leeuw De, A.A.C.

    2005-01-01

    Full text: Hyperthermia treatment planning (HTP) is a useful tool for improvement of clinical hyperthermia treatments. Aim of this study was to determine the correlation between HTP and measurements during hyperthermia treatments. We compared the calculated specific absorption rate (SAR) with clinically measured SAR-values, from ΔT-measurements, in cervix carcinoma patients. General difficulties for such clinical verifications are changes in the anatomy during the different steps and possible movement of the catheters. We used one fixed invasive catheter in the tumor additional to the usual non-invasive catheters in the vagina, bladder and rectum, for insertion of multisensor thermocouple probes. A special CT-scan with the patient in treatment position and the catheters in situ was made for the HTP. We performed these verifications in a total of 11 treatments in 7 patients. The main difficulties for accurate verification were of clinical nature: difficulties arising from the use of gynaecological tampon and the limited number of measurements in tissue. Remaining air in the vagina and sub-optimal tissue contact of the catheters resulted in bad thermal contact between thermocouples and tissue, causing measurement artefacts that are difficult to correlate with calculations. These artefacts are probably not specific for thermocouple measurements, but more general for intraluminal temperature and SAR measurements. (author)

  20. PSYCHOSEXUAL FUNCTIONING AFTER TREATMENT FOR CANCER OF THE CERVIX - A COMPARATIVE AND LONGITUDINAL-STUDY

    SCHULTZ, WCMW; VANDEWIEL, HBM; BOUMA, J

    1991-01-01

    Twenty-six couples participated in a 2-year longitudinal study of sexual functioning before and after treatment for carcinoma of the cervix. Sexual functioning was measured on admission prior to their treatment and at 6, 12 and 24 months follow-up and made operational in terms of current sexual

  1. External beam and HDR intracavitary irradiation: an effective tool in the primary treatment of cancer of the uterine cervix - excellent 10 year results and low side effects

    Hammer, Josef; Zoidl, Johann P.; Track, Christine; Seewald, Dietmar H.; Labeck, Werner

    1996-01-01

    Purpose/Objective: The purpose of this paper is to present our 15 years experience in the primary treatment of cervical cancer with a combination of external beam irradiation and high dose rate brachytherapy. Survival data will be presented and the safe use of intrauterine HDR applications will be demonstrated. Material and Methods: From August 1980 to December 1990, 303 patients with cancer of the uterine cervix underwent primary irradiation in a combination of external beam and HDR intracavitary treatment at the Department of Radiation Oncology at the Sisters of Mercy Hospital in Linz, Austria. All patients were classified according to the FIGO rules: Stage I 54 patients, stage II 171, stage III 75 and stage IV 3 patients. 8 patients were lost to follow up. The mean follow up time of survivors is 110 months. Results: A complete remission could be achieved in 282 patients (93%); persistent tumour was found in 21 patients at the first follow up check 3 to 5 months after completion of irradiation. The actuarial overall survival probability for all patients at 5 and 10 years is 62 % and 49 % respectively, the disease specific survival probability is 68 % and 64 %. The local control rate at 5 and 10 years is 73 % and 72 % respectively. According to stage, disease specific survival lies at 90 % for stage I, 69 % for stage II, and 49 % for stage III and IV at 5 years, and at 10 years 87 %, 66 % and 41 % respectively. The actuarial local control probability for stages I, II, and III/IV is 90 %, 74 %, and 60 % respectively at 5 years, and 88 %, 74 %, and 57 % at 10 years (Kaplan-Meier calculations). From all 303 patients 34 suffered from 40 severe and moderate side effects (glossary of Chassagne and Sismondi). The rate for grade II complications is 10 % and for grade III 3 %. Conclusion: Intrauterine HDR brachycurietherapy in addition to external beam irradiation for primary treatment of invasive carcinoma of the uterine cervix provides the same treatment results as LDR

  2. Survival of nonsurgically staged patients with negative lymphangiograms who had Stage IIB carcinoma of the cervix treated by pelvic radiation plus hydroxyurea

    Piver, M.S.; Krishnamsetty, R.M.; Emrich, L.J.

    1985-01-01

    Twenty patients with Stage IIB carcinoma of the cervix who did not undergo pretherapy para-aortic lymphadenectomy, but who had negative preradiation therapy lymphangiograms, were treated with pelvic radiation plus hydroxyurea. Patients received a median of 5020 rads of pelvic radiation plus 4000 rads of radium to point A. During radiation therapy and for a total of 12 weeks, patients received hydroxyurea administered at a dose of 80 mg/kg of body weight every 3 days if the white blood cell count was greater than or equal to 2,500/mm3 and platelets were greater than or equal to 75,000/mm3. The median follow-up time was 28 months (6 to 83 months). The estimated 5-year survival rate was 92%. Seventeen patients are alive with no evidence of disease (median, 28 months); one died of intercurrent disease with no evidence of disease (17 months); one is alive with no evidence of disease after recurrence (18 months); and one died of cervical cancer (22 months). The survival rate of patients with nonsurgically staged negative pretherapy lymphangiograms who had Stage IIB cervical cancer treated by pelvic radiation therapy plus hydroxyurea approximated the improved survival rate reported for patients with negative pretherapy para-aortic lymphadenectomy who were treated with pelvic radiation therapy plus hydroxyurea. Both studies would suggest that pelvic radiation plus hydroxyurea improves the rate of survival in patients with Stage IIB cervical cancer

  3. Use of social media to conduct a cross-sectional epidemiologic and quality of life survey of patients with neuroendocrine carcinoma of the cervix: a feasibility study.

    Zaid, Tarrik; Burzawa, Jennifer; Basen-Engquist, Karen; Bodurka, Diane C; Ramondetta, Lois M; Brown, Jubilee; Frumovitz, Michael

    2014-01-01

    To determine the feasibility of using social media to perform cross-sectional epidemiologic and quality-of-life research on patients with rare gynecologic tumors, we performed a survey of patients with neuroendocrine tumors of the cervix using Facebook. After approval from our Institutional Review Board, a support group of patients with neuroendocrine tumors of the cervix was identified on Facebook. Group members were asked to complete a survey comprising 84 questions evaluating clinical presentation; treatment; recurrence; quality of life; and sexual function. The survey was posted for 30 days, during which 57 women responded from 8 countries across 4 continents treated at 51 centers. All respondents provided a detailed clinical and tumor history. The mean age was 38.5 years. The stage distribution was stage I, 36 patients (63%); II, 13 (23%); III, 2 (4%); and IV, 6 (11%). Forty-nine patients (86%) had small cell and 8 (14%) had large cell tumors. Forty-five of the respondents (79%) had completed primary therapy and were without evidence of disease. Five (9%) had recurrence, 3 (5%) had persistent disease after therapy, and 4 (7%) were still under treatment. Forty-one patients (72%) reported symptoms at time of presentation. Thirty-seven patients (65%) received multimodality primary therapy. Quality of life instruments demonstrated high scores for anxiety and a negative impact of anxiety and cancer on functional and emotional well-being. Sexual function scores did not differ significantly between respondents and the PROMIS reference population. Use of a social media network to perform epidemiologic and quality of life research on patients with rare gynecologic tumors is feasible and permits such research to be conducted efficiently and rapidly. © 2013.

  4. Clinical outcomes from an innovative protocol using serial ultrasound imaging and a single MR image to guide brachytherapy for locally advanced cervix cancer.

    van Dyk, Sylvia; Narayan, Kailash; Bernshaw, David; Kondalsamy-Chennakesavan, Srinivas; Khaw, Pearly; Lin, Ming Yin; Schneider, Michal

    The aim of this study was to report clinical outcomes in a series of patients who underwent serial ultrasound and a single MRI to plan and verify intracavitary brachytherapy. Data for patients who were referred for curative intent radiotherapy for International Federation of Gynecology and Obstetrics (FIGO) Stage 1-1V cervix cancer between January 2007 and March 2012 were analyzed. All patients received external beam radiotherapy with concurrent chemotherapy and sequential high-dose rate brachytherapy. Brachytherapy was planned and verified using serial ultrasound imaging and a single MRI. Data from 191 patients were available for analyses. The median (range) followup time was 5.08 (0.25-8.25) years. Five-year local control, failure-free survival, cancer-specific survival, and overall survival were 86%, 57.3%, 70% and 63%, respectively. Mean (standard deviation) combined external beam radiotherapy and brachytherapy target doses, equivalent to doses in 2 Gy fractions were 80.4 Gy10 (3.89), median (range) 80 (49-96) Gy10. Grade 3 or greater gastrointestinal, genitourinary, or vaginal late toxicity occurred in 3%, 1.6%, and 2% of patients, respectively. Survival, patterns of failure, and late complication rates were similar to published series of MRI/CT-based brachytherapy practices. This large study demonstrates that favorable treatment outcomes can be obtained using a pragmatic and innovative combination of ultrasound and MR imaging. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  5. Image guided adaptive external beam radiation therapy for cervix cancer: Evaluation of a clinically implemented plan-of-the-day technique.

    Buschmann, Martin; Majercakova, Katarina; Sturdza, Alina; Smet, Stephanie; Najjari, Dina; Daniel, Michaela; Pötter, Richard; Georg, Dietmar; Seppenwoolde, Yvette

    2017-10-12

    Radiotherapy for cervix cancer is challenging in patients exhibiting large daily changes in the pelvic anatomy, therefore adaptive treatments (ART) have been proposed. The aim of this study was the clinical implementation and subsequent evaluation of plan-of-the-day (POTD)-ART for cervix cancer in supine positioning. The described workflow was based on standard commercial equipment and current quality assurance (QA) methods. A POTD strategy, which employs a VMAT plan library consisting of an empty bladder plan, a full bladder plan and a motion robust backup plan, was developed. Daily adaption was guided by cone beam computed tomography (CBCT) imaging after which the best plan from the library was selected. Sixteen patients were recruited in a clinical study on ART, for nine POTD was applied due to their large organ motion derived from two computed tomography (CT) scans with variable bladder filling. All patients were treated to 45Gy in 25 fractions. Plan selection frequencies over the treatment course were analyzed. Daily doses in the rectum, bladder and cervix-uterus target (CTV-T) were derived and compared to a simulated non-adapted treatment (non-ART), which employed the robust plan for each fraction. Additionally, the adaption consistency was determined by repeating the plan selection procedure one month after treatment by a group of experts. ART-specific QA methods are presented. 225 ART fractions with CBCTs were analyzed. The empty bladder plan was delivered in 49% of the fractions in the first treatment week and this number increased to 78% in the fifth week. The daily coverage of the CTV-T was equivalent between ART and the non-ART simulation, while the daily total irradiated volume V42.75Gy (95% of prescription dose) was reduced by a median of 87cm 3 . The median delivered V42.75Gy was 1782cm 3 . Daily delivered doses (V42.75Gy, V40Gy, V30G) to the organs at risk were statistically significantly reduced by ART, with a median difference in daily V42.75Gy in

  6. Change in knowledge of women about cervix cancer, human papilloma virus (HPV) and HPV vaccination due to introduction of HPV vaccines.

    Donders, Gilbert G G; Bellen, Gert; Declerq, Ann; Berger, Judith; Van Den Bosch, Thierry; Riphagen, Ine; Verjans, Marcel

    2009-07-01

    Test knowledge of HPV, cervix cancer awareness and acceptance of HPV vaccination of women now and a year ago. Questionnaires were filled out by 305 women visiting four gynaecologists of the Regional Hospital Heilig Hart, Tienen, Belgium during two subsequent weeks. Fisher T or Chi(2) were used as statistical methods to compare the data with the survey of 381 women exactly one year before. Knowledge about HPV as a cause of cervix cancer and the presence of a vaccine rose from roughly 50% in 2007 to over 80% in 2008 (pwomen below 26 years had now acquired almost equivalent knowledge to older women about the virus, cervix cancer and the vaccine, but they were far less likely to accept the vaccine due to its cost, unless it would be reimbursed (OR 4.2 (1.6-11) p=0.0055). One year after introduction of the first two HPV vaccines, over 75% of women attending an ambulatory gynaecology clinic know HPV causes cervix cancer and that you can get vaccinated against it. Compared with a year earlier, young and lower educated women had dramatically improved their knowledge. However, women below 26 years are less prepared to pay the cost for vaccination if it is not reimbursed.

  7. Comparison of one and two low dose rate brachytherapy insertions in the treatment of stage IIB cervix cancer with radiation therapy alone

    Ferrigno, Robson; Faria, S.L.C.O.

    1996-01-01

    Purpose/Objective: To compare one and two intracavitary brachytherapy with low dose rate in the management of stage IIB cervix cancer through a prospective and randomized trial. Materials and Methods: From September 1989 to December 1992, 81 patients with stage IIB cervix cancer were randomized in two arms according to the number of intracavitary brachytherapy insertion to be realized. Of these, 34 were treated by two intracavitary insertions (group A) and 47 by one insertion (group B). The external beam radiotherapy (EBRT) was realized through a Cobalt unit at whole pelvis with total dose of 40Gy in 20 fractions of 2,0Gy, in box arrangement, followed by parametrial complementation of 10Gy. The brachytherapy was realized right after the end of EBRT. The patients from group A were underwent to two insertions of 25Gy, calculated at point A, defined by the Manchester system. The interval between each insertions was 2 weeks. The patients from group B were underwent to one insertion of 40 Gy at point A. The average dose rate was 60cGy per hour at point A. Results: With the follow up ranging from 36 to 75 months and medium of 55 months, the disease free survival of the patients from group A was not statistically different of those from group B, 70,6% and 72,3% respectively (p=0,711). Local recurrence occurred in four patients from group A (11,7%) and in eight from group B (17%). Distant metastasis occurred in one patient from group A (2,9%) and in two from group B (4,2%). Three patients from group A (8,8%) and three from group B (6,4%) were lost to follow up and considered as dead. The causes of death among patients from group A were progression of local disease in four, distant metastasis in one, complicated diabetes mellitus in one and actinic intestinal complications in other one. The cause of deaths among patients from group B were progression of local disease in eight and distant metastasis in two. The grade I and II rectal complications rate was 5,9% and 6,3% at

  8. Toward an individualized target motion management for IMRT of cervical cancer based on model-predicted cervix-uterus shape and position

    Bondar, Luiza; Hoogeman, Mischa; Mens, Jan Willem; Dhawtal, Glenn; Pree, Ilse de; Ahmad, Rozilawati; Quint, Sandra; Heijmen, Ben

    2011-01-01

    Background and Purpose: To design and evaluate a 3D patient-specific model to predict the cervix-uterus shape and position. Methods and Materials: For 13 patients lying in prone position, 10 variable bladder filling CT-scans were acquired, 5 at planning and 5 after 40 Gy. The delineated cervix-uterus volumes in 2-5 pre-treatment CT-scans were used to generate patient-specific models that predict the cervix-uterus geometry by bladder volume. Model predictions were compared to delineations, excluding those used for model construction. The prediction error was quantified by the margin required around the predicted volumes to accommodate 95% of the delineated volume and by the predicted-to-delineated surface distance. Results: The prediction margin was significantly smaller (average 50%) than the margin encompassing the cervix-uterus motion. The prediction margin could be decreased (from 7 to 5 mm at planning and from 10 to 8 mm after 40 Gy) by increasing (from 2 to 5) the number of CT-scans used for the model construction. Conclusion: For most patients, even with a model based on only two CT-scans, the prediction error was well below the margin encompassing the cervix-uterus motion. The described approach could be used to create prior to treatment, an individualized treatment strategy.

  9. Acellular porcine small intestinal submucosa graft for cervicovaginal reconstruction in eight patients with malformation of the uterine cervix.

    Ding, Jing-Xin; Chen, Xiao-Jun; Zhang, Xu-Yin; Zhang, Ying; Hua, Ke-Qin

    2014-04-01

    Can surgical reconstruction of the cervix and vagina in patients be achieved using an acellular porcine small intestinal submucosa (SIS) graft? Our experiences of combined laparoscopic and vaginal cervicovaginal reconstruction using an SIS graft in eight patients were positive, with successful reconstruction and no complications, cervical stenosis or vaginal stenosis. In patients with agenesis and dysgenesis of the uterine cervix and vagina, surgical reconstruction of the internal genitalia is a challenging problem for gynecologists. Hysterectomy with the creation of an artificial vagina was the treatment of choice in the 1990s. Recently, conservative management has been gradually adopted to avoid extirpation of the uterus, including the canalization techniques, the uterovaginal anastomosis and the reconstruction of cervical and vaginal agenesis with some autologous tissues. This prospective observational study from January 2012 to March 2013 included 8 patients aged 10-18 years with malformation of the cervix (1 with cervical agenesis, 1 with a cervical body consisting of a fibrous band and 6 with obstruction of the cervical os) and vagina (4 with complete vaginal aplasia and 4 with a 1-3 cm long vaginal pouch) diagnosed by physical examination and magnetic resonance imaging. Eight patients underwent combined laparoscopic and vaginal cervicovaginal reconstruction using an SIS graft during the end of menstruation. A T-shaped intrauterine device connected with a 14-French Foley catheter was inserted into the uterine cavity to keep the newly created cervix patent, and then a permanent lower uterine cerclage was placed. Patients were assessed post-operatively at 1, 2, 4, 6, 12 and 15 months, and data on menstruation and the morphology of the neovagina and cervix were recorded. The mean ± SD age of the patients was 14.5 ± 2.8 (10-18) years. All patients had a history of cyclic abdominal pain, and the average delay in diagnosis was 4.5 ± 4.0 (0-12) months. One

  10. [Premature birth in patient with cervix incompetence and history of myasthenia gravis].

    Fuentealba, Maximiliano; Troncoso, Miguel; Vallejos, Joaquin; Ponce, Sebastian; Villablanca, Nelson; Melita, Pablo

    2013-09-01

    Cervical incompetence it's a dilatation of the cervix during the third trimester of pregnancy that ends with the interruption of it. The incidence in Chile is about 0.1-2% of the total pregnancies and it's one of the causes of preterm birth. A 34 years old pregnant patient. Timectomized at age 18 to treat her miastenia gravis, previously trated with medication, had 4 previous preterm labours all of them under 25 weeks and vaginal births. All fetuses died postpartum. A cerclage was made during the third, fourth and fifth pregnancies. She didn't present hypertension during the gestation and no cervical diameter under 15mm. Since the fourth gestation the following tests are taken: Antifosfolipidic antibodies, APTT,PT. All the results are either normal or negative. Microbial cultures were negative. No amniocentesis was made. A McDonald cervical cerclage was made during pregnancies number 3, 4 and 5 on the 16th week to delay the labor. Also oral micronized progesterone, on a 400mg/24 hours dosis, was administered to avoid preterm birth. On the 24th week the pharmacological treatment started including Intramuscular Betamethasone, 12 mg/24 hours (2 doses), to induce lung maturity on the fetus. It is thought that the administration of progesterone could have improved the situation of the patient, because it acts as a labour repressants. The use of cerclage could have helped, but the factors that may influence the effectiveness of this method are unknown. Perhaps there is some immunologic factor associated with the miastenia gravis that alters the normal course of pregnancy.

  11. A Systematic Overview of Radiation Therapy Effects in Cervical Cancer (Cervix Uteri)

    Einhorn, Nina [Karolinska Hospital, Stockholm (Sweden). Dept. of Oncology; Trope, Claes; Ridderheim, Mona; Boman, Karin; Sorbe, Bengt; Cavallin-Staahl, Eva

    2003-09-01

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

  12. A Systematic Overview of Radiation Therapy Effects in Cervical Cancer (Cervix Uteri)

    Einhorn, Nina; Trope, Claes; Ridderheim, Mona; Boman, Karin; Sorbe, Bengt; Cavallin-Staahl, Eva

    2003-01-01

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

  13. Long term follow up results of serum squamous cell carcinoma antigen level in uterine cervix cancer treated by radiotherapy

    Yun, Hyong Geun

    2003-01-01

    To evaluate the long term significance of the squamous cell carcinoma (SCC) antigen (Ag) as a tumor marker in uterine cervix carcinoma. The SCC antigen levels of pre-radiotherapy and serial post-radiotherapy serum were analyzed in 48 patients who received radiotherapy with histologically proven primary SCC of the uterine cervix. Pre-radiotherapy SCC Ag level was high (≥2 ng/ml) at 79.2%. After the treatment, the SCC Ag level was significantly decreased. The SCC Ag level measured at about 3 months after radiotherapy was high at 23.0%. In further follow up measurements, a rise of the SCC Ag to a high level was well associated with clinical relapse. The specificity of the elevated SCC Ag level in association with recurrent or persistent disease was 100%, and the sensitivity was 85.7%. In 3 of 4 lung metastasis cases, lung lesions were detected in chest PA before elevation of the SCC Ag level. The median lead time of the high SCC Ag level to clinical recurrence was 4 months. SCC Ag was a good tumor marker for monitoring treatment effect in patients with increased pre-treatment levels except in case of early lung metastasis. Elevation of the SCC Ag level after radiotherapy accurately predicted the treatment failure with lead time of 4 months. But, in early lung metastasis cases, the SCC level may be normal temporarily. Thus, chest PA should be checked to evaluate the presence of lung metastasis

  14. A case of radiation keratosis after sieve radiotherapy for cancer of the uterine cervix

    Imanaka, Kazufumi; Okuno, Takehiko; Tsuboi, Yoshitaka

    1981-01-01

    A case of radiation keratosis, regarded as the precancercerous state of the skin, is reported. A 54-year-old woman with cervical cancer was treated by postoperative sieve radiotherapy with 6,000 R as the tumor dose. Although free from cervical cancer, 10 years after this irradiation treatment, she was found to manifest multiple radiation keratosis coinciding with the pores of the sieve. We suggest that patients treated by irradiation for malignant diseases must be carefully followed for long periods, attending to not only the recurrence of the primary disease but also to radioinduced malignancy. (author)

  15. Case of radiation keratosis after sieve radiotherapy for cancer of the uterine cervix

    Imanaka, K.; Okuno, T.; Tsuboi, Y. (Hyogo-Ken Cancer Center, Kobe (Japan)

    1981-12-01

    A case of radiation keratosis, regarded as the precancercerous state of the skin, is reported. A 54-year-old woman with cervical cancer was treated by postoperative sieve radiotherapy with 6,000 R as the tumor dose. Although free from cervical cancer, 10 years after this irradiation treatment, she was found to manifest multiple radiation keratosis coinciding with the pores of the sieve. We suggest that patients treated by irradiation for malignant diseases must be carefully followed for long periods, attending to not only the recurrence of the primary disease but also to radioinduced malignancy.

  16. Specific features of cytological and colposcopical pattern in pregnant women with benign cervix uteri pathology in anamnesis.

    Bysaha, Nataliya Yu

    2016-01-01

    a tendency of increasing incidence of the cervix uteri precancer and cancer in women of reproductive age is noticed recently being related to the growth of number of the sexually-transmitted infections. The cervix uteri pathology incidence in women of fertile age is 20-25%. to study the specific features of the cytological and colposcopical pattern in pregnant patients with benign cervix uteri pathology in the anamnesis and the character of its change post partum. we have examined 195 women during their pregnancy and 3-5 months post partum. All pregnant women, alongside with generally accepted clinical and laboratory examinations, were subjected to the simple and extended colposcopy, cytology of the targeted smears and, according to indications, the histological studies of bioptate. according to the results of the colcoscopical studies and the signs of the cervix uteri pathology found, the patients were divided into several groups. A control group included 49 pregnant women. The clinical and instrumental examination of 146 women with cervix uteri pathology has been carried out both during pregnancy and post partum. the structure of the clinical forms of benign and premalignant changes in the cervix uteri epithelium in pregnant patients has been found. Specific features of the cytological and colposcopical pattern in pregnant patients with benign cervix uteri pathology in anamnesis have been studied. The relationship between the parity of pregnancy, delivery, route of delivery and regress of both benign and premalignant changes in the cervix uteri epithelium 3-5 months post partum has been determined.

  17. Role of Visual Inspection of Cervix with Acetic Acid (VIA in Detecting Precancerous Lesions of Cervix

    Kamrun Nessa

    2014-01-01

    Full Text Available Background: Carcinoma of cervix is the most common malignancy in female and a major public health problem worldwide. It is the leading cause of death from cancer among women in low resource settings. In Bangladesh, mortality rate is high as most of the cases with cervical cancer are diagnosed in advanced stage. World Health Organization considers cervical cancer as a preventable disease as it can be identified in preinvasive stage. Considerable efforts have been given in detection and treatment of the condition all over the world. A number of cervical cancer screening tests are available. Among them, visual inspection of cervix with acetic acid is rational and can be competently performed by physicians with proper training. Objective: To find out the feasibility of the visual inspection of cervix with acetic acid for the detection of the precancerous lesions of the cervix in our country. Materials and Methods: This cross sectional, analytical study was carried out among the patients attending the outpatient department of Bangabandhu Sheikh Mujib Medical University (BSMMU who were VIA positive and sent for colposcopy in the colposcopy clinic in the department of Obstetrics and Gynecology in BSMMU from June to December 2004. Two hundred samples were considered for this study. Results: Out of 200 cases, colposcopically 85% had CIN and invasive lesions, 4% had inflammatory lesions while 11% had normal findings. Colposcopy directed punch biopsy revealed positive lesions in 81%, 4% had inflammatory lesions while 15% had normal findings. Conclusion: The study concluded that VIA and colposcopy are the important methods in the evaluation of cervical premalignancy. VIA may be an important tool for screening of cervical cancer in low resource settings as it is simple, easy to perform and cost-effective. After screening, VIA positive cases must be referred for colposcopic evaluation. We can screen cervical cancer by VIA all over the country and thus reduce

  18. Carcinoma of the cervix in young females

    Gerbaulet, A.; Maylin, C.

    1994-01-01

    Does the cervix cancer represent really a different disease as it was defined by Bolla in 1979 already ? A double question remains set: can we establish this cancer evolutive form and fit to it the therapy ? 51 refs

  19. Relation between the treated region of the patient with ca. of the uterine cervix and her body-type in whole pelvis irradiation with conformation technique

    Morita, Kozo; Kakehi, Masae

    1975-01-01

    In whole pelvis irradiation using the conformation technique for the patient with carcinoma of the uterine cervix, standardization of the shape of the treated region was tried on the basis of measuring the pelvis in X-ray films. This was done on the X-rays of 200 patients with carcinoma of the uterine cervix. The body-type of the patient the most remarkably influenced the shape of the treated region. Ten clinical types of cam-group (treated region) were determined, in order to perform conformation radiotherapy for carcinoma of the uterine cervix. Although the shape of the treated region could also be changed by the invasion of the lesion, the position of the portio and the general condition of the patients, these 10 standard types of cam-group can be applied practically to almost all of the patients. (Evans, J.)

  20. SU-E-P-58: Dosimetric Study of Conventional Intensity-Modulated Radiotherapy and Knowledge-Based Radiation Therapy for Postoperation of Cervix Cancer

    Ma, C; Yin, Y [Shandong Tumor Hospital, Jinan, Shandong Provice (China)

    2015-06-15

    Purpose: To compare the dosimetric difference of the target volume and organs at risk(OARs) between conventional intensity-modulated radiotherapy(C-IMRT) and knowledge-based radiation therapy (KBRT) plans for cervix cancer. Methods: 39 patients with cervical cancer after surgery were randomly selected, 20 patient plans were used to create the model, the other 19 cases used for comparative evaluation. All plans were designed in Eclipse system. The prescription dose was 30.6Gy, 17 fractions, OARs dose satisfied to the clinical requirement. A paired t test was used to evaluate the differences of dose-volume histograms (DVH). Results: Comparaed to C-IMRT plan, the KBRT plan target can achieve the similar target dose coverage, D98,D95,D2,HI and CI had no difference (P≥0.05). The dose of rectum, bladder and femoral heads had no significant differences(P≥0.05). The time was used to design treatment plan was significant reduced. Conclusion: This study shows that postoperative radiotherapy of cervical KBRT plans can achieve the similar target and OARs dose, but the shorter designing time.

  1. Consensus Guidelines for Delineation of Clinical Target Volume for Intensity-Modulated Pelvic Radiotherapy for the Definitive Treatment of Cervix Cancer

    Lim, Karen; Small, William; Portelance, Lorraine; Creutzberg, Carien; Juergenliemk-Schulz, Ina M.; Mundt, Arno; Mell, Loren K.; Mayr, Nina; Viswanathan, Akila; Jhingran, Anuja; Erickson, Beth; De Los Santos, Jennifer; Gaffney, David; Yashar, Catheryn; Beriwal, Sushil; Wolfson, Aaron

    2011-01-01

    Purpose: Accurate target definition is vitally important for definitive treatment of cervix cancer with intensity-modulated radiotherapy (IMRT), yet a definition of clinical target volume (CTV) remains variable within the literature. The aim of this study was to develop a consensus CTV definition in preparation for a Phase 2 clinical trial being planned by the Radiation Therapy Oncology Group. Methods and Materials: A guidelines consensus working group meeting was convened in June 2008 for the purposes of developing target definition guidelines for IMRT for the intact cervix. A draft document of recommendations for CTV definition was created and used to aid in contouring a clinical case. The clinical case was then analyzed for consistency and clarity of target delineation using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE), with kappa statistics as a measure of agreement between participants. Results: Nineteen experts in gynecological radiation oncology generated contours on axial magnetic resonance images of the pelvis. Substantial STAPLE agreement sensitivity and specificity values were seen for gross tumor volume (GTV) delineation (0.84 and 0.96, respectively) with a kappa statistic of 0.68 (p < 0.0001). Agreement for delineation of cervix, uterus, vagina, and parametria was moderate. Conclusions: This report provides guidelines for CTV definition in the definitive cervix cancer setting for the purposes of IMRT, building on previously published guidelines for IMRT in the postoperative setting.

  2. Dosimetric comparison in a cancer of the Cervix with different therapeutic modalities

    Alonso Iracheta, L.; Casa de Julian, M. A. de la; Samper Ots, P.; Penas Cabrera, M. D. de las; Jimenez Gonzalez, J. M.

    2013-01-01

    Cervical cancer is usually treated with radiotherapy composed of 3D (RC3D) and supine position, and is usually not usually outline the small intestine in cases of exclusively pelvic irradiation. In our Center we wanted to check what dose receives the small intestine in these cases and if the positioning of the patient or used irradiation technique influence the distribution of the histogram dose-volume. (Author)

  3. A 7 gene expression score predicts for radiation response in cancer cervix

    Rajkumar, Thangarajan; Vijayalakshmi, Neelakantan; Sabitha, Kesavan; Shirley, Sundersingh; Selvaluxmy, Ganesharaja; Bose, Mayil Vahanan; Nambaru, Lavanya

    2009-01-01

    Cervical cancer is the most common cancer among Indian women. The current recommendations are to treat the stage IIB, IIIA, IIIB and IVA with radical radiotherapy and weekly cisplatin based chemotherapy. However, Radiotherapy alone can help cure more than 60% of stage IIB and up to 40% of stage IIIB patients. Archival RNA samples from 15 patients who had achieved complete remission and stayed disease free for more than 36 months (No Evidence of Disease or NED group) and 10 patients who had failed radical radiotherapy (Failed group) were included in the study. The RNA were amplified, labelled and hybridized to Stanford microarray chips and analyzed using BRB Array Tools software and Significance Analysis of Microarray (SAM) analysis. 20 genes were selected for further validation using Relative Quantitation (RQ) Taqman assay in a Taqman Low-Density Array (TLDA) format. The RQ value was calculated, using each of the NED sample once as a calibrator. A scoring system was developed based on the RQ value for the genes. Using a seven gene based scoring system, it was possible to distinguish between the tumours which were likely to respond to the radiotherapy and those likely to fail. The mean score ± 2 SE (standard error of mean) was used and at a cut-off score of greater than 5.60, the sensitivity, specificity, Positive predictive value (PPV) and Negative predictive value (NPV) were 0.64, 1.0, 1.0, 0.67, respectively, for the low risk group. We have identified a 7 gene signature which could help identify patients with cervical cancer who can be treated with radiotherapy alone. However, this needs to be validated in a larger patient population

  4. Trachelectomy for cancer of the cervix: dargent's operation. Vaginal hysterectomy for early cancer of the cervix stage IA1 and CIN III

    Ottosen, Christian

    2011-01-01

    Radical vaginal trachelectomy is today an established method of treating selected women with cervical cancer stage IA2 and IB1, with tumour size less than 2cm without precluding future childbearing. This technique has been used for more than 20 years with reassuring oncological safety and excellent...

