scholarly journals CyberKnife Stereotactic Ablative Radiotherapy for Recurrent or Oligometastatic Gynecological Cancers

2021 ◽  
Author(s):  
Tejinder Kataria ◽  
Pushpa Naga ◽  
Susovan Banerjee ◽  
Deepak Gupta ◽  
Kushal Narang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Gynecological Cancer ◽  
Dose Range ◽  
Gynecologic Cancer ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Stereotactic Ablative Radiotherapy ◽  
Gynecological Cancers ◽  
Study Results ◽  
Grade 3

Abstract Purpose Use of stereotactic ablative radiotherapy (SABR) in the treatment of recurrent or metastatic lesions from a primary gynecologic cancer is a relatively new concept. The present study aims to assess the safety, efficacy, and possible toxicity profile of CyberKnife SABR, recurrent or metastatic disease. Materials/Methods CyberKnife VSI-based SABR was offered to 20 oligometastatic/recurrent gynecological cancer patients between 2013 and 2019. Patient, tumor, and treatment characteristics including radiotherapy details, clinical outcome in terms of local control rates, and toxicities are reported in this study. Results Twenty-five recurrent or oligometastatic lesions for 20 primary gynecologic cancer patients including cervical (n = 8), ovarian (n = 6), endometrial (n = 5), and vulvar (n = 1) cancers were analyzed. Of these, 4 (16%) were intracranial lesions and remaining 21 (84%) were extracranial, consisting of 14 (67%) extrapelvic and 7 (33%) pelvic lesions. The median SABR dose delivered was 60 Gy biologically effective dose (range 42–133 Gy) in an average of four fractions (range 1–6). The mean follow-up was 18 (range 2–70) months. Local tumor control was achieved in 82% of patients. There was no grade ≥ 3 toxicity recorded. Conclusion Our study results suggest that CyberKnife SABR is an effective treatment modality with no major morbidity in patients with recurrent or oligometastatic gynecological cancers.

scholarly journals 10031-RT-02 Results of reactor-based BNCT for 44 cases of recurrent and refractory high-grade meningiomas and road to accelerator based BNCT

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii11-ii11
Author(s):  
Shin-Ichi Miyatake ◽  
Shinji Kawabata ◽  
Masahiko Wanibuchi ◽  
Satoshi Takai ◽  
Koji Takeuchi ◽  
...  
Keyword(s):  
Treatment Failure ◽  
External Beam Radiotherapy ◽  
Clinical Results ◽  
Local Tumor Control ◽  
Prolonged Survival ◽  
Tumor Control ◽  
High Grade ◽  
Particle Radiation ◽  
Failure Patterns ◽  
Grade 3

Abstract Introduction: High-grade meningioma (HGM) is difficult clinical entity to treat. Especially recurrent HGM after some radiotherapy has very miserable prognosis. For example median overall survival (mOS) of recurrent HGM after radiotherapy is reported as 2 years. We applied tumor-selective particle radiation BNCT using nuclear reactor for 44 recurrent HGMs. Methods: From 2005 to 2019, we treated 44 recurrent and refractory HGMs by reactor-based BNCT. The patients’ WHO grades are grade 2:20 cases, grade 3:24 cases. Prior to BNCT, totally 114 times operations and 72 times SRS and 14 times external beam radiotherapy were applied for them. OS, tumor shrinkage, causes of treatment failure were analyzed. Results: Median follow-up was 26.0 months. MOS after BNCT was 29.6 (95% CI:16.1–40.4) months. Grade 2 and 3 showed mOS as 44.4 (27.4-) and 21.55 (10.6–30.6) months, respectively and there is statistically significance (p=0.0009). All treated tumor showed rapid shrinkage on MRI. Treatment failure patterns are local recurrence, out of field recurrence, systemic metastasis, CSF dissemination, as 35.5%, 20.6%, 17.6%, 8.8 %, respectively. These results showed good local tumor control and prolonged survival for recurrent HGM cases. Conclusions: Our cases were heavily treated with repetitive surgeries and repetitive radiotherapy. In addition the rate of grade 3 patients was extremely high. In a word our cases seemed to have poor prognosis. In spite of these poor condition, reactor-based BNCT exerted good local control and prolonged survival for recurrent and refractory HGMs. Depending on the clinical results, PMDA gave us the permission to apply investigator-lead clinical trial for recurrent and refractory HGMs using accelerator-based BNCT with financial support from AMED (one of the agency of Japanese government). In our talk, let us open some results from this trial.

