scholarly journals Lymph flow guided irradiation of regional lymph nodes in patients with cervical cancer: Preliminary analysis of scintigraphic data

2018 ◽  
Vol 23 (6) ◽  
pp. 503-509 ◽  
Author(s):  
Sergey Nikolaevich Novikov ◽  
Pavel Ivanovich Krzhivitskii ◽  
Sergey Vasilevich Kanaev ◽  
Igor Viktorovitch Berlev ◽  
Margarita Viktorovna Kargopolova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Preliminary Analysis ◽  
Lymph Flow ◽  
Regional Lymph Nodes

PREOPERATIVE SPECT-CT VISUALIZATION OF SENTINEL LYMPH NODES IN PATIENTS WITH CERVICAL CANCER: PRELIMINARY ANALYSIS OF THE DATA

2019 ◽  
Vol 65 (4) ◽  
pp. 524-531
Author(s):  
Sergey Kanaev ◽  
M. Bisyarin ◽  
Pavel Krzhivitskiy ◽  
I. Berlev ◽  
Sergey Novikov ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Preliminary Analysis ◽  
Clinical Stage ◽  
Flow Patterns ◽  
Sentinel Lymph Nodes ◽  
Lymph Flow ◽  
Radiotherapy Planning ◽  
Iliac Region ◽  
Internal Iliac

Purpose: to determine preoperative SPECT-CT localization of sentinel lymph nodes (SLN) in women with cervical cancer. Materials and methods: SPECT-CT visualization of SLN was performed in 44 women with clinical stage IB-IIB cervical cancer. SPECT-CT examinations started 120-240 min after peritumoural injections of 99mTc-radiocolloids (200-300MBq in 0.4-1ml). All visualized LNs with uptake of radiocolloids were regarded as SLN. In all women we determined topography of SLN and lymph-flow patterns. Results: SLN were successfully visualized in 93.1% cases (41/44 women). The bilateral pattern of lymph flow was mentioned in 26 (63.4%), monolateral - in 15 (36.5%) cases. SLN localized in external iliac region in 25 (60.9%), internal iliac - in 14 (34.1%), obturator - in 22 (53.6%), presacral - in 1 (2.4%), common iliac region - in 21 (53,8%) cases. Uptake of radiocolloids in paraaortal lymph nodes was mentioned in 14 (34.1%) women Conclusion: SPECT-CT visualization of SLN can give important information for surgery and radiotherapy planning.

scholarly journals SPECT-CT IMAGING AND SENTINEL LYMPH NODES BIOPSY IN PATIENTS WITH CERVICAL CANCER

2020 ◽  
Vol 66 (2) ◽  
pp. 167-172
Author(s):  
M. Bisyarin ◽  
Pavel Krzhivitskiy ◽  
Sergey Kanaev ◽  
Sergey Novikov ◽  
I. Berlev ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
False Negative ◽  
Lymph Node Biopsy ◽  
Lymph Flow ◽  
Regional Lymph Nodes ◽  
Node Biopsy ◽  
Low Sensitivity

Purpose: to determine accuracy of sentinel lymph node biopsy in patients with IAB-IIAB cervical cancer. Materials and methods: diagnostic performance of sentinel lymph node (SLN) biopsy was evaluated in 46 women with cervical cancer. SLN mapping was performed after peritumoural injection of 99mTc-labelled radiocolloids. All regional lymph nodes with uptake of radiocolloids were regarded as sentinel. SSLN biopsy was completed by standard lymph node dissection in all cases Results: SLN were visualized and detected in 42 of 46 (91.3%) cases. The monolateral pattern of lymph flow was determined in 19 women, bilateral localization of SLN revealed in remained 23 cases. Monolateral lymph flow characterized by high probability of metatstic involvement of regional lymph nodes (21.1%) and low sensitivity of SLN biopsy (0%). On the contrary, in women with bilateral lymph flow metastases in regional lymph nodes were mentioned in 2 of 23 cases (8.7%) and sensitivity of SLN biopsy was 100%. Conclusion: In patients with SLN localization on both sides of the pelvis SLN biopsy correctly predicted status of regional lymph nodes. In cases with monolateral localization of SLN biopsy characterized by high false negative rates.

THE ROLE OF SURGICAL STAGE IN COMBINATION THERAPY FOR PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER

2019 ◽  
Vol 65 (5) ◽  
pp. 749-755
Author(s):  
D. Reyes Santyago ◽  
Anzhella Khadzhimba ◽  
M. Smirnova ◽  
Sergey Maksimov
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Combination Therapy ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Relapse Free Survival ◽  
Regional Lymph Nodes ◽  
Free Survival ◽  
Locally Advanced Cervical Cancer

Objective: to justify the expediency of the surgical stage as a part of the combination treatment for stage IIA-IIIB cervical cancer. Materials and methods. The study included 343 women with stage IIA-IIIB cervical cancer treated from 2013 to 2016 with mandatory follow-up for at least 2 years. Patients were divided into 2 groups. The first group included 214 patients who received a combination treatment. At the first stage, neoadjuvant chemoradiation therapy was performed (remote radiation therapy 5 days a week with radio modification with Cisplatin once a week at a dose of 40 mg/m2). After evaluating the effect, patients were subjected to surgical treatment or continued chemoradiotherapy. The second group (n = 129) received standard combined radiation therapy. Various schemes of combination and complex treatment and standard combined radiation therapy were evaluated using the indices of general and relapse-free survival. Results. The proposed scheme for the combination therapy for patients with locally advanced cervical cancer showed significantly higher survival rates at all the analyzed stages. For the combined treatment group with complete cytoreduction, the two-year overall and relapse-free survival with stage IIA is 94.1% vs. 82.4%, with IIB 90.8% vs. 80.3%, with IIB 87.5% vs. 75%, with IIB with metastatic lesion of regional lymph nodes 85% vs. 70%. For the second group, two-year overall and relapse-free survival with stage IIA 75% vs. 50%, with IIB 70.9% vs. 56.3%, with IIB 59.1% vs. 40.9%, with IIB with metastatic lesion of regional lymph nodes 62.2% and 40.5%. The advantages of this approach are most clearly seen within patients with metastatic lesions of regional lymph nodes (85% vs. 62% accordingly). Conclusion. Cytoreductive surgery in combination with the combination therapy allows to achieve a significant increase in overall and relapse-free survival for patients with locally advanced cervical cancer compared with standard treatment programs.