  5. WE-G-BRD-07: Automated MR Image Standardization and Auto-Contouring Strategy for MRI-Based Adaptive Brachytherapy for Cervix Cancer

    Saleh, H Al; Erickson, B; Paulson, E

    2015-01-01

    Purpose: MRI-based adaptive brachytherapy (ABT) is an emerging treatment modality for patients with gynecological tumors. However, MR image intensity non-uniformities (IINU) can vary from fraction to fraction, complicating image interpretation and auto-contouring accuracy. We demonstrate here an automated MR image standardization and auto-contouring strategy for MRI-based ABT of cervix cancer. Methods: MR image standardization consisted of: 1) IINU correction using the MNI N3 algorithm, 2) noise filtering using anisotropic diffusion, and 3) signal intensity normalization using the volumetric median. This post-processing chain was implemented as a series of custom Matlab and Java extensions in MIM (v6.4.5, MIM Software) and was applied to 3D T2 SPACE images of six patients undergoing MRI-based ABT at 3T. Coefficients of variation (CV=σ/µ) were calculated for both original and standardized images and compared using Mann-Whitney tests. Patient-specific cumulative MR atlases of bladder, rectum, and sigmoid contours were constructed throughout ABT, using original and standardized MR images from all previous ABT fractions. Auto-contouring was performed in MIM two ways: 1) best-match of one atlas image to the daily MR image, 2) multi-match of all previous fraction atlas images to the daily MR image. Dice’s Similarity Coefficients (DSCs) were calculated for auto-generated contours relative to reference contours for both original and standardized MR images and compared using Mann-Whitney tests. Results: Significant improvements in CV were detected following MR image standardization (p=0.0043), demonstrating an improvement in MR image uniformity. DSCs consistently increased for auto-contoured bladder, rectum, and sigmoid following MR image standardization, with the highest DSCs detected when the combination of MR image standardization and multi-match cumulative atlas-based auto-contouring was utilized. Conclusion: MR image standardization significantly improves MR image

  6. WE-G-BRD-07: Automated MR Image Standardization and Auto-Contouring Strategy for MRI-Based Adaptive Brachytherapy for Cervix Cancer

    Saleh, H Al; Erickson, B; Paulson, E [Medical College of Wisconsin, Milwaukee, WI (United States)

    2015-06-15

    Purpose: MRI-based adaptive brachytherapy (ABT) is an emerging treatment modality for patients with gynecological tumors. However, MR image intensity non-uniformities (IINU) can vary from fraction to fraction, complicating image interpretation and auto-contouring accuracy. We demonstrate here an automated MR image standardization and auto-contouring strategy for MRI-based ABT of cervix cancer. Methods: MR image standardization consisted of: 1) IINU correction using the MNI N3 algorithm, 2) noise filtering using anisotropic diffusion, and 3) signal intensity normalization using the volumetric median. This post-processing chain was implemented as a series of custom Matlab and Java extensions in MIM (v6.4.5, MIM Software) and was applied to 3D T2 SPACE images of six patients undergoing MRI-based ABT at 3T. Coefficients of variation (CV=σ/µ) were calculated for both original and standardized images and compared using Mann-Whitney tests. Patient-specific cumulative MR atlases of bladder, rectum, and sigmoid contours were constructed throughout ABT, using original and standardized MR images from all previous ABT fractions. Auto-contouring was performed in MIM two ways: 1) best-match of one atlas image to the daily MR image, 2) multi-match of all previous fraction atlas images to the daily MR image. Dice’s Similarity Coefficients (DSCs) were calculated for auto-generated contours relative to reference contours for both original and standardized MR images and compared using Mann-Whitney tests. Results: Significant improvements in CV were detected following MR image standardization (p=0.0043), demonstrating an improvement in MR image uniformity. DSCs consistently increased for auto-contoured bladder, rectum, and sigmoid following MR image standardization, with the highest DSCs detected when the combination of MR image standardization and multi-match cumulative atlas-based auto-contouring was utilized. Conclusion: MR image standardization significantly improves MR image

  7. PREVENTION OF CANCER OF THE CERVIX UTERI AT AN ANTENATAL CLINIC

    I. E. Bakhlaev

    2009-01-01

    Full Text Available Cervical cancer (CC morbidity is analyzed on the basis of the data of the Karelian cancer register over the period 1998-2007. During this period, 816 cases of CC were registered and 126 were found at an antenatal clinic (AC. Its early detection rate was ascertained to be 96% during screening at the AC. A comprehensive examination was made in 1742 women with various cervical diseases, of them 37.5% were infected with human papillomavirus (HPV. High-grade dysplasia and carcinoma in situ were diagnosed in 6.6% of the HPV-infected patients. Large-scale screening for HPV infection and pretumor disorders with their further treatment will aid in reduc- ing CC morbidity and mortality rates.

  8. Imaging of uterine cervix carcinoma

    Viala, J.

    2000-01-01

    Imaging of uterine cervix carcinoma has evolved during the last decade. Recent developments in magnetic resonance imaging have expanded the role of MRI in evaluating the pathology of uterine cervix carcinoma. MRI is now the modality of choice for tumor staging, evaluating tumor response to treatment, diagnosing recurrences and for evaluating pregnant patients. MRI images will soon be used to calculate dosimetry for brachytherapy with matching and fusion software. (author)

  9. External Beam Boost for Cancer of the Cervix Uteri When Intracavitary Therapy Cannot Be Performed

    Barraclough, Lisa Helen; Swindell, Ric; Livsey, Jacqueline E.; Hunter, Robin D.; Davidson, Susan E.

    2008-01-01

    Purpose: To assess the outcome of patients treated with radical radiotherapy for cervical cancer who received an external beam boost, in place of intracavitary brachytherapy (ICT), after irradiation to the whole pelvis. Methods and Materials: Case notes were reviewed for all patients treated in this way in a single center between 1996 and 2004. Patient and tumor details, the reasons why ICT was not possible, and treatment outcome were documented. Results: Forty-four patients were identified. The mean age was 56.4 years (range, 26-88 years). Clinical International Federation of Gynecology and Obstetrics or radiologic stage for Stages I, II, III, and IV, respectively, was 16%, 48%, 27%, and 7%. A total radiation dose of 54-70 Gy was given (75% received ≥60 Gy). Reasons for ICT not being performed were technical limitations in 73%, comorbidity or isolation limitations in 23%, and patient choice in 4%. The median follow-up was 2.3 years. Recurrent disease was seen in 48%, with a median time to recurrence of 2.3 years. Central recurrence was seen in 16 of the 21 patients with recurrent disease. The 5-year overall survival rate was 49.3%. The 3-year cancer-specific survival rate by stage was 100%, 70%, and 42% for Stages I, II, and III, respectively. Late Grades 1 and 2 bowel, bladder, and vaginal toxicity were seen in 41%. Late Grade 3 toxicity was seen in 2%. Conclusion: An external beam boost is a reasonable option after external beam radiotherapy to the pelvis when it is not possible to perform ICT

  10. A comparison of mghr prescription to doses at points A and B in intracavitary radiotherapy of cervix cancer

    Park, C.I.; Ha, S.W.; Kang, W.S.

    1981-01-01

    The 42 patients with carcinoma of the cervix, performed intracavitary radiotherapy, were analysed the doses at points A and B comparing to the mghr prescription. The doses at points A and B were calculated by PC-12 computer planning system. Correlation coefficiency between doses at points A and B and the mghr prescription are 0.82 (p<0.001) and 0.90 (p<0.001) respectively. The slope of the point A line is 0.70 and the slope of the point B is 0.21. Therefore, the dose at point A is approximately 3/4 the mghr prescription and the dose at point B is approximately 1/4 the mghr prescription. (author)

  11. Reproductive Tract infections and Premalignant Lesions of Cervix: Evidence from Women Presenting at the Cancer Detection Centre of the Indian Cancer Society, Delhi, 2000-2012.

    Dey, Subhojit; Pahwa, Parika; Mishra, Arti; Govil, Jyotsna; Dhillon, Preet K

    2016-10-01

    Burden of cervical cancer (CC) is highest for women in low- and middle-income countries (LMICs). Human papillomavirus (HPV) is implicated as the necessary cause of CC although a number of other factors aid the long process of CC development. One among them is the presence of reproductive tract infections (RTIs). This study investigated the associations between RTIs and CC from India. This study utilized secondary data from the Cancer Detection Centre of the ICS, Delhi. Data were accessed from MS access database and were analyzed using MS Excel and SPSS 16.0. Multivariate analysis using unconditional logistic regression produced odds ratios (ORs) and 95 % confidence intervals (CIs). This study used data from 11,427 women over a period of 2000-2012. Women with RTIs had Candida, Trichomonas vaginalis (TV) or coccoid infections with all having similar prevalence (~4-5 %). 9.4 % of women had premalignant lesions of cervix; ASCUS was most common (7.9 %) followed by LSIL (1.3 %). TV was significantly associated with ASCUS, LSIL and all premalignant lesions of cervix (P Lack of awareness and hygiene, and limited access to gynecologists in LMICs lead to frequent and persistent RTIs which aid and abet HPV infection and CC occurrence. These also need to be addressed to reduce CC and RTIs among women in LMICs.

  12. The body’s immune response in the induction and progression of cancer of the cervix uteri: possible mechanisms

    O. V. Kurmyshkina

    2011-01-01

    Full Text Available Human papillomavirus (HPV that is a main cause of cancer of the cervix uteri (CCU has immunogenic properties, i.e. an abilityto activate antiviral immunity responses as adaptive HPV-specific and innate ones. For this reason, despite multiple mechanisms generated by HPV to avoid immunity responses, the human body can eliminate the infection in most cases. At the same time, CCU results from the combined influence of many factors of different nature, among which the factors that impair the normal course of an immune response are of vital importance.This review describes the major factors and mechanisms, which promote the establishment of persistent HPV infection and the progression of dysplasia to cancer, on the one hand, and allow the tumor cells in CCU to restrict the body’s immune reactions, on the other Immune disorders induced by the virus and/or tumor cells are considered at both local and systemic levels. Particular emphasis is placed on the molecular mechanisms that can change the population composition and functional activity of leukocytes and the cytokine profile of cells and can form the tumor suppressor microenvironment.

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

    E. K. Tanriverdieva

    2012-01-01

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

  14. Multiple neoplasms among cervical cancer patients in the material of the lower Silesian cancer registry.

    Izmajłowicz, Barbara; Kornafel, Jan; Błaszczyk, Jerzy

    2014-01-01

    According to the definition by the International Agency for Research on Cancer (IARC), primary multiple neoplasms are two or more neoplasms of different histopathological build in one organ, or two or more tumors occurring in one patient, regardless of the time of their occurrence (synchronic - up to 6 months, metachronous - after 6 months), coming from an organ or a tissue and not being an infiltration from another neoplasm, a relapse or a metastasis. It was the aim of the study to analyze the frequency of the occurrence of multiple neoplasms among patients suffering from uterine cervix cancer, with a special interest in coexistent neoplasms, the time of their occurrence and total 5-year survivals. The data from the Lower Silesian Cancer Registry concerning the years 1984-2009 formed the material of the present study. 5.3% of all cervix neoplasms occurred as multiple cancers. Cervix neoplasms were 13.4% of multiple neoplasms. On average, cervical cancer occurred as a subsequent cancer in 6 patients yearly (60.7% of the occurrences of cervical cancer were in the period of 5 years following treatment for the first neoplasm). 5-year survival in patients suffering from primarily multiple cervix neoplasms constituted 57% and was convergent with the results for all patients suffering from cervical cancer. Cervical cancer as the first neoplasm occurred in 287 patients, on average in 11 patients annually. In the period of the first 5 years after the treatment of cervical cancer, there were 42.8% occurrences of other cancers. Cervical neoplasms most frequently coexisted with cancers of the breast, lung and large intestine. The frequency of the occurrence of multiple neoplasm among cervical cancer patients is increasing. Most frequently they coexist with other tobacco-related neoplasms, those related to HPV infections and with secondary post-radiation neoplasms. These facts should be taken into consideration during post-treatment observation and when directing diagnostic

  15. The forecasting of radiation injuries of the urinary bladder and rectum in patients with uterine cervix carcinoma

    Zharinov, G.M.; Gabelov, A.A.

    1984-01-01

    The frequency and degree of severity of radiation in unjuries of the urinary bladder and rectum after combined treatment of 725 patients with uterine cercix carcigoma are analysed. A quantitative index was worked out permi-- tting one to give an ob ective evaluation of the degree of early radiation reactions of the ad acent organs. The determination of the ''radiation injuries prognosis index'' (RIPI) makes it possible to forecast the occurence and degree of severity of late radiation injuries of the urinary bladder and rectum. The evaluation of RIPI mean values in the patients' groups provides an opportunity to oompare the damaging effect of different methods and regiment directly in the process of radiation therapy. The above method improves the potentialities of the forecasting of radiation injuries of the urinary bladder and rectum in patients with uterine cervix carcinoma

  16. The prediction of late rectal complications in patients treated with high dose-rate brachytherapy for carcinoma of the cervix

    Clark, Brenda G.; Souhami, Luis; Roman, Ted N.; Chappell, Rick; Evans, Michael D.C.; Fowler, Jack F.

    1997-01-01

    Purpose: The aim of this work is to investigate an unusually high rate of late rectal complications in a group of 43 patients treated with concomitant irradiation and chemotherapy for carcinoma of the cervix between December 1988 and April 1991, with a view to identifying predictive factors. Methods and Materials: The biologically effective dose received by each patient to the rectal reference point defined by the International Commission of Radiation Units and Measurements, Report 38, were calculated. Radiotherapy consisted of 46 Gy external beam irradiation plus three high dose-rate intracavitary treatments of 10 Gy each prescribed to point A. Cisplatin 30 mg/m 2 was given weekly throughout the duration of the irradiation. The results have been compared to data from 119 patients treated with irradiation alone to assess the confounding effect of the cisplatin. Results: The relationship between the biologically effective dose delivered to the rectal reference point and the development of late complications shows a strong dose-response with a threshold for complications occurring at approximately 125 Gy 3 corresponding to a brachytherapy dose of approximately 8 Gy per fraction. This value is approximately the same biologically effective dose threshold as that found for external beam irradiation in the head and neck region. The data from the group of patients treated without cisplatin is comparable to the data from the first group of patients in the lower dose ranges; the higher doses were not used and thus are not available for comparison. Conclusion: Using the linear quadratic model applied to our clinical results, we have established a threshold for late rectal complications for patients treated with external beam irradiation and high dose-rate brachytherapy for carcinoma of the cervix. This threshold is consistent with similar data for external beam irradiation in the head and neck region

  17. Standards, options and recommendations: concomitant radio chemotherapy for cancer of the cervix: a critical analysis of the literature and update of SOR

    Haie-Meder, C.; Lhomme, C.; Fervers, B.; Bataillard, A.; Chauvergne, J.; Fondrinier, E.; Guastalla, J.P.; Resbeut, M.

    2000-01-01

    The 'Standards, Options and Recommendations'(SOR) project, started in 1993, is a collaboration between the National Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres (CRLCC) and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. To update, according to the methodology of SOR, the Standards, Options and Recommendations for the management of patients with cancer of the cervix, and in particular, the place of concomitant radio-chemotherapy. Data have been identified by a literature search using Medline (to April 1999) and the personal reference lists of experts. Once the guidelines were defined, the document was submitted for review to independent national and international reviewers and to the medical committees of the CRCC. The principle recommendations concerning the place of radio-chemotherapy in the treatment of cancer of the cervix are 1) the available data shows a significant increase in local control (level of evidence A) and of overall survival (level of evidence B1)following concomitant radio-chemotherapy as compared to radiotherapy alone or the combination of radiotherapy-hydroxyurea. For stages IB, IIA, proximal IIB with bad prognostic factors (tumour size greater than 4 cm and/or invasion of pelvic nodes and/or microscopic invasion of the parametrium) and without lumbo-aortic nodal invasion, concomitant radio-chemotherapy can be considered as standard treatment. This benefit is less clear for stages distal IIB, III and IVA without para-aortic nodal invasion (level of evidence C) and must be confirmed (expert agreement). 2) the toxicity of radio-chemotherapy is essentially hematologic and

  18. Dosimetric evaluation of a combination of brachytherapy applicators for uterine cervix cancer with involvement of the distal vagina; Avaliacao dosimetrica de uma combinacao de aplicadores para braquiterapia de tumores do colo uterino com acometimento da porcao distal da vagina

    Guimaraes, Roger Guilherme Rodrigues [Real e Benemerita Sociedade Portuguesa de Beneficencia, Sao Paulo, SP (Brazil). Servico de Radioterapia Estereotactica; Carvalho, Heloisa de Andrade; Stuart, Silvia Radwanski; Rubo, Rodrigo Augusto [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Servico de Radioterapia], e-mail: handrade@hcnet.usp.br; Seraide, Rodrigo Migotto [Centro de Oncologia Campinas, SP (Brazil)

    2009-07-15

    Objective: To evaluate an alternative brachytherapy technique for uterine cervix cancer involving the distal vagina, without increasing the risk of toxicity. Materials And Methods: Theoretical study comparing three different high-dose rate intracavitary brachytherapy applicators: intrauterine tandem and vaginal cylinder (TC); tandem/ring applicator combined with vaginal cylinder (TR+C); and a virtual applicator combining both the tandem/ring and vaginal cylinder in a single device (TRC). Prescribed doses were 7 Gy at point A, and 5 Gy on the surface or at a 5 mm depth of the vaginal mucosa. Doses delivered to the rectum, bladder and sigmoid colon were kept below the tolerance limits. Volumes covered by the isodoses, respectively, 50% (V50), 100% (V100), 150% (V150) and 200% (V200) were compared. Results: Both the combined TR+C and TRC presented a better dose distribution as compared with the TC applicator. The TR+C dose distribution was similar to the TRC dose, with V150 and V200 being about 50% higher for TR+C (within the cylinder). Conclusion: Combined TR+C in a two-time single application may represent an alternative therapy technique for patients affected by uterine cervix cancer involving the distal vagina. (author)

  19. Clinical experience of Phelloberin A in diarrhea during the treatment of cancer of the cervix uteri with radiation

    Kagabu, Teruo; Takano, Toshiaki; Sano, Toshiyuki; Kaneda, Osamu; Saito, Masataka

    1978-01-01

    This drug containing chlorinated berberine and Gennoshoko extract was administered to cases which suffered from diarrhea during external irradiation, and its effect on them were observed. Out of 35 cases of cancer of the cervix uteri from stage I to III, 20 cases in which watery diarrhea was induced over three times a day by external irradiation were given 12 tablets per a day in four divided doses for 7 days. In external irradiation a total of 3000 rads was irradiated in 200 rads per a day (1000 rads per a week) by the whole pelvic irradiation, and after that, irradiation was performed up to 6000 rads by shielding the center. Diarrhea was observed in 20 of 35 cases during external irradiation (57.1%). Diarrhea was recognized in 4 cases in the range from 1000 to 2000 rads (20%), in 13 cases in the range from 2000 to 3000 rads (65%), and 3 cases irradiated by shielding the center (15%). Response to this drug was effective within 3 days after the administration in 9 cases (45%), a little effective in 7 cases (35%), and ineffective in 4 cases (20%). There was a past history of hypertension in cases whose response was ineffective. In the clinical examination after the administration of this drug, abnormalities in kidney and liver functions were not recognized. From the above-mentioned results, it was suggested that this drug was effective on diarrhea which occurred during external irradiation. (Kanao, N.)

  20. Properties of Surfactin C-15 Nanopeptide and Its Cytotoxic Effect on Human Cervix Cancer (HeLa Cell Line

    Zahra Nozhat

    2012-01-01

    Full Text Available Surfactin is one of the most powerful biosurfactants that has been known so far. It is an acidic cyclic nonribosomal lipoheptapeptide that is produced by Bacillus subtilis. In this presentation we investigated different properties of surfactin C-15. The nanomicelle forming ability of surfactin C-15 in different aqueous environments with various ionic strengths was studied by scanning electron microscope. Surfactin second structure was investigated by Far-UV CD spectrum. Its hemolytic activity and cytotoxicity were measured by hemolysis and MTT assays, respectively. Surfactin formed spherical nanomicelles in distilled water and amorphous nanomicelles in PBS buffer . The hemolysis assay results indicated that HC50 of surfactin was 47 μM. Surfactin C-15 arrested growth of human cervix cancer HeLa cell line in a time- and dosage-dependent method, so that its IC50 at 16, 24, and 48h were 86.9, 73.1, and 50.2 μM, respectively.

  1. A clinical and pathological study of acute rectal injury by the radiation therapy of uterine cervix cancer

    Honke, Yoshifumi; Katsuta, Shizutomo; Katayama, Hiroshi; Haruma, Ken; Fujiwara, Atsushi; Suenaga, Kenji.

    1983-01-01

    The clinical features, magnifying colonoscopic findings and pathological findings of acute radiation proctitis were investigated in 40 cases of uterine cervix cancer and the following results were obtained. 1)As a clinical simptom, diarrhea was observed in about half of all cases. 2)The value of serum total protein and number of leukocyte decreased until the dose of 30 Gy (3000 rads) and no remarkable change of them were observed afterwards. Hemoglobin value did not change throughout the whole clinical course. 3)Magnifying colonoscopic findings showed remarkable change with increase of the dose and especially irregularity of pit was observed in all cases. 4)In pathological findings, edema, degenerative change of epitherial cells and decreased number of goblet cells were observed from the beginning. In cases that received more than 50 Gy (5000 rads), fibrosis developed and the epithelium showed strong regeneration. Also Paneth cells were observed in 5 out of 40 cases. 5)Remarkable change was not observed before or after the radiation by barium enema. (author)

  2. Clinical experience of Sheroproct suppository in rectal damage accompanied with radiotherapy of cancer of the uterine cervix

    Sugimori, Hajime; Matsuyama, Toshitake

    1976-01-01

    1 - 2 pieces per a day of Sheroproct suppository were given to 22 cases which were suffered from rectitis or rectal hemorrhage during or after radiotherapy of cancer of the uterine cervix. The effects were judged as follows according to the degree of main symptoms such as pain, hemorrhage and mucous stool: marked effectiveness (the symptoms decreased within three days and disappeared within one week), effectiveness (it takes over four days to decrease the symptoms and the symptoms disappeared within one week, and a little effectiveness (the symptoms disappeared within one or two weeks). As to pain in 20 cases, marked effectiveness was recognized in 11 cases, a little effectiveness in 3 cases, and no effectiveness in one case. In 16 cases of acute inflamation induced during radiotherapy, 9 cases showed markedly effective, 4 cases showed effective, and one case showed no effective. On improvement of mucous stool, this drug was effective in acute rectitis, but it was not effective in chronic cases. There was little effect in rectal hemorrhage after the radiotherapy. It was suggested that this drug was useful to treat pain of rectitis. (Tsunoda, M.)

  3. Comparison of high dose rate (HDR) and low dose rate (LDR) brachytherapy in the treatment of stage IIIB cervix cancer with radiation therapy alone. The preliminary results

    Trippe, Nivaldo; Novaes, P.E.; Ferrigno, R.; Pellizzon, A.C.; Salvajoli, J.V.; Fogaroli, R.C.; Maia, M.A.C.; Baraldi, H.E.

    1996-01-01

    Purpose/Objective: To compare the results between HDR and LDR brachytherapy in the treatment of stage IIIB cervix cancer with radiation therapy alone through a prospective and randomized trial. Materials and Methods: From September 1992 to December 1993, 65 patients with stage IIIB cervical cancer were randomized to one of the following treatment schedule according to the brachytherapy used to complement the dose of external beam radiotherapy (EBRT): 1 - High dose rate (HDR) - 36 patients - 4 weekly insertions of 6,0 Gy at point A 2 - Low dose rate (LDR) - 29 patients - 2 insertions two weeks apart of 17,5 Gy at point A The External Beam radiotherapy was performed through a Linac 4MV, in box arrangement for whole pelvis and in AP-PA fields for parametrial complementation of dose. The dose at the whole pelvis was 45 Gy in 25 fractions of 1,8 Gy and the parametrial dose was 16 Gy. The brachytherapy was realized with Fletcher colpostats and intrauterine tandem, in both arms. The HDR brachytherapy was realized through a Micro-Selectron device, working with Iridium-192 with initial activity of 10 Ci and started ten days after the beginning of EBRT. The total treatment time was shortened in two weeks for this group. The LDR brachytherapy started only after the end of EBRT. Results: With the minimum follow up of 24 months and medium of 31 months, the disease free survival was 50% among the 36 patients in HDR group and 47,8% among the 29 patients in LDR group. Local failures occurred in 50% and 52,8% respectively. Grade I and II complications were restricted to rectites and cistites and the incidence of them was 8,3% for HDR group and 13% for LDR group. Until the time of evaluation there were no grade III complications in any group. Conclusions: Although the number of patients is small and the time of follow up still short, these preliminary results suggest that the HDR brachytherapy has an equivalent efficiency in local control as the LDR in the treatment of stage IIIB

  4. Statistical study on cancer patients of cancer research hospital

    Shim, Yoon Sang; Choi, Soo Yong; Won, Hyuk; Kim, Kee Hwa

    1991-01-01

    The total number of malignant neoplasms included on this study 7,787 cases(10.4%) among 74,928 cases for 2 years. On sex, females with 57.6% were much more than males with 42.4%. The highest proportion of cancer 50-59 age group. The most frequent primary site among males was found to be stomach with 36.2%, followed by liver(12.3%), lung(12.2%), esophagus(15.5%) and larynx(4.9%). In females, the first order was uterine cervix with 47.3%, followed most common type of morphology of malignant neoplasms was adenocarcinoma(39.0%) in males an squamous cell carcinoma(56.2%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 4.6% for patient with carcinoma-in-situ, 76.3% for patients with localized involvement, 11.6% for patients with regional involvement and 7.5% for patients with distant involvement. Among,the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 19.0% for surgery, 27.7 for radiotherapy and 24.2% for chemotherapy. Among the cancer patients confirmed by medical records, 11.2% was traced more than 5 years. (Author)

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

    Frischkorn, R.

    1986-01-01

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

  6. Computational study of incidence of secondary neoplasms in cancer therapy of uterine cervix

    Santos, W.S.; Valeriano, C.C.S.; Caldas, L.V.E.; Neves, L.P.; Perini, A.P.; Silva, R.M.V.

    2016-01-01

    There is a serious, and growing, concern about the increased risk of the emergence of a second cancer, induced by radiation associated with the radiation treatment. To assess the radiation doses to organs outside the target volume, in this work, we modeled several computational exposure scenarios, based on Monte Carlo simulation (MCNPX code). We used a VARIAN 2100c accelerator, and a female virtual anthropomorphic phantom to simulate a treatment of uterine cancer. The results presented show that the computational exposure scenario provides a versatile and accurate tool to assess the risk of secondary cancer. (author)

  7. Gene promoter methylation and protein expression of BRMS1 in uterine cervix in relation to high-risk human papilloma virus infection and cancer.

    Panagopoulou, Maria; Lambropoulou, Maria; Balgkouranidou, Ioanna; Nena, Evangelia; Karaglani, Makrina; Nicolaidou, Christina; Asimaki, Anthi; Konstantinidis, Theocharis; Constantinidis, Theodoros C; Kolios, George; Kakolyris, Stylianos; Agorastos, Theodoros; Chatzaki, Ekaterini

    2017-04-01

    Cervical cancer is strongly related to certain high-risk types of human papilloma virus infection. Breast cancer metastasis suppressor 1 (BRMS1) is a tumor suppressor gene, its expression being regulated by DNA promoter methylation in several types of cancers. This study aims to evaluate the methylation status of BRMS1 promoter in relation to high-risk types of human papilloma virus infection and the development of pre-cancerous lesions and describe the pattern of BRMS1 protein expression in normal, high-risk types of human papilloma virus-infected pre-cancerous and malignant cervical epithelium. We compared the methylation status of BRMS1 in cervical smears of 64 women with no infection by high-risk types of human papilloma virus to 70 women with proven high-risk types of human papilloma virus infection, using real-time methylation-specific polymerase chain reaction. The expression of BRMS1 protein was described by immunohistochemistry in biopsies from cervical cancer, pre-cancerous lesions, and normal cervices. Methylation of BRMS1 promoter was detected in 37.5% of women with no high-risk types of human papilloma virus infection and was less frequent in smears with high-risk types of human papilloma virus (11.4%) and in women with pathological histology (cervical intraepithelial neoplasia) (11.9%). Methylation was detected also in HeLa cervical cancer cells. Immunohistochemistry revealed nuclear BRMS1 protein staining in normal high-risk types of human papilloma virus-free cervix, in cervical intraepithelial neoplasias, and in malignant tissues, where staining was occasionally also cytoplasmic. In cancer, expression was stronger in the more differentiated cancer blasts. In conclusion, BRMS1 promoter methylation and aberrant protein expression seem to be related to high-risk types of human papilloma virus-induced carcinogenesis in uterine cervix and is worthy of further investigation.

  8. Human Papillomavirus Infections and Cancer Stem Cells of Tumors from the Uterine Cervix

    López, Jacqueline; Ruíz, Graciela; Organista-Nava, Jorge; Gariglio, Patricio; García-Carrancá, Alejandro

    2012-01-01

    Different rate of development of productive infections (as low grade cervical intraepithelial neoplasias), or high grade lesions and cervical malignant tumors associated with infections of the Transformation zone (TZ) by High-Risk Human Papillomavirus (HR-HPV), could suggest that different epithelial host target cells could exist. If there is more than one target cell, their differential infection by HR-HPV may play a central role in the development of cervical cancer. Recently, the concept that cancer might arise from a rare population of cells with stem cell-like properties has received support in several solid tumors, including cervical cancer (CC). According to the cancer stem cell (CSC) hypothesis, CC can now be considered a disease in which stem cells of the TZ are converted to cervical cancer stem cells by the interplay between HR-HPV viral oncogenes and cellular alterations that are thought to be finally responsible for tumor initiation and maintenance. Current studies of CSC could provide novel insights regarding tumor initiation and progression, their relation with viral proteins and interplay with the tumor micro-environment. This review will focus on the biology of cervical cancer stem cells, which might contribute to our understanding of the mechanisms responsible for cervical tumor development. PMID:23341858

  9. Biological effective dose studies in carcinoma of uterine cervix

    Yadav, Poonam; Ramasubramanian, V.

    2008-01-01

    Cancer of cervix is the second most common cancer worldwide among women. Several treatments related protocols of radiotherapy have been followed over few decades in its treatment for evaluating the response. These physical doses varying on the basics of fractionation size, dose rate and total dose needed to be indicated as biological effective dose (BED) to rationalize these treatments. The curative potential of radiation therapy in the management of carcinoma of the cervix is greatly enhanced by the use of intracavitary brachytherapy. Successful brachytherapy requires the high radiation dose to be delivered to the tumor where as minimum radiation dose reach to surrounding normal tissue. Present study is aimed to evaluate biologically effective dose in patients receiving high dose-rate brachytherapy plus external beam radiotherapy based on tumor cell proliferation values in cancer of the cervix patients. The study includes 30 patients' data as a retrospective analysis. In addition determine extent of a dose-response relationship existing between the biological effective dose at Point A and the bladder and rectum and the clinical outcomes

  10. On-line estimations of delivered radiation doses in three-dimensional conformal radiotherapy treatments of carcinoma uterine cervix patients in linear accelerator.

    Putha, Suman Kumar; Saxena, P U; Banerjee, S; Srinivas, Challapalli; Vadhiraja, B M; Ravichandran, Ramamoorthy; Joan, Mary; Pai, K Dinesh

    2016-01-01

    Transmission of radiation fluence through patient's body has a correlation to the planned target dose. A method to estimate the delivered dose to target volumes was standardized using a beam level 0.6 cc ionization chamber (IC) positioned at electronic portal imaging device (EPID) plane from the measured transit signal (S t ) in patients with cancer of uterine cervix treated with three-dimensional conformal radiotherapy (3DCRT). The IC with buildup cap was mounted on linear accelerator EPID frame with fixed source to chamber distance of 146.3 cm, using a locally fabricated mount. S t s were obtained for different water phantom thicknesses and radiation field sizes which were then used to generate a calibration table against calculated midplane doses at isocenter (D iso,TPS ), derived from the treatment planning system. A code was developed using MATLAB software which was used to estimate the in vivo dose at isocenter (D iso,Transit ) from the measured S t s. A locally fabricated pelvic phantom validated the estimations of D iso,Transit before implementing this method on actual patients. On-line dose estimations were made (3 times during treatment for each patient) in 24 patients. The D iso,Transit agreement with D iso,TPS in phantom was within 1.7% and the mean percentage deviation with standard deviation is -1.37% ±2.03% ( n = 72) observed in patients. Estimated in vivo dose at isocenter with this method provides a good agreement with planned ones which can be implemented as part of quality assurance in pelvic sites treated with simple techniques, for example, 3DCRT where there is a need for documentation of planned dose delivery.

