scholarly journals Chemoradiotherapy in the treatment of locally advanced cervical cancer

2013 ◽  
Vol 12 (3) ◽  
pp. 114-117
Author(s):  
Lina Daukantienė ◽  
Konstantinas Povilas Valuckas ◽  
Eduardas Aleknavičius ◽  
Teresė Pipirienė-Želvienė
Keyword(s):  
Cervical Cancer ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Considerable Proportion ◽  
Advanced Cervical Cancer ◽  
Consolidation Chemotherapy ◽  
Critical Pathways ◽  
Locally Advanced Cervical Cancer ◽  
Prevention And Early Detection ◽  
Detection Strategies

The purpose of this article is overview of currently available knowledge found in literature about the chemoradiation for locally advanced cervical cancer.Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in females worldwide. Despite the available prevention and early detection strategies, carcinoma of the uterine cervix is still diagnosed as locally advanced disease in a considerable proportion of patients. Standart treatment of locally advanced cervical cancer is cisplatin-based chemoradiation. Unfortunately, results of the treatment are not sufficient and cancer relapses are frequent. New cytostatics regimens either alone or in combination with cisplatin are searching as radiosensitizers with concurrent radiotherapy. Neoadjuvant/induction chemotherapy, adjuvant/consolidation chemotherapy strategies, molecular agents targeting critical pathways are under investigation in clinical trials to improve results of the treatment.The purpose of this article is overview of currently available knowledge found in literature about the chemoradiation for locally advanced cervical cancer.Key words: locally advanced cervical cancer, chemoradiation, adjuvant/consolidation chemotherapy, neoadjuvant/induction chemotherapy.Chemospindulinis vietiškai išplitusio gimdos kaklelio vėžio gydymas Straipsnio tikslas – apžvelgti ir pateikti šiuo metu prieinamoje literatūroje sukauptas žinias apie konservatyvų chemospindulinį vietiškai išplitusio gimdos kaklelio vėžio gydymą.Gimdos kaklelio vėžys yra trečia dažniausiai pasaulyje nustatoma moterų vėžio forma ir ketvirta pagal dažnį moterų mirties nuo vėžio priežastis. Nepaisant profilaktikos priemonių bei patikros programos, nemaža dalis gimdos kaklelio vėžio atvejų nustatoma jau vietiškai išplitusios IIB–IVA stadijos. Šiuo metu vietiškai išplitusio gimdos kaklelio vėžio gydymo standartas – suderintas chemospindulinis gydymas cisplatinos pagrindu. Deja, gydymo rezultatai nėra patenkinami, atkryčio dažnis išlieka didelis. Siekiant geresnių gydymo rezultatų atlikta ir atliekama daug klinikinių tyrimų, spindulinio gydymo metu taikant naujus citostatikus ar jų derinius su cisplatina, tiriama neoadjuvantinės/indukcinės bei adjuvantinės/konsoliduojančios chemoterapijos reikšmė, „taikinių“ terapijos panaudojimo galimybė.Reikšminiai žodžiai: vietiškai išplitęs gimdos kaklelio vėžys, chemospindulinis gydymas, adjuvantinė/konsoliduojanti chemoterapija, neoadjuvantinė/indukcinė chemoterapija.

Long Follow-up of Patients With Locally Advanced Cervical Cancer Treated With Concomitant Chemobrachyradiotherapy With Cisplatin and Ifosfamide Followed by Consolidation Chemotherapy

2015 ◽  
Vol 25 (2) ◽  
pp. 315-319 ◽  
Author(s):  
Branka Petric Miše ◽  
Tihana Boraska Jelavic ◽  
Ante Strikic ◽  
Darijo Hrepic ◽  
Krešimir Tomic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Late Toxicity ◽  
Local Control Rate ◽  
Advanced Cervical Cancer ◽  
Consolidation Chemotherapy ◽  
Locally Advanced Cervical Cancer ◽  
Gynecology And Obstetrics ◽  
Valuable Treatment

ObjectivesLocally advanced cervical cancer (LACC) is one of the leading health problems of the developing countries. We present long-term outcomes of treatment with a concomitant chemobrachyradiotherapy followed by consolidation chemotherapy regimen.Materials and MethodsWe treated 118 patients with LACC (International Federation of Gynecology and Obstetrics stages IB2-IVA) with external radiotherapy (50 Gy in 25 fractions) and concomitant chemobrachyradiotherapy (low-dose rate). Chemotherapy was applied during brachyradiotherapy (cisplatin on day 1 in combination with 24-hour infusion of ifosfamide and mesna uroprotection). Four cycles of consolidation chemotherapy were given starting 4 weeks after the second concomitant chemobrachyradiotherapy cycle.ResultsAfter median follow-up period of 99.3 months, we observed acceptable acute and late toxicity, local control rate of 97.5%, and an overall survival of 74.6% at 96 months.ConclusionsChemobrachyradiotherapy regimen followed by consolidation chemotherapy described in this article is a valuable treatment option for LACC.

Tailored radical hysterectomy for locally advanced cervical cancer

2020 ◽  
Vol 30 (8) ◽  
pp. 1136-1142
Author(s):  
Noriaki Sakuragi ◽  
Masanori Kaneuchi ◽  
Tatsuya Kato ◽  
Chisa Shimada ◽  
Yukiharu Todo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Radical Hysterectomy ◽  
Advanced Disease ◽  
Early Stage ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Node Metastasis

ObjectiveThe survival and prognostic factors for locally advanced cervical cancer treated with nerve-sparing Okabayashi–Kobayashi radical hysterectomy have not been elucidated. We aimed to evaluate the oncological outcomes of those patients after radical hysterectomy with adjuvant chemotherapy.MethodsThis retrospective cohort study was conducted from January 2002 to December 2011. Treatment was conducted at a single tertiary center in northern Japan. We used the Okabayashi–Kobayashi radical hysterectomy with lymphadenectomy. We applied unilateral nerve preservation for stage IIA/IIB cancer if there was a one-sided extension of the disease outside the cervix. Indication for adjuvant therapy was based on Sedlis criteria. High-risk was defined as evidence of lymph node metastasis, pathological parametrial invasion, and a positive/close surgical margin. The choice of adjuvant therapy was chemotherapy which consisted of paclitaxel and cisplatin.ResultsThe study included 76 early-stage IB1 (≤4 cm) and IIA1 cervical cancer and 45 locally advanced stage IB2 (>4 cm), IIA2, and IIB disease treated consecutively. The median follow-up was 106 (range: 6-203) months. There were 18 (15%) patients with recurrence, with five of 76 in the early-stage (7%) and 13 of 45 in the locally advanced disease (29%) (P<0.001). For locally advanced cervical cancer, pT classification (P<0.001), lymph node metastasis (P=0.007), and histology (P=0.05) were associated with locoregional recurrence. The five-year locoregional recurrence rate in the locally advanced disease was 20% and 5% in the early-stage disease (P=0.01). The five-year disease-free survival in the locally advanced cervical cancer was 71% and 93% in the early-stage disease (P<0.001). The overall survival in locally advanced disease depended on the adeno-type histology and lymph node metastasis.ConclusionThe tailored use of nerve-sparing Okabayashi–Kobayashi radical hysterectomy with adjuvant chemotherapy based on tumor histology and lymph node metastasis may be a possible option as a treatment of locally advanced cervical cancer in selected patients.

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