scholarly journals High-Grade Cervical Dysplasia following Radiation Therapy for Invasive Cervical Cancer: A Report of Four Cases

2015 ◽  
Vol 8 (2) ◽  
pp. 217-221 ◽  
Author(s):  
Mila Pontremoli Salcedo ◽  
Andrea M. Milbourne ◽  
Anuja Jhingran ◽  
Patricia J. Eifel ◽  
Pedro T. Ramirez ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Gynecologic Oncology ◽  
Invasive Cervical Cancer ◽  
Locally Advanced ◽  
Cervical Dysplasia ◽  
High Grade ◽  
Advanced Cervical Cancer ◽  
Recurrent Cervical Cancer ◽  
Locally Advanced Cervical Cancer

Introduction: The standard treatment for locally advanced cervical cancer is chemoradiation, with the majority of patients having a complete response to the therapy. The current surveillance recommendations from the Society of Gynecologic Oncology include annual cytology, with a small proportion of patients subsequently diagnosed with high-grade cervical dysplasia (CIN 2/3). To date, there is limited information regarding the optimal treatment and outcome for patients diagnosed with CIN 2/3. The current report describes the diagnosis, management and outcome of 4 patients diagnosed with CIN 2/3 following chemoradiation. Case Description: We describe 4 patients who developed CIN 2/3 seven months to 8 years following radiation therapy for locally advanced cervical cancer. All 4 patients were asymptomatic and the abnormalities were first detected by a Pap test. Three of the patients were managed conservatively with observation, and the CIN 2/3 resolved without intervention. One patient underwent 2 cervical conizations followed by a hysterectomy with no residual dysplasia noted on the hysterectomy specimen. Conclusion: The majority of patients with recurrent cervical cancer after chemoradiation are symptomatic, and most cases are detected by a physical examination. The role of cytology, colposcopy and biopsies may be of limited value. Furthermore, the significance of the diagnosis of CIN 2/3 in patients previously treated with radiation therapy was not associated with recurrent disease in the 4 patients described. Our results suggest that cytology may be of limited value in detecting recurrence in patients following radiation therapy, even when CIN 2/3 is detected.

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.

SURGERY FOR RESIDUAL DISEASE AFTER RADIOTHERAPY IN LOCALLY ADVANCED CERVICAL CANCER

2019 ◽  
Vol 65 (5) ◽  
pp. 721-725
Author(s):  
Elmira Shakirova ◽  
Andrey Panov ◽  
Alevtina Akhmetzyanova ◽  
Aliya Gafiullina ◽  
L. Ibragimova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Residual Disease ◽  
Locally Advanced ◽  
Residual Tumor ◽  
Advanced Cervical Cancer ◽  
Mri Imaging ◽  
Recurrent Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Visible Effect ◽  
Adjuvant Hysterectomy

Aims: Chemoradiation (CRT) is the standard treatment for locally advanced cervical cancer (LACC). However part of the patients develop recurrence during the first year after treatment despite good visible effect at the first follow-up. The role of completion surgery after radiotherapy (RT) is still debated. A number of papers have showed that up to 60% of patients have residual tumor after CRT and RT. But such a surgery is not widely recommended because of increased morbidity of the treatment. The aim of this study was to assess the results of surgery after radiotherapy of LACC. Method: We retrospectively evaluated data on 86 patients with cervical cancer IB - IIIB stages (mostly stage IIB) who underwent surgery in different modalities after CRT and RT with good clinical response in our department in 2015-2018. Results: When small asymptomatic residual disease was detected early after radiotherapy radical hysterectomy was feasible in most of the cases. Patients with clinical manifestation of recurrence had very poor prognosis. Surgery of recurrent cervical cancer sufficiently deteriorates quality of life, even if possible. Conclusion: Thorough examination with adding MRI imaging after initial treatment of cervical cancer needed to identify patients who may benefit from adjuvant hysterectomy.

scholarly journals Rare Radiation Complications after Treatment of Cervical Cancer