  11. Medium-dose-rate brachytherapy of cancer of the cervix: preliminary results of a prospectively designed schedule based on the linear-quadratic model

    Leborgne, Felix; Fowler, Jack F.; Leborgne, Jose H.; Zubizarreta, Eduardo; Curochquin, Rene

    1999-01-01

    Purpose: To compare results and complications of our previous low-dose-rate (LDR) brachytherapy schedule for early-stage cancer of the cervix, with a prospectively designed medium-dose-rate (MDR) schedule, based on the linear-quadratic model (LQ). Methods and Materials: A combination of brachytherapy, external beam pelvic and parametrial irradiation was used in 102 consecutive Stage Ib-IIb LDR treated patients (1986-1990) and 42 equally staged MDR treated patients (1994-1996). The planned MDR schedule consisted of three insertions on three treatment days with six 8-Gy brachytherapy fractions to Point A, two on each treatment day with an interfraction interval of 6 hours, plus 18 Gy external whole pelvic dose, and followed by additional parametrial irradiation. The calculated biologically effective dose (BED) for tumor was 90 Gy 10 and for rectum below 125 Gy 3 . Results: In practice the MDR brachytherapy schedule achieved a tumor BED of 86 Gy 10 and a rectal BED of 101 Gy 3 . The latter was better than originally planned due to a reduction from 85% to 77% in the percentage of the mean dose to the rectum in relation to Point A. The mean overall treatment time was 10 days shorter for MDR in comparison with LDR. The 3-year actuarial central control for LDR and MDR was 97% and 98% (p = NS), respectively. The Grades 2 and 3 late complications (scale 0 to 3) were 1% and 2.4%, respectively for LDR (3-year) and MDR (2-year). Conclusions: LQ is a reliable tool for designing new schedules with altered fractionation and dose rates. The MDR schedule has proven to be an equivalent treatment schedule compared with LDR, with an additional advantage of having a shorter overall treatment time. The mean rectal BED Gy 3 was lower than expected

  12. A systematic review and meta-analysis on the attribution of human papillomavirus (HPV) in neuroendocrine cancers of the cervix.

    Castle, Philip E; Pierz, Amanda; Stoler, Mark H

    2018-02-01

    There remains uncertainty about the role of human papillomavirus (HPV) infection in causing small-cell neuroendocrine carcinoma (SCNC) and large-cell neuroendocrine carcinoma (LCNC) of the cervix. To clarify the role of HPV in the development of SCNC and LCNC, we conducted a systematic review and meta-analyses. PubMed and Embase were searched to initially identify 143 articles published on or before June 1, 2017. Studies were limited to methods that tested for HPV in the cancer tissue directly to minimize misattribution. Thirty-two studies with 403 SCNC and 9 studies of 45 LCNC were included in the analysis. For SCNC, 85% (95% confidence interval [95%CI]=71%-94%) were HPV positive, 78% (95%CI=64%-90%) were HPV16 and/or HPV18 positive, 51% (95%CI=39%-64%) were singly HPV18 positive, and 10% (95%CI=4%-19%) were singly HPV16 positive. In a subset of 5 SCNC studies (75 cases), 93% were positive for p16 INK4a by immunohistochemistry and 100% were HPV positive. For LCNC, 88% (95%CI=72%-99%) were HPV positive, 86% (95%CI=70%-98%) were positive for HPV16 or HPV18, 30% were singly HPV18 positive (95%CI=4%-60%), and 29% (95%CI=2%-64%) were singly HPV16 positive. In conclusion, most SCNC and LCNC are caused by HPV, primarily HPV18 and HPV16. Therefore, most if not all SCNC and LCNC will be prevented by currently available prophylactic HPV vaccines. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. CyberKnife Boost for Patients with Cervical Cancer Unable to Undergo Brachytherapy

    Haas, Jonathan Andrew; Witten, Matthew R.; Clancey, Owen; Episcopia, Karen; Accordino, Diane; Chalas, Eva

    2012-01-01

    Standard radiation therapy for patients undergoing primary chemosensitized radiation for carcinomas of the cervix usually consists of external beam radiation followed by an intracavitary brachytherapy boost. On occasion, the brachytherapy boost cannot be performed due to unfavorable anatomy or because of coexisting medical conditions. We examined the safety and efficacy of using CyberKnife stereotactic body radiotherapy (SBRT) as a boost to the cervix after external beam radiation in those patients unable to have brachytherapy to give a more effective dose to the cervix than with conventional external beam radiation alone. Six consecutive patients with anatomic or medical conditions precluding a tandem and ovoid boost were treated with combined external beam radiation and CyberKnife boost to the cervix. Five patients received 45 Gy to the pelvis with serial intensity-modulated radiation therapy boost to the uterus and cervix to a dose of 61.2 Gy. These five patients received an SBRT boost to the cervix to a dose of 20 Gy in five fractions of 4 Gy each. One patient was treated to the pelvis to a dose of 45 Gy with an external beam boost to the uterus and cervix to a dose of 50.4 Gy. This patient received an SBRT boost to the cervix to a dose of 19.5 Gy in three fractions of 6.5 Gy. Five percent volumes of the bladder and rectum were kept to ≤75 Gy in all patients (i.e., V75 Gy ≤ 5%). All of the patients remain locally controlled with no evidence of disease following treatment. Grade 1 diarrhea occurred in 4/6 patients during the conventional external beam radiation. There has been no grade 3 or 4 rectal or bladder toxicity. There were no toxicities observed following SBRT boost. At a median follow-up of 14 months, CyberKnife radiosurgical boost is well tolerated and efficacious in providing a boost to patients with cervix cancer who are unable to undergo brachytherapy boost. Further follow-up is required to see if these results remain durable.

  14. Comparison of CT based-CTV plan and CT based-ICRU38 plan in brachytherapy planning of uterine cervix cancer

    Cho, Jung Keun; Han, Tae Jong

    2007-01-01

    Purpose : In spite of recent remarkable improvement of diagnostic imaging modalities such as CT, MRI, and PET and radiation therapy planing systems, ICR plan of uterine cervix cancer, based on recommendation of ICRU38(2D film-based) such as point A, is still used widely. A 3-dimensional ICR plan based on CT image provides Dose-Volume Histogram(DVH) information of the tumor and normal tissue. In this study, we compared tumor-dose, rectal-dose and bladder-dose through an analysis of DVH between CTV plan and ICRU38 plan based on CT image. Method and Material : We analyzed 11 patients with a cervix cancer who received the ICR of Ir-192 HDR. After 40Gy of external beam radiation therapy, ICR plan was established using PLATO(Nucletron) v.14.2 planning system. CT scan was done to all the patients using CT-simulator(Ultra Z, Philips). We contoured CTV, rectum and bladder on the CT image and established CTV plan which delivers the 100% dose to CTV and ICRU plan which delivers the 100% dose to the point A. Result : The volume(average±SD) of CTV, rectum and bladder in all of 11 patients is 21.8±6.6cm 3 , 60.9±25.0cm 3 , 111.6±40.1cm 3 respectively. The volume covered by 100% isodose curve is 126.7±18.9cm 3 in ICRU plan and 98.2±74.5cm 3 in CTV plan(p=0.0001), respectively. In (On) ICRU planning 22.0cm 3 of CTV volume was not covered by 100% isodose curve in one patient whose residual tumor size is greater than 4cm, while more than 100% dose was irradiated unnecessarily to the normal organ of 62.2±4.8cm 3 other than the tumor in the remaining 10 patients with a residual tumor less than 4cm in size. Bladder dose recommended by ICRU 38 was 90.1±21.3% and 68.7±26.6% in ICRU plan and in CTV plan respectively(p=0.001) while rectal dose recommended by ICRU 38 was 86.4±18.3% and 76.9±15.6% in ICRU plan and in CTV plan, respectively(p=0.08). Bladder and rectum maximum dose was 137.2±50.1%, 101.1±41.8% in ICRU plan and 107.6±47.9%, 86.9±30.8% in CTV plan, respectively

  15. Adenocarcinoma of the Uterine Cervix

    Chung, Eun Ji; Shin, Hyun Soo; Lee, Hyung Sik; Kim, Gwi Eon; Loh, Juhn Kyu; Suh, Chang Ok

    1991-01-01

    Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents 4.1% of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49years(range, 27-79years) and the peak incidence was in the group 50 to 59years of age. More half of the patients were postmenopausal (46/76=60.5%). Most patients(76%)had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage Iib was 43.4%. There were 4 major histologic subtypes: pure adenocarcinoma(48/76=63.2%), adenosquamous carcinoma(20/76=26.3%), papillary (5/76=6.6%) and clear cell carcinoma(3/76=3.9%). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was 68%, and the 5-year survival rates for stage Ib, II and III were 90%, 66% and 54%, respectively. Control of pelvic tumors was achieved in 938%, 90.2% and 50.0% of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival

  16. Adenocarcinoma of the Uterine Cervix

    Chung, Eun Ji; Shin, Hyun Soo; Lee, Hyung Sik; Kim, Gwi Eon; Loh, Juhn Kyu; Suh, Chang Ok [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1991-12-15

    Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents 4.1% of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49years(range, 27-79years) and the peak incidence was in the group 50 to 59years of age. More half of the patients were postmenopausal (46/76=60.5%). Most patients(76%)had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage Iib was 43.4%. There were 4 major histologic subtypes: pure adenocarcinoma(48/76=63.2%), adenosquamous carcinoma(20/76=26.3%), papillary (5/76=6.6%) and clear cell carcinoma(3/76=3.9%). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was 68%, and the 5-year survival rates for stage Ib, II and III were 90%, 66% and 54%, respectively. Control of pelvic tumors was achieved in 938%, 90.2% and 50.0% of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.

  17. Patterns of radiotherapy practice for patients with squamous carcinoma of the uterine cervix. A patterns of care study

    Eifel, Patricia J.; Owen, Jean; Stouffer, Nicole O.; Hanks, Gerald E.

    1997-01-01

    Purpose: To determine the impact of evolving technology and the influence of published findings from retrospective and prospective studies on the patterns of radiotherapy practice for patients with carcinoma of the uterine cervix. Materials and Methods: 66 institutions were randomly selected for the National Survey (NS) from a master list of all radiation facilities in the United States, proportionally stratified according to practice type. To study the potential influence of patient ethnicity on practice patterns, 12 additional facilities were selected for a Minority-Rich Survey (MRS) from a list of institutions that reported a high proportion of minority patients in their census. Each facility submitted a list of patients treated in 1992-94 with radiation for squamous carcinoma of the cervix. Patients who had clinical evidence of distance metastases or who were treated with initial hysterectomy were excluded. Patients were randomly selected from each institution for review. A total of 601 patients' records were reviewed in the treating institution by one of two trained research associates. Information was recorded about patients' characteristics, diagnostic evaluation, tumor extent, treatment approach, and radiotherapy techniques. Results: Of 601 patients, 31%, 40%, 24% and 4% had FIGO Stage I, II, III, or IV disease, respectively. 79% of women had a Karnofsky status ≥90 and 76% had a pre-treatment Hgb ≥10. Black women tended to have lower hemoglobin levels and a poorer performance status than Hispanic or non-Hispanic white patients although the distribution of tumors according to FIGO stage was similar for women of different ethnic groups. Diagnostic work-up included a CT scan in (411(516)) patients for whom information was available (80%). Of these, 61 (15%) were interpreted as showing evidence of nodal metastasis in either the abdomen or pelvis. Lymphangiogram or MRI were obtained in only 4% and 5% of patients, respectively. 104 patients had surgical

  18. Effects of Fermented Mushroom of Cordyceps sinensis, Rich in Selenium, on Uterine Cervix Cancer

    Jing Ji

    2014-01-01

    Full Text Available The purpose of this study was to investigate the effect of fermented mushroom of Cordyceps sinensis (CS, rich in selenium (Se-CS, on uterine cervical cancer in mice. The methylcholanthrene- (MCA- induced tumor model was used in this paper. After the mice were administered Se-CS, the animals showed 40% tumor incidence (P<0.05. Se-CS also enhanced the immune functions. Se-CS treatment showed significant (P<0.05–0.01 restoration in the level of glutathione content, lipid peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na+/K+-ATPase activity, and glutathione S transferase activity. This finding suggested that the concomitant use of Se and CS could be a potential therapeutic approach to improve the efficacy of therapy for uterine cervical cancer.

  19. Raman spectroscopic studies on exfoliated cells of oral and cervix

    Hole, Arti; Sahu, Aditi; Shaikh, Rubina; Tyagi, Gunjan; Murali Krishna, C.

    2018-01-01

    Visual inspection followed by biopsy is the standard procedure for cancer diagnosis. Due to invasive nature of the current diagnostic methods, patients are often non-compliant. Hence, it is necessary to explore less invasive and rapid methods for early detection. Exfoliative cytology is a simple, rapid, and less invasive technique. It is thus well accepted by patients and is suitable for routine applications in population screening programs. Raman spectroscopy (RS) has been increasingly explored for disease diagnosis in the recent past. In vivo RS has previously shown promise in management of both oral and cervix cancers. In vivo applications require on-site instrumentation and stringent experimental conditions. Hence, RS of less invasive samples like exfoliated cells has been explored, as this facilitates collection at multiple screening centers followed by analysis at a centralized facility. In the present study, efficacy of Raman spectroscopy in classification of 15 normal and 29 abnormal oral exfoliated cells specimens and 28 normal and 38 abnormal cervix specimens were explored. Spectra were acquired by Raman microprobe (HE 785, Horiba-Jobin-Yvon, France) from several areas to span the pellet. Spectral acquisition parameters were: microscopic objective: 40X, power: 40 mW, acquisition time: 15 s and average: 3. PCA and PC-LDA of pre-processed spectra was carried out on a 4-model system of normal and tumor of both cervix and oral specimens. Leave-one-out-cross-validation findings indicate 73 % correct classification. Findings suggest RS of exfoliated cells may serve as a patient-friendly, non-invasive, rapid and objective method for management of cervix and oral cancers.

  20. Magnetic resonance imaging of cancer of uterine cervix and body. Preliminary study in 9 cases of body cancer and 20 of cervical cancer

    Michel, G.; Galakhoff, C.; Masselot, J.; Vanel, D.; Heran, F.; Charpentier, P.; Castaigne, D.; Gerbaulet, A.; George, M.

    1987-01-01

    We studied nine cases of endometrial carcinoma and twenty of cervix carcinoma. Correlation with histology is made after curietherapy in 8 cases of endometrial carcinoma. Tumor is not always seen and particularly when there is no mass effect on macroscopic examination. Myometral invasion is not seen with accuracy: the interruption of junctional zone is not a good sign. The cervix tumors are well seen on T2 sequences before any treatment. There extra uterine extension is difficult to appreciate. The best results of RMI were in the follow-up after radiotherapy. Therefore it appears actually to us the best indication of RMI [fr

  1. An Optimization-Driven Analysis Pipeline to Uncover Biomarkers and Signaling Paths: Cervix Cancer

    Enery Lorenzo

    2015-05-01

    Full Text Available Establishing how a series of potentially important genes might relate to each other is relevant to understand the origin and evolution of illnesses, such as cancer. High‑throughput biological experiments have played a critical role in providing information in this regard. A special challenge, however, is that of trying to conciliate information from separate microarray experiments to build a potential genetic signaling path. This work proposes a two-step analysis pipeline, based on optimization, to approach meta-analysis aiming to build a proxy for a genetic signaling path.

  2. The significance of eosinophilia during external irradiation for uterine cervix cancer

    Kikuchi, Yuzo; Washizuka, Norio; Kishiyama, Kazutaka; Yamada, Ryuichi; Hasegawa, Tenmatsu

    1980-01-01

    To study the mechanism of eosinophilia, correlation between immunological skin test including DNCB, PHA and PPD test, the grade of diarrhea were evaluated 32 cases of uterine cancer which received external irradiation. Also the comparison of eosinophilia and diarrhea among the three fraction group and each score group of skin test were done. The maximum value of absolute eosinophils and multiple increase in eosinophils increased more significantly in 4750 rads/20f/5 weeks group than in other group, but did'nt correlate among each score group of skin test. Also eosinophilia did'nt correlate significantly to skin test and the grade of diarrhea. (author)

  3. Efficacy of Tsumura Juzentaihoto for radiation-associated complaints in cancer of the uterine cervix

    Morishita, Munetaka; Tokuhashi, Yasaburo; Kawai, Yoshio; Mizuno, Kazuo; Abe, Satoshi.

    1986-01-01

    Twenty-nine patients receiving radiation therapy were allocated into one of four groups: (1) irradiation alone (n = 7), (2) irradiation + 7.5 g/day of Tsumura Juzentaihoto (n = 6), (3) postoperative irradiation (n = 5), and (4) postoperative irradiation + Tsumura Juzentaihoto (n = 11). Radiation-associated complaints for evaluation were loss of appetite, general fatigue, thirst, vomiting or nausea, diarrhea, and fever. Scores for relief of these complaints tended to be good in patients given Tsumura Juzentaihoto when doses of 10 Gy or more were irradiated. Tsumura Juzentaihoto appears to be useful in patients with irradiation alone rather than in those with postoperative irradiation. (Namekawa, K.)

  4. Accurate and economical intracavitary endocurietherapy in the treatment of uterine cervix cancer

    Kumar, P.P.; Good, R.R.

    1986-01-01

    A modified afterloading cervical applicator and intracavitary endocurietherapy application technique eliminates several problems associated with the Henschke cervical applicator, and conventional preloading technique. The Kumar cervical applicator minimizes patient discomfort, and improves patient mobility while reducing the tendency of the applicator to rotate during the 40 to 50 hours of uterine intracavitary endocurietherapy. The use of hygroscopic laminaria tent for gradual cervical dilatation in plate of manual cervical dilatation, and the use of inflatable Foley balloon threaded onto the tandem instead of vaginal packing, to separate the 137 Cesium sources away from the rectum and bladder, eliminate the need of general anesthesia for the majority of patients undergoing intracavitary endocurietherapy. (orig.) [de

  5. Prevalence of Adverse Effects Post-Brachytherapy on Women with Uterine Cervix Cancer in Durango, Mexico

    Herrera, Higmar; Yanez, Elvia; Deras, Diana C.; Reyes, Francianella

    2010-01-01

    This work aimed at determining the local prevalence of adverse effects on women with CaCu that recieved LDR brachytherapy treatment at CECAN. The data was extracted from the patient's and medical physics' departement records. Non Gaussian statistics was used due to dose distribution characteristics. A total of 103 patients were studied with average age of 55±13 years and Ia-IV FIGO clinical clasification. The observed prevalence is higher than that reported by other studies. It was observed that patients with proctitis were prescribed a slightly higher dose than those without adverse effects (90% confidence). Patients with proctitis also presented higher age (95% confidence) when compared with the mean of the studied population. The inverse applies to the group with other adverse effects, its average age is lower than the mean (90% confidence).

  6. The role of chemotherapy and radiotherapy in the treatment of advanced cervical cancer

    Marjamaegi, M.M.

    1998-01-01

    A retrospective analyses was performed in a series of patients with advanced cervix cancer. The aim of this analyses was to evaluate the efficiency of radiotherapy and chemotherapy for advanced cervix cancer. For the patients with advanced stages, active multidisciplinary treatment is necessary for local control and suppression of distant metastases

  7. The evaluation of dose of TSEI with TLD and diode detector of the uterine cervix cancer

    Je, Young Wan; Na, Keyung Su; Yoon, Il Kyu; Park, Heung Deuk

    2005-01-01

    To evaluate radiation dose and accuracy with TLD and diode detector when treat total skin with electron beam. Using Stanford Technique, we treated patient with Mycosis Fungoides. 6 MeV electron beam of LINAC was used and the SSD was 300 cm. Also, acrylic speller(0.8 cm) was used. The patient position was 6 types and the gantry angle was 64, 90 and 116 degree. The patient's skin dose and the output were detected 5 to 6 times with TLD and diode. The deviations of dose detected with TLD from tumor dose were CA + 6%, thigh + 8%, umbilicus + 4%, calf - 8%, vertex - 74.4%, deep axillae - 10.2%, anus and testis - 87%, sole - 86% and nails shielded with 4 mm lead + 4%. The deviations of dose detected with diode were - 4.5% ∼ + 5% at the patient center and - 1.1% ∼ + 1% at the speller. The deviation of total skin dose was + 8% ∼ - 8% and that deviation was within the acceptable range(±10%). The boost dose was irradiated for the low dose areas(vertex, anus, sole). The electron beam output detected at the sootier was stable. It is thought that the deviation of dose at patient center detected with diode was induced by detection point and patient position.

  8. Use of 3D imaging and awareness of GEC-ESTRO recommendations for cervix cancer brachytherapy throughout Australia and New Zealand

    Dyk, S Van; Bernshaw, D.; Byram, D.

    2010-01-01

    Full text: A 2005 survey of practices indicated limited use of three dimensional (3D) imaging modalities and planning methods in cervix cancer brachytherapy in Australia and New Zealand. However, advancing technologies and published recommendations are influencing change. This survey aims to identify both changes in practice and awareness and uptake of Groupe European de Curietherapie of the European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) recommendations. Methods: A survey was emailed to all radiotherapy departments with brachytherapy facilities. Twenty departments practise brachytherapy for cancer of the cervix. The survey consisted of five questions enquiring about use and type of 3D imaging; rate of reimaging and replanning; and contouring, prescribing and reporting practices. Results: A 100% response rate was obtained. Sixty-five per cent of departments use 3D CT imaging to plan brachytherapy insertions. Thirty per cent of departments use two-dimensional ( 2D ) x-rays. Four departments (20%) use a combination of imaging modalities including CT, ultrasound and MRI. Sixtyfive per cent of departments reimage and replan for each insertion. Four departments (20%) contour, prescribe dose and report treatment according to GEC-ESTRO recommendations. Conclusions: There has been a marked increase in the use of 3D imaging and awareness of GEC-ESTRO recommendations. Implementation and reporting of image-based gynaecological brachytherapy is strongly dependent on local resources and infrastructure.

  9. Pulse dose-rate brachytherapy and treatment of uterine cervix cancer: impact of a 3D or a 2D dosimetric support

    Tournat, H.; Chilles, A.; Charra-Brunaud, C.; Peiffert, D.; Ahmad, F.; Metayer, Y.

    2007-01-01

    Purpose To evaluate two dosimetric supports used in pulse dose rate brachytherapy (P.D.R.): coverage of target volumes, dose to organs at risk, residual tumor after surgery, survival. Patients and methods Twenty patients treated for uterine cervix tumor first by brachytherapy P.D.R. had a dosimetric CT-scan after implantation. For 9 patients, the treatment was planned from standard radiographies and then reported on CT-scan images. For 11 patients, it was directly planned from CT-scan. Six weeks after, 18 patients underwent surgery. Results With a median follow-up of 22 months, 2 year actuarial survival was 89%. Six patients developed grade II urinary or gynecological complications (LENT SOMA scale). No residual tumor was found for 12 patients (7 with a 3D treatment and 5 a 2 D treatment). Ninety-five percent of C.T.V.H.R. received 53 Gy (2D treatment) or 63 Gy (3D treatment). Two cm 3 of bladder wall received 63 Gy (2D) or 74 Gy (3D) although 2 cm 3 of rectal wall received 37 Gy (2D) and 35 Gy (3D). Conclusion Using CT-scan made us improve the coverage of the uterine cervix but increase the dose received by the bladder, without increasing the rate of histological remission after surgery. We should be prudent before changing our practice. (authors)

  10. Socioeconomic characteristics of patients with squamous cell carcinoma of the uterine cervix treated with radiotherapy in the 1992 to 1994 patterns of care study

    Katz, Angela; Eifel, Patricia J.; Moughan, Jennifer; Owen, Jean B.; Mahon, Irene; Hanks, Gerald E.

    2000-01-01

    Purpose: To describe the relationship between socioeconomic variables and the treatment of patients with radiotherapy for cervix cancer. Methods and Materials: Sixty-two institutions were randomly selected from a list of all radiotherapy facilities in the United States. From these we randomly selected and reviewed 471 cases of squamous cell carcinoma treated during 1992 to 1994. To create an additional minority-rich sample, we randomly selected 215 additional cases from 17 randomly selected institutions that admitted > 40% minority patients. The median household income of each patient's neighborhood was determined by matching her zip code to data from the 1990 United States Census. Results: Patients who lived in low-income neighborhoods, who had only Medicaid coverage, or who were treated at large academic or minority-rich institutions tended to have a poorer initial performance status, higher-stage or bulky central disease, and a lower pretreatment hemoglobin level. Ability to complete treatment did not correlate with ethnicity or income. However, noncompliant patients tended to be treated at minority-rich institutions and were more often ≤ 40 or > 60 years old. Patients who completed definitive treatment were more likely to have had ≤ 1 low-dose-rate intracavitary implants if they were black, came from a low-income neighborhood, were covered by Medicaid or Medicare only, or were treated at a minority-rich institution. Patients who were treated in academic institutions received higher mean radiation doses to Point A (83.8 Gy) than those treated in research- or non-research-participating facilities (79.4 and 80.9 Gy, respectively; p = 0.002). Patients who received their radiation therapy in facilities that treated an average of ≤ 3 patients per year also received lower mean doses to Point A (79.1 vs. 83.0 Gy; p = 0.001). Conclusion: The treatment received by patients who belonged to minority groups, came from low-income neighborhoods, or were treated in large

  11. Bony Calvarium as the Sole Site ofMetastases in Squamous Cell Carcinomaof the Uterine Cervix

    Mohammad Mohammadianpanah

    2010-10-01

    Full Text Available Isolated skeletal metastasis to the bony calvarium is extremely rare in patients with squamous cell carcinoma of the uterine cervix. We describe the clinical and imaging findings in a case of squamous cell carcinoma of the uterine cervix with metastases tothe bony calvarium as the sole site of metastasis. The patient was a 65-year-old woman with squamous cell carcinoma of the uterine cervix, FIGO stage IIIb, whose initial treatement was chemoradiation therapy. After 22 sessions of external-beam radiation,she developed headaches. On physical examination she had skull bone tenderness. On plain skull X-ray, there were osteolytic bony lesions. Brain MRI showed multiple enhancing skull bone metatstses. Eventually, a whole body bone scintigraphy revealed isolated diffuse increased activity in the bony calvarium. In the literature review, wefound only three similar cases of cervical cancer with scalp metastases and involvement of the bony calvarium.

  12. The effect of troglitazone on thermal sensitivity in uterine cervix cancer cells

    Lee, Ji Hye; Kim, Won Dong; Park, Woo Yoon

    2010-01-01

    Troglitazone (TRO), a PPAR-γ agonist, can reduce heat shock protein (HSP) 70 and increase the antioxidant enzymes, such as superoxide dismutase (SOD) and catalase, which might affect thermal sensitivity. Here, we investigated whether TRO modifies thermal sensitivity in uterine cervical cancer cells, which is most commonly treated by hyperthermia (HT). HeLa cells were treated with 5μM TRO for 24 hours before HT at 42 .deg. C for 1 hour. Cell survival was analyzed by clonogenic assay. The expression of HSPs was analyzed by Western blot. SOD and catalase activity was measured and reactive oxygen species (ROS) was measured using 2',7'-dichlorofluorescin diacetate and dihydroethidium. The decreased cell survival by HT was increased by preincubation with TRO before HT. Expression of HSP 70 was increased by HT however, it was not decreased by preincubation with TRO before HT. The decreased Bcl-2 expression by HT was increased by preincubation with TRO. SOD and catalase activity was increased by 1.2 and 1.3 times, respectively with TRO. Increased ROS by HT was decreased by preincubation with TRO. TRO decreases thermal sensitivity through increased SOD and catalase activity, as well as scavenging ROS in HeLa cells.

  13. [Molecular aspects of human papillomaviruses and their relation to uterine cervix cancer].

    García-Carrancá, A; Gariglio, P V

    1993-01-01

    Papillomaviruses (wart viruses) are responsible for the development of benign and malignant epithelial lesions in mammals. More than 60 different types of human papillomaviruses (HPVs) have been isolated to date. Some of them are major candidates as etiologic agents in cervical cancer. DNA from HPV types 16, 18 and 33 is usually found integrated in about 90 percent of genital carcinomas. Integration of the viral DNA into the cellular genome may be an important step towards the development of malignancy. Two early genes of HPVs (E6 y E7) are involved in cellular transformation. Another early gene (E2) participates in gene control by directly binding to conserved DNA motifs in the viral genome. Several protein factors of viral and cellular origin interact with the regulatory region of HPVs and participate in the regulation transcription of oncogenes E6 and E7. Cellular factors, such as immune system and oncogene and anti-oncogene alterations, seem to play an important role in papillomavirus-associated cervical carcinogenesis.

  14. Rectum separation in patients with cervical cancer for treatment planning in primary chemo-radiation

    Marnitz, Simone; Budach, Volker; Weißer, Friederike; Burova, Elena; Gebauer, Bernhard; Vercellino, Filiberto Guiseppe; Köhler, Christhardt

    2012-01-01

    To proof feasibility of hydrogel application in patients with advanced cervical cancer undergoing chemo-radiation in order to reduce rectal toxicity from external beam radiation as well as brachytherapy. Under transrectal sonographic guidance five patients with proven cervical cancer underwent hydro gel (20 cc) instillation into the tip of rectovaginal septum adherent to posterior part of the visible cervical tumor. Five days after this procedure all patients underwent T2 weighted transversal and sagittal MRI for brachytherapy planning. MRI protocol included T2 weighted fast spin echo (FSE) imaging in sagittal, coronal and para-axial orientation using an 1.5 Tesla MRI. Separation of anterior rectal wall and cervix was documented. Hydrogel application was uneventful in all patients and no toxicity was reported. Separation ranged from 7 to 26 mm in width (median 10 mm). The length of the separation varied between 18 and 38 mm (median 32 mm). In all patients displacement was seen in the posterior vaginal fornix, and/or at the deepest part of uterine cervix depending on the extension of the cul-de-sac in correlation to the posterior wall of the uterus. In patients with bulky tumor and/or deep (vaginal) extend of peritoneal cavity tumour was seen mainly cranial from the rectovaginal space and therefore above the hydrogeI application. Only in the extra-peritoneal (lower) part of the cervix a good separation could be achieved between the rectum and cervix. Hydrgel instillation in patients with cervial cancer undergoing chemoradiation is safe and feasible. Because of the loose tissue of the cul-de-sac and its intra- and extraperitoneal part, hydrogel instillation of 20 cc did not result in a sufficient separation of the cervix from anterior wall

  15. Methods for Cf-252 cervix cancer therapy and treatment planning for GYN malignancies in Lexington

    Coffey, C.W.; Yoneda, J.; Beach, J.L.; Maruyama, Y.

    1986-01-01

    This paper presents the clinical physics methods and treatment planning techniques used in both the external beam and brachytherapy treatment of GYN malignancies in the Radiotherapy Department of the University of Kentucky Medical Center. Specific description of the departmental implant suite and brachytherapy procedures are included. The optimization of brachytherapy applicator placement, source arrangement, and normal and tumor total dose and dose distributions are presented. Quality assurance protocols for teletherapy and brachytherapy and patient and staff safety procedures with Cf-252 are discussed

  16. Urothelial cells in smears from cervix uteri

    Palaoro, Luis Alberto; Guerra, Fernando; Angeleri, Anabela; Palamas, Marta; Melba, Sardi-Segovia; Rocher, Adriana Esther

    2012-01-01

    Objectives: To establish the cytological criteria to identify the urothelial cells in cervical smears in order to avoid mistakes in the cytological diagnosis. Materials and Methods: Cervical smears from 34 post menopausal women with vesicovaginal fistulas, advanced bladder prolapse and genital erosive lichen planes (vulvar kraurosis) (Group 1) and transitional cell metaplasia of the cervix (TCM, Group 2) were stained with Papanicolaou technique. The cervical samples were taken during the routine annual examination for prevention of the uterine cancer. Results: The smears of cervix from Group 1 showed urothelial cells from the three layers of the transitional epithelium. The umbrella cells are the bigger ones with relatively large nuclei. Frequently, they are multinucleated with single or multiple nucleoli and a typical “frothy” cytoplasm (cytoplasmic vacuoles). The cells of the Group 2 showed nuclei with oval to spindled shapes, some tapered ends, less cytoplasm than squamous metaplastic cells, powdery chromatin, small nucleoli and nuclear grooves. Conclusions: The umbrella cells may be mistaken for dysplastic cells originating in low grade squamous intraepithelial lesions lesions (LSILs) due to their nuclear and cytoplasm sizes. Therefore, it is important to know the possibility of their appearance in the cervical smears, especially in post menopausal patients in order to avoid a false diagnosis of an intraepithelial lesion. It is unlikely that deeper cells of urothelium would be confused with high grade squamous intraepithelial lesion (HSIL) cells. However, their presence might be a reason of mistake in the diagnosis. TCM is an under-recognized metaplastic phenomenon of the cervix and vagina, which is a mimicker of high-grade squamous intraepithelial lesion. The differential characteristic between umbrella cells, cells from TCM and the deeper urothelial cells, and LSIL and HSIL are detailed in the present paper. PMID:22438615

  17. Clinical impact of de-regulated Notch-1 and Notch-3 in the development and progression of HPV-associated different histological subtypes of precancerous and cancerous lesions of human uterine cervix.

