scholarly journals An Analysis of Long-Term Outcomes in Patients with Locally Advanced Cervical Cancer Treated by Chemoradiation with Reference to the Additional Performance of Hysterectomy Due to Emergency Vaginal Bleeding or Hemorrhage.

2020 ◽  
Author(s):  
Agnieszka Lewandowska ◽  
Lukasz Wicherek ◽  
Krzysztof Koper ◽  
Sebastian Szubert ◽  
Joanna Terlikiewicz ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Survival Data ◽  
Vaginal Bleeding ◽  
Locally Advanced ◽  
Survival Rates ◽  
Control Group ◽  
Severe Bleeding ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Initial Surgery

Abstract AimStandard treatment for locally advanced cervical cancer patients (LACC) consists of chemoradiation followed by vaginal brachytherapy. However, many patients with LACC surgery undergo surgical treatment with hysterectomy during comprehensive cancer treatment. The aim of the present study has been to analyze the survival data of those who underwent hysterectomy due to vaginal bleeding or hemorrhage prior to definitive chemoradiation. Materials and methodsThe study group included 35 patients with stage IIB (according to the FIGO classification) cervical cancer who received chemoradiation following salvage hysterectomy performed because of severe bleeding. The control group consisted of 44patients with stage IIB cervical cancer treated with primary chemoradiation without completion hysterectomy. ResultsThe median period for patient follow-up was 100 months. We did not observe inferior survival rates among the patients treated with salvage hysterectomy prior to chemoradiation compared to those treated with chemoradiation alone (P=0.77). The 5-year survival rate for patients treated with initial surgery was 62% compared to 61% for those treated with primary chemoradiation. Six (17%) patients from the group treated with hysterectomy experienced severe adverse events. ConclusionWhen hysterectomy due to vaginal bleeding or hemorrhage in patients with locally advanced cervical cancer is performed prior to chemoradiation, it may have curative significance and provide some overall survival benefit.

Therapeutic efficacy of epidermal growth factor receptor monoclonal antibody combined with concurrent chemoradiotherapy in treatment of locally advanced cervical cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17012-e17012
Author(s):  
Wenli Chen ◽  
Tao Li ◽  
Wei Zhang ◽  
Jialin Yang ◽  
Jian Wang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Locally Advanced ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Control Group ◽  
Study Group ◽  
Advanced Cervical Cancer ◽  
Free Survival ◽  
Locally Advanced Cervical Cancer

e17012 Background: There are few studies about epidermal growth factor receptor monoclonal antibody nimotuzumab for the treatment of locally advanced cervical cancer. We aimed to assess the therapeutic efficacy and analyse prognostic factors of chemoradiotherapy combined with nimotuzumab in cervical cancer (stage IIB-IVA) . Methods: We retrospectively analyzed 23 patients with locally advanced cervical cancer(stage IIB-IVA) ,who received concurrent chemoradiotherapy combined with nimotuzumab from 2012 to 2014 (the study group) ,and 30 patients with the similar baseline characteristics who received concurrent chemoradiotherapy alone (the control group). The overall response rates, 5-year overall survival rates, progression-free survival and acute adverse events of the two groups were compared .Multivariate prognostic analysis was performed by a Cox proportional hazards model. Results: The median follow-up time were 46 months (IQR 16-60) in the study group and 42 months (2-60) in the control group.The overall response rates were 87% and 73.3% (P = 0.384) . The 5-year overall survival rates were 63.6% and 36.1% (hazard ratio 2.208,95% CI 0.878-5.557,P = 0.092) .The median progression-free survival in the study group was not achieved (95%CI 9-55) versus 27 months (1-60) in the control group (hazard ratio 2.635, 95% CI 1.030-6.737, P= 0.043).Multivariate prognostic analysis indicated that stage and whether to be combined with nimotuzumab were the influential factors for progression-free survival time.Adverse events were similar between groups.The most common grade 3 or 4 adverse events during treatment in the study group versus the control group were leucopenia(9 [39%] vs 11 [36%]),thrombocytopenia (3 [13%] vs 6 [20%]),anaemia (4 [17%] vs 4 [13%]). Conclusions: Concurrent chemoradiotherapy combined with nimotuzumab in the treatment can improve the progression-free survival time of advanced cervical cancer, while not increasing the incidence of adverse reactions.However, because of the small size of sample in this research, these findings suggest that it is necessary to perform a prospective study with expanded sample size.

