Efficacy of radical doses of pelvic radiotherapy for primary tumor treatment in patients with newly diagnosed organ metastatic cervical cancer

Background: Metastatic cervical cancer carries poor prognosis. The factors associated with distant metastasis in newly diagnosed cervical cancer patients are not clear.Methods: A retrospective analytical study was performed to study the pattern of distant metastasis, and to evaluate the factors associated with de-novo metastatic cervical cancer. Univariate and multivariate analysis (by MANOVA) were used to evaluate the association. P≤0.05 was considered significant.Results: Out of 1321 newly diagnosed cervical cancer patients, 54 (4.1%) had de-novo metastatic disease and most of which (81%) were found at single site. Common sites of distant metastasis were non-regional nodes, followed by liver, lung, peritoneum and bone. Univariate analysis showed the factors associated with de-novo metastasis were non squamous subtype, high grade histology, bulky primary tumor (>4 cm), pelvic/para-aortic lymphadenopathy, and hydroureteronephrosis. Multivariate analysis revealed the factors associated with de-novo metastasis were bulky primary tumor (>4 cm), high grade histology, pelvic/para aortic lymphadenopathy, hydroureteronephrosis.Conclusions: Newly diagnosed cervical cancer patients with bulky primary tumor, high grade histology, pelvic or para aortic lymphadenopathy, hydroureteronephrosis are associated with higher risk of de-novo distant metastasis.

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Leptomeningeal metastasis of uterine cervical cancer 17 years after primary tumor treatment

Clinical Case Reports ◽

10.1002/ccr3.445 ◽

2015 ◽

Vol 4 (1) ◽

pp. 54-61 ◽

Cited By ~ 1

Author(s):

Takahiro Oike ◽

Tatsuya Ohno ◽

Shin‐Ei Noda ◽

Tomomi Murata ◽

Takashi Hirakawa ◽

...

Keyword(s):

Cervical Cancer ◽

Primary Tumor ◽

Leptomeningeal Metastasis ◽

Uterine Cervical Cancer ◽

Tumor Treatment

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Combinative evaluation of primary tumor and lymph nodes to predict pelvic lymphatic metastasis in cervical cancer: an integrated PET-IVIM MRI study

Cancer Imaging ◽

10.1186/s40644-020-00298-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Chen Xu ◽

Xiaoran Li ◽

Yanchi Shi ◽

Bo Wang ◽

Hongzan Sun

Keyword(s):

Cervical Cancer ◽

Lymph Nodes ◽

Lymphatic Metastasis ◽

Primary Tumor ◽

Mri Study

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Pelvic radiotherapy for cervical cancer affects importantly the reproducibility of cytological alterations evaluation

BMC Clinical Pathology ◽

10.1186/s12907-018-0078-z ◽

2018 ◽

Vol 18 (1) ◽

Author(s):

Fernanda A. Lucena ◽

Ricardo F. A. Costa ◽

Maira D. Stein ◽

Carlos E. M. C. Andrade ◽

Geórgia F. Cintra ◽

...

Keyword(s):

Cervical Cancer ◽

Pelvic Radiotherapy ◽

Cytological Alterations

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Brachytherapy-based radiotherapy is associated with improved survival for newly diagnosed metastatic cervical cancer

Brachytherapy ◽

10.1016/j.brachy.2020.11.001 ◽

2020 ◽

Author(s):

Lin Ding ◽

Zhuofei Bi ◽

Zihao Pan ◽

Xiaoli Yu ◽

Xiaohui Zhao ◽

...

Keyword(s):

Cervical Cancer ◽

Newly Diagnosed

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Assessment of biological parameters in head and neck cancer based on in vivo distribution of 18F-FDG-FLT-FMISO-PET/CT images

Tumori Journal ◽

10.1177/0300891619868012 ◽

2019 ◽

Vol 106 (1) ◽

pp. 33-38

Author(s):

Paulina Cegla ◽

Joanna Kazmierska ◽

Sebastian Gwozdz ◽

Rafal Czepczynski ◽

Julian Malicki ◽

...

Keyword(s):