    Richa Tripathi

    Full Text Available Cervical cancer is the leading cause of cancer related deaths among women in India. Limited reports are available for Notch-1 and Notch-3 protein in cervical carcinoma, which play crucial role in cell proliferation, differentiation, and apoptosis.This study was designed to evaluate the role of Notch-1 and Notch-3 with context to HPV infection in cervical carcinoma. A total of 168 tissue biopsy samples comprising of tumor specimens (n = 98, precancer (n = 30 and non-neoplastic cervical tissues (n = 40 were screened for HPV infection by PCR and expression of Notch-1 and Notch-3 protein by Immunohistochemistry and Immunoblotting.80% (24/30 were found to be positive for HPV in precancer and 86.7% (85/98 in cancer patients. Notch-1 expression of precancer and cancer cases was found to be significantly down-regulated with severity of disease in nuclear (3.43±0.29; 2.04±0.19, p = 0.0001, p = 0.0001 and cytoplasm (3.07±0.29; 2.29±0.17, p = 0.0001, p = 0.0001 obtained from different stages as compared to normal cervix tissue (5.40±0.19, 4.97±0.15; p<0.001; p<0.001. However, Notch-3 expression of above cases was significantly up-regulated with severity of disease and showed intense nuclear (4.17±0.39; 4.74±0.18, p = 0.0001, p = 0.0001 and cytoplasm (3.67±0.36; 4.48±0.18, p = 0.0001, p = 0.0001 of different stages as compared to normal cervix tissue (0.95±0.20, 0.70±0.20; p<0.001; p<0.001 respectively.These findings suggest that Notch-1 and Notch-3 may play an important role with synergistic effect of HPV in regulating development and proliferation of cervical cancer through the deregulation of Notch signalling. This study also shows the clinical utility of both proteins which may be used as predictable biomarkers in diagnosing different histological sub-types of HPV associated cervical cancer. Nevertheless, abnormal activation of this pathway may provide legitimate targets for cervical cancer therapy.

  18. Prognostic importance of lymph node-to-primary tumor standardized uptake value ratio in invasive squamous cell carcinoma of uterine cervix

    Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang; Cheon, Gi Jeong

    2017-01-01

    Using integrated PET/CT, we evaluated the prognostic value of [ 18 F]FDG uptake ratio between pelvic lymph node (LN) and primary tumor in invasive squamous cell carcinoma (SCCA) of the uterine cervix. We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIA cervical SCCA who underwent preoperative [ 18 F]FDG PET/CT scans. PET/CT parameters such as maximum standardized uptake value (SUV) of the primary cervical cancer (SUV cervix ) and LN (SUV LN ), and the LN-to-cervical cancer SUV ratio (SUV LN /SUV cervix ) were assessed. Prognostic values of PET/CT-derived metabolic and volumetric variables and clinicopathology parameters were analyzed to predict progression-free survival (PFS) in regression analyses. Clinical data, treatment modalities, and results were reviewed for 103 eligible patients. Median post-surgical follow-up was 29 months (range, 6-89), and 19 (18.5%) patients experienced recurrence. Multivariate logistic regression analysis showed that SUV LN / SUV cervix > 0.1747(P = 0.048) was the independent risk factor of recurrence. Patient group categorized by SUV LN /SUV cervix showed significant difference in PFS (log-rank test, P < 0.001). Preoperative SUV LN /SUV cervix measured by [ 18 F]FDG PET/CT was significantly associated with recurrence, and has an incremental prognostic value for PFS in patients with cervical SCCA. (orig.)

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

    Pedersen, D.; Bentzen, S.M.; Overgaard, J.

    1994-01-01

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

  20. Fractionation in medium dose rate brachytherapy of cancer of the cervix

    Leborgne, Felix; Fowler, Jack F.; Leborgne, Jose H.; Zubizarreta, Eduardo; Chappell, Rick

    1996-01-01

    Purpose: To establish an optimum fractionation for medium dose rate (MDR) brachytherapy from retrospective data of patients treated with different MDR schedules in comparison with a low dose rate (LDR) schedule. Methods and Materials: The study population consists of consecutive Stage IB-IIA-IIB patients who received radiotherapy alone with full dose brachytherapy plus external beam pelvic and parametrial irradiation from 1986-1993. Patients also receiving surgery or chemotherapy were excluded. The LDR group (n = 102, median follow-up: 80 months) received a median dose to Point A of two 32.5 Gy fractions at 0.44 Gy/h plus 18 Gy of external whole pelvic irradiation. The MDR1 group (n = 30, median follow-up: 45 months) received a mean dose of two 32 Gy fractions at 1.68 Gy/h. An individual dose reduction of 12.5% was planned for this group according to the Manchester experience, but only a 4.8% dose reduction was achieved. The MDR2 group (n = 10, median follow-up: 36 months) received a dose of two 24 Gy fractions at 1.65 Gy/h. The MDR3 group (n = 10, median follow-up 33 months) received a mean dose of three 15.3 Gy fractions at 1.64 Gy/h. And finally, the MDR4 group (n = 38, median follow-up: 24 months) received six 7.7 Gy fractions from two pulses 6 h apart in each of three insertions at 1.61 Gy/h. The median external pelvic dose to MDR schedules was between 12 and 20 Gy. The linear quadratic (LQ) formula was used to calculate the biologically effective dose (BED) to tumor (Gy 10 ) and rectum (Gy 3 ), assuming T(1(2)) for repair = 1.5 h. Results: The crude central recurrence rate was 6% for LDR (mean BED = 95.4 Gy 10 ) and 10% for MDR4 (mean BED = 77.0 Gy 10 ) (p = NS). The remaining MDR groups had no recurrences. Grade 2 and 3 rectal or bladder complications were 0% for LDR (rectal BED = 109 Gy 3 ), 83% for MDR1 (BED = 206 Gy 3 ), and 30% for MDR3 (BED = 127 Gy 3 ). The MDR2 and MDR4 groups presented no complications (BED, 123 Gy 3 , and 105 Gy 3 , respectively

  1. Cervix carcinomas: place of intensity-modulated radiotherapy

    Barillot, I.

    2009-01-01

    While indications of modulated intensity radiation therapy (I.M.R.T.) are perfectly defined in head and neck and prostate cancer patients, this technique remains under evaluation for gynecologic tumours. The implementation of conformal three dimensional radiotherapy in the late 1990 has been the first important step for optimisation of treatment of cervix carcinomas, as it permitted a better target coverage with a significant reduction of the bladder dose. However, this technique often leads to an irradiation of a larger volume of rectum in locally advanced stages and could only spare a limited amount of intestine. I.R.M.T. is one of the optimisation methods potentially efficient for a better sparing of digestive tract during irradiation of cervix carcinomas. The aim of this literature review is to provide the arguments supporting this hypothesis, and to define the place of this technique for dose escalation. (authors)

  2. Statistical study on cancer patients of Korea cancer centre hospital

    Choi, Soo Yong; Kim, Kee Hwa; Mok, Kang Sung [Korea Cancer Center Hospital of Korea Atomic Energy Research Institute, Seoul (Korea, Republic of)

    1994-12-01

    The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author).

  3. Statistical study on cancer patients of Korea cancer centre hospital

    Choi, Soo Yong; Kim, Kee Hwa; Kang Sung Mok

    1994-12-01

    The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author)

  4. Uterus effusion after irradiation for carcinoma of the cervix

    Ma Shaokang; Gao Juzhen; Wu Lingying

    2007-01-01

    Objective: To analyse the clinical characteristics of patients with uterus effusion after irradiation for carcinoma of the cervix. Methods: 151 patients with uterus effusion after irradiation for carcinoma of the cervix were retrospectively analyzed. Results: All these 151 patients who had been treated by radiotherapy had FIGO stage IIB or IIIB lesions including 32 adenocarcinomas. The most common symptom was irregular vaginal discharge or drainage (65 patients), followed by irregular vaginal bleeding (32 patients), and abdominal or pelvic mass (27 patients). Twenty-seven patients were entirely asymptomatic. The positive rate of uterus effusion found by B-ultrasound scan was 100%. When uterus effusion was found, 87 patients (57.6%) had malignant tumor, including 62 with residual or recurrent cervical carcinoma and 25 with secondary primary malignant uterus tumor. Sixty-four patients had uterus effusion alone including 8 with pyometra. Of these 64 patients, 17 underwent abdominal hysterectomy with bilateral salpingo-oophorectomy (BSOH), the others were treated with drainage till the fluid disappeared. Of the 62 patients with residual or recurrent cervical carcinoma, 19 underwent BSOH and 43 were treated by palliative irradiation or chemotherapy. Twenty-five patients who had secondary primary malignant uterus tumor were treated by BSOH. The 5-year survival rate of patients with uterus effusion alone, with residual tumor (with recurrent tumor), or with secondary primary malignancy were 54.8%, 0%, 28.7% and 47.5%, respectively. The prognosis of the patients with uterus effusion alone was better than those with secondary primary malignant uterus tumor. Patients with residual or recurrent cervical cancer had the worst prognosis. Conclusions: Patients with uterus effusion after irradiation for carcinoma of the cervix often have tumor including secondary primary, malignant uterus tumor. The prognosis is different, which depends on if the patient has tumor or not. (authors)

  5. Results of treatment with concurrent radiotherapy and cisplatin-based chemotherapy for cancer of the uterine cervix - a preliminary assessment

    Rusiecka, M.; Dryl, B.; Bojarowska, K.; Slocka, B.; Ziemba, B.

    2002-01-01

    To compare results of radiochemotherapy and radiotherapy in patients with cervical cancer. Fifty three patients with locally advanced cervical cancer, undergoing combined radiochemotherapy (C) and a control group of 50 patients treated with irradiation only (R) entered the study. All patients in group C treated with concurrent radiochemotherapy showed positive therapeutic effect - no cases of stable disease nor progress. Complete remission (CR) was observed in more than half of the cases (54.72 %) directly after treatment, as compared with group R - 19.64%. However, more than 70% of patients treated with combined therapy demonstrated bone-marrow damages. Only 4 of these patients (7.55%) did not complete cytostatic treatment because of thrombocytopoenia. Low thrombocyte count caused permanent exclusion of the patient from the chemotherapy schedule. Post-irradiation side effects, such as proctitis, urocystis and enterocolitis posed another problem: combined radiochemotherapy increased the percentage of patients with post-irradiation reactions, although the intensity of these reactions was neither increased nor lenghtier. Our results of combining irradiation with cisplatin-based chemotherapy treatment allow to recommend this schedule of therapy as a standard for locally advanced cervical cancer treatment. (author)

  6. Evaluation of human papillomavirus elimination from cervix uteri by infrared laser exposure.

    Dymkovets, V P; Ezhov, V V; Manykin, A A; Belov, S V; Danileiko, Yu K; Osiko, V V; Salyuk, V A

    2011-12-01

    Elimination of types 16 and 18 human papilloma virus from the surface of cervix uteri for secondary prevention of cervical cancer was evaluated. The method is protected by patent of invention of the Russian Federation. Infrared laser therapy of cervix uteri was carried out in patients with precancer diseases of cervix uteri at Department of Gynecology of Municipal Clinical Hospital No. 52 (Moscow). Papillomavirus infection was eliminated using a Russian diode laser (lambda=1.06 μ, radiation power 10 W) with a collimating headpiece using carbon die at a distance of 10-12 cm from the exposed surface. The treatment resulted in a high percentage of elimination of types 16 and 18 oncogenic virus 4-6 weeks and during delayed periods after exposure.

  7. Statistical study on cancer patients of cancer research hospital

    Shim, Yun Sang; Choi, Soo Yong; Kim, Ki Wha; Kang, Sung Mok

    1993-01-01

    The total number of malignant neoplasms included in this study 15,737 cases(11.8%) among 133,251 cases for 3 years. On sex, females with 52.9% were much more than males with 47.1%. The highest proportion of cancer patients by age was 33.7% in males and 28.5% in females, respectivelty for 50-59 age group. The most frequent primary site among males was found to be stomach with 35.5%, followed by liver(14.7%), lung(13.0%), esophagus(5.4%) and colon (3.2%). In females, the first order was uterine cervix with 40.6%, followed by stomach(17.2%), breast(14.4), rectum(3.7%) and lung(3.4%). The most common type of morphology of malignant neoplasms was adenocarcinoma(47.4%) in males an squamous cell carcinoma(58.0%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the exent of disease was 2.5% for patient with carcinoma-in-situ, 54.1% for patients with localized involvement, 13.3% for patients with regional involvement and 8.5% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 23.6% for surgery, 25.3% for radiotherapy and 30.3% for chemotherapy. Among the cancer patients confirmed by medical records, 7.7% was traced more than 5 years. (Author)

  8. Gastric metastasis of cervix uteri carcinoma, rare cause of lower gastric stenosis.

    Moldovan, B; Banu, E; Pocreaţă, D; Buiga, R; Rogoz, S; Pripisi, L; Cimpeanu, L; Moldovan, A; Jeder, O; Badea, A; Biris, P

    2012-01-01

    the paper presents a rare case of metachronous gastric metastasis of uterine cervix cancer, clinically manifested through severe pyloric stenosis. 49-year-old patient, operated on in January 2009, with uterine cervix cancer (Squamous cell carcinoma T2bN1M0), is hospitalized in August 2011 with pyloric stenosis: epigastric pains, abundant, stasis, late postprandial emesis, significant weight loss, stomach form visible upon abdomen inspection. Endoscopy: antral stenosis with intact gastric mucosa, and CT-scan: circumferential intramural gastric tumor, stomach dilated in the upper part, lack of cleavage between the tumor and the liver bed of the gall bladder. CEA increased to 13,78 (below 5), CA 19-9 slightly increased 29.9 (below 27). The case is considered as a second neoplasia and a D2 subtotal gastrectomy was performed, with 1 positive ganglion out of 27 on block with atypical hepatectomy of segments 4-5 for liver invasion, the final mounting being Y Roux. The histopathological examination shows a gastric metastasis of squamous carcinoma, of uterine cervix origin, the invaded perigastric ganglion having the same aspect of uterine cervix carcinoma. The post-surgery evolution was favorable, under chemo radiotherapy the patient being alive without relapse at 9 months post-surgery. In the literature there are 2 more cases of gastric metastasis of uterine cervix carcinoma, and 4 of uterine carcinoma without topographic indication, but without the histological documentation of the tumor filiation, without data related to resecability or follow-up, the case at hand being, from this perspective, the first documented resectable metachronous gastric metastasis from a cervix uteri carcinoma. Celsius.

  9. Clinical evaluation of developed product for recovery of immune system in the treatment of cancer patients

    Cho, Chul-Ku; Choi, Soo Yong; Rhyu, Sung Ryeol; Kim, Ki Wha; Kim, Ji Yun; Yun, Na Ra [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2006-01-15

    We evaluate the clinical efficacy of pilot product (HemoHIM) on recovery from hematopoiesis damage in cancer patients who received radiotherapy and chemotherapy. The cancer patients studied were as follows : cancer of the breast(47 intakers and 136 non-intakers), uterine cervix(38 intakers and 73 non-intakers), and head and neck(7 intakers and 15 non-intakers). The clinical efficacy of pilot product(HemoHIM) in cancer patients who received radiotherapy and chemotherapy was analyzed. In breast cancer patients, the number of leukocytes decreased according to duration of treatment in both groups. However, intakers showed a less decreasing trend compared with non-intakers. Especially, under limiting value in range of leukocyte number of intakers was significantly higher than that of non-intakers. This result incicates that HemoHIM reduce the severe leukopenia. Values of lymphocyte in both groups decreased similarly after treatment, and it was similar to that of leukocyte. Values of erythrocyte in both groups decreased similarly after treatment, but the values were within normal range. In cervix cancer patients, the results were similar to that of breast cancer patients. In cancer of head and neck, values of leukocyte slightly decreased according to duration of treatment in both group. However, it needs to collect more subjects continuously because of small number of cancer patients. No toxicological side effects of HemoHIM were observed in serological analysis, and possibility to alleviate fatigue and inflammation was investigated in some cases.

  10. Clinical evaluation of developed product for recovery of immune system in the treatment of cancer patients

    Cho, Chul-Ku; Choi, Soo Yong; Rhyu, Sung Ryeol; Kim, Ki Wha; Kim, Ji Yun; Yun, Na Ra

    2006-01-01

    We evaluate the clinical efficacy of pilot product (HemoHIM) on recovery from hematopoiesis damage in cancer patients who received radiotherapy and chemotherapy. The cancer patients studied were as follows : cancer of the breast(47 intakers and 136 non-intakers), uterine cervix(38 intakers and 73 non-intakers), and head and neck(7 intakers and 15 non-intakers). The clinical efficacy of pilot product(HemoHIM) in cancer patients who received radiotherapy and chemotherapy was analyzed. In breast cancer patients, the number of leukocytes decreased according to duration of treatment in both groups. However, intakers showed a less decreasing trend compared with non-intakers. Especially, under limiting value in range of leukocyte number of intakers was significantly higher than that of non-intakers. This result incicates that HemoHIM reduce the severe leukopenia. Values of lymphocyte in both groups decreased similarly after treatment, and it was similar to that of leukocyte. Values of erythrocyte in both groups decreased similarly after treatment, but the values were within normal range. In cervix cancer patients, the results were similar to that of breast cancer patients. In cancer of head and neck, values of leukocyte slightly decreased according to duration of treatment in both group. However, it needs to collect more subjects continuously because of small number of cancer patients. No toxicological side effects of HemoHIM were observed in serological analysis, and possibility to alleviate fatigue and inflammation was investigated in some cases

  11. State of motor function of stomach in patients with cervix uteri carcinoma in combined radiotherapy

    Zhidovtseva, M.I.; Shutilova, A.A.; Dynnik, M.S.; Lugovskaya, K.A.; Duma, V.A.

    1978-01-01

    Data on studying stomach motor function in patients with carvix uteri carcinoma of 2 and 3 stages in combined radiotherapy are given. The patients were examined before radiotherapy and directly after it as well as in 1-2 years using the X-ray method for 50 patients and electrogastrography for 68 patients. Revealed changes in stomach motor function, being considered as a response to irradiation, were manifested more often in decreasing motility, evacuatory function and bioelectric stomach activity. These functional changes result in disturbance of general state of patients, appearance of symptomatology of stomach dysfunction and serve as indications for the prescription of correcting therapy, which includes diet and preparations strengthening stomach motor activity

  12. [Quantitative analysis of diffusion-weighted magnetic resonance images during chemoradiation therapy for cancer of the cervix uteri: Prognostic role of pretreatment diffusion coefficient values].

    Kharuzhyk, S A

    2015-01-01

    to carry out a quantitative analysis of diffusion-weighted magnetic resonance images (DWI) in cancer of the cervix uteri (CCU) and to estimate the possibility of using pretreatment measured diffusion coefficient (MDC) to predict chemoradiation therapy (CRT). The investigation prospectively enrolled 46 women with morphologically verified Stages IB-IVB CCU. All the women underwent diffusion-weighted magnetic resonance imaging of pelvic organs before and after treatment. A semiautomatic method was used to determine tumor signal intensity (SI) on DWI at b 1000 s/mm2 (SI b1000) and tumor MDC. The reproducibility of MDC measurements was assessed in 16 randomly selected women. The investigators compared the pretreatment quantitative DWI measures in complete and incomplete regression (CR and IR) groups and the presence and absence of tumor progression during a follow-up. An association of MDC with progression-free and overall survivals (PFS and OS) was determined in the patients. A semiautomatic tumor segmentation framework could determine the pretreatment quantitative DMI measures with minimal time spent and high reproducibility. The mean tumor MDC was 0.82 +/- 0.14 x 10(-3) mm2/s. CR and IR were established in 28 and 18 women, respectively. The MDC < or = 0.83 x 10(-3) mm2/s predicted CR with a sensitivity of 64.3% and a specificity of 77.8% (p=0.007). The median follow-up was 47 months (range, 3-82 months). With the MDC < or = 0.86 x 10(-3) mm2/s, 5-year PFS was 74.1% versus 42.1% with a higher MDC (p=0.023) and 5-year OS was 70.4 and 40.6%, respectively (p=0.021). The survival difference was insignificant in relation to the degree of tumor regression. The pretreatment IS at b1000 was of no prognostic value. The pretreatment tumor MDC may serve as a biomarker for predicting the efficiency of CRT for CCU.

  13. Design and construction of a holder to the safety handling of Cs-137 to be used in cervix cancer treatments using intracavitary brachytherapy by afterloading

    Gonzales, E.; Lea, D.

    1996-01-01

    In venezuelan public hospitals where cervix cancer treatments are performed by means of Cs-137 manual afterloading systems, the handling of the sources is done with two type of holders, metallic and plastic, the plastic holders are pieces of induced serious radio-sanitary problem such as loser of the Cs-137 source and radioactive contamination in the treatment area, this has caused the interruption of the treatments in many hospitals. This interruption had a high social cost because of the thousands women waiting for intracavitary therapy. To start again with the treatments, the metallic holders were required but there were not enough funds in the budget, because of this problem in a short time IVIS'S health physics drew and made a low price source holder. (authors). 2 figs., 2 tabs

  14. Clinical impact of de-regulated Notch-1 and Notch-3 in the development and progression of HPV-associated different histological subtypes of precancerous and cancerous lesions of human uterine cervix.

    Tripathi, Richa; Rath, Gayatri; Jawanjal, Poonam; Sharma, Shweta; Singhal, Pallavi; Bhambhani, Suresh; Hussain, Showket; Bharadwaj, Mausumi

    2014-01-01

    Cervical cancer is the leading cause of cancer related deaths among women in India. Limited reports are available for Notch-1 and Notch-3 protein in cervical carcinoma, which play crucial role in cell proliferation, differentiation, and apoptosis. This study was designed to evaluate the role of Notch-1 and Notch-3 with context to HPV infection in cervical carcinoma. A total of 168 tissue biopsy samples comprising of tumor specimens (n = 98), precancer (n = 30) and non-neoplastic cervical tissues (n = 40) were screened for HPV infection by PCR and expression of Notch-1 and Notch-3 protein by Immunohistochemistry and Immunoblotting. 80% (24/30) were found to be positive for HPV in precancer and 86.7% (85/98) in cancer patients. Notch-1 expression of precancer and cancer cases was found to be significantly down-regulated with severity of disease in nuclear (3.43±0.29; 2.04±0.19, p = 0.0001, p = 0.0001) and cytoplasm (3.07±0.29; 2.29±0.17, p = 0.0001, p = 0.0001) obtained from different stages as compared to normal cervix tissue (5.40±0.19, 4.97±0.15; pcervix tissue (0.95±0.20, 0.70±0.20; pcancer through the deregulation of Notch signalling. This study also shows the clinical utility of both proteins which may be used as predictable biomarkers in diagnosing different histological sub-types of HPV associated cervical cancer. Nevertheless, abnormal activation of this pathway may provide legitimate targets for cervical cancer therapy.

  15. Clinical significance of measurement of changes of serum IGF-II, SCC and CYFRA21-1 levels after operation in patients with carcinoma of uterine cervix

    Kuang Lei

    2010-01-01

    Objective: To explore the clinical significance of changes of serum IGF-II, SCC and CYFRA21-1 levels after operation in patients with carcinoma uterine cervix. Methods: Serum levels of IGF-II, SCC and CYFRA21-1 were determined with RIA repeatedly in 31 patients with carcinoma of uterine cervix (before operation 1 month after operation and 6 month after operation) and once in 35 controls. Results: Before operation,serum levels of IGF-II, SCC and CYFRA21-1 in the patients were significantly higher than those in the controls (P<0.01). One month after operation all the serum levels were approaching normal. Six month later,the levels in the patients without recurrence remained normal. However, the levels in the 6 patients with recurrence returned to those before operation again. Conclusion: Changes of serum IGF-II, SCC and CYFRA21-1 levels are closely related to the tumor burden and may be of prognostic importance. (authors)

  16. Dose Distribution over Different Parts of Cancer Patients During Radiotherapy Treatment in Bangladesh

    Miah, F.K.; Ahmed, M.F.; Begum, Z.; Alam, B.; Chowdhury, Q.

    1998-01-01

    Measurements have been carried out to determine the dose distribution over different parts of the body of 12 cancer patients during radiotherapy treatment. Patients with breast cancer, lung cancer, cervix and larynx cancer treated with either X ray therapy or 60 Co therapy were particularly considered. The doses to the organs and tissues outside the primary beam of the patients under treatment were found to vary with a maximum value of 9096 ± 25 mSv at the neck of a lung cancer patient to a minimum value of 2 ± 0.5 mSv at the right leg of a breast cancer patient. The variation of doses was well explained by the exposure and patient data given for each patient. The measured data in each part of the body have been found to be consistent indicating confidence in the measurements. (author)

  17. An evidence-based estimate of the appropriate rate of utilization of radiotherapy for cancer of the cervix

    Usmani, Nawaid; Foroudi, Farshad; Du, Jenny; Zakos, Celine; Campbell, Holly; Bryson, Peter; Mackillop, William J.

    2005-01-01

    Purpose: Current estimates of the proportion of cancer patients who will require radiotherapy (RT) are based almost entirely on expert opinion. The objective of this study was to calculate the proportion of incident cases of cervical cancer that should receive RT by application of an evidence-based approach. Methods and Materials: A systematic review of the literature was done to identify indications for RT for cervical cancer and to ascertain the level of evidence that supported each indication. A survey of Canadian gynecologic oncologists and radiation oncologists who treat cervical cancer was done to determine the level of acceptance of each indication among doctors who practice in the field. An epidemiologic approach was then used to estimate the incidence of each indication for RT in a typical North American population of patients with cervical cancer. Results: The systematic review of the literature identified 29 different indications for RT for cervical cancer. The majority of the 75 experts who responded to the mail survey stated that they 'usually' or 'always' recommended RT in all but one of the clinical situations that were identified as indications for RT on the basis of the systematic review. The analysis of epidemiologic data revealed that, in a typical North American population, 65.4% ± 2.5% of cervical cancer cases will develop one or more indications for RT at some point in the course of the illness, 63.4% ± 2.3% will develop indications for RT as part of their initial management, and 2.0% ± 0.9% will develop indications for RT for progressive or recurrent disease. The effects of variations in case mix on the need for RT was examined by sensitivity analysis, which suggested that the maximum plausible range for the appropriate rate of utilization of RT was 54.3% to 67.9%. The proportion of cases that required RT was stage dependent: 10.6% ± 1.2% in Stage IA, 74.9% ± 1.3% in Stage IB, 100% in Stages II and III, and 97.2% ± 1.1% in Stage IV

  18. Evaluation of cervical cerclage for sonographically incompetent cervix in at high risk patients

    Mustajab, Y.; Jehanzaib, M.

    2008-01-01

    To determine the impact of Cervical Cerclage (CC) for prolongation of pregnancy, maternal and foetal outcome. This Descriptive cross-sectional study was conducted over a period of 2 years patients with history of two or more recurrent midtrimester abortions/preterm deliveries were included. Those with abnormal foetus, vaginal bleeding and choreoamneonitis were excluded. All patients were subjected to transvaginal sonography. Those having sonographic evidence of cervical shortening/dilatation/cone formation were subjected to McDonald suture. Age, parity, period of gestation and aetiological factors were determined. Results were evaluated on the basis of pregnancy prolongation, 14-28 weeks (7.5%), 28-36 weeks (18.7%), 35-37 weeks (73.7%), vaginal delivery in (70%), instrumental (1305%), Caesarean section (17.5%),miscarriage (7.5%), prematurity (18.7%), term delivery (73.7%), prenatal death (13.7%), foetal survival rate (85.1%). No intraoperative complication found. During pregnancy premature rupture of membrane (3.7%), abruption (2.5%), severe pre-eclampsia (3.7%). During labour cervical dystocia was found in (2.5%), foetal distress (8.7%), mal-presentations (6.2%), cervical trauma (3.7%). We determined a high success rate of cervical cerclage on properly selected patients with sonographic evidence of cervical changes. Cervical sonography can be a valuable adjunct to clinical evaluation of these patients. (author)

  19. Lumboaortic radiotherapy in patients with cervical cancer. Experience of the National Cancer Institute

    Santini B, Alejandro; Becerra S, Sergio; Gayan G, Patricio; Carcamo I, Marcela; Bianchi G, Benjamin

    2010-01-01

    Background: Uterine cancer is still a prevalent disease in Chile. Is common to treat patients with tumors in stages IIB and IIIB where the risk of pelvic and paraortic limph node involvement is very high. Its treatment is radio-chemotherapy. Objective: To present a retrospective analysis of patients that suffered cervix-uterine cancer who were treated with radiotherapy including the aortic-lumbar area. Methods: From the revision of patients who were treated of cervix-uterine cancer between the years 1995 and 2007, 39 were treated including aortic-lumbar chains. Evolution and toxicity were analyzed. Two radiotherapy techniques were used. The first one, during the nineties, included two parallel previous and later and opposed fields, and a second technique, currently used, where pelvis and paraortic are radiated at the same time through four lateral (AP-PA) fields. Results: The dosimeter analysis of both techniques shows that there is a higher volume of radiated normal tissue with the two fields techniques, mainly in the small bowel. On the other hand, the toxicity was significantly different being today's technique less toxic and showing low gastrointestinal

  20. The cervical smear pattern in patients with chronic pelvic ...

    Background: Cancer of the cervix is the commonestmalignancy of the genital tract inNigeria. In an atmosphere of opportunistic screening due to lack of a national screening programme, studies are needed to determine patients at risk of premalignant lesions of the cervix. Goal: To determine cervical smear pattern in patients ...

  1. Patterns of brachytherapy practice for patients with carcinoma of the cervix (1996-1999): A Patterns of Care Study

    Erickson, Beth; Eifel, Patricia; Moughan, Jennifer; Rownd, Jason M.S.; Iarocci, Thomas; Owen, Jean

    2005-01-01

    Purpose/Objective: To analyze the details of brachytherapy practice in patients treated for carcinoma of the cervix in the United States between 1996 and 1999. Methods and Materials: Radiation facilities were selected from a stratified random sample. Patients were randomly selected from lists of eligible patients treated at each facility. A total of 442 patients' records were reviewed in 59 facilities to obtain data about patients' characteristics, evaluation, tumor extent, and treatment. National estimates were made using weights that reflected the relative contribution of each institution and of each patient within the sampled institutions. From our survey we estimate that 16,375 patients were treated in the United States during this study period. Unless otherwise specified, brachytherapy practice was based on the 408 patients who had their brachytherapy or all their treatment at the surveyed facility. Results: A total of 91.5% of patients underwent brachytherapy at the initial treating institution; 8.5% were referred to a second site for brachytherapy. Forty-two percent of U.S. facilities referred at least some patients to a second facility for brachytherapy. Of U.S. facilities that treated ≤2 eligible patients per year, 61% referred all of their patients to a second facility for brachytherapy or treated with external RT alone; none of the U.S. facilities with larger experience (>2 eligible patients per year) referred all their patients to a second facility for brachytherapy treatment, but 28% referred some patients to an outside facility for brachytherapy. Overall, 94% of patients who completed treatment with curative intent received brachytherapy. Of these patients who had brachytherapy, 77.8%, 13.3%, and 0.9%, respectively, were treated with low-dose-rate (LDR), high-dose-rate (HDR), or a combination of HDR and LDR brachytherapy; 7.9% had interstitial brachytherapy (5.7% LDR and 1.9% HDR, 0.3% mixed). In facilities that treated >2 patients per year, 15

  2. Cost analysis of erythropoietin versus blood transfusions for cervical cancer patients receiving chemoradiotherapy

    Kavanagh, Brian D.; Fischer, Bernard A.; Segreti, Eileen M.; Wheelock, John B.; Boardman, Cecilia; Roseff, Susan D.; Cardinale, Robert M.; Benedict, Stanley H.; Goram, Adrian L.