scholarly journals Emergency Embolization of Pelvic Vessels in Patients With Locally Advanced Cervical Cancer and Massive Vaginal Bleeding: A Case Series in a Latin American Oncological Center

2020 ◽  
pp. 1376-1383
Author(s):  
Adriana Alméciga ◽  
Juliana Rodriguez ◽  
Julián Beltrán ◽  
James Sáenz ◽  
Abel Merchán ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Latin American ◽  
Vaginal Bleeding ◽  
Recurrent Disease ◽  
Locally Advanced ◽  
Case Series ◽  
Severe Bleeding ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer

PURPOSE Locally advanced cervical cancer may present with uncontrollable vaginal bleeding in up to 70% of cases. Pelvic vessel embolization has been used as an urgent maneuver for achieving fast hemostatic control. This report describes outcomes of selective pelvic vessel embolization in patients with severe bleeding due to a locally advanced cervical cancer. METHODS In this retrospective study, technical aspects, clinical variables, and bleeding-related morbidity were described. The frequency of recurrent disease and the vital status at 1 year of follow-up were determined. Analysis was performed with statistical software R, version 3.6.2. The setting was Instituto Nacional de Cancerología- Bogotá, Colombia, between January 2009 and July 2017. RESULTS A total of 47 patients were included. Median age was 44 years (range, 26-70 years). The pre-embolization median hemoglobin level was 7.9 g/dL (range, 5.0-11.3 g/dL). Blood transfusions were administered to 41 women (87.2%). Bleeding control was achieved in 95.7% of cases in the first 24 hours after the embolization. There were no major complications. In 17 cases (36.2%), minor complications were reported; the most common was pelvic pain. In 17.1% of cases, a second embolization was required. After 12 months of follow-up, 27.7% of patients were alive without disease, 44.7% were alive with disease, and 25.5% of them have died of cervical cancer progression. CONCLUSION Selective pelvic vessel embolization is a useful alternative in patients with locally advanced cervical cancer and life-threatening bleeding. Its impact on recurrent disease and death due to oncologic cause is not clear.

scholarly journals Neoadjuvant Chemotherapy Consisting of Cisplatin and Nab-paclitaxel Improves the Complete Remission Rate of Locally Advanced Cervical Cancer Patients

2021 ◽  
Author(s):  
Xiao-Li Yu ◽  
Miao-Fang Wu ◽  
Lin Ding ◽  
Jin Yang ◽  
Shou-Min Bai
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Complete Remission ◽  
Concurrent Chemoradiotherapy ◽  
Remission Rate ◽  
Locally Advanced ◽  
Control Group ◽  
Advanced Cervical Cancer ◽  
External Radiotherapy ◽  
Locally Advanced Cervical Cancer