scholarly journals Extended-field intensity-modulated radiotherapy and dosage boost for lymph node metastasis are beneficial for the prognosis of FIGO IIICr and IVA cervical cancer patients with positive regional lymph nodes

2020 ◽  
Author(s):  
Yuhua Zhao ◽  
Gong Li ◽  
Lei Gao
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Intensity Modulated Radiotherapy ◽  
Figo Stage ◽  
Concurrent Chemotherapy ◽  
Regional Lymph Nodes ◽  
Free Survival ◽  
Node Metastasis ◽  
Extended Field

Abstract Background: This study aimed to evaluate the therapeutic efficacy of extended-field intensity-modulated radiotherapy (EF-IMRT) and dosage boost for positive lymph nodes, prognostic factors, treatment failure, and toxicity for Federation of Gynecology and Obstetrics (FIGO) stage IIICr and IVA cervical cancer patients with positive regional lymph nodes.Methods: We retrospectively evaluated 34 patients with stage IIICr and IVA who had received treatment in our institute between 2013 and 2016. Patients with stage IVA cervical cancer who had been enrolled in the analysis all had positive regional lymph nodes (pelvic or/and para-aortic). All 34 patients were treated with EF-IMRT and simultaneously integrated boost-IMRT (SIB-IMRT) for lymph node metastasis with concurrent chemotherapy and brachytherapy. Positive regional lymph nodes (short-axis diameter ≥5 mm in computed tomography [CT] or magnetic resonance imaging [MRI]) remaining after SIB-IMRT were then treated with sequential boost-IMRT (SeB-IMRT). The prognostic factors for overall survival (OS); disease-free survival (DFS); local control rate (LCR); regional control rate (RCR); distant metastasis-free survival (DMFS), including age, FIGO stage, pretreatment hemoglobin (HB) level, tumor size, para-aortic lymph node (PALN) metastasis, point A equivalent dose in 2-Gy fractions (EQD2 dose), concurrent chemotherapy, and adjuvant chemotherapy cycles, were analyzed.Results: Complete response (CR) was achieved in 31 (91.2%) patients with acceptable adverse effects. Notably, the three-year OS, DFS, LCR, RCR, DMFS for these patients were 73.5%, 70.6%, 88.1%, 87.9%, and 81.6%, respectively. In particular, the three-year OS, DFS, LCR, RCR, and DMFS of patients with positive PALNs was 41.7%, 33.3%, 65.6%, 72.2%, and 60.2%, respectively. The corresponding values in patients without positive PALNs were 90.9%, 90.9%, 100%, 95.5%, and 90.9%, respectively.Conclusions: Our study suggested that the EF-IMRT and nodal dosage boost decreased regional node failure and that patients with stage IIIC1r and IVA cervical cancer without PALN metastasis who received EF-IMRT and SIB-IMRT with or without SeB-IMRT had a significant survival advantage in terms of the DFS and OS.

scholarly journals The Study Drug Pathomorphism And Immunohistochemical Parameters Of Tumor In Endoarterial Of Regional Long-Term Chemotherapy In Treatment Of Cervical Cancer

2010 ◽  
Vol 1 ◽  
Author(s):  
V Navruzova ◽  
N Yuldasheva
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Tumor Invasion ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Study Drug ◽  
Complete Regression ◽  
Regional Lymph Nodes ◽  
Results Of Treatment

Background: To improve the results of radiotherapy for cervical cancer used local and systemic radio-modification drugs.Materials and methods: 1984 patients with locally advanced cervical cancer (2b - 3a stage), which at one stage of complex treatment by a course indo-arterial of regional long-term poly-chemotherapy (EARDPHT) mode: methotrexate - 50 mg/m2, the first 12 hours, fluorouracil 1000 mg/m2, over the next 12 hours and cisplatin - 100 mg/m2, for 48 hours, 2 stage - surgical treatment in the volume expanding hysterectomy 3 type (modification of Wertheim - Meigs).Results: The results of treatment of locally cervical cancer using VADRPHT, depending on the unilateral and bilateral tumor invasion in parametrial tissue showed that under unilateral lesion of parametrium results of treatment were higher than for the bilateral involvement of parametrium. Medical pathomorphosis in tumors of different severity was observed in 86.9% of patients, metastasis to regional lymph nodes were detected in 36% of operated patients, and also studied the degree of therapeutic pathomorphosis in lymph nodes. There was revealed that the complete regression of tumors, 5 - year survival rate is 98%, whereas in tumor regression of more than 50% of the original volume – 78.5%, with stabilization of tumor - no more than 58.4%.Conclusion:  The study of molecular-biological parameters of the tumor cells show the effectiveness of conducted neo-advent indo-arterial chemotherapy and play an important role in further treatment and prediction of disease.

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