    2001-01-01

    Purpose: Red blood cell (RBC) transfusions or erythropoietin (EPO) can be used to evade the detrimental effects of anemia during radiotherapy, but the economic consequences of selecting either intervention are not well defined. The RBC transfusion needs during chemoradiotherapy for cervix cancer were quantified to allow comparison of RBC transfusion costs with the projected cost of EPO in this setting. Methods and Materials: For patients receiving pelvic radiotherapy, weekly cisplatin, and brachytherapy, the RBC units transfused during treatment were tallied. RBC transfusion costs per unit included the blood itself, laboratory fees, and expected value (risk multiplied by cost) of transfusion-related viral illness. EPO costs included the drug itself and supplemental RBC transfusions when hemoglobin was not adequately maintained. An EPO dosage based on reported usage in cervix cancer patients was applied. Results: Transfusions were given for hemoglobin <10 g/dL. Among 12 consecutive patients, 10 needed at least 1 U of RBC before or during treatment, most commonly after the fifth week. A total of 37 U was given during treatment, for an average of 3.1 U/patient. The sum total of the projected average transfusion-related costs was $990, compared with the total projected EPO-related costs of $3869. Conclusions: Because no proven clinical advantage has been documented for EPO compared with RBC transfusions to maintain hemoglobin during cervix cancer treatment, for most patients, transfusions are an appropriate and appealingly less expensive option

  3. The efficacy of concurrent cisplatin and 5-flurouracil chemotherapy and radiation therapy for locally advanced cancer of the uterine cervix

    Choi, Il Jung; Park, Eunku Seul; Han, Myung Seok; Choi, Youngmin; Je, Goo Hwa; Kim, Hyun Ho

    2008-01-01

    Objective To evaluate the efficacy of concurrent chemoradiation (CCRT) using 5-flurouracil (5-FU) and cisplatin for locally advanced cervical cancer. Methods We reviewed the medical records of 57 patients with locally advanced cervical cancer (stage IIB-IVA and bulky IB2-IIA tumor) who underwent the CCRT at Dong-A University Hospital from January 1997 to June 2007. The CCRT consisted of 5-FU, cisplatin and pelvic radiation. Every three weeks, 75 mg/m2 cisplatin was administered on the first day of each cycle and 5-FU was infused at the dose of 1,000 mg/m2/d from the second day to the fifth day of each cycle. Radiation was administered to the pelvis at a daily dose of 1.8 Gy for five days per week until a medium accumulated dose reached to 50.4 Gy. If necessary, the radiation field was extended to include paraaortic lymph nodes. Consolidation chemotherapy was performed using 5-FU and cisplatin. Results Fifty-seven patients were enrolled and the median follow-up duration was 53 months (range 7-120 months). The overall response rate was 91.5% (74% complete response and 17.5% partial response). The 5-year overall survival and 3-year progression free survival rates were 69.4% and 74.9%, respectively. During the follow-up period (median 23 months, range 7-60 months), fourteen patients were diagnosed as recurrent disease. Conclusion CCRT with 5-FU and cisplatin which is the primary treatment for patients with locally advanced cervical cancer was effective and well tolerated. PMID:19471554

  4. Comparative study vagina mould/ fletcher applicator in MRI guided pulsed rate brachytherapy in patients reached by an uterine cervix carcinoma; Etude comparative moule vaginal/applicateur de fletcher en curietherapie de debit pulse guide par IRM chez les patientes atteintes d'un cancer du col uterin

    Francois, G.; Dumas, I.; Mazeron, R.; Verezesan, O.; Monnier, L.; Vieillot, S.; Gensse, M.C.; Haie-Meder, C. [Institut Gustave-Roussy, 94 - Villejuif (France)

    2009-10-15

    This study began in february 2009 and included until today ten patients. twenty patients are planned. The analysis of preliminary results show a much higher tolerance for the vaginal cast device. The dosimetry data were the object of a preliminary study that seems demonstrate an equivalence of the both modalities, with differences concerning the doses to critical organs; The definitive result swill be presented with the data including the twenty planned patients. (N.C.)

  5. Depression in Cancer Patients

    Beyhan Bag

    2014-06-01

    Full Text Available It is not enough to consider treatment and care depression in the oncology that is the most common psychiatric illness in cancer patient affects of cancer treatment and the patient`s quality of life negatively, which is determined through researches in the field. With development of psycho-oncology it has been demonstrated to establish an important link between the cancer patient`s treatment as well as psycho-social support for the patient and psychiatric treatment and care for the if it is needed. With this connection between them it has been proposed to use of bio-psycho-social-model in cancer patient to improve their care. To achieve this goal, it is expected from medical personnel to realize patients psychosocial need und if he/she has a psychiatric disorders or syndromes. For the medical personnel that work in oncology services, it is inevitable to organize in order to raise the awareness of depression in the cancer patients. In the present study, it is focused on raising the awareness of depression in cancer patient for the medical personnel. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 186-198

  6. Is the routine use of bevacizumab in the treatment of women with advanced or recurrent cancer of the cervix sustainable?

    Klag N

    2016-06-01

    Full Text Available Natalie Klag, Adam C Walter, Kristen M Sheely, Kelly J Manahan, John P Geisler Division of Gynecologic Oncology, Cancer Treatment Centers of America Newnan, Georgia, USA Background: New chemotherapy combinations are being tested for the treatment of women with advanced, persistent or recurrent cervical cancer. We sought to evaluate the cost effectiveness of some newer combination therapies in cervical cancer. Patients and methods: A cost effectiveness decision model was used to analyze Gynecologic Oncology Group 240. All regimens were modeled for seven cycles. The regimens studied are as follows: regimen 1, cisplatin/paclitaxel (CP; regimen 2, CP with bevacizumab (CP+B; regimen 3, paclitaxel/topotecan (PT; and regimen 4, PT with bevacizumab (PT+B. Overall survival, cost, and complications were studied. Sensitivity analyses were performed. Results: Mean chemotherapy costs over mean total costs for seven cycles of each follows: CP $571/$32,966; CP+B $61,671/$96,842; PT $9,211/$71,620; and PT+B $70,312/$109,211. Incremental cost-effectiveness ratio (ICER for CP+B was $133,559/quality adjusted life year (QALY. ICER for PT+B was $124,576/QALY. To achieve an incremental ICER for CP+B:CP of <$50,000/QALY gained, the mean overall survival has to increase from 1.1 years with CP to 3.5 years with CP+B. An ICER <$50,000/QALY for the other regimens would take a survival of >10 years for PT and 4.1 years for PT+B. Treating 1,000 women with cervical cancer with CP+B would cost almost double the cost of treating >18,000 women with ovarian cancer annually (carboplatin/paclitaxel. Conclusion: CP is the most cost effective regimen. A 12-month increase in overall survival will not even make the newer combinations cost effective. Currently, the use of bevacizumab is not sustainable at today's costs. Keywords: cervical cancer, chemotherapy, bevacizumab, cost-effectiveness

  7. (18F)-fluorodeoxyglucose PET/CT in cervix cancer: Lymph node assessment and prognostic/predictive value of primary tumour analysis

    Leseur, J.; Williaume, D.; Le Prise, E.; De Crevoisier, R.; Devillers, A.; Garin, E.; Fougerou, C.; Bouriel, C.; Leveque, J.; Monpetit, E.; Blanchot, J.

    2011-01-01

    Purpose. - In cervix carcinoma: (a) to evaluate the ability of ( 18 F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the lymph node detection; (b) to investigate the prognostic and predictive value of the primary cervical PET parameters. Patients and methods. - Ninety patients treated for cervix carcinoma and evaluated initially by MRI and FDG PET were included. The performances of FDG-PET for lymph node detection (relatively to the lymph node dissection) have been described (sensitivity, specificity, positive predictive value and negative predictive value). PET tumour parameters analyzed were: maximum standard uptake value (SUV max ), the volume and the maximum diameter. The prognostic and predictive values of these parameters were investigated. The tumour response was evaluated on surgical specimens. Results. - PET detected the cervical tumour with a sensitivity of 97% (mean values: SUV max = 15.8, volume = 27 mm 3 , maximum diameter = 47). For the detection of the lymph nodes, the values of sensibility, specificity, positive predictive value and negative predictive value were: 86, 56, 69 and 78% in the pelvic, and 90, 67, 50 and 95% for the para-aortic area, respectively. The SUV max was correlated with histologic response (P = 0.04). The frequency of partial histological response was significantly higher for tumour SUV max > 10.9 (P = 0.017). The maximum PET diameter and pathologic response had an impact on disease-free survival and overall survival in multivariate analysis (P < 0.05). Conclusion. - PET has high sensitivity in detecting pelvic and para-aortic lymph nodes. Some primary cervical tumour PET parameters are useful as prognostic and predictive factors. (authors)

  8. A HISTOPATHOLOGICAL STUDY OF NEOPLASTIC LESIONS OF UTERINE CERVIX OF PERI AND POSTMENOPAUSAL WOMEN

    Jogesh Kakati

    2017-03-01

    Full Text Available BACKGROUND Neoplastic lesions of uterine cervix is one of the most common malignant neoplasms in women. The tremendous success in giving a confirmed diagnosis of the disease by doing histopathological examination is of prime importance in giving the most appropriate treatment and to understand the prognosis. The aim of the study is to study the incidence and age-wise distribution of the neoplastic lesions of the uterine cervix in peri and postmenopausal women by doing histopathological examination of neoplastic lesions and by doing correlation of clinical findings with histopathological examination. MATERIALS AND METHODS The study included 803 cases of total cervical specimens, out of which 180 cases of neoplastic cervical lesions were found, out of which 150 cases were found in the peri and postmenopausal age groups, i.e. above 40 years of age. The study was done in Gauhati Medical College and Hospital, Guwahati, from the period 1 st June, 2013, to 1 st June, 2014. The specimens that were included in the study were punch biopsies, hysterectomies and polypectomies and cervical specimens were studied by doing histopathological examinations. RESULTS Out of the 150 cases of neoplastic lesions in the peri and postmenopausal women, the most common neoplastic lesion was cervical intraepithelial neoplasia, i.e. CIN (8.3% of the cervix, followed by malignant (5.6% and benign (4.7% lesions of the cervix in this study group of patients. CONCLUSION Histopathological examination of the cervix is an effective method of giving a confirmed diagnosis of all the noncancerous, precancerous and cancerous lesions of uterine cervix, which helps in giving the most appropriate treatment and also helps in understanding the prognosis.

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

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

    2015-01-01

    PURPOSE: 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....../CT. METHODS: 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...

  10. T- and NK-cell populations with regulatory phenotype and markers of apoptosis in circulating lymphocytes of patients with CIN3 or microcarcinoma of the cervix: evidence for potential mechanisms of immune suppression.

    Kurmyshkina, Olga V; Kovchur, Pavel I; Schegoleva, Ludmila V; Volkova, Tatyana O

    2017-01-01

    expression, confirming that this change likely has different functional significance for these two subsets. A search for correlations between the phenotypic parameters analyzed in this study was performed to demonstrate that women with early neoplastic lesions of the cervix, such as carcinoma in situ and microinvasive carcinoma, displayed a coordinated increase in expression of Treg markers in circulating lymphocytes, along with more pronounced cross-relationships between Treg numbers, CD95 expression on T cells, and apoptosis, compared to the control group. The results of this study suggest that a diversity of immune regulatory mechanisms that provide support for initial stages of invasive growth in cervical cancer patients includes systemic changes in the ratios between the principal regulatory and effector lymphocyte populations both within adaptive and innate immunity.

  11. Radiotherapy Results of Carcinoma of Cervix with positive Resection Margin

    Huh, Seung Jae; Kim, Dae Yong; Ahn, Yong Chan; Kim, Won Dong; Wu, Hong Gyun; Ha, Sung Whan; Kim, Il Han; Park, Charn Il

    1996-01-01

    Purpose : Patients with cervical cancer who have positive resection margins after radical hysterectomy are at increased risk for local recurrence. The results of postoperative pelvic radiotherapy for cervix cancer with positive resection margins were analyzed to evaluated the role of radiotherapy. Materials and Methods : Between 1979 and 1992, 60 patients of cervix carcinoma were treated with postoperative radiotherapy after radical hysterectomy because of positive vaginal(48 patients) or parametrial resection margins(12 patients). Patients were treated with external beam radiation therapy(EBRT) alone (12 patients) or EBRT plus vaginal ovoid irradiation (VOI) (48 patients). The median follow-up period was 5 months. Results : The 5-year actuarial disease free and overall survival rates for all patients were 75.2%, 84.1%, respectively. The overall recurrence rate was 23%(14/60). In 48 patients with positive vaginal resection margins, the pelvic recurrence was 8%(4/48). Distant metastasis was 15%(7/48). Of the 43 patients with positive vaginal resection margins treated with EBRT and VOI, recurrence rate was 21%(9/43), while recurrence rate was 40%(2/5) in the EBRT only treated group. In 12 patients with positive parametrial margins, three patients (25%) had distant metastases. The most significant prognostic factor was lymph node metastasis. Complications resulting from radiotherapy occurred at a rate of 32%(19/60) and grade III complications occurred in three patients (5%). Conclusion : Postoperative radiotherapy can produce excellent pelvic control rates in patients with positive resection margins. In patients with positive vaginal margins, whole pelvic EBRT and BOI is recommended

  12. Highly differentiated keratinizing squamous cell cancer of the cervix: a rare, locally aggressive tumor not associated with human papillomavirus or squamous intraepithelial lesions.

    Morrison, C; Catania, F; Wakely, P; Nuovo, G J

    2001-10-01

    The purpose of this study is to report an unusual variant of cervical squamous cell carcinoma, not associated with either human papillomavirus infection or antecedent squamous intraepithelial lesions. Five women had a diagnosis of invasive cervical cancer discovered at hysterectomy performed for prolapse (two cases), leiomyoma (one case), or a vaginal fistula (two cases). The women ranged in age from 47 to 78 years (mean 59 years). Four of the five had a history of normal Papanicolaou (Pap) smears; the other had a Pap smear diagnosis of atypical squamous cells of undetermined significance (ASCUS). All had large cervical tumors (two with parametrial involvement and one with vaginal involvement) that showed extensive keratin formation, an inverted pattern of growth, and, except for one case, minimal cytologic atypia. There was extensive hyperkeratosis and parakeratosis adjacent to each tumor; none had evidence of squamous intraepithelial lesion. Human papillomavirus testing by polymerase chain reaction in situ hybridization and reverse-transcribed polymerase chain reaction in situ was negative in each case, compared with a detection rate of 107 of 108 (99%) for squamous intraepithelial lesion-associated cervical squamous cell and adenocarcinomas. Two of the women died of extensive local recurrence; two other women were recently diagnosed. We conclude that highly differentiated keratinizing squamous cell carcinoma of the cervix is a rare entity not associated with human papillomavirus infection or squamous intraepithelial lesion and thus difficult to detect on routine cervical cancer screening.

  13. Hysteroscopic management of a stenotic cervix.

    Suen, Michael W H; Bougie, Olga; Singh, Sukhbir S

    2017-06-01

    To demonstrate an approach to the hysteroscopic management of a stenotic cervix. Step-by-step explanation of the techniques using video and animation (educational video). Academic tertiary level referral center. Patients with cervical stenosis, inclusive of both reproductive age and postmenopausal women. Gynecologists require intrauterine access for many procedures, but a stenotic cervix can obstruct surgery. Blind dilation of a stenotic cervix can lead to a cervical laceration or uterine perforation, with concomitant complications. The hysteroscopic management of a stenotic cervix includes optimizing the surgical environment, performing vaginoscopy and "no-touch" hysteroscopy, and revision of the cervical canal. Revision can be performed using microscissors, micrograspers, or a cutting loop electrode. Partial cervical canal excision to aid in hysteroscopy access should be reserved in women who are not interested in future pregnancy or those who are postmenopausal. Outpatient hysteroscopy uses smaller instruments and shows operative success with patient satisfaction. Although these techniques are demonstrated in an outpatient hysteroscopy setting, they can be adapted for use in an operating theater. The individual steps and approach are emphasized. Intrauterine access can be achieved with various techniques. The "see-and-treat" approach demonstrated in this video can allow access into the uterine cavity despite a stenotic cervix. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. [Precancerous lesions of the uterine cervix in Pointe-Noire, Congo].

    Moukassa, D; N'Golet, A; Lingouala, L G; Eouani, M L; Samba, J B; Mambou, J V; Ompaligoli, S; Moukengue, L F; Taty-Pambou, E

    2007-02-01

    The purpose of this study was to determine the cytological profile and risk factors for intraepithelial precancerous lesions of the uterine cervix in an urban community of Pointe-Noire, an industrialized seaport located in the southeast region of Congo-Brazzaville. A transverse study was carried out over a period of 18 months (January 2003 to July 2004) in the Center for the Study of Human and Animal Diseases (CSHAD) at the General Adolphe Sie Hospital in Pointe-Noire. A total of 1347 files of women benefiting from cervico-vaginal smears were included in the study. Testing was undertaken either at the request of the patient (voluntary screening) or at the request of a health care provider (physician, midwife or nurse) in relation with various gynecological problems. The relative frequency of intraepithelial lesions was estimated to be 15.36% including 9.17% of low-grade intraepithelial lesions (Ig IEL) and 6.19% of high-grade intraepithelial lesions (hg IEL). The mean age of patients with hg IEL was 42.25 years (range, 12 to 17). Study of the interval between actual age at the time of sample collection and age of first sexual relations showed that women presenting IEL had an interval of at least 20 years. This interval probably corresponds to the time necessary for the interaction between human papillomavirus (HPV) and epithelial cells of the uterine cervix to induce intraepithelial lesions that lead to development of cancer of the uterine cervix. Comparative analysis of the number of sexual partners between the group of women with normal smears and the group with smears showing hg IEL indicated a clear predominance of the mean number of partners in the latter group, i.e., 2 +/- 1,2 versus 5 +/- 1,8 (p cervix in the Kouilou department of Congo-Brazzaville. These data will serve as benchmarks and guidance for forthcoming screening campaigns for early detection of uterine cervix cancer.

  15. An experimental study on cervix cancer with combination of HSV-TK/GCV suicide gene therapy system and 60Co radiotherapy

    Chen, Daozhen; Tang, Qiusha

    2010-01-01

    To evaluate the killing effect of HSV-TK/GCV suicide gene therapy system combined with 60 Co radiotherapy on human cervical cancer Hela cell line in vitro and in vivo, and to explore the radiosensitization by HSV-TK/GCV system. HSV-TK/GCV suicide gene therapy system and 60 Co radiotherapy were used separately or in combination on human cervical cancer Hela cell line in vitro and in vivo to compare their effects. Colony formation test and the rate of radiosensitization effect (E/O) were employed to observed the radiosensitization by HSV-TK/GCV system. HSV-TK/GCV suicide gene therapy system had strong therapeutic effects on Hela cells in vitro and in vivo (the inhibition rates were 45.8% and 39.5%, respectively), moreover, the combined administration of gene therapy and radiotherapy had stronger therapeutic effects in vitro and in vivo (the inhibition rate was 87.5% in vitro, and the inhibition rate was 87.9% in vivo) (P < 0.01). The inhibition rate by radiotherapy alone was 42.4% in vitro and 35.8% in vivo. The sensitivity of combined therapy to radiotherapy increased more than that of therapy alone, the ability of colony formation decreased (P < 0.01). The rate of radiosensitivity effect (E/O) was 3.17(> 1.4), indicating HSV-TK/GCV system could exert a sensitizing effect on 60 Co radiotherapy of the transplanted human cervical cancer cell in nude mice. HSV-TK/GCV system had radiosensitization. Gene therapy combined with radiotherapy may be a good supplementary method for cervix cancer synthetic treatment

  16. Literature analysis of radiotherapy in uterine cervix cancer for the processing of the patterns of care study in Korea

    Lee, Rena

    2005-01-01

    Although computed tomography (CT) simulators are commonly used in radiation therapy department, many institution still use conventional CT for treatment. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocenter point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images. In 7/21 patients, anatomic structures on DRR image were different from the simulation image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. These result represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup error

  17. Literature analysis of radiotherapy in uterine cervix cancer for the processing of the patterns of care study in Korea

    Lee, Rena [Ewha Womans University Mokdong Hospital, Seoul (Korea, Republic of)

    2005-09-15

    Although computed tomography (CT) simulators are commonly used in radiation therapy department, many institution still use conventional CT for treatment. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocenter point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images. In 7/21 patients, anatomic structures on DRR image were different from the simulation image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. These result represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup

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

    Jain Vandana

    2007-01-01

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

  19. Systematic gene microarray analysis of the lncRNA expression profiles in human uterine cervix carcinoma.

    Chen, Jie; Fu, Ziyi; Ji, Chenbo; Gu, Pingqing; Xu, Pengfei; Yu, Ningzhu; Kan, Yansheng; Wu, Xiaowei; Shen, Rong; Shen, Yan

    2015-05-01

    The human uterine cervix carcinoma is one of the most well-known malignancy reproductive system cancers, which threatens women health globally. However, the mechanisms of the oncogenesis and development process of cervix carcinoma are not yet fully understood. Long non-coding RNAs (lncRNAs) have been proved to play key roles in various biological processes, especially development of cancer. The function and mechanism of lncRNAs on cervix carcinoma is still rarely reported. We selected 3 cervix cancer and normal cervix tissues separately, then performed lncRNA microarray to detect the differentially expressed lncRNAs. Subsequently, we explored the potential function of these dysregulated lncRNAs through online bioinformatics databases. Finally, quantity real-time PCR was carried out to confirm the expression levels of these dysregulated lncRNAs in cervix cancer and normal tissues. We uncovered the profiles of differentially expressed lncRNAs between normal and cervix carcinoma tissues by using the microarray techniques, and found 1622 upregulated and 3026 downregulated lncRNAs (fold-change>2.0) in cervix carcinoma compared to the normal cervical tissue. Furthermore, we found HOXA11-AS might participate in cervix carcinogenesis by regulating HOXA11, which is involved in regulating biological processes of cervix cancer. This study afforded expression profiles of lncRNAs between cervix carcinoma tissue and normal cervical tissue, which could provide database for further research about the function and mechanism of key-lncRNAs in cervix carcinoma, and might be helpful to explore potential diagnosis factors and therapeutic targets for cervix carcinoma. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. [Treatment of human papilloma virus of the cervix using cryosurgery].

    González Sánchez, J L; Celis, C; Rodríguez de Santiago, J D; Peña Sandoval, M; Menéndez Velásquez, J

    1991-05-01

    The causal lesions by VPH in the cervix, are associated to cancer. Currently 56 different subtypes have been isolated, from which, the 16, 18, 31, 33, 35 and 39 are more frequently related with the cervical intraepithelial neoplasia; from here derives the importance of opportune treatment. The objective of this paper is to evaluate VPH of the cervix opportune treatment with cryosurgery. Seventy five patients were analyzed, from April 1988 to May 1990 with diagnosis of cervical VPH, by cytology, colposcopy and histopathology; in whom cryosurgery with double freezing technique, was practiced; and were evaluated ever six months, during two years with cytology and colposcopy. Whenever there was persistence or recurrence, cryosurgery was used again; doing this even three times, previously discarding intraepithelial cancer. Seventy seven per cent of the patients received only one session; 16% two, and 7% three. At the six months review, it was found that 92% of the cases were negative, and 8% with persistence; at 12 months, 89% negative and 11% with recurrences; at 18 months, 93% negative, 3% with persistence and 4% with recurrence; at 24 months, 96% negative and 4% with recurrence. It is concluded that cryosurgery is efficacious in the treatment of these lesions, easy to use, well tolerated, with minimal side effects, it does not require anesthesia and is of a low cost.

  1. Correlation of Traditional Point a With Anatomic Location of Uterine Artery and Ureter in Cancer of the Uterine Cervix

    Wang, K.-L.; Yang, Y.-C.; Chao, K. S. Clifford; Wu, M.-H.; Tai, H.-C.; Chen, T.-C.; Huang, M.-C.; Chen, J.-R.; Su, T.-H.; Chen, Y.-J.

    2007-01-01

    Purpose: Point A, used for dose specification for intracavitary brachytherapy for cervical cancer, is the point at which the uterine artery and ureter cross. This study assessed compatibility of commonly used traditional point A (TPA) and actual anatomic point A (APA). Methods and Materials: We visualized and placed radiopaque clips at the APA during pelvic and paraaortic lymphadenectomy in 11 patients with cervical carcinoma. Orthogonal and oblique radiographs were obtained after insertion of brachytherapy applicators. We measured the distance between the TPA and APA and estimated the brachytherapy dose to each of the two points. Results: A total of 64 brachytherapy treatments were performed. The mean distances between the TPA and APA were 5.2 ± 1.0 cm on the right and 5.4 ± 1.1 cm on the left. The estimated brachytherapy doses delivered to the APA as a percentage of the presumed 500-cGy fraction size to the TPA were 35.2% (176.6 ± 59.0 cGy) on the right and 30.0% (150.2 ± 42.9 cGy) on the left. The marked discrepancy in the position of the two points was not related to individual kinetic variations during brachytherapy treatment, tumor size, or bladder filling. Conclusions: The conventional TPA does not provide an accurate estimate of the APA determined during lymphadenectomy, indicating a need to reevaluate the current practice for determining the brachytherapy prescription for cervical cancer. ( (ClinicalTrials.gov) Identifier, NCT00319462)

  2. Roles of posttherapy 18F-FDG PET/CT in patients with advanced squamous cell carcinoma of the uterine cervix receiving concurrent chemoradiotherapy.

    Liu, Feng-Yuan; Su, Tzu-Pei; Wang, Chun-Chieh; Chao, Angel; Chou, Hung-Hsueh; Chang, Yu-Chen; Yen, Tzu-Chen; Lai, Chyong-Huey

    2018-07-01

    To assess the clinical roles of [ 18 F]fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) performed 2-3 months after completion of concurrent chemoradiotherapy (CCRT), along with pretherapy characteristics, in patients with advanced squamous cell carcinoma of the uterine cervix enrolled in a prospective randomized clinical trial. Posttherapy PET/CT in patients with advanced FIGO stage or positive pelvic or para-aortic lymph node (PALN) defined on pretherapy PET/CT was classified as positive, equivocal, or negative. Overall survival (OS) rates between patients with different PET/CT results are compared. Pretherapy characteristics are examined for association with posttherapy PET/CT results and for prognostic significance in patients with equivocal or negative PET/CT. PET/CT scans (n = 55) were positive, equivocal and negative in 9, 13 and 33 patients, respectively. All patients with positive scans were confirmed to have residual or metastatic disease and died despite salvage therapies. There is a significant OS difference between patients with positive and equivocal scans (P PET/CT (P = .033) and predicts a poorer survival in patients with equivocal or negative posttherapy PET/CT (P PET/CT 2-3 months posttherapy implies treatment failure and novel therapy is necessary to improve outcomes for such patients. A more intense posttherapy surveillance may be warranted in patients with positive pretherapy PALN.

  3. Lymphoma of the Cervix

    Juanita Parnis

    2012-01-01

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

  4. Apparatus for treating carcinoma of the uterine cervix

    Kumar, P.P.

    1984-01-01

    Disclosed is an apparatus for treating carcinoma of the uterine cervix by judiciously applying radioactive material immediately adjacent the uterine cervix for an extended period of time empirically determined by the radiologist. The novel apparatus comprises three radioactively chargeable components including a central tubular tandem vaginally insertable longitudinally into the uterine cervix and two non-lineal tubular ovoidal assemblies longitudinally locatable at the cervix and positioned laterally between the respective vaginal walls and the uterine cervix. The ovoidal assemblies are conveniently removably and pivotably connected to the central tandem component externally of the vaginal along the sagittal plane through a novel adapter member whereby the radioactively chargeable ovoidal assemblies tend to remain within a laterally extending plane located substantially midway the transversely separated vasicovaginal and rectovaginal septa, even though the patient periodically shifts her reclining posture during the extended treatment by said vaginally protruding apparatus

  5. Magnetic resonance imaging for assessment of parametrial tumour spread and regression patterns in adaptive cervix cancer radiotherapy

    Schmid, Maximilian P.; Fidarova, Elena [Dept. of Radiotherapy, Comprehensive Cancer Center, Medical Univ. of Vienna, Vienna (Austria)], e-mail: maximilian.schmid@akhwien.at; Poetter, Richard [Dept. of Radiotherapy, Comprehensive Cancer Center, Medical Univ. of Vienna, Vienna (Austria); Christian Doppler Lab. for Medical Radiation Research for Radiation Oncology, Medical Univ. of Vienna (Austria)] [and others

    2013-10-15

    Purpose: To investigate the impact of magnetic resonance imaging (MRI)-morphologic differences in parametrial infiltration on tumour response during primary radio chemotherapy in cervical cancer. Material and methods: Eighty-five consecutive cervical cancer patients with FIGO stages IIB (n = 59) and IIIB (n = 26), treated by external beam radiotherapy ({+-}chemotherapy) and image-guided adaptive brachytherapy, underwent T2-weighted MRI at the time of diagnosis and at the time of brachytherapy. MRI patterns of parametrial tumour infiltration at the time of diagnosis were assessed with regard to predominant morphology and maximum extent of parametrial tumour infiltration and were stratified into five tumour groups (TG): 1) expansive with spiculae; 2) expansive with spiculae and infiltrating parts; 3) infiltrative into the inner third of the parametrial space (PM); 4) infiltrative into the middle third of the PM; and 5) infiltrative into the outer third of the PM. MRI at the time of brachytherapy was used for identifying presence (residual vs. no residual disease) and signal intensity (high vs. intermediate) of residual disease within the PM. Left and right PM of each patient were evaluated separately at both time points. The impact of the TG on tumour remission status within the PM was analysed using {chi}2-test and logistic regression analysis. Results: In total, 170 PM were analysed. The TG 1, 2, 3, 4, 5 were present in 12%, 11%, 35%, 25% and 12% of the cases, respectively. Five percent of the PM were tumour-free. Residual tumour in the PM was identified in 19%, 68%, 88%, 90% and 85% of the PM for the TG 1, 2, 3, 4, and 5, respectively. The TG 3 - 5 had significantly higher rates of residual tumour in the PM in comparison to TG 1 + 2 (88% vs. 43%, p < 0.01). Conclusion: MRI-morphologic features of PM infiltration appear to allow for prediction of tumour response during external beam radiotherapy and chemotherapy. A predominantly infiltrative tumour spread at the

  6. Construction and use of an applicator of the afterloading type for treatment of the uterine cervix

    Miola, U.J.; Vizeu, D.M.; Moura, A.M.S.; Petito, J.W.

    The construction of an afterloading type applicator for treatment of cancer of the uterine cervix is described. The technique of intercavitary treatment of cancer of the uterine cervix used in the Osvaldo Cruz Institute of Radiotherapy (Brazil) is also discribed [pt

  7. [Physiotherapy of cancer patients].

    Gomez, Izabella; Szekanecz, Éva; Szekanecz, Zoltán; Bender, Tamás

    2016-07-01

    Physiotherapy of cancer patients is one of the most controversial issues in our country. Malignant diseases are firstly mentioned as a contraindication of physiotherapy. Until now, physiotherapy was not suggested (or only in limited accessibility) for those patients who had malignant disease in medical history. International medical practice was less restrictive in managing this topic. The development of imaging techniques put this question in a new light. On the basis of evidence, the majority of articles have reported beneficial effects of physiotherapy in cancer patients, and only few articles mentioned it as harmful. Of course, each patient requires an individual assessment, however, if we exclude the possibility of tumor recurrence and metastasis, most of physiotherapy procedures can be used safely. One of the aims of this review is to support the physicians' decisions when to prescribe treatments, in such a way, that more patients could receive physiotherapy. Orv. Hetil., 2016, 157(31), 1224-1231.

  8. Value of Magnetic Resonance Imaging Without or With Applicator in Place for Target Definition in Cervix Cancer Brachytherapy

    Pötter, Richard [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Federico, Mario [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Department of Radiation Oncology, Gran Canaria University Hospital, Las Palmas de Gran Canaria (Spain); Sturdza, Alina [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Fotina, Irina [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Institute of Physics and Technology, Tomsk Polytechnic University, Tomsk Oblast (Russian Federation); Hegazy, Neamat [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Department of Clinical Oncology, Medical University of Alexandria, Alexandria (Egypt); Schmid, Maximilian; Kirisits, Christian [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Nesvacil, Nicole, E-mail: nicole.nesvacil@meduniwien.ac.at [Department of Radiotherapy, Comprehensive Cancer Center, Medical University of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria)

    2016-03-01

    Purpose: To define, in the setting of cervical cancer, to what extent information from additional pretreatment magnetic resonance imaging (MRI) without the brachytherapy applicator improves conformity of CT-based high-risk clinical target volume (CTV{sub HR}) contours, compared with the MRI for various tumor stages (International Federation of Gynecology and Obstetrics [FIGO] stages I-IVA). Methods and Materials: The CTV{sub HR} was contoured in 39 patients with cervical cancer (FIGO stages I-IVA) (1) on CT images based on clinical information (CTV{sub HR}-CT{sub Clinical}) alone; and (2) using an additional MRI before brachytherapy, without the applicator (CTV{sub HR}-CT{sub pre-BT} {sub MRI}). The CT contours were compared with reference contours on MRI with the applicator in place (CTV{sub HR}-MRI{sub ref}). Width, height, thickness, volumes, and topography were analyzed. Results: The CT-MRI{sub ref} differences hardly varied in stage I tumors (n=8). In limited-volume stage IIB and IIIB tumors (n=19), CTV{sub HR}-CT{sub pre-BT} {sub MRI}–MRI{sub ref} volume differences (2.6 cm{sup 3} [IIB], 7.3 cm{sup 3} [IIIB]) were superior to CTV{sub HR}-CT{sub Clinical}–MRI{sub ref} (11.8 cm{sup 3} [IIB], 22.9 cm{sup 3} [IIIB]), owing to significant improvement of height and width (P<.05). In advanced disease (n=12), improved agreement with MR volume, width, and height was achieved for CTV{sub HR}-CT{sub pre-BT} {sub MRI}. In 5 of 12 cases, MRI{sub ref} contours were partly missed on CT. Conclusions: Pre-BT MRI helps to define CTV{sub HR} before BT implantation appropriately, if only CT images with the applicator in place are available for BT planning. Significant improvement is achievable in limited-volume stage IIB and IIIB tumors. In more advanced disease (extensive IIB to IVA), improvement of conformity is possible but may be associated with geographic misses. Limited impact on precision of CTV{sub HR}-CT is expected in stage IB tumors.