Abstract Background: This study was aimed to determine the effect of neoadjuvant chemotherapy consisting of nab-paclitaxel and cisplatin (NACT-nPC) in patients with locally advanced cervical cancer.Materials and Methods: The consecutive, newly diagnosed, non-metastatic and locally advanced cervical cancer patients were retrospectively recruited between October 2016 and June 2020 in our hospital. All patients received concurrent chemoradiotherapy alone or following neoadjuvant chemotherapy. Patients were divided into two groups: one receiving NACT-nPC, and the control group receiving no or other regimes of neoadjuvant chemotherapy. We compared the complete remission rate of primary tumor at the end of external radiotherapy and chemoradiotherapy between the two groups. Results: A total of 198 patients were enrolled in this study, including 60 in NACT-nPC group and 138 in control group. At the end of external radiotherapy, 27 patients in NACT-nPC group and 32 patients in control group achieved complete remission (P = 0.002). At the end of chemoradiotherapy, 56 patients in NACT-nPC group and 114 patients in control group achieved complete remission (P = 0.033). The acute side effects above grade 3 in NACT-nPC group was 41.7% (25/60) and manageable, lower than control group which was 77/138 (55.8%).Conclusions: NACT-nPC can improve the complete response rate of patients with locally advanced cervical cancer followed by concurrent chemoradiotherapy, and the toxicity is tolerable. Furthermore, we suspect the NACT-nPC can improve the survival of the patients. However, further prospective studies are needed to confirm this result.

The 50-month results of the four non-platinum concurrent chemoradiation regimens for locally advanced cervical cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5540-5540
Author(s):  
P. Kamnerdsupaphon ◽  
I. Chitapanarux ◽  
V. Sukthomya ◽  
V. Lorvidhaya
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Complete Response ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Randomized Clinical Study ◽  
Disease Free

5540 Objectives: To determine the efficacy, disease free and overall survivals of radiation therapy in combination with four non-platinum chemotherapy regimens for locally advanced cervical cancer. Materials and Methods: Eligible patients were those with a diagnosis of locally advanced cervical cancer, under 70 years of age, and undergone the necessary prestudy investigations. All patients received external-beam pelvic irradiation to a minimum dose of 5,000 cGy, and brachytherapy delivered to bring the minimum total dose at point A to 7,500 cGy. Patients were randomized to receive one of four chemotherapy regimens: Arm1: oral 5FU 250 mg/m2/day, Arm2: mitomycin 12 mg/m2 on days 1 and 28 + oral 5FU 200 mg/m2/day, Arm3: mitomycin 12 mg/m2 on days 1 and 28 followed by 5FU 1,000 mg/m2/day on days 1 through 4 and 28 through 31, Arm4: oral hydroxyurea 25 mg/kg/day. Results: From September 1995 to October 2001, the study include 921 women; 226 in arm 1, 229 in arm 2, 234 in arm 3, and 232 in arm 4. The median follow-up time was 51.69 months. More than 89% of the patients achieved complete response. Disease free survival rates were 62.4% among arm 1, 63.8% among arm 2, 66.2% among arm 3, and 68.5% among arm 4. Overall survival rates were 77.4%, 79.5%, 80.8%, and 84.5% respectively. Conclusion: The efficacy of these regimens were not inferior to the standard platinum based regimen for locally advanced cervical cancer. This study demonstrates the results of large randomized clinical study of radiochemotherapy and requires the longer follow up time for the late complications. No significant financial relationships to disclose.

scholarly journals Intratumoral Injection of H101 in Combination With Concurrent Chemoradiotherapy for Locally Advanced Cervical Cancer

2021 ◽  
Author(s):  
Xiang Zhang ◽  
Yingchang Wang ◽  
xiaojuan Lv ◽  
Fangfang Wang ◽  
Qiong Zhou ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Control Group ◽  
Advanced Cervical Cancer ◽  
Tumor Length ◽  
Locally Advanced Cervical Cancer ◽  
Gynecology And Obstetrics ◽  
And Control