scholarly journals Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters

2014 ◽  
Vol 03 (01) ◽  
pp. 038-042 ◽  
Author(s):  
Ushashree Das ◽  
Shilpa Patel ◽  
Kalpana Dave ◽  
Ronak Bhansali
Keyword(s):  
At Risk ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Cancer Patients ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Predictive Values ◽  
Percentage Weight ◽  
Sensitivity Specificity ◽  
Approximate Percentage

Abstract Aim: To assess the nutritional status of gynecological cancer patients using scored Patient Generated Subjective Global Assessment (PG-SGA) then compare it with the body mass index (BMI), hemoglobin, serum albumin, and approximate percentage weight lost in last 1 month so as to find any one parameter that can be used in place of the comprehensive assessment tool. Materials and Methods: Sixty gynecological cancer patients were assessed for their nutritional status using BMI, serum albumin, hemoglobin, percentage weight lost in last 1 month, and scored PG-SGA. Correlation, sensitivity, specificity, and predictive values of the former four parameters compared to scored PG-SGA were calculated. Results: 88.33% of cases were at risk of or had some degree of malnutrition according to scored PG-SGA. Serum albumin level ≤ 2 g/dl had highest specificity and positive predictive value at 1, whereas percentage weight lost in last month had better overall sensitivity, specificity, and positive and negative predictive values of 0.5833, 0.9444, 0.875, and 0.7727, respectively. The Pearson′s correlation coefficient between scored PG-SGA and percentage weight lost in last 1 month was 0.784, highest among all the parameters. Conclusion: 88.33% of gynecologic cancer cases had some degree of malnutrition or were at risk of malnutrition. Approximate percentage weight lost in last 1 month, that is, ≥ 5% may be used in place of the comprehensive scored PG-SGA to triage the patients in case the latter is not used for some reason. Severe hypoalbuminemia ≤ 2 g/dl is an indicator of severe malnutrition in gynecologic cancer cases.

scholarly journals COVID-19: gynecologic cancer surgery at a single center in Madrid

2020 ◽  
Vol 30 (8) ◽  
pp. 1108-1112
Author(s):  
Javier de Santiago ◽  
Carmen Yelo ◽  
Maria F Chereguini ◽  
Ana Conde ◽  
Javier Galipienzo ◽  
...  
Keyword(s):  
Vulvar Cancer ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Cancer Surgery ◽  
Single Center ◽  
Median Hospital Stay ◽  
Day Range ◽  
Medical Facilities ◽  
Surgical Options ◽  
Grade 3

ObjectivesWhile numerous medical facilities have been forced to suspend oncological surgery due to system overload, debate has emerged on using non-surgical options on cancer cases during the pandemic. The goal of our study was to analyze, in a retrospective cohort study, the results of gynecological cancer surgery and evaluate postoperative complications in a single center in one of the most affected areas in Europe.MethodsWe retrospectively analyzed the records of patients who were referred between March 2020 and May 2020 for primary surgical treatment of breast, endometrial, ovarian, cervical, or vulvar cancer.ResultsThe study included a total of 126 patients. Median age was 60 years (range 29–89). Patients were referred with breast (76/126, 60.3%), endometrial (29/126, 23%), ovarian (14/126, 11.1%), cervical (5/126, 4%), or vulvar cancer (2/126, 1.6%). Polymerase chain reaction (PCR) test for detection of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) was only conducted in 50% of cases due to the low availability of tests during the first phase of our study, and was indicated only in suspected cases according to the healthcare authorities' protocol. Median hospital stay was 1 day (range 0–18). Excluding breast surgery, laparoscopy was the most used procedure (43/126, 34.1%). 15 patients had a postoperative complication (15/126, 11.9%); only in 2 patients (2/15 13.3%) were there reports of Clavien–Dindo grade 3 or 4 complications. 6 patients tested positive for COVID-19 following a PCR diagnostic test, and these surgeries were cancelled.ConclusionsAdequate protective measures in the setting of COVID-19 free institutions enabled the continuity of cancer surgery without significant compromise of the safety of patients or healthcare workers.

Daily irinotecan and concomitant radiotherapy for locally advanced pancreatic cancer: Feasibility and MTD

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15124-15124
Author(s):  
C. Carrie ◽  
C. De La Fouchardière ◽  
D. Perol ◽  
S. Negrier ◽  
F. Desseigne ◽  
...  
Keyword(s):  
Objective Response ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Tumor Control ◽  
Karnofsky Score ◽  
Exact Test ◽  
Study Results ◽  
Secondary Endpoints ◽  
Grade 3 ◽  
Adenocarcinoma Of The Pancreas

