Concurrent chemoradiation in treatment of carcinoma cervix

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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Multimodality Therapy for Locally Advanced Cervical Carcinoma: State of the Art and Future Directions

Journal of Clinical Oncology ◽

10.1200/jco.2007.10.8324 ◽

2007 ◽

Vol 25 (20) ◽

pp. 2952-2965 ◽

Cited By ~ 137

Author(s):

Bradley J. Monk ◽

Krishnansu S. Tewari ◽

Wui-Jin Koh

Keyword(s):

Cervical Cancer ◽

Cervical Carcinoma ◽

State Of The Art ◽

Locally Advanced ◽

Multimodality Therapy ◽

Advanced Cervical Cancer ◽

Future Directions ◽

Risk Of Death ◽

Locally Advanced Cervical Cancer ◽

Advanced Cervical Carcinoma

Globally, cervical cancer is the second most common cause of cancer-related mortality among women causing approximately 234,000 deaths annually among developing countries and killing 40,000 in developed nations. Most of these deaths occur in women with bulky or locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stages IIB through IVA, when lesions are not amenable to high cure rates with surgery or radiation (RT). The standard prescription for RT used to treat locally advanced cervical cancer has been dictated by common practice and patterns of care studies. In contrast, the addition of concomitant chemotherapy to RT has been studied in a number of randomized prospective trials, which are discussed in detail. When added to RT, cisplatin reduces the relative risk of death from cervical carcinoma by approximately 50% by decreasing local/pelvic failure and distant metastases. In 1999, weekly intravenous cisplatin at 40 mg/m2 for 6 weeks in combination with RT was established as a new standard for the treatment of locally advanced cervical carcinoma. More recently, this recommendation has been expanded to include women with FIGO stage IB2 lesions as well as those with bulky stage IIA cancers. This monograph reviews the state of the art in treating locally advanced cervical cancer with combined chemotherapy and RT and discusses clinical and pathologic prognostic factors that impact cure. Quality of life during and after multimodality therapy is considered as well as ongoing clinical trials and future directions.

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THE ROLE OF SURGICAL STAGE IN COMBINATION THERAPY FOR PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER

Problems in oncology ◽

10.37469/0507-3758-2019-65-5-749-755 ◽

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.

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Rare Radiation Complications after Treatment of Cervical Cancer

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs05.06.176 ◽

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

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