Head And Neck ◽

Primary Tumor ◽

Tumor Biology ◽

Standardized Uptake Value ◽

Intratumor Heterogeneity ◽

Biological Parameters ◽

Newly Diagnosed ◽

In Vivo Distribution ◽

Pet Ct

Objective: Several genetic analyses have identified tumor diversity not only among tumors from different patients (intertumor heterogeneity) but also within individual tumors (intratumor heterogeneity). The aim of this study was to analyze the intratumor heterogeneity and other biological parameters based on in vivo distribution in triple-tracer positron emission tomography with computed tomography (PET/CT) study in patients with newly diagnosed head and neck (H&N) cancer. Methods: Thirty-six patients with newly diagnosed H&N cancer were included in the study. Institutional Bioethical Committee approved the study protocol and informed consent was received from every participant. All patients underwent series of 3 PET/CT scans with [18F]Fluorodeoxyglucose (18F-FDG-PET), [18F]Fluorothymidine (18F-FLT-PET), and [18F]Fluoromisonidazole (18F-FMISO-PET) before treatment. Scans were performed on separate days, within a timeframe of 2 weeks. Several PET/CT parameters grading tumor biology including maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), its equivalent (total hypoxic lesion [TLH] and total proliferative lesion [TLP]), and heterogeneity (area under the curve–cumulative SUV histogram) for the primary tumor were compared. Results: All patients showed increased uptake of 18F-FDG in primary tumor, ranging from 2.29 to 14.89 SUVmax. Respectively, SUVmax values for 18F-FLT ranged from 0.93 to 16.11 and for 18F-FMISO 0.36–4.07. Based on 3-year follow-up, we divided patients in terms of survival forecasts (first with good prognosis and second with worse). Higher values of TLG/TLP/TLH and SUVmax were observed in the second group in all 3 tracers (for 18F-FDG: 167.40 vs 100.32, 11.15 vs 8.95; for 18F-FLT: 116.61 vs 60.67, 7.09 vs 5.47; for 18F-FMISO: 37.34 vs 22.30, 1.70 vs 1.61 respectively). Statistically significant differences were shown in SUVmax in 18F-FDG and 18F-FLT ( P<0.034, P<0.034, respectively; in TLG, P=0.05; TLP, P=0.04; and TLH, P=0.05). Conclusion: Our preliminary results suggest worse prognosis in patients with higher heterogeneity values of primary tumor in proliferation and hypoxia images and combination of metabolic and volumetric parameters in TLG and its equivalent and heterogeneity of primary tumor seems to be a prognostic factor.

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Disparate histologic responses in simultaneously resected primary and metastatic osteosarcoma following intravenous neoadjuvant chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.1987.5.8.1185 ◽

1987 ◽

Vol 5 (8) ◽

pp. 1185-1190 ◽

Cited By ~ 32

Author(s):

J Nachman ◽

M A Simon ◽

L Dean ◽

D Shermeta ◽

P Dawson ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Primary Tumor ◽

Metastatic Tumor ◽

Cell Heterogeneity ◽

Newly Diagnosed ◽

Histologic Response ◽

Postoperative Therapy ◽

Metastatic Osteosarcoma ◽

Tumor Cell Heterogeneity ◽

Response To Neoadjuvant Chemotherapy

Seven patients with newly diagnosed metastatic osteosarcoma underwent simultaneous resection of the primary tumor and metastases following intravenous (IV) neoadjuvant chemotherapy. Histologic response was assessed in all tumor specimens. Disparate responses were noted between primary tumor and metastases and, in some cases, between two or more metastatic tumor deposits. The diverse histologic response to neoadjuvant chemotherapy suggests tumor cell heterogeneity. Changing postoperative therapy on the basis of the histologic response induced in the primary tumor may not be appropriate.

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Association between the location of transposed ovary and ovarian dose in patients with cervical cancer treated with postoperative pelvic radiotherapy

Radiation Oncology ◽

10.1186/s13014-019-1437-3 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Xiao-juan Lv ◽

Xiao-long Cheng ◽

Ye-qiang Tu ◽

Ding-ding Yan ◽

Qiu Tang

Keyword(s):

Cervical Cancer ◽

Radical Hysterectomy ◽

Adjuvant Radiotherapy ◽

Iliac Crest ◽

Ovarian Function ◽

Pelvic Radiotherapy ◽

Cutoff Value ◽

Ovarian Transposition ◽

Transverse Distance ◽

Upper Boundary

Abstract Background and purpose How to protect the ovarian function during radiotherapy is uncertain. The purpose of this study was to explore the association between the location of the transposed ovary and the ovarian dose in patients with cervical cancer received radical hysterectomy, ovarian transposition, and postoperative pelvic radiotherapy. Methods A retrospective analysis was conducted of 150 young patients with cervical cancer who received radical hysterectomy, intraoperative ovarian transposition, and postoperative adjuvant radiotherapy in Zhejiang Cancer Hospital. Association between location of the transposed ovaries and ovarian dose was evaluated. The transposed position of ovaries with a satisfactory dose was explored using a receiver operator characteristic curve (ROC) analysis. Patients’ ovarian function was followed up 3 months and 1 year after radiotherapy. Results A total of 32/214 (15%) transposed ovaries were higher than the upper boundary of the planning target volume (PTV). The optimum cutoff value of > 1.12 cm above the iliac crest plane was significantly associated with ovaries above the upper PTV boundary. When the ovaries were below the upper boundary of PTV, the optimum cutoff value of transverse distance > 3.265 cm between the ovary and PTV was significantly associated with ovarian max dose (Dmax) ≤ 4Gy, and the optimum cutoff value of transverse distance > 2.391 cm was significantly associated with ovarian Dmax≤5Gy. A total of 77 patients had received complete follow-up, and 56 patients (72.7%) showed preserved ovarian function 1 year after radiotherapy, which was significantly increased compared with 3 months (44.2%) after radiotherapy. Conclusions The location of transposed ovaries in patients with cervical cancer is significantly correlated with ovarian dose in adjuvant radiotherapy. We recommend transposition of ovaries > 1.12 cm higher than the iliac crest plane to obtain ovarian location above PTV. When the transposed ovary is below the upper boundary of PTV, ovarian Dmax ≤4Gy may be obtained when the transverse distance between the ovary and PTV was > 3.265 cm, and the ovarian Dmax≤5Gy may be obtained when the transverse distance was > 2.391 cm.

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