15124 Background: To determine the maximal tolerated dose (MTD) of daily irinotecan with radiotherapy (RT) in patients (pts) with locally advanced adenocarcinoma of the pancreas. Methods: Between 09/2000 and 05/2006, 30 pts with histologically proved adenocarcinoma of pancreas were included in this prospective phase I/II study. Irinotecan was administrated daily, 1 hour before RT session. Doses were escalated by increment of 2 mg/m2 every 3 patients for an initial dose of 6 mg/m2/day. RT was delivered at 2 Gy per session, 5 fractions per week to a total dose of 50 Gy to the doses tumor volume. Primary endpoint was toxicity; secondary endpoints were tumor objective response (OR) defined as complete or partial response, secondary operability and overall survival (OS). Inoperability was assessed by surgeon. All images were reviewed by a radiologist. OR rates were compared using the Fisher’s exact test. Results: 30 pts were entered over 6 years through 7 dose levels from 6 mg/m2/day. Sex ratio was 1:1, median age was 58 years (range 33–71), Karnofsky score was ≥ 90 in 93%. Current median follow-up is 45 months. No dose limiting toxicity was yet observed (last level 18 mg/m2/day). Three patients experienced grade 3 toxicity at level 1 (ulcer perforation), level 6 (nausea, vomiting and abdominal pain), and level 7 (nausea, vomiting and hypokaliemia), respectively. OR rates were 33% at 4 weeks. 3/13 pts (23%) included within the 3 first levels (= 10 mg/m2/day) experienced an OR at 4 weeks, versus 7/17 (41%) in the levels > 10 mg/m2/day (P = 0.44). 3 pts underwent surgery because of control tumor. Median OS was 13 months (95% CI 11–14) with 24 patient’s death. One patient is in complete remission since 21 months. Conclusions: Maximal tolerated dose is not yet reached. Despite response rate is not the main aim of the study, results suggest that RT combined with a higher daily level of irinotecan could be associated with a better tumor control. No significant financial relationships to disclose.

Differences in quality of life and emotional health by diagnosis among women with early-stage gynecological cancers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23180-e23180 ◽  
Author(s):  
Rachel Isaksson Vogel ◽  
Patricia Jewett ◽  
Audrey Messelt ◽  
Heewon Lee ◽  
Susan Everson-Rose ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Endometrial Cancer ◽  
Cancer Patients ◽  
Vulvar Cancer ◽  
Early Stage ◽  
Emotional Health ◽  
Gynecological Cancer ◽  
Gynecological Cancers ◽  
Post Traumatic

e23180 Background: Psychosocial outcomes have been described in women with gynecological cancers, but potential differences by diagnosis have received less attention. We sought to compare quality of life (QOL) and emotional health among early stage gynecological cancer survivors by disease location. Methods: We present baseline data from an ongoing cohort study of gynecological cancer patients treated at an academic cancer center. Measures include cancer-related QOL, emotional health and negative (post-traumatic stress disorder-PTSD) and positive (post-traumatic growth-PTG) reactions to cancer. Univariate and multivariate linear regression models (restricted to stage I or II; excluding vaginal/vulvar) explored differences in QOL and emotional health by diagnosis. Potential confounders considered for inclusion in the final models were age, stage, education, income, partner status, treatment status, and race. Results: 222 patients with early stage disease completed the survey: 56 (25.2%) ovarian, 122 (55.5) endometrial, 33 cervical (14.9%), and 11 (5%) vaginal/vulvar cancer. Cervical and vaginal/vulvar cancer patients reported greater cancer-related distress, anxiety and PTSD scores (Table). Endometrial cancer patients reported lowest PTG scores. Conclusions: Our analyses suggest early stage gynecological cancer patients face different psychosocial sequelae based on diagnosis, with worse outcomes generally being associated with younger age. Further research is needed to assess low PTG among endometrial cancer patients, since PTG is considered a potentially beneficial psychosocial outcome of cancer. [Table: see text]

scholarly journals The Effect of Art Therapy in Women with Gynecologic Cancer: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Wenjing Fu ◽  
Yan Huang ◽  
Xing Liu ◽  
Jianhua Ren ◽  
Mengqin Zhang
Keyword(s):  
Cancer Patients ◽  
Art Therapy ◽  
Case Reports ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Health Condition ◽  
Current Evidence ◽  
Psychological Outcome ◽  
Rigorous Research

Objectives. The purpose of this study was to evaluate the evidence of art therapy on the psychological outcome, quality of life (QOL), and cancer-related symptoms in women with gynecological cancer. Methods. A systematic literature search was conducted. The randomized controlled trials, quasiexperimental studies, case reports, and qualitative studies were all included. Result. 1,587 articles were retrieved. A total of 9 articles met the inclusion criteria. The existing studies provided initial evidence to suggest that art therapy may benefit gynecological cancer patients with respect to improving psychological outcome and QOL, reducing fatigue related to cancer, and improving subjective overall health condition. However, the quality of the current evidence limits the efficacy of these findings. Conclusion. Research on art therapy of gynecologic cancer patients is insufficient. We cannot draw the conclusion that art therapy benefits gynecological cancer patients in the psychological outcome, QOL, and cancer-related symptoms. More rigorous research is needed.