Abstract BackgroundTo evaluate the clinical benefit of concurrent chemoradiotherapy in combination with H101 injection for the treatment of locally advanced cervical cancer (LACC) patients.MethodsThe patients, all diagnosed with stage IIB or III cervical cancer according to The International Federation of Gynecology and Obstetrics (FIGO) stage (2009) with tumor length ≥6cm were enrolled at Zhejiang Cancer Hospital from July 2015 to April 2017. All patients received concurrent chemoradiotherapy (CCRT) in combination with intratumoral H101 injection before and during external beam radiotherapy (EBRT). The parameters recorded and analyzed included progression-free survival (PFS), overall survival (OS), tumor regression after EBRT and side effects, which were compared to another group of patients with similar characteristics treated with CCRT alone.ResultsTwenty patients were treated with CCRT in combination with intratumoral H101 injection and another group of 20 patients treated with CCRT alone was selected as control. The median follow-up time was 38 months (range 10-58 months). The 3-year local, regional, and overall PFS rates were 95% vs 66.6%(p = 0.02), 95% vs 62.5%(p = 0.029), and 65% vs 43.8%(p = 0.19), for H101 group and control group respectively. The 3-year (OS) was 74.3% vs 54.5%(p = 0.098), respectively. The median reduction of tumor length and volume for H101 group and control group were 37.7% vs 28.7%(p = 0.016) and 75.1% vs 62.4%(p = 0.001), respectively. The major adverse event related to H101 was fever.ConclusionCCRT in combination with intratumoral H101 injection is effective in treating LACC, and has an acceptable safety profile.Trial registrationThe study was registered at Chinese Clinical Trail Registry (ChiCTR-OPC-15006142).

Phase III placebo controlled double blind randomized trial of radiation therapy for stage 2B-4A cervical cancer with immunomodulator Z-100: JGOG-DT101 study.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5506-5506 ◽  
Author(s):  
Keiichi Fujiwara ◽  
Yasuo Ohashi ◽  
Kazunori Ochiai ◽  
Kiichiro Noda
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Randomized Trial ◽  
Locally Advanced ◽  
Survival Rates ◽  
Phase Iii ◽  
Advanced Cervical Cancer ◽  
Double Blind ◽  
Locally Advanced Cervical Cancer ◽  
Platinum Based Chemotherapy

5506 Background: We previously reported that the lower dose (0.2 μg) of immunomodulator Z-100 showed better overall survival (OS) compared to higher dose (40 μg) in patients with locally advanced cervical cancer who received radiation therapy (RT). Therefore, we conducted a placebo controlled double-blind randomized trial to elucidate the role of additive immunotherapy in standard RT. Methods: Patients of stages 2B to 4A squamous cell carcinoma of the uterine cervix, who were scheduled to receive standard RT with or without platinum-based chemotherapy, were eligible. Z-100 at 0.2 μg (Z) or placebo (P) was given subcutaneously twice a week during the RT, followed by maintenance therapy by administering either Z or P once every two weeks. Therapy was continued until disease progression or termination of the trial in2011. Primary endpoint was OS, secondary endpoints were recurrent-free survival (RFS), response rate (RR), and safety. Sample size was calculated by assuming 5-year survival rates (5YSR) as 60% in Arm Z and 38-44% for Arm P, (hazard ratio HR: 0.526-0.625), and was determined to be 120 patients in each arm. Results: Between 2004 and 2006, 249 patients were randomized. Total of 244 patients were eligible for safety analysis, and 243 patients were eligible for survival analysis. In Arm Z, 29 deaths were reported, and in Arm P, 42. 5YSR was 75.7% (95%CI: 66.4-82.8%) for Arm Z and 65.8 % (95%CI: 56.2-73.8%) for Arm P; HR was 0.646 (95%CI: 0.400-1.043). Survival benefit in Arm Z was observed regardless of chemoradiation or radiation alone. There were no differences between arms in terms of RR and RFS, and side effects. Neoplasms, including benign cases, observed were 4 in Arm Z, and 13 in Arm P. Conclusions: Immunomodulator Z-100, used as an adjuvant therapy after radiation, showed clinically significant improvement of OS in locally advanced cervical cancer, although the statistical power was less than anticipated because survival rates were unexpectedly higher than expected for both arms. Further exploration of Z-100 is warranted. Clinical trial information: C000000221.

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