  9. Value of Magnetic Resonance Imaging Without or With Applicator in Place for Target Definition in Cervix Cancer Brachytherapy

    Pötter, Richard; Federico, Mario; Sturdza, Alina; Fotina, Irina; Hegazy, Neamat; Schmid, Maximilian; Kirisits, Christian; Nesvacil, Nicole

    2016-01-01

    Purpose: To define, in the setting of cervical cancer, to what extent information from additional pretreatment magnetic resonance imaging (MRI) without the brachytherapy applicator improves conformity of CT-based high-risk clinical target volume (CTV_H_R) contours, compared with the MRI for various tumor stages (International Federation of Gynecology and Obstetrics [FIGO] stages I-IVA). Methods and Materials: The CTV_H_R was contoured in 39 patients with cervical cancer (FIGO stages I-IVA) (1) on CT images based on clinical information (CTV_H_R-CT_C_l_i_n_i_c_a_l) alone; and (2) using an additional MRI before brachytherapy, without the applicator (CTV_H_R-CT_p_r_e_-_B_T _M_R_I). The CT contours were compared with reference contours on MRI with the applicator in place (CTV_H_R-MRI_r_e_f). Width, height, thickness, volumes, and topography were analyzed. Results: The CT-MRI_r_e_f differences hardly varied in stage I tumors (n=8). In limited-volume stage IIB and IIIB tumors (n=19), CTV_H_R-CT_p_r_e_-_B_T _M_R_I–MRI_r_e_f volume differences (2.6 cm"3 [IIB], 7.3 cm"3 [IIIB]) were superior to CTV_H_R-CT_C_l_i_n_i_c_a_l–MRI_r_e_f (11.8 cm"3 [IIB], 22.9 cm"3 [IIIB]), owing to significant improvement of height and width (P<.05). In advanced disease (n=12), improved agreement with MR volume, width, and height was achieved for CTV_H_R-CT_p_r_e_-_B_T _M_R_I. In 5 of 12 cases, MRI_r_e_f contours were partly missed on CT. Conclusions: Pre-BT MRI helps to define CTV_H_R before BT implantation appropriately, if only CT images with the applicator in place are available for BT planning. Significant improvement is achievable in limited-volume stage IIB and IIIB tumors. In more advanced disease (extensive IIB to IVA), improvement of conformity is possible but may be associated with geographic misses. Limited impact on precision of CTV_H_R-CT is expected in stage IB tumors.

  10. Embryonal rhabdomyosarcoma of the cervix | Ocheke | African ...

    Embryonal rhabdomyosarcoma (sarcoma botyroides) of the cervix, which is rare, is described in a 16-yearold. The combined use of chemotherapy, radiotherapy and surgery has markedly improved survival in those with this condition. However, our patient did not benefit from this treatment modality due to late presentation ...

  11. Cancer patients, emergencies service and provision of palliative care

    Bruno Miranda

    2016-06-01

    Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.

  12. Biochemical changes in neutrophils of cervical cancer patients treated with 60Co

    Krishnamurthy, Vijayalakshmi; Gunalan, Gayathri; Haridas, Sumathy; Thangamani, Vanitha

    2008-01-01

    Cervical carcinoma is the second most common malignancy of the female genital tract in India. The highest incidence occurs at Chennai. This study was conducted on 30 women with biopsy-proved squamous cell carcinoma of the cervix of stage IIb. The neutrophil count increased significantly in cancer patients compared to control subjects. Total protein, glycogen and total lipid increased in neutrophils of cervical cancer patients. The level of cholestrol, triglycerides and fatty acids increased significantly in neutrophils of such patients compared to control subjects. The activity of alkaline phosphatase increased significantly in cervical cancer patients. Upon treatment with cobalt-60, these changes were brought to near-normal levels. This study highlights the impairment in the neutrophil function in cervical cancer patients, which may lead to reduced immune status. (author)

  13. Assessment of improved organ at risk sparing for advanced cervix carcinoma utilizing precision radiotherapy techniques

    Georg, D.; Georg, P.; Hillbrand, M.; Poetter, R.; Mock, U. [Dept. of Radiotherapy, Medical Univ. AKH, Vienna (Austria)

    2008-11-15

    Purpose: to evaluate the potential benefit of proton therapy and photon based intensity-modulated radiotherapy in comparison to 3-D conformal photon radiotherapy (3D-CRT) in locally advanced cervix cancer. Patients and methods: in five patients with advanced cervix cancer 3D-CRT (four-field box) was compared with intensity modulated photon (IMXT) and proton therapy (IMPT) as well as proton beam therapy (PT) based on passive scattering. Planning target volumes (PTVs) included primary tumor and pelvic and para-aortic lymph nodes. Dose-volume histograms (DVHs) were analyzed for the PTV and various organs at risk (OARs) (rectal wall, bladder, small bowel, colon, femoral heads, and kidneys). In addition dose conformity, dose inhomogeneity and overall volumes of 50% isodoses were assessed. Results: all plans were comparable concerning PTV parameters. Large differences between photon and proton techniques were seen in volumes of the 50% isodoses and conformity indices. DVH for colon and small bowel were significantly improved with PT and IMPT compared to IMXT, with D{sub mean} reductions of 50-80%. Doses to kidneys and femoral heads could also be substantially reduced with PT and IMPT. Sparing of rectum and bladder was superior with protons as well but less pronounced. Conclusion: proton beam RT has significant potential to improve treatment related side effects in the bowel compared to photon beam RT in patients with advanced cervix carcinoma. (orig.)

  14. Assessment of improved organ at risk sparing for advanced cervix carcinoma utilizing precision radiotherapy techniques

    Georg, D.; Georg, P.; Hillbrand, M.; Poetter, R.; Mock, U.

    2008-01-01

    Purpose: to evaluate the potential benefit of proton therapy and photon based intensity-modulated radiotherapy in comparison to 3-D conformal photon radiotherapy (3D-CRT) in locally advanced cervix cancer. Patients and methods: in five patients with advanced cervix cancer 3D-CRT (four-field box) was compared with intensity modulated photon (IMXT) and proton therapy (IMPT) as well as proton beam therapy (PT) based on passive scattering. Planning target volumes (PTVs) included primary tumor and pelvic and para-aortic lymph nodes. Dose-volume histograms (DVHs) were analyzed for the PTV and various organs at risk (OARs) (rectal wall, bladder, small bowel, colon, femoral heads, and kidneys). In addition dose conformity, dose inhomogeneity and overall volumes of 50% isodoses were assessed. Results: all plans were comparable concerning PTV parameters. Large differences between photon and proton techniques were seen in volumes of the 50% isodoses and conformity indices. DVH for colon and small bowel were significantly improved with PT and IMPT compared to IMXT, with D mean reductions of 50-80%. Doses to kidneys and femoral heads could also be substantially reduced with PT and IMPT. Sparing of rectum and bladder was superior with protons as well but less pronounced. Conclusion: proton beam RT has significant potential to improve treatment related side effects in the bowel compared to photon beam RT in patients with advanced cervix carcinoma. (orig.)

  15. A Case of Lymphoepithelioma-like Carcinoma in the Uterine Cervix.

    Takebayashi, Kanetoshi; Nishida, Masakazu; Matsumoto, Harunobu; Nasu, Kaei; Narahara, Hisashi

    2015-02-11

    Lymphoepithelioma-like carcinoma occurring in the reproductive organs is a rare variant of squamous cell carcinoma, and this tumor of the uterine cervix accounts for 0.7% of all primary cervical uterine neoplasms. Associations with Epstein-Barr virus (EBV) and human papilloma virus (HPV) have been demonstrated in some studies. Some investigators suggested that EBV has an important role in the initiation of lymphoepitheliomalike carcinoma in Asian women. Here we report the case of a 45-year-old Japanese woman, gravida 2 and parity 2. She was admitted due to severe atypical genital bleeding caused by uterine cervical cancer. A >60-mm tumor was detected at the uterine cervix, and no distal metastasis or swallowing of lymph nodes was revealed by magnetic resonance imaging and a computed tomography scan. The cervical cancer stage FIGO Ib2 was diagnosed, and a radical hysterectomy was performed for this malignant tumor. The in situ hybridization for EBV was negative. HVP infection was strongly suspected because the squamous cell carcinoma was observed macroscopically in the uterine cervix. The prognosis of uterine lymphoepithelioma-like carcinoma is thought to be better than those of other cervical cancer types, but careful follow-up at fixed intervals is recommended. The patient has been followed up for 4 months since her surgery, and no evidence of recurrence has been detected.

  16. A case of lymphoepithelioma-like carcinoma in the uterine cervix

    Kanetoshi Takebayashi

    2015-03-01

    Full Text Available Lymphoepithelioma-like carcinoma occurring in the reproductive organs is a rare variant of squamous cell carcinoma, and this tumor of the uterine cervix accounts for 0.7% of all primary cervical uterine neoplasms. Associations with Epstein-Barr virus (EBV and human papilloma virus (HPV have been demonstrated in some studies. Some investigators suggested that EBV has an important role in the initiation of lymphoepithelioma-like carcinoma in Asian women. Here we report the case of a 45-year-old Japanese woman, gravida 2 and parity 2. She was admitted due to severe atypical genital bleeding caused by uterine cervical cancer. A >60-mm tumor was detected at the uterine cervix, and no distal metastasis or swallowing of lymph nodes was revealed by magnetic resonance imaging and a computed tomography scan. The cervical cancer stage FIGO Ib2 was diagnosed, and a radical hysterectomy was performed for this malignant tumor. The in situ hybridization for EBV was negative. HVP infection was strongly suspected because the squamous cell carcinoma was observed macroscopically in the uterine cervix. The prognosis of uterine lymphoepithelioma-like carcinoma is thought to be better than those of other cervical cancer types, but careful follow-up at fixed intervals is recommended. The patient has been followed up for 4 months since her surgery, and no evidence of recurrence has been detected.

  17. Dose-volume effect relationships for late rectal morbidity in patients treated with chemoradiation and MRI-guided adaptive brachytherapy for locally advanced cervical cancer: Results from the prospective multicenter EMBRACE study

    Mazeron, Renaud; Fokdal, Lars U; Kirchheiner, Kathrin

    2016-01-01

    Purpose To establish dose volume–effect relationships predicting late rectal morbidity in cervix cancer patients treated with concomitant chemoradiation and MRI-guided adaptive brachytherapy (IBABT) within the prospective EMBRACE study. Material and method All patients were treated with curative ...

  18. Prognostic importance of lymph node-to-primary tumor standardized uptake value ratio in invasive squamous cell carcinoma of uterine cervix

    Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of)

    2017-10-15

    Using integrated PET/CT, we evaluated the prognostic value of [{sup 18}F]FDG uptake ratio between pelvic lymph node (LN) and primary tumor in invasive squamous cell carcinoma (SCCA) of the uterine cervix. We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIA cervical SCCA who underwent preoperative [{sup 18}F]FDG PET/CT scans. PET/CT parameters such as maximum standardized uptake value (SUV) of the primary cervical cancer (SUV{sub cervix}) and LN (SUV{sub LN}), and the LN-to-cervical cancer SUV ratio (SUV{sub LN}/SUV{sub cervix}) were assessed. Prognostic values of PET/CT-derived metabolic and volumetric variables and clinicopathology parameters were analyzed to predict progression-free survival (PFS) in regression analyses. Clinical data, treatment modalities, and results were reviewed for 103 eligible patients. Median post-surgical follow-up was 29 months (range, 6-89), and 19 (18.5%) patients experienced recurrence. Multivariate logistic regression analysis showed that SUV{sub LN} / SUV{sub cervix} > 0.1747(P = 0.048) was the independent risk factor of recurrence. Patient group categorized by SUV{sub LN}/SUV{sub cervix} showed significant difference in PFS (log-rank test, P < 0.001). Preoperative SUV{sub LN}/SUV{sub cervix} measured by [{sup 18}F]FDG PET/CT was significantly associated with recurrence, and has an incremental prognostic value for PFS in patients with cervical SCCA. (orig.)

  19. Psychotherapy for cancer patients.

    Chong Guan, Ng; Mohamed, Salina; Kian Tiah, Lai; Kar Mun, Teoh; Sulaiman, Ahmad Hatim; Zainal, Nor Zuraida

    2016-07-01

    Objective Psychotherapy is a common non-pharmacological approach to help cancer patients in their psychological distress. The benefit of psychotherapies was documented, but the types of psychotherapies proposed are varied. Given that the previous literature review was a decade ago and no quantitative analysis was done on this topic, we again critically and systematically reviewed all published trials on psychotherapy in cancer patients. Method We identified 17 clinical trials on six types of psychotherapy for cancer patients by searching PubMed and EMBASE. Result There were four trials involved adjunct psychological therapy which were included in quantitative analysis. Each trial demonstrated that psychotherapy improved the quality of life and coping in cancer patients. There was also a reduction in distress, anxiety, and depression after a psychological intervention. However, the number and quality of clinical trials for each type of psychotherapy were poor. The meta-analysis of the four trials involved adjunct psychological therapy showed no significant change in depression, with only significant short-term improvement in anxiety but not up to a year-the standardized mean differences were -0.37 (95% confidence interval (CI) = -0.57, -0.16) at 2 months, -0.21 (95% CI = -0.42, -0.01) at 4 months, and 0.03 (95 % CI = -0.19, 0.24) at 12 months. Conclusion The evidence on the efficacy of psychotherapy in cancer patients is unsatisfactory. There is a need for more rigorous and well-designed clinical trials on this topic.

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

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

    1992-01-01

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

  1. Cancer risk in patients with alopecia areata: a nationwide population-based matched cohort study.

    Chen, Chih-Chiang; Chang, Yun-Ting; Liu, Han-Nan; Chen, Yi-Ju

    2018-05-01

    Alopecia areata (AA) is an organ-specific autoimmune disorder. Defective immune system related disorders are prone to increase the risk of cancer formation. However, the association among AA and variety of cancer types had never been studied. A nationwide population-based matched cohort study was conducted to evaluate the cancer risk in patients with AA. Records from Taiwan National Health Insurance Research Database were analyzed. Cases of AA from 1997 to 2013 and cancers registered in the catastrophic illness profile from the same time period were collected. The standard incidence ratio (SIR) of each cancer was calculated. In total, 2099 cancers among 162,499 patients with AA and without prior cancers were identified. The overall cancer risks in AA patients were slightly decreased, especially among male subjects (SIR: 0.89). Refer to individual cancer, the cancer risk of nonmelanoma skin cancer (NMSC) (SIR: 0.59), upper GI cancer (SIR: 0.70), liver cancer (SIR: 0.82), uterine, and cervix cancer (SIR: 0.84) were significantly lower in patients with AA. In contrast, AA patients were inclined to have lymphoma, breast cancer, kidney, and urinary bladder cancer with the SIR of 1.55, 2.93, and 2.95, respectively. Age stratified analyses revealed female AA patients younger than 50 years old have even higher risk of breast cancer (SIR: 3.37). Further sensitivity analysis showed similar results after excluding major autoimmune disorders. Cancer risk in AA patients is organ specific, and it is not associated with the underlying autoimmune disorders in patients with AA. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. Comparison of human papillomavirus DNA tests, liquid-based cytology and conventional cytology for the early detection of cervix uteri cancer.

    Girianelli, Vania R; Thuler, Luiz Claudio S; Szklo, Moyses; Donato, Alexandre; Zardo, Lucilia M G; Lozana, José A; Almeida Neto, Olimpio F; Carvalho, Aurenice C L; Matos, Jorge H; Figueiredo, Valeska

    2006-12-01

    To compare the performance of human papillomavirus DNA tests (samples collected by a healthcare professional and self-collected) and liquid-based cytology with conventional cytology in the detection of cervix uteri cancer and its precursor lesions. A cross-sectional study was carried out in 1777 women living in poor communities in Rio de Janeiro State, Brazil. Eligibility criteria included ages 25-59 years and not having had a Papanicolau test within at least 3 years prior to the study. Cytology (conventional or liquid-based) and human papillomavirus DNA (collected by a healthcare professional or self-collected) tests were performed using samples collected in a single visit. Women with abnormalities in at least one test and a systematic sample of 70 women with negative test results were referred to a colposcopic examination. Test readings were double-masked, and the outcome of interest was high-grade squamous intraepithelial lesion or worse. The pathology report was used as the gold standard. The prevalence of high-grade squamous intraepithelial lesion or worse was 2.0%. Human papillomavirus DNA test collected by a health professional alone or combined with conventional cytology had the highest sensitivity (91.4 and 97.1%, respectively). The highest specificity was found for conventional cytology (91.6%) and for a human papillomavirus DNA test collected by a healthcare professional (90.2%). On the basis of only test performance, the use of human papillomavirus DNA tests, alone or combined with cytology, would seem to be recommended. Its population-wide implementation, however, is conditional on a cost-effectiveness analysis.

  3. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology; La pratique de la technique du ganglion sentinelle dans diverses indications: sein, col uterin, prostate, vulve et verge. Methodologie pratique

    Brenot-Rossi, I. [Centre de Lutte Contre le Cancer, Institut Paoli-Calmettes, Service de Medecine Nucleaire, 13 - Marseille (France)

    2008-08-15

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid {sup 99m}Tc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

  4. TOPOISOMERASE-I AND TOPOISOMERASE-II ACTIVITY IN HUMAN BREAST, CERVIX, LUNG AND COLON-CANCER

    MCLEOD, HL; DOUGLAS, F; OATES, M; SYMONDS, RP; PRAKASH, D; VANDERZEE, AGJ; KAYE, SB; BROWN, R; KEITH, WN

    1994-01-01

    The identification of human DNA topoisomerases as cellular targets for active anti-cancer drugs has stimulated further interest in topoisomerase function in tumour biology. Topoisomerase I and II catalytic activity is detectable in many normal and malignant tissues. However, little is known about

  5. Californium-252: isotope for modern radiotherapy of cervix, uterine and vaginal carcinomas

    Maruyama, J.; Beach, J.L.; Nagell, J.R. van

    1984-01-01

    Cf-252 is an isotope that can easily be afterloaded into available gynecological applicators and used for bulky cervix, uterus or vaginal cancer therapy. It is economical, time and cost effective in use, and can be applied to the therapy of many patients throughout the world. It is more effective for neutron therapy than machine fast neutron therapy and is the only form of neutron therapy producing consistent complication-free 5-year cure of advanced cancers currently available. Cf-252 is an isotope for modern gynecological tumor therapy for the future. Isodose curves for Cf-252 implants revealed dose distributions conforming well to tumor. (orig.) [de

  6. Obstructed uteri with a cervix and vagina.

    Wright, Kelly Nicole; Okpala, Ogochukwu; Laufer, Marc R

    2011-01-01

    To describe a rare anomaly of the female reproductive tract and review the embryology associated with the defect. Case report and review of the literature. Major academic medical center. A 14-year-old girl with two hemiuteri lacking any communication with a single normal midline cervix and vagina. Diagnostic laparoscopy with chromopertubation to identify the anomaly and subsequent bilateral supracervical hemihysterectomies. Incidence, pathogenesis, fertility implications, and treatment options for patients with congenital defects in the upper vagina, cervix, and uterus. Based on classic embryology, the lower vagina forms from the urogenital sinus while the upper vagina, cervix, and uterus form from the müllerian ducts. If a cervix is present, then the upper vagina and uterus are also usually present and should communicate. This anomaly cannot be fully explained by traditional embryologic developmental theory. It is likely that an insult occurred between 9 weeks, when the uterovaginal canal is formed, and 12 weeks, when the müllerian ducts fuse. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Radio chemotherapy for uterine cervix carcinoma

    Resbeut, M.; Alzieu, C.; Gonzague-Casabianca, L.; Haie-Meder, C.

    2000-01-01

    Low-stage uterine cervix carcinoma can be treated by either surgery, radiation therapy or combined treatments with high cure rates ranging from 90 to 95 % for stage IB1 tumors. However, the standard treatment, combining external beam plus intracavitary radiation, fails to control the progression of the disease in 35 to 90 % of patients with locally advanced cervical cancer. No substantial improvements have been made in the treatment of these tumors in the past two decades. The addition of concurrent 5-FU in a phase III study failed to improve the results in the overall patient population, but the five-year DFS was significantly better in a subset of patients (tumor > 5 cm and IB/IIA or medial parametrial IIB disease). Concurrent chemo-radiation and adjuvant chemotherapy with epirubicin showed, in a phase III study, a significant longer DFS in patients treated with chemotherapy despite the same long-term local tumor control. After many phase II studies, five phase III studies have recently demonstrated a 40 to 60 % reduction in the relative risk of recurrence with cisplatin containing chemo-radiation. Across these studies, the risk of death was reduced by 30 to 50 %. The benefit was less clear in patients with stages III-IV tumors than in patients with lower stages associated with poor prognostic factors. Hematologic and gastrointestinal toxicity of chemo-radiation was greater than that of radiotherapy alone. However, late side effects were similar in the different treatment groups. These results must be confirmed with a longer follow-up. The importance of concurrent chemotherapy during the brachytherapy procedure should be analyzed. It has yet to be determined which chemotherapy regimen achieves the most favorable therapeutic ratio. (authors)

  8. Second primary tumor and radiation induced neoplasma in the uterine cancer

    Sakurai, Tomoyasu; Nishio, Masamichi; Kagami, Yoshikazu; Murakami, Yoshitaka; Narimatsu, Naoto; Kanemoto, Toshitaka

    1984-01-01

    This report is concerned with multiple primary cancers developing in invasive uterine cancer. Second primary tumors were recorded 27 women with a total of 30 non-uterine cancer (exception of radiation-induced cancer). 17 patients of radiation-induced neoplasm were observed (Rectal cancer 4, soft part sarcoma 4, cancer of urinary bladder 3, bone tumor 3, uterin cancer 2 and cancer of Vulva 1). One case is 4 legions (corpus, sigma, thymoma and stomach), 2 cases are 3 lesions (uterine cervix, stomach and maxillay siuis: uterine cervix, thyroidal gland and radiation-induced soft part sarcoma). Only 5 of these 17 patients were known irradiated dose (50 Gy--55 Gy), however others unknown. The mean latent periods of 17 cases of radiation induced neoplasms are 19.4 years. 16 patients of late second cancers of the cervix appearing from 11 to 36 years (average 19.5 years) after initial radiotherapy were recorded. (author)

  9. 15 Pattern of bladder cancer at University Teaching Hospital, Lusaka,

    Esem

    bladder cancer who presented to the hospital during this period were recruited .... malignant tissues. Table 2: Distribution of variables among patients. Gender number. Percentage .... cancer of the cervix, cancer of the eye, breast cancer,. Kaposi's sarcoma .... as a result of national wide roll out of anti retroviral treatment in ...

  10. Treatment of 29 patients with bulky squamous cell carcinoma of the cervix with simultaneous cisplatin, 5-fluorouracil, and split-course hyperfractionated radiation therapy

    Heaton, D.; Yordan, E.; Reddy, S.; Bonomi, P.; Lee, M.S.; Lincoln, S.; Graham, J.; Dolan, T.; Miller, A.; Phillips, A. (Rush Presbyterian-St. Lukes Hospital, Chicago, IL (USA))

    1990-09-01

    Attempting to improve local disease control in bulky primary or recurrent pelvic tumors, 29 patients with squamous cell carcinoma of the cervix were treated with concomitant chemotherapy and split-course hyperfractionated radiation therapy between April 1983 and August 1988. Cisplatin (CDDP) and 5-fluorouracil (5-FU) have been shown to be radiation enhancers; furthermore, CDDP, radiation therapy, and continuous-infusion 5-FU have elicited high local response rates in head and neck squamous cell carcinoma. A pilot study of cyclical week on/week off CDDP, continuous-infusion 5-FU, and hyperfractionated radiation therapy was developed. Radiation was administered at 116 cGy twice daily, Days 1-5, every other week for a median dose of 4600 cGy to a pelvic field, with paraaortic extension if indicated. Concomitant chemotherapy included CDDP 60 mg/m2 IV Day 1 and 5-FU 600 mg/m2 IV continuous infusion for 96 hr following CDDP infusion. Patients received a median of four cycles of combined treatment, and intracavitary or interstitial brachytherapy followed in 21 patients. Local pelvic response was achieved in 29 of 29 (100%): complete response (CR) in 19 of 29 (66%), partial response (PR) in 10 of 29 (34%). Among CR patients 10 of 19 (53%) were without evidence of disease at a mean follow-up of 29 (range 12-76) months. Five-year actuarial disease-free survival among complete responders was 65%. Of the 10 CR patients 2 failed in the pelvis, for a local control rate of 17/19 (89%). Chemotherapy-related and acute radiation morbidity was minimal but 2 patients required surgical correction of radiation injury. Aggressive combination of split-course hyperfractionated radiation therapy with radiation enhancers resulted in promising local control of bulky pelvic tumor, with an acceptable complication rate, in this otherwise very poor prognostic group of patients.

  11. Cancer patients' evaluation of communication

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit

    2013-01-01

    The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication.......The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication....

  12. Lung cancer in younger patients

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

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

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

    2015-10-15

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

  14. MR imaging of the pelvis in the diagnosis of the endometrium in breast cancer patients in tamoxifen therapy

    Hauth, E.; Libera, H.; Forsting, M.; Kimmig, R.

    2006-01-01

    Purpose: The purpose of the study was to determine the value of MR imaging of the pelvis in the diagnostic work-up of the endometrium in breast cancer patients in tamoxifen therapy. Materials and methods: MR imaging of the pelvis was performed on 24 patients (mean: 62 years, range: 51-74 years) and 30 healthy women (mean: 65 years, range: 51-73 years). The volume of the uterus and cervix and the maximal thickness of the endometrium, junctional zone and myometrium of the uterus were determined and compared to the confidence interval of the parameters in healthy women. The Mann-Whitney U-test was used to identify differences in the volume of the uterus and cervix and in the thickness of the uterine wall layers in both groups. Results: A comparison of the volume of the uterus and cervix and the thickness of the uterine wall layers in the two groups yielded no significant differences. The volume of the uterus and cervix showed no statistical differences between the two groups. The maximal height of the endometrium in the patient group showed a mean of 0.6 cm (range: 0.1-2.2 cm), and a mean of 0.4 cm (range: 0.1-1.2 cm) in the group of healthy women. The differences were not statistically significant. In all healthy women the endometrium showed homogeneous signal intensity in the sagittal T2-weighted images. In 12 of the 24 breast cancer patients, the endometrium showed inhomogeneous signal intensity. In 9 of 12 patients with an inhomogeneous endometrium with a thickness equal to or greater than 0.6 cm, histopathology confirmed polyps. In 3 patients endometrium hyperplasia was found. In one patient histopathology revealed a polyp and an endometrium carcinoma in stage T1 a N0. The endometrium carcinoma was not able to be seen via MR imaging. (orig.)

  15. Estadiamento cirúrgico do câncer de colo de útero localmente avançado Surgical staging of locally advanced uterine cervix cancer

    Heitor Ricardo Cosiski Marana

    2005-12-01

    controle locorregional da doença na pelve.PURPOSE: to assess to what extent the surgical staging differs from the clinical staging among cases of advanced uterine cervix carcinoma, and also to assess the percentage of cases with positive para-aortic ganglia in this group of patients. METHODS: this is a descriptive prospective study in which 36 patients with histological diagnosis of uterine cervix carcinoma considered locally advanced were included (stages IB2, IIB, IIIA and B, and IVA. The cases were submitted to clinical staging, according to FIGO criteria. All patients were to be treated with neoadjuvant chemotherapy. Age ranged from 40 to 73 years, with a mean of 56.2±7.9. The procedure started with pelvic lymphadenectomy followed by para-aortic lymphadenectomy, in case the pelvic lymph nodes were positive on surgical examination. Examination of the abdominal cavity and lymphadenectomy were done either through laparotomy or laparoscopy, chosen at random. In each case, the clinical staging was compared to the surgical staging, considered the gold standard. RESULTS: in the clinical staging (CS, 7 cases were classified as IB2 (tumors larger than 4 cm, 22 cases as CSII and 7 cases as CSIII. The surgical assessment changed the clinical staging as follows: the stage was decreased in six cases, and increased in 13. There was agreement only in 18 cases (50%. The para-aortic lymph nodes were affected in six cases. CONCLUSIONS: clinical staging of locally advanced uterine cervix carcinoma is incorrect in most of the cases. Such inconsistency may lead to excessive treatment in some cases, but about one fourth of the patients with positive para-aortic ganglia would not be adequately treated with the current standard treatment radiotherapy with chemosensitization, which aims at the local regional control of the pelvic disease.

  16. Prevention of carcinoma of cervix with human papillomavirus vaccine.

    Gavarasana, S; Kalasapudi, R S; Rao, T D; Thirumala, S

    2000-01-01

    Carcinoma of cervix is the most common cancer found among the women of India. Though cervical cytology screening was effective in preventing carcinoma of cervix in developed nations, it is considered unsuitable in developing countries. Recent research has established an etiological link between human papillomavirus infection and carcinoma of cervix. In this review, an attempt is made to answer the question, 'whether carcinoma of cervix can be prevented with human papillomavirus vaccine?' Literature search using Pubmed and Medline was carried out and relevant articles were reviewed. There is ample experimental evidence to show that DNA of human papillomavirus integrates with cervical cell genome. Viral genes E6 and E7 of HPV type 16 and 18 inactivate p53 function and Rb gene, thus immortalize the cervical epithelial cells. Recombinant vaccines blocked the function of E6 and E7 genes preventing development of papillomas in animals. Vaccination with HPV-VLPs encoding for genes of E6 and E7 neutralizes HPV integrated genome of malignant cells of uterine cervix. Based on experimental evidence, it is possible to prevent carcinoma of cervix with human papillomavirus vaccine, Further research is necessary to identify a effective and safe HPV vaccine, routes of administration and characteristics of potential beneficiaries.

  17. Recommendations from gynaecological (GYN) GEC ESTRO working group (II): Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology

    Poetter, Richard; Haie-Meder, Christine; Limbergen, Erik van; Barillot, Isabelle; Brabandere, Marisol De; Dimopoulos, Johannes; Dumas, Isabelle; Erickson, Beth; Lang, Stefan; Nulens, An; Petrow, Peter; Rownd, Jason; Kirisits, Christian

    2006-01-01

    The second part of the GYN GEC ESTRO working group recommendations is focused on 3D dose-volume parameters for brachytherapy of cervical carcinoma. Methods and parameters have been developed and validated from dosimetric, imaging and clinical experience from different institutions (University of Vienna, IGR Paris, University of Leuven). Cumulative dose volume histograms (DVH) are recommended for evaluation of the complex dose heterogeneity. DVH parameters for GTV, HR CTV and IR CTV are the minimum dose delivered to 90 and 100% of the respective volume: D90, D100. The volume, which is enclosed by 150 or 200% of the prescribed dose (V150, V200), is recommended for overall assessment of high dose volumes. V100 is recommended for quality assessment only within a given treatment schedule. For Organs at Risk (OAR) the minimum dose in the most irradiated tissue volume is recommended for reporting: 0.1, 1, and 2 cm 3 ; optional 5 and 10 cm 3 . Underlying assumptions are: full dose of external beam therapy in the volume of interest, identical location during fractionated brachytherapy, contiguous volumes and contouring of organ walls for >2 cm 3 . Dose values are reported as absorbed dose and also taking into account different dose rates. The linear-quadratic radiobiological model-equivalent dose (EQD 2 )-is applied for brachytherapy and is also used for calculating dose from external beam therapy. This formalism allows systematic assessment within one patient, one centre and comparison between different centres with analysis of dose volume relations for GTV, CTV, and OAR. Recommendations for the transition period from traditional to 3D image-based cervix cancer brachytherapy are formulated. Supplementary data (available in the electronic version of this paper) deals with aspects of 3D imaging, radiation physics, radiation biology, dose at reference points and dimensions and volumes for the GTV and CTV (adding to [Haie-Meder C, Poetter R, Van Limbergen E et al

  18. Preventing Infections in Cancer Patients

    ... Protect: Know the Signs and Symptoms of Infection Neutropenia and Risk for Infection Health Care Providers Educational Materials Cancer and Flu How to Prevent Flu from Spreading Flu Symptoms Information for Families and Caregivers Flu Treatment for Cancer Patients and ...