scholarly journals Sexual Rehabilitation After Pelvic Radiotherapy and Vaginal Dilator Use: Consensus Using the Delphi Method

2014 ◽  
Vol 24 (8) ◽  
pp. 1499-1506 ◽  
Author(s):  
Rinske Maria Bakker ◽  
Moniek M. ter Kuile ◽  
Willemijn M. Vermeer ◽  
Remi A. Nout ◽  
Jan Willem M. Mens ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Patient Information ◽  
Delphi Study ◽  
Gynecological Cancer ◽  
Information Provision ◽  
Oncology Nurses ◽  
Gynecological Cancers ◽  
Sexual Rehabilitation ◽  
Treatment Information ◽  
Radiation Oncologists

ObjectiveThis study aimed to reach consensus among professional experts on patient information provision and support regarding sexual rehabilitation and vaginal dilator use after radiotherapy (RT) for gynecological cancers.MethodsA 3-round online Delphi study was conducted among 10 radiation oncologists, 10 gynecologic oncologists, and 10 oncology nurses from 12 gynecological cancer centers providing RT for gynecological tumors. We assessed the desired content and provider of instructions and patient support regarding sexuality and vaginal dilator use. Responses were measured on a 7-point scale varying from “totally disagree” to “totally agree.” Consensus was reached when 70% of participants’ answers fell within 2 scale categories with an interquartile range less than or equal to 1.ResultsThe panel agreed that information about sexual rehabilitation using vaginal dilators should be provided by radiation oncologists before treatment. Information should always be provided to sexually active cervical and vaginal cancer patients younger than 70 years. Tailored information was recommended for vulvar and endometrial cancer patients, patients older than 70 years, and sexually inactive patients. Preferably, specifically trained oncology nurses should give psychological and practical support. Participants recommended vaginal dilation to prevent vaginal adhesions, tightening, and shortening. The panel advised to start dilation around 4 weeks after treatment to perform dilation 2 to 3 times a week for 1 to 3 minutes and to continue dilation for 9 to 12 months. Plastic dilator sets were considered the most suitable type of dilator.ConclusionsConsensus was reached on patient information provision and support during sexual rehabilitation after RT for gynecological cancers. Results were used to develop a sexual rehabilitation intervention.

scholarly journals Use of Chinese Herbal Medicine Improves Chemotherapy-Induced Thrombocytopenia among Gynecological Cancer Patients: An Observational Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yi-Hong Wu ◽  
Hsing-Yu Chen ◽  
Chyong-Huey Lai ◽  
Chein-Shuo Yeh ◽  
Jong-Hwei S. Pang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Large Scale ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Recurrent Ovarian Cancer ◽  
Chinese Herbs ◽  
Management Options ◽  
Chinese Herbal ◽  
Before And After ◽  
Fixed Proportion

Background.Chemotherapy-induced thrombocytopenia (CIT) is a serious complication among patients with gynecological malignancies, yet management options are limited. This study aimed at reporting the potential of the Chang Gung platelet elevating formula (CGPEF), a prescription with a fixed proportion of Chinese herbs, for improving CIT among gynecologic cancer patients.Materials.From 1/1/2007 to 31/12/2009, a total of 23 patients with two consecutive CIT episodes (≤ 100×103/μL) (last cycle: C0; index cycle: C1) received the CGPEF from the nadir of platelet count of C1 and through the subsequent chemotherapy cycles (C2 and beyond). The CGPEF was taken orally four times a day. The evolution of platelet counts of 18 patients after administration of CGPEF was analyzed (2 patients had different chemotherapy regimens after CGPEF, two patients discontinued CGPEF due to the flavor and the amount of CGPEF, and one patient had no further chemotherapy).Results.Most of the patients had recurrent ovarian cancer (11/18, 61%) with a median of 2.5 previous chemotherapy regimens, and carboplatin-based regimens were the most commonly used for these patients (13/18, 72%). The trend of successive CIT could be reversed after taking CGPEF. Also, the platelet nadir was higher after CGPEF treatment (16.5×103/μL versus 32×103/μL, before and after CGPEF treatment, resp.,p= 0.002). Moreover, the chemotherapy interval decreased from 30.5 days to 24 days. No thrombocytosis, clinical bleeding, thromboembolism, or other adverse events were found among these patients.Conclusions.The CGPEF is worthy of further large-scale, well-designed clinical trials for CIT among gynecological cancer patients.

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