scholarly journals Selection of Treatment Regimens for Recurrent Cervical Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaopei Chao ◽  
Xiaochen Song ◽  
Huanwen Wu ◽  
Yan You ◽  
Ming Wu ◽  
...  

ObjectiveThe selection of individualized treatment for recurrent cervical cancer is challenging. This study aimed to investigate the impact of various therapies on survival outcomes after recurrence.MethodsEligible patients were diagnosed with recurrent cervical cancer between March 2012 and April 2018. Postrecurrence progression-free survival (PFS) and overall survival (OS) were investigated in the whole cohort and in subgroups, categorized by recurrence site and prior radiotherapy history, using a multivariate model that incorporated treatment for primary and recurrent tumors, histological pathology, and FIGO staging.ResultsTwo hundred and sixty recurrent cervical cancer patients were included. As of March 1, 2020, the median postrecurrence PFS and OS were 7.0 (range 0-94) and 24.0 (1.8-149.1) months, respectively. In a multivariate model measured by PFS, radiotherapy was superior to other therapies for the whole cohort (p=0.029) and recurrence only within the pelvic cavity (p=0.005), but the advantages of radiotherapy disappeared in patients with a history of radiotherapy (p values >0.05). For recurrence only beyond the pelvic cavity, combination therapy resulted in improved PFS (p=0.028). For recurrence both within and beyond the pelvic cavity, no therapy regimen provided additional PFS benefits (p values >0.05). Radiotherapy and combination therapy were also associated with improved postrecurrence OS for recurrence within the pelvic cavity (p=0.034) and only beyond the pelvic cavity (p=0.017), respectively.ConclusionsIn cervical cancer patients, postrecurrence radiotherapy can improve PFS and OS for patients with recurrence within the pelvic cavity and without prior radiotherapy. For recurrence beyond the pelvic cavity or cases with a history of radiotherapy, combination or individualized therapy may provide potential survival benefits.

2021 ◽  
Vol 4 (1) ◽  
pp. 37-43
Author(s):  
Nur Azizah Indriastuti ◽  
Riski Oktafia ◽  
Novika Riswanti

Cervical cancer is one of the deadliest types of cancer that attacks women in the world. One of the treatment efforts for cancer is chemotherapy. Patients with cervical cancer who receive chemotherapy more than twice will experience impaired self-concept. This study aims to determine self-concept in cervical cancer patients who have undergone chemotherapy in Yogyakarta. This research uses qualitative method with phenomenology approach. Data collection is done with interview and observation. Participants totaling five people were determined by purposive sampling. The validity of the data used source triangulation and checked the data back to the participants. Analysis of data were by comparing among categories, marking and describing descriptively. The results of the study are 6 themes, namely physical changes, emotional changes, changes in sexual relations, changes in relationships with family, changes in the role of parenting and social changes in society. The impact of chemotherapy causes various changes in cervical cancer patients which make the self-concept of cervical cancer patients undergo changes


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10572-10572
Author(s):  
Amelia Sawyers ◽  
Margaret Chou ◽  
Paul Johannet ◽  
Nicholas Gulati ◽  
Yingzhi Qian ◽  
...  

10572 Background: Several reports have suggested that cancer patients are at increased risk for contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and suffering worse coronavirus disease 2019 (COVID-19) outcomes. However, little is known about the impact of cancer status on presentation and outcome. Here, we report on the association between cancer status and survival in hospitalized patients who tested positive for SARS-CoV-2 during the height of pandemic in New York City. Methods: Of the 6,724 patients who were hospitalized at NYU Langone Health (3/16/20 - 7/31/20) and tested positive for SARS-CoV-2, 580 had either active cancer (n = 221) or a history of cancer (n = 359). Patients were classified as having active malignancy if they either received treatment within six months of their COVID-19 diagnosis or they had measurable disease documented at the time of their hospitalization. Patients were categorized as having a history of cancer if there was no evidence of measurable disease or there were no treatments administered within six months of their COVID-19 diagnosis. We compared the baseline clinicodemographic characteristics and hospital courses of the two groups, and the relationship between cancer status and the rate of admission to the intensive care unit (ICU), use of invasive mechanical ventilation (IMV), and all-cause mortality. Results: There was no differences between the two groups in their baseline laboratory results associated with COVID-19 infection, incidence of venous thromboembolism, or incidence of severe COVID-19. Active cancer status was not associated with the rate of ICU admission ( P = 0.307) or use of IMV ( P = 0.236), but was significantly associated with worse all-cause mortality in both univariate and multivariate analysis with ORs of 1.48 (95% CI: 1.04-2.09; P = 0.028) and 1.71 (95% CI: 1.12-2.63; P = 0.014), respectively. Conclusions: Active cancer patients had worse survival outcomes compared to patients with a history of cancer despite similar COVID-19 disease characteristics in the two groups. Our data suggest that cancer care should continue with minimal interruptions during the pandemic to bring about response and remission as soon as possible. Additionally, these findings support the growing body of evidence that malignancy portends worse COVID-19 prognosis, and demonstrate that the risk may even apply to those without active disease.


