Pelvic irradiation versus pelvic irradiation with concurrent chemotherapy followed by extrafascial hysterectomy in the treatment of locally advanced cervical cancer in Honduras.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15556-e15556
Author(s):  
Hoover Rodyl Henriquez Cooper ◽  
Linus T. Chuang ◽  
Joel Cardenas ◽  
Pedro Guillermo Zelayas
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Clinical Response ◽  
Locally Advanced ◽  
Concurrent Chemotherapy ◽  
Advanced Cervical Cancer ◽  
Complete Clinical Response ◽  
Pelvic Irradiation ◽  
Pelvic Radiation ◽  
Locally Advanced Cervical Cancer

e15556 Background: Because of the lack of brachytherapy in Honduras, patients with locally advanced cervical cancer underwent extrafascial hysterectomy after upfront pelvic irradiation or pelvic irradiation with concurrent chemotherapy. Methods: We compared the effect of pelvic radiotherapy with that of pelvic radiation and concurrent chemotherapy with cisplatin in women with advanced cervical cancer. Between 2008 and 2011, 165 women with advanced cervical cancer confined to the pelvis (stages IB2 through IIIB) received either 70 Gy of radiation to the pelvis alone or with concurrent weekly cisplatin. Patients underwent subsequently extrafascial hysterectomy six weeks after completion of radiation therapy. Results: Of the 165 eligible patients, 90 (54.5%) patients received only pelvic radiation therapy, and 75 (45.5%) patients received pelvic radiation and chemotherapy. Squamous cell carcinoma was identified in 135 (82%) cases and adenocarcinoma in 30 (18%) cases. On the final hysterectomy specimen, 69 (77.8%) patients who received pelvic radiation had a complete clinical response with no residual diseases; there were 40 (53.3%) patients who received pelvic radiation and chemotherapy achieved a complete response (p<0.001). In the group of patients that were treated with pelvic radiation and chemotherapy, only 25 out of 75 (33.3%) patients received the required cisplatin on schedule. The complete clinical response rate of the 25 patients who received the complete course of pelvic radiation and chemotherapy was 80%. Conclusions: Treatment of locally advanced cervical cancer in low-resource settings is met with challenges including the lack of brachytherapy, and unpredictable availability of chemotherapy. Only 33% of patients that were treated with the intention of concurrent chemo-radiation were able to receive cisplatin on schedule. This resulted in a significantly lower response in the patients who were treated with pelvic radiation and chemotherapy. In settings where the availability of chemotherapy is not always available, primary pelvic radiation for advanced cervical cancer resulted in a better treatment response.

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 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

Variation in care in concurrent chemotherapy administration during radiation for locally advanced cervical cancer

2016 ◽  
Vol 142 (2) ◽  
pp. 286-292 ◽  
Author(s):  
Shitanshu Uppal ◽  
Marcela G. del Carmen ◽  
Laurel W. Rice ◽  
R. Kevin Reynolds ◽  
Shruti Jolly ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Concurrent Chemotherapy ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Chemotherapy Administration ◽  
Variation In Care

Phase I trial of nelfinavir added to cisplatin chemotherapy with concurrent pelvic radiation for locally advanced cervical cancer

2019 ◽  
Vol 154 ◽  
pp. 267-268 ◽  
Author(s):  
A.E. Garcia-Soto ◽  
N.D. McKenzie ◽  
J.M. Pearson ◽  
L. Portelance ◽  
J.A. Lucci ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Phase I ◽  
Phase I Trial ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Pelvic Radiation ◽  
Locally Advanced Cervical Cancer
Sign in / Sign up

Export Citation Format

Share Document