  19. Dosimetric comparison between intensity modulated brachytherapy versus external beam intensity modulated radiotherapy for cervix cancer: a treatment planning study

    Subramani, V.; Sharma, D.N.; Jothy Basu, K.S.; Rath, G.K.; Gopishankar, N.

    2008-01-01

    To evaluate the dosimetric superiority of intensity modulated brachytherapy (IMBT) based on inverse planning optimization technique with classical brachytherapy optimization and also with external beam intensity modulated radiotherapy planning technique in patients of cervical carcinoma

  20. Uterine cervix cancer treatment at Radiumhemmet: 90 years′ experience. Time trends of age, stage, and histopathology distribution

    Hellman, Kristina; Hellström, Ann-Cathrin; Pettersson, B Folke

    2014-01-01

    Since the introduction of screening programs for cervical cancer (CC) the incidence has decreased and CC is discovered at an earlier stage. The purpose of this study was to analyze time trends in age, stage, and histopathology over a 90-year period and to our knowledge this is the largest single institutional series in the literature of invasive cervical carcinoma (CC) cases. This is a retrospective study comprising 18,472 women treated for CC from 1914 until 2004 at Radiumhemmet, Stockholm. The material is part of the international CC statistics published since 1937 in the League of Nations' Annual Reports, and since 1958 under the patronage of International Federation of Gynecology and Obstetrics (FIGO). During the 90-year study period, the annual number of cases treated increased to over 400 up until 1965, after which there was a gradual drop to less than 100 cases in 2004. A pronounced shift toward earlier stages at diagnosis was noted. The mean age at diagnosis increased in all stages, predominantly in advanced stages. A reduction in squamous cell carcinoma (SCC) cases and a sixfold increase in the proportion of adenocarcinoma (AC) cases were observed. The mean age at diagnosis for squamous and AC cases shifted after 1970, when the SCC cases ultimately became 3 years older than the AC cases in contrast to around 1950 when they were 3 years younger than the AC cases. The changes in the distribution by age, stage, and histopathology during this 90-year period are probably associated with: improved social conditions and increased access to health care, the introduction of screening programs for CC in the 1960s, and a change in the risk factors for CC (changed sexual behavior, introduction of contraceptive pills, and changed smoking habits). This is a study on changes in the distribution by age, stage, and histopathology in a large series of cervical cancer treated in Sweden during a 90-year period. It also includes an historical review about the development of

  1. Uterine cervix cancer treatment at Radiumhemmet: 90 years′ experience. Time trends of age, stage, and histopathology distribution

    Hellman, Kristina; Hellström, Ann-Cathrin; Pettersson, B Folke

    2014-01-01

    Since the introduction of screening programs for cervical cancer (CC) the incidence has decreased and CC is discovered at an earlier stage. The purpose of this study was to analyze time trends in age, stage, and histopathology over a 90-year period and to our knowledge this is the largest single institutional series in the literature of invasive cervical carcinoma (CC) cases. This is a retrospective study comprising 18,472 women treated for CC from 1914 until 2004 at Radiumhemmet, Stockholm. The material is part of the international CC statistics published since 1937 in the League of Nations' Annual Reports, and since 1958 under the patronage of International Federation of Gynecology and Obstetrics (FIGO). During the 90-year study period, the annual number of cases treated increased to over 400 up until 1965, after which there was a gradual drop to less than 100 cases in 2004. A pronounced shift toward earlier stages at diagnosis was noted. The mean age at diagnosis increased in all stages, predominantly in advanced stages. A reduction in squamous cell carcinoma (SCC) cases and a sixfold increase in the proportion of adenocarcinoma (AC) cases were observed. The mean age at diagnosis for squamous and AC cases shifted after 1970, when the SCC cases ultimately became 3 years older than the AC cases in contrast to around 1950 when they were 3 years younger than the AC cases. The changes in the distribution by age, stage, and histopathology during this 90-year period are probably associated with: improved social conditions and increased access to health care, the introduction of screening programs for CC in the 1960s, and a change in the risk factors for CC (changed sexual behavior, introduction of contraceptive pills, and changed smoking habits). This is a study on changes in the distribution by age, stage, and histopathology in a large series of cervical cancer treated in Sweden during a 90-year period. It also includes an historical review about the development

  2. Can the coverage of screening for cancer of the cervix be improved using the Electoral Register? A pilot study.

    Cook, G A; Wald, N J

    1985-09-30

    We conducted a pilot study to assess the feasibility using the Electoral Register to carry out a cervical cancer screening programme on a Health District basis. A random sample of 500 names and addresses were drawn from a computerised list of the Electoral Register from three Electoral Wards in Oxford. A pilot study showed that the Electoral Register could be used successfully in this way and that the proportion of women aged 35-64 years who had a cervical smear examination as a result of the screening initiative was increased by a quarter, from 64% to 79%. The numbers of women involved at each step of the screening process were determined, and these may provide a useful guide to others considering implementing similar schemes.

  3. Uterine cervix cancer treatment at Radiumhemmet: 90 years' experience. Time trends of age, stage, and histopathology distribution.

    Hellman, Kristina; Hellström, Ann-Cathrin; Pettersson, B Folke

    2014-04-01

    Since the introduction of screening programs for cervical cancer (CC) the incidence has decreased and CC is discovered at an earlier stage. The purpose of this study was to analyze time trends in age, stage, and histopathology over a 90-year period and to our knowledge this is the largest single institutional series in the literature of invasive cervical carcinoma (CC) cases. This is a retrospective study comprising 18,472 women treated for CC from 1914 until 2004 at Radiumhemmet, Stockholm. The material is part of the international CC statistics published since 1937 in the League of Nations' Annual Reports, and since 1958 under the patronage of International Federation of Gynecology and Obstetrics (FIGO). During the 90-year study period, the annual number of cases treated increased to over 400 up until 1965, after which there was a gradual drop to less than 100 cases in 2004. A pronounced shift toward earlier stages at diagnosis was noted. The mean age at diagnosis increased in all stages, predominantly in advanced stages. A reduction in squamous cell carcinoma (SCC) cases and a sixfold increase in the proportion of adenocarcinoma (AC) cases were observed. The mean age at diagnosis for squamous and AC cases shifted after 1970, when the SCC cases ultimately became 3 years older than the AC cases in contrast to around 1950 when they were 3 years younger than the AC cases. The changes in the distribution by age, stage, and histopathology during this 90-year period are probably associated with: improved social conditions and increased access to health care, the introduction of screening programs for CC in the 1960s, and a change in the risk factors for CC (changed sexual behavior, introduction of contraceptive pills, and changed smoking habits). © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  4. Brachytherapy for carcinoma of the cervix: A Canadian survey of practice patterns in a changing era

    Pearce, Andrew; Craighead, Peter; Kay, Ian; Traptow, Laurel; Doll, Corinne

    2009-01-01

    Background and purpose: This survey aimed to document practices of Canadian radiation oncologists performing gynecologic brachytherapy for carcinoma of the cervix and to determine what the effect of the phasing-out of LDR after-loading systems from the commercial market is having on practice. Materials and methods: A 26-item questionnaire was developed to survey various aspects of brachytherapy practice to include: number of patients treated, prescription points/volume, dose and fractionation, timing, critical structure delineation, expected changes due to the phasing-out of support for low dose rate systems, and support for the development of national guidelines. A link to a web-based survey collection instrument was emailed to each radiation oncologist in Canada practicing gynecologic brachytherapy. Results: A 67% response rate was achieved in this web-based survey. Radiation oncologists currently using HDR brachytherapy are most commonly delivering 5 fractions of 6 Gy in addition to an EBRT dose of 45 Gy in 25 fractions. The median total dose equivalents to Point A was 82.9 Gy for both early and advanced disease. In response to the announcement by a major vendor that they would be phasing-out service for a popular LDR after-loader, 49% of Canadian radiation oncologists who practice brachytherapy for cervix cancer are changing to an HDR technique with a further 9% changing to a PDR technique. Eighty-six percent of respondents would support the development of national guidelines for cervix brachytherapy in Canada. Conclusions: Variation in practice exists in Canada in brachytherapy for cervix cancer. Many centers are in the process of phasing-out LDR techniques in response to the withdrawal of commercial support for these systems. Support for the development of Canadian national guidelines is high.

  5. Implications for dosimetric changes when introducing MR-guided brachytherapy for small volume cervix cancer: a comparison of CT and MR-based treatments in a single centre

    Dempsey, Claire; Govindarajulu, Geetha; Sridharan, Swetha; Capp, Anne; O'Brien, Peter

    2014-01-01

    To evaluate cervix brachytherapy dosimetry with the introduction of magnetic resonance (MR) based treatment planning and volumetric prescriptions and propose a method for plan evaluation in the transition period. The treatment records of 69 patients were reviewed retrospectively. Forty one patients were treated using computed tomography (CT)-based, Point A-based prescriptions and 28 patients were treated using magnetic resonance (MR)-based, volumetric prescriptions. Plans were assessed for dose to Point A and organs at risk (OAR) with additional high-risk clinical target volume (HR-CTV) dose assessment for MR-based brachytherapy plans. ICRU-38 point doses and GEC-ESTRO recommended volumetric doses (D2 cc for OAR and D 100 , D 98 and D 90 for HR-CTV) were also considered. For patients with small HR-CTV sizes, introduction of MR-based volumetric brachytherapy produced a change in dose delivered to Point A and OAR. Point A doses fell by 4.8 Gy (p = 0.0002) and ICRU and D 2cc doses for OAR also reduced (p < 0.01). Mean Point A doses for MR-based brachytherapy treatment plans were closer to those of HR-CTV D 100 for volumes less than 20 cm 3 and HR-CTV D 98 for volumes between 20 and 35 cm 3 , with a significant difference (p < 0.0001) between Point A and HR-CTV D 90 doses in these ranges. In order to maintain brachytherapy dose consistency across varying HR-CTV sizes there must be a relationship between the volume of the HR-CTV and the prescription dose. Rather than adopting a ‘one size fits all’ approach during the transition to volume-based prescriptions, this audit has shown that separating prescription volumes into HR-CTV size categories of less than 20 cm 3 , between 20 and 35 cm 3 , and more than 35 cm 3 the HR-CTV can provide dose uniformity across all volumes and can be directly linked to traditional Point A prescriptions.

  6. Bone Involvement by Adenocarcinoma of the Uterine Cervix: A Rare Entity

    Crisci, Vincenzina; Mainenti, Pier Paolo; Corvino, Fabio; Lauria, Rossella; Maurea, Simone

    2015-01-01

    Adenocarcinoma is the second most frequent cancer of the uterine cervix after squamous carcinoma, and the most frequent histotype is the mucinous one. Endo-cervical adenocarcinoma accounts for about 10–30% of all cervical cancers and clinically the lesion can be asymptomatic or, more frequently, presenting with anomalous bleeding and/or vaginal discharge. A 41-year-old woman with a diagnosis of adenocarcinoma of the uterine cervix was subjected to chemotherapy after radical surgery. During the follow-up, the patient underwent a Positron Emission Tomography integrated with Computed Tomography and pelvic Magnetic Resonance, which showed rapid and diffuse disease progression from the site of the lesion to the pelvic bones. Bone involvement in patients with cervical cancer, being a rare event, is significant since it greatly reduces life expectancy. The majority of metastatic bone lesions in cervical cancer seem to be of osteolytic nature. In our patient, Positron Emission Tomography integrated with Computed Tomography and Magnetic Resonance were the imaging methods used during the follow-up and both techniques clearly showed diffuse and rapid tumour spread to the bones

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

    Bardia, M.R.; Bhargava, S.C.; Chaudhary, R.K.; Agrawal, V.K.; Singh, K.; Vyas, R.

    1987-01-01

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

  8. Carcinoma of the cervix: a third treatment

    Quigley, M.M.; Knab, D.R.; McMahon, E.B.

    1975-01-01

    A selected group of 136 patients with Stage I squamous cell carcinoma of the cervix was treated in six naval hospitals during the period 1957--1965 using a three-stage combined radiation therapy and surgery protocol. Treatment consisted of two radium applications to the cervix, followed in 6 weeks by extraperitoneal lymphadenectomy. If the lymph nodes were tumor-negative, simple hysterectomy in 3 to 6 months completed the protocol. If the nodes were tumor-positive, a course of external pelvic irradiation was given with midline shielding. The incidence of positive nodes was 9.6 percent. Actuarial survival for all patients was 89.4 percent, comparable to the rate obtained by radical surgery or radiation alone. Postoperative and postradiation complications were minimal, with no urinary or bowel fistulas. There was no operative mortality

  9. Radiotherapy in carcinoma of the uterine cervix phase III

    Alvarez Villa, O; Reinerio, A; Felipe Castillo, A; Alonso Pantiga, R; Roig, M

    1985-01-01

    Between April 1968 and December 1980, 61 patients with phase III cancer of the cervix were treated. Fifty-six of them were squamous-cell carcinomas and five adenocarcinomas. The treatment consisted of a combination of external irradiation at doses varying between 4,000 and 7,000 rads and intracavitary radiotherapy with doses of 4.000 to 6.000 MHz, according to the schemes of the D.M. Anderson of Houston. The results obtained as far as survival is concerned and calculated by the actuarial method were 40% after five and ten years. The local control rate reached was 74%. The severe complications caused by the treatment reached 8.1%.

  10. Muscle dysfunction in cancer patients

    Christensen, Jesper Frank; Jones, L W; Andersen, J L

    2014-01-01

    dysfunction in cancer patients lies in the correlation to vital clinical end points such as cancer-specific and all-cause mortality, therapy complications and quality of life (QoL). Such associations strongly emphasize the need for effective therapeutic countermeasures to be developed and implemented...... implications of muscle dysfunction in cancer patients. The efficacy of exercise training to prevent and/or mitigate cancer-related muscle dysfunction is also discussed. DESIGN: We identified 194 studies examining muscular outcomes in cancer patients by searching PubMed and EMBASE databases. RESULTS: Muscle...... dysfunction is evident across all stages of the cancer trajectory. The causes of cancer-related muscle dysfunction are complex, but may involve a wide range of tumor-, therapy- and/or lifestyle-related factors, depending on the clinical setting of the individual patient. The main importance of muscle...

  11. Lynch Syndrome-Related Clear Cell Carcinoma of the Cervix: A Case Report

    Nakamura, Kohei; Nakayama, Kentaro; Minamoto, Toshiko; Ishibashi, Tomoka; Ohnishi, Kaori; Yamashita, Hitomi; Ono, Ruriko; Sasamori, Hiroki; Razia, Sultana; Hossain, Mohammad Mahmud; Kamrunnahar, Shanta; Ishikawa, Masako; Ishikawa, Noriyoshi; Kyo, Satoru

    2018-01-01

    Lynch syndrome, a hereditary cancer syndrome, occurs because of germline mutations in at least one of four DNA mismatch repair genes (MutL Homolog 1 (MLH1), MutS Homolog 2 (MSH2), MutS Homolog 6 (MSH6), and PMS1 Homolog 2 (PMS2)). The disorder is associated with colorectal, endometrial, and other epithelial malignancies, but not cervical cancer. We report a woman with Lynch syndrome with synchronous cervical cancer. This is the first report of Lynch syndrome-related clear cell carcinoma of the cervix, which indicates the possibility of an association between cervical cancer and Lynch syndrome. Suitable genetic tests are required to determine whether common genetics can account for synchronous or subsequent malignancies in Lynch syndrome patients and their families. Such knowledge will also enhance our understanding of the genetic mechanisms governing the development of apparently unrelated cancers. PMID:29587389

  12. Lynch Syndrome-Related Clear Cell Carcinoma of the Cervix: A Case Report

    Kohei Nakamura

    2018-03-01

    Full Text Available Lynch syndrome, a hereditary cancer syndrome, occurs because of germline mutations in at least one of four DNA mismatch repair genes (MutL Homolog 1 (MLH1, MutS Homolog 2 (MSH2, MutS Homolog 6 (MSH6, and PMS1 Homolog 2 (PMS2. The disorder is associated with colorectal, endometrial, and other epithelial malignancies, but not cervical cancer. We report a woman with Lynch syndrome with synchronous cervical cancer. This is the first report of Lynch syndrome-related clear cell carcinoma of the cervix, which indicates the possibility of an association between cervical cancer and Lynch syndrome. Suitable genetic tests are required to determine whether common genetics can account for synchronous or subsequent malignancies in Lynch syndrome patients and their families. Such knowledge will also enhance our understanding of the genetic mechanisms governing the development of apparently unrelated cancers.

  13. Lynch Syndrome-Related Clear Cell Carcinoma of the Cervix: A Case Report.

    Nakamura, Kohei; Nakayama, Kentaro; Minamoto, Toshiko; Ishibashi, Tomoka; Ohnishi, Kaori; Yamashita, Hitomi; Ono, Ruriko; Sasamori, Hiroki; Razia, Sultana; Hossain, Mohammad Mahmud; Kamrunnahar, Shanta; Ishikawa, Masako; Ishikawa, Noriyoshi; Kyo, Satoru

    2018-03-25

    Lynch syndrome, a hereditary cancer syndrome, occurs because of germline mutations in at least one of four DNA mismatch repair genes (MutL Homolog 1 ( MLH1 ), MutS Homolog 2 ( MSH2 ), MutS Homolog 6 ( MSH6 ), and PMS1 Homolog 2 ( PMS2 )). The disorder is associated with colorectal, endometrial, and other epithelial malignancies, but not cervical cancer. We report a woman with Lynch syndrome with synchronous cervical cancer. This is the first report of Lynch syndrome-related clear cell carcinoma of the cervix, which indicates the possibility of an association between cervical cancer and Lynch syndrome. Suitable genetic tests are required to determine whether common genetics can account for synchronous or subsequent malignancies in Lynch syndrome patients and their families. Such knowledge will also enhance our understanding of the genetic mechanisms governing the development of apparently unrelated cancers.

  14. Mortalidade e assistência oncológica no Rio de Janeiro: câncer de mama e colo uterino Mortality and care oncology in Rio de Janeiro: cancer of the breast and cervix of uterus

    Raíla de Souza Santos

    2011-06-01

    Full Text Available O município do Rio de Janeiro apresenta grandes taxas de mortalidade para o câncer de mama e colo uterino. Analisou-se a trajetória dos óbitos por câncer de mama e colo uterino no município do Rio de Janeiro e relacionaram-se a oferta de serviços de saúde e o fluxo de pacientes entre o local de residência e o hospital. Estudo ecológico de base populacional que analisou óbitos por câncer de mama e colo uterino no município do Rio de Janeiro, no período de 2005-2008, mapeando os fluxos de casos da residência para os serviços de saúde. O Sistema de Informação sobre Mortalidade registrou, no período analisado, 3.384 óbitos por câncer de mama e 771 óbitos por câncer do colo de útero. A localização geográfica dos estabelecimentos de saúde define uma distribuição espacial dos óbitos extremamente desigual, alternando padrões de escassez em algumas áreas (periferia da cidade e excesso em outras (Centro.La ciudad de Rio de Janeiro tiene altas tasas de mortalidad por cáncer de mama y cuello uterino. Se analizó la trayectoria de las muertes por cáncer de mama y cáncer cervico-uterino en Rio de Janeiro y se vinculó la prestación de servicios de salud y el flujo de pacientes entre la residencia y el hospital. Estudio ecológico basado en la población que examinó las muertes de cáncer de mama y el cáncer cervical en la ciudad de Rio de Janeiro, en el período 2005-2008. El Sistema de Información sobre la mortalidad ha registrado en el período analizado 3.384 muertes por cáncer de mama y 771 muertes por cáncer de cáncer de cuello uterino. La ubicación geográfica de los centros de salud definió una distribución espacial de las muertes extremadamente desigual, alternando los padrones de escasez en algunas zonas (fuera de la ciudad y el exceso en los demás (Central.The city of Rio de Janeiro has high rates of mortality for breast cancer and uterine cervix. In this study was analyzed the trajectory of deaths

  15. Quantified approach to the analysis and prevention of urinary complications in radiotherapeutic treatment of cancer of the cervix

    Pourquier, H.; Delard, R.; Achille, E.

    1987-01-01

    This paper is the report of a dosimetric study of 79 urinary complications after radical radiation treatment (1975-1979) of 624 cervical uterine tumors. Treatment consisted of external irradiation (25 MeV linear accelerator) and intracavitary irradiation (Fletcher-Suit-Delclos applicator). Dosimetric-computerized studies were expressed as the maximum bladder dose on the trigone, as proposed by the I.C.R.U. Bladder doses were actually studied as a function of intracavitary irradiation and intracavitary + external irradiation. The results show a significant difference in patients with and without complications based on the dose reaching the bladder. The relative contribution of external therapy and intracavitary irradiation and their value can serve as one of the primary indicators for predicting complications. These values should be determined before placement of intracavitary sources. We found that the dose to the critical organs cannot be defined as a single number. These results argue in favor of adapting individual patient therapy based on rectal and bladder dosimetry and may be adjustable to all treatment modalities

  16. PROSPECTIVE EVALUATION OF AN IN VITRO RADIATION RESISTANCE ASSAY IN LOCALLY ADVANCED CANCER OF THE UTERINE CERVIX: A SOUTHWEST ONCOLOGY GROUP STUDY

    Randall, Leslie M; Monk, Bradley J; Moon, James; Parker, Ricardo; Al-Ghazi, Muthana; Wilczynski, Sharon; Fruehauf, John P; Markman, Maurie; Burger, Robert A

    2010-01-01

    Objectives To investigate the feasibility of performing a fresh-tissue, in vitro radiation resistance assay (IVRRA) in a cooperative group setting and to assess the association of IVRRA results with clinical outcomes. Methods Women with Stages IIB-IVA carcinoma of the uterine cervix without obvious para-aortic lymphadenopathy on imaging were eligible. Primary tumor biopsies were shipped to a central testing facility where agar-based cell suspensions were exposed to 300 cGy of RT ± cisplatin and cultured for 5 days. 3H-thymidine incorporation was used to determine percent cell inhibition (PCI) of test specimen compared to that of the untreated control. Tumors were considered to exhibit extreme radiation resistance (ERR), intermediate radiation resistance (IRR) or low radiation resistance (LRR) based on a standard data set from 39 previously studied specimens. Standardized doses of external beam radiation and intracavitary brachytherapy, when feasible, in addition to platinum-based chemotherapy were mandated. Progression-free survival (PFS) was the primary endpoint. Clinical response and overall survival (OS) were secondary endpoints. Clinical investigators were blinded to assay data and vice versa. Results Thirty-six patients were enrolled, but analysis was limited to 17 patients whose specimens were adequate for IVRRA. The median follow-up time was 40 months. There was no association between IVRRA and response. In the Cox model, IRR/ERR tumors showed worse PFS [HR=11.2 (95% CI 1.3–96, p=0.03)] and worse OS [HR=11.7 (95% CI 1.4–99.6, p=0.03)] compared to LRR tumors when IVRRA was performed with RT alone, but there were no associations between IVRRA and PFS or OS when cisplatin was added to the IVRRA. Conclusions IVRRA (RT alone) results correlated with PFS and OS in this prospective trial, but follow-up trials are indicated to address feasibility and to confirm results in an expanded cohort. If confirmed, IVRRA could potentially direct molecular identification

  17. MULTIPLE PRIMARY MALIGNANCIES IN PATIENTS.cdr

    RICHY

    the youngest was 36 years old. Four of our patients were females. Two patients had cancers of the colon followed by ovarian malignancy in one and a rectal malignancy in the other. Of the other patients, one had cancer of the cervix and later she developed None Hodgkin's lymphoma. Two had bilateral breast malignancies.

  18. The Role of 18F-FDG PET/CT in Assessing Therapy Response in Cervix Cancer after Concurrent Chemoradiation Therapy

    Choi, Jiyoun; Kim, Hyun Jeong; Jeong, Yong Hyu; Lee, Jaehoon; Cho, Arthur; Yun, Mijin; Lee, Jong Doo; Kim, Yong Bae; Kim, Young Tae; Kang, Won Jun

    2014-01-01

    To determine whether persisting cervical fluorodeoxyglucose (FDG) uptake after concurrent chemoradiotherapy (CCRT) for cervical cancer can reflect residual malignancy. F-FDG PET/CT was performed before and after CCRT in 136 patients with cervical cancer. The maximum and mean standardized uptake values (SUVmax and SUVmean) were recorded from PET/CT scans performed pre- and post-treatment. SUVs were correlated with treatment response after CCRT. Final treatment response was determined by MRI and further follow-up PET/CT. One hundred four of 136 patients underwent pelvic MRI, and 32 of 136 patients underwent further follow-up PET/CT. Patients were classified into two categories: patients with residual tumor or patients without residual tumor (complete responder). Preand post-treatment serum squamous cell carcinoma antigen (SCC) levels were also recorded for comparison. The optimal cutoff value of SUVmax for predicting residual cervical tumor was determined using receiver-operating characteristic (ROC) analysis. Of 136 patients, 124 showed complete response on further follow-up studies and 12 were confirmed to have residual tumor. The post-treatment SUVmax and pre-/posttreatment SUVmean of complete responders were significantly lower than those of patients with residual tumor: 2.5±0.8 and 7.2±4.2/1.9±0.7 for complete responders and 5.7±2.6 and 12.8±6.9/3.7±0.7 for patients with residual tumor (p 18 F-FDG PET/CT after CCRT for cervical cancer may be caused by residual tumor or post-therapy inflammation. A higher cutoff SUVmax than conventional criteria for cervical cancer in post-CCRT PET/CT might help to detect residual tumor

  19. Clinical results in carcinoma of the cervix: radium compared to caesium using remote afterloading

    Jackson, S.M.; Fairey, R.N.; Kornelsen, R.O.; Young, M.E.J.; Wong, F.L.

    1989-01-01

    In 1979 the Cancer Control Agency of British Columbia changed from radium to remote controlled afterloaded caesium in the treatment of carcinoma of the cervix. In 3 years prior to the change, 139 patients received radium as part of their treatment and in the 3 years after the change, 158 patients received caesium. Overall referral patterns, patient and cancer demographics, and treatment policies were stable throughout the 6-year period. Radiotherapy technique, dose, dose distribution and dose rate were comparable for both radium and caesium treated patients. The results of treatment in the two time periods showed no difference in survival, local tumour control or complications. The use of afterloading has not compromised treatment results and has allowed better nursing care for patients and protection from radiation for all staff. (author)

  20. Uterus necrosis after radiochemotherapy in two patients with advanced cervical cancer

    Marnitz, S.; Hinkelbein, W.; Koehler, C.; Schneider, A.; Fueller, J.

    2006-01-01

    Background: Simultaneous platinum-based radiochemotherapy is the standard of care for patients with advanced or node-positive cancer of the uterine cervix. A large body of literature concerning therapy-related acute and late morbidity is available. Chemoradiation-associated necrosis of the uterus has not been described so far. Case Report: Two patients are reported who were treated by combine chemoradiation between 2004 and 2005 for histologically confirmed cervical cancer following laparoscopic staging. Both patients were diagnosed with squamous cell cancer of the cervix FIGO stage IIB (T2b pN1 pM1 LYM G2) and FIGO IIIA (T3a pN1 MO G2), respectively. External-beam radiotherapy was applied in a 3-D-planned four-field technique, covering pelvic lymph nodes and primary tumor. Simultaneously, cisplatin was given to both patients. Following chemoradiation, both patientsdeveloped pelvic pain and an elevation of C-reactive protein (CRP) in the presence of a normal leukocyte count. Both patients underwent relaparoscopy, and necrosis of the uterus combined with partial necrosis of the bladder was diagnosed in patient 1. Patient 1 underwent total supralevatoric exenteration and patient 2 laparoscopically assisted hysterectomy withbilateral salpingo-oophorectomy. Conclusion: In patients with persisting or incident pelvic pain, questionable findings in imaging techniques and/or elevated inflammation parameters following completion of chemoradiation for cervical cancer, differential diagnosis should include radiogenic necrosis of the uterus and other pelvic organs. Laparoscopy is an ideal technique to exclude or confirm this diagnosis. (orig.)

  1. Positional variability of a tandem applicator system in HDR brachytherapy for primary treatment of cervix cancer. Analysis of the anatomic pelvic position and comparison of the applicator positions during five insertions

    Wulf, J.; Popp, K.; Oppitz, U.; Baier, K.; Flentje, M.

    2004-01-01

    Purpose: evaluation of the inter- and intraindividual applicator variability of multiple high-dose-rate (HDR) brachytherapy applications for primary treatment of cancer of the uterine cervix. Material and methods: retrospective analysis of 460 pairs of orthogonal X-ray films for conventional treatment in 92 patients with five intrauterine applications using an HDR tandem applicator. Measurement of the position of the applicator origin relative to a bony reference system in three dimensions. Evaluation of the differences of the applicator position in all 460 applications (interindividual variability), of the five applications in a single patient (intraindividual variability) and of the intraindividual variability relative to the applicator position at the first application. Results: the position of the applicator origin in the pelvis ranged from 23 mm cranial and 55 mm caudal to the top of femoral heads, 23 mm right and 27 mm left to the pelvic midline, and 6-53 mm dorsal to the mid of the femoral heads. Standard deviation (SD) of interindividual applicator variability was 12.9 mm (minimum/maximum -55/+23 mm, mean -13.6 mm) in longitudinal, 5.1 mm (-27/+23 mm, mean 1.6 mm) in lateral, and 7.6 mm (6/53 mm, mean 26 mm) in anterior-posterior [AP] direction. SD of intraindividual variability was 5.5 mm (-21/+23 mm, mean 0 mm) in longitudinal, 2.5 mm (-17/+19 mm, mean 0 mm) in lateral, and 4.2 mm (-15/+18 mm, mean 0 mm) in AP direction compared to intraindividual variability relative to the first insertion with an SD of 8.9 mm (-23/+36 mm, mean 2.8 mm) in longitudinal, 4.0 mm (-11/+23 mm, mean 0 mm) in lateral, and 6.8 mm (-27/+17 mm, mean -0.8 mm) in AP direction. Conclusion: intraindividual applicator variability is significantly smaller than interindividual variability. Applicator-related procedures such as midline shielding or dose matching of tele- and brachytherapy should be performed with information on at least one individual applicator position. (orig.)

  2. Positional variability of a tandem applicator system in HDR brachytherapy for primary treatment of cervix cancer. Analysis of the anatomic pelvic position and comparison of the applicator positions during five insertions

    Wulf, J.; Popp, K.; Oppitz, U.; Baier, K.; Flentje, M. [Dept. of Radiotherapy, Univ. of Wuerzburg (Germany)

    2004-04-01

    Purpose: evaluation of the inter- and intraindividual applicator variability of multiple high-dose-rate (HDR) brachytherapy applications for primary treatment of cancer of the uterine cervix. Material and methods: retrospective analysis of 460 pairs of orthogonal X-ray films for conventional treatment in 92 patients with five intrauterine applications using an HDR tandem applicator. Measurement of the position of the applicator origin relative to a bony reference system in three dimensions. Evaluation of the differences of the applicator position in all 460 applications (interindividual variability), of the five applications in a single patient (intraindividual variability) and of the intraindividual variability relative to the applicator position at the first application. Results: the position of the applicator origin in the pelvis ranged from 23 mm cranial and 55 mm caudal to the top of femoral heads, 23 mm right and 27 mm left to the pelvic midline, and 6-53 mm dorsal to the mid of the femoral heads. Standard deviation (SD) of interindividual applicator variability was 12.9 mm (minimum/maximum -55/+23 mm, mean -13.6 mm) in longitudinal, 5.1 mm (-27/+23 mm, mean 1.6 mm) in lateral, and 7.6 mm (6/53 mm, mean 26 mm) in anterior-posterior [AP] direction. SD of intraindividual variability was 5.5 mm (-21/+23 mm, mean 0 mm) in longitudinal, 2.5 mm (-17/+19 mm, mean 0 mm) in lateral, and 4.2 mm (-15/+18 mm, mean 0 mm) in AP direction compared to intraindividual variability relative to the first insertion with an SD of 8.9 mm (-23/+36 mm, mean 2.8 mm) in longitudinal, 4.0 mm (-11/+23 mm, mean 0 mm) in lateral, and 6.8 mm (-27/+17 mm, mean -0.8 mm) in AP direction. Conclusion: intraindividual applicator variability is significantly smaller than interindividual variability. Applicator-related procedures such as midline shielding or dose matching of tele- and brachytherapy should be performed with information on at least one individual applicator position. (orig.)