2020 ◽  
Vol 5 (6) ◽  
pp. 176-181
Author(s):  
О. М. Sukhina ◽  
◽  
K. V. Nemaltsova ◽  
V. S. Sukhin ◽  
◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Radiation Damage ◽  
Locally Advanced ◽  
Clinical Signs ◽  
Long Term Results ◽  
Great Effort ◽  
Radiation Toxicity ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer

Currently, cervical cancer is one of the most common types of oncological pathology. Radiation therapy is the main treatment for patients with locally advanced cervical cancer. The main goal of radiation treatment for cervical cancer is to plan the amount of radiation in which the primary tumor and the areas of regional lymph outflow are subject to the maximum possible impact with minimal radiation exposure to critical organs (rectum and bladder). However, the program of combined radiation therapy according to a radical program in patients with locally advanced cervical cancer provides for irradiation of sufficiently large volumes with high therapeutic doses. Radiation therapy with radiomodifying cytostatics or with competitive polychemotherapy improves both immediate and long-term results of treatment, but increases the risk of radiation reactions. According to clinical signs, radiation toxicity is divided into general and local, which, in turn, can be early and late, depending on the time of occurrence. The risk of radiation damage naturally increases with an increase in the total absorbed dose. The presence of comorbidities also affects the likelihood of post-radiation complications. Chronic diseases of organs located in the irradiated zone significantly increase the risk of their radiation damage. Individual radiosensitivity plays a decisive role in the occurrence of radiation complications. The article describes a case of a urinary-small intestinal fistula in patient A., 80 years old. The patient has been observed in the clinic of the State Organization «Grigoriev Institute for Medical Radiology and Oncology National Academy of Medical Sciences of Ukraine» since 2016 for cervical cancer FIGO IVA stage (pathohistological conclusion was squamous cell non-keratinizing cancer), a course of combined radiation therapy with modification of 5-fluorouracil under a radical program was carried out. The relapse-free period for cervical cancer was 4 years, the patient regularly underwent control examinations at the Institute's clinic. Since March 2020 has had complaints about the presence of feces in the urine, which is why she came to the clinic. Conclusion. Treatment of this category of patients is a difficult task that requires time and great effort from both medical staff and patients

scholarly journals Concurrent chemoradiation in treatment of carcinoma cervix

1970 ◽  
Vol 2 (1) ◽  
pp. 4-8
Author(s):  
Meeta Singh ◽  
Rajshree Jha ◽  
Josie Baral ◽  
Suniti Rawal
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Concurrent Chemoradiation ◽  
Advanced Cervical Cancer ◽  
European Organization ◽  
Locally Advanced Cervical Cancer ◽  
Advanced Cervical Carcinoma ◽  
To Come

Aim: to compare if concurrent chemoradiation is better than radiotherapy given alone in the treatment of women with locally advanced cervical cancer from published literature Method: Study Design: Randomized control trials of > than 2, 403 women participants who underwent treatment for advanced cervical carcinoma mainly in two huge center i.e. from National Cancer Institute (NCI), USA and European Organization for Research and Treatment of Cancer (EORTC) were reviewed regarding the treatment they received at the center: concurrent chemoradiation/ radiation therapy alone. The results were analyzed to come to conclusion. Result demonstrated a 30-50% improvement in survival when cisplatin-based chemotherapy in NCI or 5 fluorouracil and cisplatin based chemotherapy was used in EORTC was administered with concurrent radiation therapy (chemoradiation) Conclusions: The addition of chemotherapy (cisplatin) in NCI and (cisplatin and fluorouracil) in the EORTC for the treatment of locally advanced cervical cancer with the concurrent chemoradition have elicited better survival than those treated with radiotherapy alone dittoed by several other trials which can be anticipated to benefit Nepalese women with locally advanced cervical carcinoma. Key-words: Cancer cervix, chemoradiation, radiotherapy   doi:10.3126/njog.v2i1.1467 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 4 - 8 May -June 2007

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