  3. Neuroendocrine small cell carcinoma of the uterine cervix.

    Reig Castillejo, Anna; Membrive Conejo, Ismael; Foro Arnalot, Palmira; Rodríguez de Dios, Nuria; Algara López, Manuel

    2010-07-01

    Neuroendocrine small cell carcinoma of the uterine cervix (SCC) is a rare disease that mixes clinical and biological characteristics of both cervical neoplasms and neuroendocrine small cell cancer. The prognosis is poor and the optimal treatment has not yet been clarified. Multimodality treatment, with surgery and concurrent chemoradiation has recently been shown to improve local control and survival rates.

  4. Direct reconstruction and associated uncertainties of 192Ir source dwell positions in ring applicators using gafchromic film in the treatment planning of HDR brachytherapy cervix patients

    Awunor, O. A.; Dixon, B.; Walker, C.

    2013-05-01

    This paper details a practical method for the direct reconstruction of high dose rate 192Ir source dwell positions in ring applicators using gafchromic film in the treatment planning of brachytherapy cervix patients. It also details the uncertainties associated with such a process. Eight Nucletron interstitial ring applicators—Ø26 mm (×4), Ø30 mm (×3) and Ø34 mm (×1), and one 60 mm intrauterine tube were used in this study. RTQA2 and XRQA2 gafchromic films were irradiated at pre-programmed dwell positions with three successive 192Ir sources and used to derive the coordinates of the source dwell positions. The source was observed to deviate significantly from its expected position by up to 6.1 mm in all ring sizes. Significant inter applicator differences of up to 2.6 mm were observed between a subset of ring applicators. Also, the measured data were observed to differ significantly from commercially available source path models provided by Nucletron with differences of up to 3.7 mm across all ring applicator sizes. The total expanded uncertainty (k = 2) averaged over all measured dwell positions in the rings was observed to be 1.1 ± 0.1 mm (Ø26 mm and Ø30 mm rings) and 1.0 ± 0.3 mm (Ø34 mm ring) respectively, and when transferred to the treatment planning system, equated to maximum %dose changes of 1.9%, 13.2% and 1.5% at regions representative of the parametrium, lateral fornix and organs at risk respectively.

  5. External cobalt 60 irradiation alone for stage IIB carcinoma of the uterine cervix

    Lei, Z.Z.; He, F.Z.

    1989-01-01

    From 1964 to 1980, 97 patients with Stage IIb carcinoma of cervix uteri were treated by external 60Co irradiation alone. Of these 97 patients, 94 (96.9%) had squamous cell carcinoma. The parametrial extension of the lesion almost reached the pelvic wall in 73.2% and vaginal extension reached to the upper half of vaginal in 24.7% of the patients. A tumor dose of 60 Gy was given to the whole pelvis by a four field technic (opposing parallel AP and lateral portals) in 6-8 weeks. A booster dose of 10 Gy was delivered to the cervix by a pair of reduced opposing parallel AP portals or a perineal portal in a week. The doses delivered were equivalent to the Time-Dose-Fractionation (TDF) value of 110-130 at the center of pelvis and 90-110 in the whole pelvis. The 5-year survival rate for all 97 patients was 56.7%. It was 59.8% when those who died of other diseases were excluded. The prognosis of patients without residual tumor on the cervix and/or vagina was better than that with residual tumor (p less than 0.01). Thirty-seven patients died of cancer (23 died of recurrence, 8 of distant metastases, 2 of both, and 4 were lost before the fifth year). Of these 37 patients, 97.3% died within 3 years after initial treatment. During the radiation treatment, reactions were moderate. Late complications included 19 (19.6%) with mild cystitis and 16 (16.5%) with mild proctitis, 2 (2.7%) developed recto-vaginal fistula. These results were slightly poorer than those using intracavitary and external irradiation or the combination of preoperative irradiation plus surgery. Yet, for patients with extensions nearing the pelvic wall or with contra-indications to surgery or intracavitary radiotherapy, external irradiation alone is still of value

  6. Cachexia among US cancer patients.

    Arthur, Susan T; Van Doren, Bryce A; Roy, Debosree; Noone, Joshua M; Zacherle, Emily; Blanchette, Christopher M

    2016-09-01

    Cancer cachexia is a debilitating condition and results in poor prognosis. The purpose of this study was to assess hospitalization incidence, patient characteristics, and medical cost and burden of cancer cachexia in the US. This study used a cross-sectional analysis of the Nationwide Inpatient Sample (NIS) for 2009. Five cancers reported to have the highest cachexia incidence were assessed. The hospitalization incidence related to cachexia was estimated by cancer type, cost and length of stay were compared, and descriptive statistics were reported for each cancer type, as well as differences being compared between patients with and without cachexia. Risk of inpatient death was higher for patients with cachexia in lung cancer (OR = 1.32; CI = 1.20-1.46) and in all cancers combined (OR = 1.76; CI = 1.67-1.85). The presence of cachexia increased length of stay in lung (IRR = 1.05; CI = 1.03-1.08), Kaposi's sarcoma (IRR = 1.47; CI = 1.14-1.89) and all cancers combined (IRR = 1.09; CI = 1.08-1.10). Additionally, cachectic patients in the composite category had a longer hospitalization stay compared to non-cachectic patients (3-9 days for those with cachexia and 2-7 days for those without cachexia). The cost of inpatient stay was significantly higher in cachexic than non-cachexic lung cancer patients ($13,560 vs $13 190; p Cachexia increases hospitalization costs and length of stay in several cancer types. Identifying the medical burden associated with cancer cachexia will assist in developing an international consensus for recognition and coding by the medical community and ultimately an effective treatment plans for cancer cachexia.

  7. Survival of Sami cancer patients

    Leena Soininen

    2012-07-01

    Full Text Available Objectives. The incidence of cancer among the indigenous Sami people of Northern Finland is lower than among the Finnish general population. The survival of Sami cancer patients is not known, and therefore it is the object of this study. Study design. The cohort consisted of 2,091 Sami and 4,161 non-Sami who lived on 31 December 1978 in the two Sami municipalities of Inari and Utsjoki, which are located in Northern Finland and are 300–500 km away from the nearest central hospital. The survival experience of Sami and non-Sami cancer patients diagnosed in this cohort during 1979–2009 was compared with that of the Finnish patients outside the cohort. Methods. The Sami and non-Sami cancer patients were matched to other Finnish cancer patients for gender, age and year of diagnosis and for the site of cancer. An additional matching was done for the stage at diagnosis. Cancer-specific survival analyses were made using the Kaplan–Meier method and Cox regression modelling. Results. There were 204 Sami and 391 non-Sami cancer cases in the cohort, 20,181 matched controls without matching with stage, and 7,874 stage-matched controls. In the cancer-specific analysis without stage variable, the hazard ratio for Sami was 1.05 (95% confidence interval 0.85–1.30 and for non-Sami 1.02 (0.86–1.20, indicating no difference between the survival of those groups and other patients in Finland. Likewise, when the same was done by also matching the stage, there was no difference in cancer survival. Conclusion. Long distances to medical care or Sami ethnicity have no influence on the cancer patient survival in Northern Finland.

  8. Standards, options and recommendations: concomitant radio chemotherapy for cancer of the cervix: a critical analysis of the literature and update of SOR; Radiochimiotherapie concomitante dans les cancers du col de l'uterus: analyse critique des donnees et mise a jour des Standards, options et recommandations

    Haie-Meder, C.; Lhomme, C. [Institut Gustave Roussy, 94 - Villejuif (France); Fervers, B.; Bataillard, A. [Federation Nationale des Centres de Lutte Contre le Cancer, FNCLCC, 75 - Paris (France); Chauvergne, J. [Institut Bergonie, Centre Regional de Lutte Contre le Cancer, 33 - Bordeaux (France); Fondrinier, E. [Centre de Lutte Contre le Cancer Paul-Papin, 49 - Angers (France); Guastalla, J.P. [Centre de Lutte Contre le Cancer Leon-Berard, 69 - Lyon (France); Resbeut, M. [Institut Paoli-Calmettes, 13 - Marseille (France)

    2000-02-01

    The 'Standards, Options and Recommendations'(SOR) project, started in 1993, is a collaboration between the National Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres (CRLCC) and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. To update, according to the methodology of SOR, the Standards, Options and Recommendations for the management of patients with cancer of the cervix, and in particular, the place of concomitant radio-chemotherapy. Data have been identified by a literature search using Medline (to April 1999) and the personal reference lists of experts. Once the guidelines were defined, the document was submitted for review to independent national and international reviewers and to the medical committees of the CRCC. The principle recommendations concerning the place of radio-chemotherapy in the treatment of cancer of the cervix are 1) the available data shows a significant increase in local control (level of evidence A) and of overall survival (level of evidence B1)following concomitant radio-chemotherapy as compared to radiotherapy alone or the combination of radiotherapy-hydroxyurea. For stages IB, IIA, proximal IIB with bad prognostic factors (tumour size greater than 4 cm and/or invasion of pelvic nodes and/or microscopic invasion of the parametrium) and without lumbo-aortic nodal invasion, concomitant radio-chemotherapy can be considered as standard treatment. This benefit is less clear for stages distal IIB, III and IVA without para-aortic nodal invasion (level of evidence C) and must be confirmed (expert agreement). 2) the toxicity of radio-chemotherapy is essentially hematologic and

  9. Computational study of incidence of secondary neoplasms in cancer therapy of uterine cervix; Estudo computacional da incidencia de tumores secundarios em tratamentos de cancer de colo uterino

    Santos, W.S.; Valeriano, C.C.S.; Caldas, L.V.E. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Neves, L.P.; Perini, A.P., E-mail: lucio.neves@ufu.br [Universidade Federal de Uberlandia (UFU), MG (Brazil). Instituto de Fisica; Belinato, W. [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Vitoria da Conquista, BA (Brazil); Silva, R.M.V. [Instituto do Cancer do Ceara, Fortaleza, CE (Brazil)

    2016-07-01

    There is a serious, and growing, concern about the increased risk of the emergence of a second cancer, induced by radiation associated with the radiation treatment. To assess the radiation doses to organs outside the target volume, in this work, we modeled several computational exposure scenarios, based on Monte Carlo simulation (MCNPX code). We used a VARIAN 2100c accelerator, and a female virtual anthropomorphic phantom to simulate a treatment of uterine cancer. The results presented show that the computational exposure scenario provides a versatile and accurate tool to assess the risk of secondary cancer. (author)

  10. [Sexy cancer--sexuality for cancer patients].

    Peleg-Nesher, Sharon; Yachini, Brurya; Inbar, Moshe

    2009-09-01

    Sexuality is a basic need for every human being as long as he or she is alive, irrespective of age or health status. Approximately 23,500 individuals are diagnosed with cancer each year in Israel and join the 120,000 cancer patients currently living in Israel. The results of cancer treatments are traditionally assessed and based on the outcome regarding mortality versus survival. An equally important aspect to be addressed in this assessment must relate to quality of life. One of the more painful insults to the quality of life of cancer patients relates to the deleterious effects on sexuality. This article aims to present physicians with the spectrum of sexuality-related issues which are encountered by cancer patients and their partners, starting from the moment of diagnosis, throughout the various stages of treatment and to provide basic knowledge. Many individuals contracting cancer have difficulty dealing with the issue of sexuality. They are typically embarrassed and feel uneasy when asking health care providers about such a non-life threatening issue. Partners similarly feel both shame and guilt. In many cases sexuality, intimacy and emotional attachment are important aspects and may be essential for survival. Addressing these issues during treatment can provide patients with a sense of security, avoiding embarrassment and further exacerbation of such problems. Unfortunately, little has been done to develop an optimal interventional program, although standard sexual treatments have often been applied. Prospective clinical research and outcomes are missing. The physician can use the well-known PLISSIT model (1978): to provide sexuality involvement on different levels. The very new BETTER model (2004) can help emphasize that cancer treatment and the disease have an influence on intimacy and sexuality.

  11. Morphological features of basal membrane of stratified squamous epithelium and underlying stroma in cervical intraepithelial neoplasias and cancer of the uterine cervix

    Oksana M. Pliten

    2015-06-01

    Kharkiv National Medical University   Abstract. The article presents the morphological features of the basal membrane of stratified squamous epithelium and underlying stroma in cervical intraepithelial neoplasias and cancer of the uterine cervix which were investigated by routine histological, histochemical and immunohistochemical methods. The present study indicated that as stages of carcinogenesis progress changes in the stromal-vascular component and in the basal membrane of the epithelium occur that has an important role in the differential diagnosis of the stages of carcinogenesis of the uterine cervix. Key words: uterine cervix, cervical intraepithelial neoplasias, cancer, stratified squamous epithelium, basal membrane, stroma, morphology.   Резюме. У роботі розглянуті морфологічні особливості базальної мембрани багатошарового плоского епітелію і підлягаючої строми при цервікальних інтраепітеліальних неоплазіях та раку шийки матки, які були досліджені за допомогою рутинних гістологічних, гістохімічних і імуногістохімічних методів. Дослідження показало, що у міру поважчання стадії канцерогенезу відбуваються зміни стромально-судинного компоненту і базальної мембрани епітелію. Виявлені зміни мають важливу роль у диференціальній діагностиці стадій канцерогенезу у шийці матки. Ключові слова: шийка матки, цервікальні інтраепітеліальні неоплазії, рак, багатошаровий плоский епітелії, базальна

  12. The value of prognostic factors for uterine cervical cancer patients treated with irradiation alone

    Grigienė, Rūta; Valuckas, Konstantinas P; Aleknavičius, Eduardas; Kurtinaitis, Juozas; Letautienė, Simona R

    2007-01-01

    The aim of our study was to investigate and evaluate the prognostic value of and correlations between preclinical and clinical factors such as the stage of the disease, blood Hb level before treatment, size of cervix and lymph nodes evaluated by CT, age, dose of irradiation and duration of radiotherapy related to overall survival, disease-free survival, local control and metastases-free survival in cervical cancer patients receiving radiotherapy alone. 162 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIA-IIIB cervical carcinoma treated with irradiation were analysed. Univariate and multivariate analyses using the Cox regression model were performed to determine statistical significance of some tumor-related factors. The Hb level before treatment showed significant influence on overall survival (p = 0.001), desease free survival (p = 0.040) and local control (p = 0.038). The lymph node status (>10 mm) assessed on CT had impact on overall survival (p = 0,030) and local control (p = 0,036). The dose at point A had impact on disease free survival (p = 0,028) and local control (p = 0,021) and the radiotherapy duration had showed significant influence on overall survival (p = 0,045), disease free survival (p = 0,006) and local control (p = 0,033). Anemia is a significant and independent prognostic factor of overall survival, disease-free survival and local control in cervical cancer patients treated with irradiation. The size of lymph nodes in CT is an independent prognostic factor for overall survival and local control in cervical cancer patients. The size of cervix uteri evaluated by CT has no prognostic significance in cervical cancer patients treated with radiotherapy. The prognostic value of FIGO stage of cervical cancer is influenced by other factors, analyzed in this study and is not an independent prognostic factor

  13. The clinical significance of follow up SCC levels in patients with recurrent squamous cell carcinoma of the cervix

    Choi, Young Min; Park, Sung Kwang; Cho, Heung Lae; Lee, Kyoung Bok; Kim, Ki Tae; Kim, Ju Ree; Sohn, Seung Chang

    2002-01-01

    To investigate the clinical usefulness of a follow-up examination using serum squamous cell carcinoma antigen (SCC) for the early detection of recurrence in patients treated for cervical squamous cell carcinoma. 20 patients who were treated for recurrent cervical squamous cell carcinoma between 1997 and 1998, who had experienced a complete remission after radiotherapy and who underwent an SCC test around the time when recurrence was detected, were included in this study. The levels of SCC were measured from the serum of the patients by immunoassay and values less than 2 ng/mL were regarded as normal. The sensitivity of the SCC test for use in the detection of recurrence, the association between the SCC values and the recurrence patterns and the tumor size and stage, and the temporal relation between the SCC increment and recurrence detection were evaluated. The SCC values were above normal in 17 out of 20 patients, so the sensitivity of the SCC test for the detection of recurrence was 85%, and the mean and median of the SCC values were 15.2 and 9.5 ng/mL, respectively. No differences were observed in the SCC values according to the recurrence sites. For 11 patients, the SCC values were measured over a pero id of 6 months before recurrence was detected, and the mean and median values were 13.6 and 3.6 ng/mL, respectively. The SCC values of 7 patients were higher than the normal range, and the SCC values of the other 4 patients were normal but 3 among them were above 1.5 ng/mL. At the time of diagnosis, the SCC valuess were measured for 16 of the 20 recurrent patients, and the SCC values of the patients with a bulky tumor (≥ 4 cm) or who were in stage IIb or III were higher than those of the patients with a non-bulky tumor or who were in stage Ib or IIa. The SCC test is thought to be useful for the early detection of recurrence during the follow up period in patients treated for cervical squamous cell carcinoma. When an effective salvage treatment is developed in

  14. Synchronous multiple primary carcinomas of ovary and cervix: a ...

    A patient with synchronous multiple primary carcinoma of cervix and ovary is described. A 50 year old patient presenting with abdominal pain and distension over the last four months and two months history of offensive vaginal discharge, weight loss and no contact bleeding. The patient had total abdominal hysterectomy ...

  15. Endogenous and radiation-induced expression of γH2AX in biopsies from patients treated for carcinoma of the uterine cervix

    Olive, Peggy L.; Banuelos, C. Adriana; Durand, Ralph E.; Kim, Joo-Young; Aquino-Parsons, Christina

    2010-01-01

    Background and purpose: The possibility of using γH2AX foci as a marker of DNA damage and as a potential predictor of tumour response to treatment was examined using biopsies from 3 sets of patients with advanced carcinoma of the cervix. The relation between endogenous γH2AX expression and hypoxia was also examined. Materials and methods: Set 1 consisted of 26 biopsies that included pre-treatment and 24 h post-radiation treatment samples. Pre-treatment biopsies from 12 patients in Set 2 were used to develop image analysis software while pre-treatment biopsies from 33 patients in Set 3 were examined for the relation between staining for the hypoxia marker pimonidazole and endogenous γH2AX expression. Formalin-fixed paraffin-embedded sections were analyzed after antigen retrieval and fluorescence antibody labeling for the hypoxia markers CAIX or pimonidazole in combination with γH2AX staining. Results: Before treatment, 24 ± 19% of cells contained γH2AX foci, with most positive cells containing fewer than 5 foci per nucleus. Twenty-four hours after exposure to the first fraction of 1.8-2.5 Gy, 38 ± 19% contained foci. CAIX positive cells were 1.4 times more likely to exhibit endogenous γH2AX foci, and pimonidazole-positive cells were 2.8 times more likely to contain γH2AX foci. For 18 patients for whom both pre-treatment and 24 h post-irradiation biopsies were available, local control was unrelated to the fraction of cells that retained γH2AX foci. However, 24 h after irradiation, tumours that had received 2.5 Gy showed a significantly higher fraction of cells with residual γH2AX foci than tumours given 1.8 Gy. Conclusions: Endogenous γH2AX foci are enriched in hypoxic tumour regions. Small differences in delivered dose can produce quantifiable differences in residual DNA damage that can overshadow inter-tumour differences in response.

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

    Huang, Eng-Yen; Chanchien, Chan-Chao; Lin, Hao; Wang, Chung-Chi; Wang, Chong-Jong; Huang, Chao-Cheng

    2013-01-01

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

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

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

    2013-12-01

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

  18. Radiation therapy of gynecological cancer

    Nori, D.; Hilaris, B.S.

    1987-01-01

    This book consists of three parts: General Principles; Clinical Applications; and Special Topics. Some of the papers are: Introduction to Basic Radiobiology; Staging and Work-up Procedures for Patients with Gynecological Cancers; Radiation Therapy in the Treatment of Cancer of the Cervix; Role of Interstitial Implantation in Gynecological Cancer; Role of Radiocolloids in Gynecological Cancer; Radiosensitizers and Protectors; and Management of Lymphoma Associated with Pregnancy

  19. Microinvasive carcinoma of the uterine cervix in a 14-year-old adolescent: case report and literature review

    Carla Vitola Gonçalves

    Full Text Available CONTEXT: Cancer of the uterine cervix is rare during adolescence. The reported rates are 0/100,000 adolescents aged 10 to 19 years and 1.7/100,000 women aged 20 to 24 years. However, several studies have shown increasing incidence of preneoplastic lesions at increasingly early ages. CASE REPORT: This paper reports a case of microinvasive carcinoma of the uterine cervix in a 14-year-old patient with menarche at 10 years of age and first coitus at 12 years of age. The objective of the present report was to alert gynecologists and pediatricians regarding the need for cervical carcinoma prevention among sexually active adolescents, based on educational programs that explain the purpose of colpocytological examinations and encourage their use, along with condom use and limitation of the number of sexual partners.

  20. Long-term survival, prevalence, and cure of cancer: a population-based estimation for 818 902 Italian patients and 26 cancer types

    Dal Maso, L.; Guzzinati, S.; Buzzoni, C.; Capocaccia, R.; Serraino, D.; Caldarella, A.; Dei Tos, A. P.; Falcini, F.; Autelitano, M.; Masanotti, G.; Ferretti, S.; Tisano, F.; Tirelli, U.; Crocetti, E.; De Angelis, R.; Virdone, S.; Zucchetto, A.; Gigli, A.; Francisci, S.; Baili, P.; Gatta, G.; Castaing, M.; Zanetti, R.; Contiero, P.; Bidoli, E.; Vercelli, M.; Michiara, M.; Federico, M.; Senatore, G.; Pannozzo, F.; Vicentini, M.; Bulatko, A.; Pirino, D. R.; Gentilini, M.; Fusco, M.; Giacomin, A.; Fanetti, A. C.; Cusimano, R.

    2014-01-01

    Background Persons living after a cancer diagnosis represent 4% of the whole population in high-income countries. The aim of the study was to provide estimates of indicators of long-term survival and cure for 26 cancer types, presently lacking. Patients and methods Data on 818 902 Italian cancer patients diagnosed at age 15–74 years in 1985–2005 were included. Proportions of patients with the same death rates of the general population (cure fractions) and those of prevalent patients who were not at risk of dying as a result of cancer (cure prevalence) were calculated, using validated mixture cure models, by cancer type, sex, and age group. We also estimated complete prevalence, conditional relative survival (CRS), time to reach 5- and 10-year CRS >95%, and proportion of patients living longer than those thresholds. Results The cure fractions ranged from >90% for patients aged cancers to cancers of all ages. Five- or 10-year CRS >95% were both reached in cancers of the stomach, colon–rectum, pancreas, corpus and cervix uteri, brain, and Hodgkin lymphoma. For breast cancer patients, 5- and 10-year CRSs reached >95% after 19 and 25 years, respectively, and in 15 and 18 years for prostate cancer patients. Five-year CRS remained 25 years after cancer diagnosis in patients with liver and larynx cancers, non-Hodgkin lymphoma, myeloma, and leukaemia. Overall, the cure prevalence was 67% for men and 77% for women. Therefore, 21% of male and 31% of female patients had already reached 5-year CRS >95%, whereas 18% and 25% had reached 10-year CRS >95%. Conclusions A quarter of Italian cancer patients can be considered cured. This observation has a high potential impact on health planning, clinical practice, and patients' perspective. PMID:25149707

  1. The Role of {sup 18}F-FDG PET/CT in Assessing Therapy Response in Cervix Cancer after Concurrent Chemoradiation Therapy

    Choi, Jiyoun; Kim, Hyun Jeong; Jeong, Yong Hyu; Lee, Jaehoon; Cho, Arthur; Yun, Mijin; Lee, Jong Doo; Kim, Yong Bae; Kim, Young Tae; Kang, Won Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    To determine whether persisting cervical fluorodeoxyglucose (FDG) uptake after concurrent chemoradiotherapy (CCRT) for cervical cancer can reflect residual malignancy. F-FDG PET/CT was performed before and after CCRT in 136 patients with cervical cancer. The maximum and mean standardized uptake values (SUVmax and SUVmean) were recorded from PET/CT scans performed pre- and post-treatment. SUVs were correlated with treatment response after CCRT. Final treatment response was determined by MRI and further follow-up PET/CT. One hundred four of 136 patients underwent pelvic MRI, and 32 of 136 patients underwent further follow-up PET/CT. Patients were classified into two categories: patients with residual tumor or patients without residual tumor (complete responder). Preand post-treatment serum squamous cell carcinoma antigen (SCC) levels were also recorded for comparison. The optimal cutoff value of SUVmax for predicting residual cervical tumor was determined using receiver-operating characteristic (ROC) analysis. Of 136 patients, 124 showed complete response on further follow-up studies and 12 were confirmed to have residual tumor. The post-treatment SUVmax and pre-/posttreatment SUVmean of complete responders were significantly lower than those of patients with residual tumor: 2.5±0.8 and 7.2±4.2/1.9±0.7 for complete responders and 5.7±2.6 and 12.8±6.9/3.7±0.7 for patients with residual tumor (p < 0.05). The pre-treatment SUVmax and pre-/post-treatment serum SCC levels of the complete responders tended to be lower than those of patients with residual tumor, but this did not have statistical significance. Using ROC analysis, an optimal cutoff SUVmax of 4.0 on the post-treatment PET/CT yielded a sensitivity, specificity, positive predictive value, and negative predictive value of 92 %, 94 %, 61 %, and 99 %, respectively (p <0.001). Persistent cervical FDG uptake in {sup 18}F-FDG PET/CT after CCRT for cervical cancer may be caused by residual tumor or post

  2. [Human papilloma virus and cervical cancer. An historical review on the development of research on cancer of the cervix uteri in Venezuela].

    García-Tamayo, Jorge; Molina, Julia; Blasco-Olaetxea, Eduardo

    2010-06-01

    The history on the relationship of VPH infection and cervical cancer was examined. Findings were initially reported in Maracaibo(1971), later in Mexico(1973) and thereafter several studies on the ultrastructure and immunohistochemistry of VPH infection and its role on cervical cancer were described. The ultrastructural findings of viral particles of HPV and their proteins, as well as their role in the incorporation of the viral genome to the human cervical cells were also described. Glycoproteins on the surface of cervical cells were reviewed and their importance on HPV infection was related to p16, blood group antigens and early genetic changes in the cell cycle with loss of heterozigocity, all of which, stimulated by the high risk HPV infection lead to cervical cancer.

  3. Correlation between the treated volume, the GTV and the CTV at the time of brachytherapy and the histopathologic findings in 33 patients with operable cervix carcinoma

    Muschitz, S.; Petrow, P.; Briot, E.; Petit, C.; De Crevoisier, R.; Duvillard, P.; Morice, P.; Haie-Meder, C.

    2004-01-01

    Background and purpose: This study correlates the treated volume, the GTV and the CTV at the time of intracavitary brachytherapy (BT) with the histopathological findings obtained by surgery (S) in 33 patients (pts) with cervix carcinoma. Patients and methods: Sixteen pts (group I), FIGO stage IB1 (1), IB2 (4), IIB (10), IIIB (1), received external beam radiotherapy (EBT) with a total dose of 45 Gy in 5 weeks and concomitant CISPLATIN 40 mg/m 2 weekly, followed by BT up to a total dose of 15 Gy. S was performed 6-8 weeks thereafter. Seventeen pts (group II), FIGO IA2 (1), IB1 (14), IIB (2), were treated by BT alone with a total dose of 60 Gy and S after 6-8 weeks. All pts had a MRI examination after BT with a moulded applicator in situ for exact delineation of GTV, CTV and critical organs and a 3D dosimetry directly from MRI data. Results: In group I (EBT+BT+S), the histopathological findings showed complete tumour sterilization (CR) in 56% of pts. Residual disease (RD) was found in 43%. Dosimetric data showed in pts with CR a larger mean treated volume (213 vs. 166 cm 3 ) and a better mean coverage of the GTV and the CTV by the reference isodose (99 and 91%) as in pts with RD (85 and 77%). In group II (BT+S), CR was found in 52%, RD in 41%. Dosimetric data showed a larger mean treated volume (154 vs. 109 cm 3 ) for pts with RD and a mean coverage of the GTV and the CTV by the reference isodose of 97 and 84% vs. 89 and 80% for pts with CR. Conclusions: An incomplete coverage of the GTV and/or the CTV by the reference isodose is an important risk factor for RD at the time of surgery. Furthermore, for pts who received BT alone, tumour size seemed to be a limiting factor for an accurate coverage of the CTV by the reference isodose

  4. Bone health in cancer patients

    Coleman, R; Body, J J; Aapro, M

    2014-01-01

    There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...... morbidity including fractures, severe pain, nerve compression and hypercalcaemia. Through optimum multidisciplinary management of patients with bone metastases, including the use of bone-targeted treatments such as potent bisphosphonates or denosumab, it has been possible to transform the course of advanced...... cancer for many patients resulting in a major reduction in skeletal complications, reduced bone pain and improved quality of life. Secondly, many of the treatments we use to treat cancer patients have effects on reproductive hormones, which are critical for the maintenance of normal bone remodelling...

  5. Injectable and Oral Contraceptive Use and Cancers of the Breast, Cervix, Ovary, and Endometrium in Black South African Women: Case–Control Study

    Urban, Margaret; Banks, Emily; Egger, Sam; Canfell, Karen; O'Connell, Dianne; Beral, Valerie; Sitas, Freddy

    2012-01-01

    Background Oral contraceptives are known to influence the risk of cancers of the female reproductive system. Evidence regarding the relationship between injectable contraceptives and these cancers is limited, especially in black South Africans, among whom injectable contraceptives are used more commonly than oral contraceptives. Methods and Findings We analysed data from a South African hospital-based case–control study of black females aged 18–79 y, comparing self-reported contraceptive use in patients with breast (n = 1,664), cervical (n = 2,182), ovarian (n = 182), and endometrial (n = 182) cancer, with self-reported contraceptive use in 1,492 control patients diagnosed with cancers with no known relationship to hormonal contraceptive use. We adjusted for potential confounding factors, including age, calendar year of diagnosis, education, smoking, alcohol, parity/age at first birth, and number of sexual partners. Among controls, 26% had used injectable and 20% had used oral contraceptives. For current and more recent users versus never users of oral or injectable contraceptives, the odds ratios (ORs) for breast cancer were significantly increased in users of oral and/or injectable contraceptives (OR 1.66, 95% CI 1.28–2.16, pcontraceptives; corresponding ORs for cervical cancer were 1.38 (1.08–1.77, p = 0.01), 1.01 (0.66–1.56, p = 0.96), and 1.58 (1.16–2.15, p = 0.004). There was no significant increase in breast or cervical cancer risk among women ceasing hormonal contraceptive use ≥10 y previously (p = 0.3 and p = 0.9, respectively). For durations of use ≥5 y versus never use, the ORs of ovarian cancer were 0.60 (0.36–0.99, p = 0.04) for oral and/or injectable contraceptive use and 0.07 (0.01–0.49, p = 0.008) for injectable use exclusively; corresponding ORs for endometrial cancer were 0.44 (0.22–0.86, p = 0.02) and 0.36 (0.11–1.26, p = 0.1). Conclusions In this study, use of oral and

  6. Injectable and oral contraceptive use and cancers of the breast, cervix, ovary, and endometrium in black South African women: case-control study.

    Margaret Urban

    Full Text Available Oral contraceptives are known to influence the risk of cancers of the female reproductive system. Evidence regarding the relationship between injectable contraceptives and these cancers is limited, especially in black South Africans, among whom injectable contraceptives are used more commonly than oral contraceptives.We analysed data from a South African hospital-based case-control study of black females aged 18-79 y, comparing self-reported contraceptive use in patients with breast (n = 1,664, cervical (n = 2,182, ovarian (n = 182, and endometrial (n = 182 cancer, with self-reported contraceptive use in 1,492 control patients diagnosed with cancers with no known relationship to hormonal contraceptive use. We adjusted for potential confounding factors, including age, calendar year of diagnosis, education, smoking, alcohol, parity/age at first birth, and number of sexual partners. Among controls, 26% had used injectable and 20% had used oral contraceptives. For current and more recent users versus never users of oral or injectable contraceptives, the odds ratios (ORs for breast cancer were significantly increased in users of oral and/or injectable contraceptives (OR 1.66, 95% CI 1.28-2.16, p<0.001 and separately among those exclusively using oral (1.57, 1.03-2.40, p = 0.04 and exclusively using injectable (OR 1.83, 1.31-2.55, p<0.001 contraceptives; corresponding ORs for cervical cancer were 1.38 (1.08-1.77, p = 0.01, 1.01 (0.66-1.56, p = 0.96, and 1.58 (1.16-2.15, p = 0.004. There was no significant increase in breast or cervical cancer risk among women ceasing hormonal contraceptive use ≥10 y previously (p = 0.3 and p = 0