2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Farnaz Foolad ◽  
Sheila Berlin ◽  
Candice White ◽  
Emma Dishner ◽  
Ying Jiang ◽  
...  

Abstract Objective Reported penicillin allergies result in alternative antimicrobial use and are associated with worse outcomes and increased costs. Penicillin skin testing (PST) has recently been shown to be safe and effective in immunocompromised cancer patients, yet its impact on antimicrobial costs and aztreonam utilization has not been evaluated in this population. Method From September 2017 to January 2018, we screened all admitted patients receiving aztreonam. Those with a self-reported history of possible immunoglobulin E (IgE)-mediated reaction to penicillin were eligible for PST with oral challenge. Results A total of 129 patients were screened, and 49 patients were included and underwent testing. Sixteen patients (33%) had hematologic malignancies and 33 patients (67%) had solid tumors. After PST with oral challenge, 46 patients (94%) tested negative, 1 patient tested positive on oral challenge, and 2 patients had indeterminate results. The median time from admission to testing was 2 days (interquartile range, 1–4). After testing negative, 33 patients (72%) were switched to beta-lactam therapy, which resulted in a total of 390 days of beta-lactam therapy. For identical therapy durations, the direct total antibiotic cost was $15 138.89 for beta-lactams versus $78 331.50 for aztreonam, resulting in $63 192.61 in projected savings. A significant reduction in median days of aztreonam therapy per 1000 patient days (10.0 vs 8.0; P = .005) was found during the intervention period. Conclusions Use of PST in immunocompromised cancer patients receiving aztreonam resulted in improved aztreonam stewardship and significant cost savings. Our study demonstrates that PST with oral challenge should be considered in all cancer patients with reported penicillin allergies.


2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 5515-5515 ◽  
Author(s):  
G. Ferrandina ◽  
D. Lorusso ◽  
M. Ludovisi ◽  
S. Pignata ◽  
R. Sorio ◽  
...  

Author(s):  
Manisha Sarkar

Background: Cervical cancer is one of many health care ironies. Better survival rates demand better quality of life (QoL). The aim of present study was to determine the change in QoL of cervical cancer patients due to treatment.Methods: An observational prospective study was conducted from July 2017 to June 2018 among 80 new cervical cancer patients without any prior history of treatment for cervical cancer, attending radiotherapy department of a tertiary care centre of West Bengal using a semi-structured schedule and European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ). Information was collected on socio-demographic and clinical aspects and QoL domains. Those with history of surgery for cervical cancer, advanced stage of disease were excluded. EORTC QLQ was administered at baseline and one month after completion of treatment. Data was analysed by percentage, means±standard deviation, range and Wilcoxon signed rank test etc. using SPSS-16.Results: Only 60 patients could be analysed as 10 patients died and 10 lost to follow-up. After treatment there was a significant improvement in global health, physical, emotional and cognitive functioning as well as decrease in symptoms like fatigue, pain, insomnia, appetite loss and constipation along with worsening of financial difficulties. There was significant improvement in body image, decrease in problems of symptom experience, peripheral neuropathy and menopausal symptoms after treatment.Conclusions: The cervical cancer patients show an overall improvement in their QoL in most of the domains after one month of treatment except worsening of financial difficulties. 


2021 ◽  
Author(s):  
Qi-ying Zhang ◽  
Zi Liu ◽  
Ya-li Wang ◽  
Jing Zhang ◽  
Wen Li ◽  
...  

Abstract Background Postoperative radiotherapy (RT) or chemoradiotherapy (CRT) improves outcomes of cervical cancer patients with risk factors. Minimally invasive surgery (MIS) has an inferior survival than open radical hysterectomy (ORH), however, the impact of MIS on postoperative RT remains uncertain. The study compared the impacts of MIS versus ORH on delivering of adjuvant RT or CRT for intermediate- or high-risk early-stage cervical cancer. Methods Data on stage IB1-IIA2 patients who underwent radical hysterectomy and postoperative RT/CRT in our institution, from 2014 to 2017, were retrospectively collected. Patients with high or intermediate-risk factors who met the Sedlis criteria received postoperative pelvic external beam radiotherapy (50Gy/25f) with platinum-based chemotherapy (0–6 cycles) according to guidelines. Disease-free survival (DFS) and overall survival (OS) were compared in the two surgical groups. Results One hundred and twenty-nine patients eligible for the study (68 in ORH; 61 in MIS groups) had similar clinicopathologic features except for the stage (highest in MIS was IB1; IIA1 in ORH) and presence of lymph vascular space invasion (higher in MIS group). The median time interval from surgery to chemotherapy and to RT was shorter in the MIS group. Three-year DFS and OS were similar in both groups. Further sub-analysis indicated that the DFS and OS in intermediate/high-risk groups had no significant difference. Cox-multivariate analyses found that tumor size > 4 cm and time interval from surgery to RT beyond seven weeks were adverse independent prognostic factors for DFS. Conclusions In early-stage (IB1-IIA2) cervical cancer patients with intermediate or high-risk factors who received postoperative RT or CRT, no matter they received ORH or MIS as their primary treatment, the DFS and OS had no significant difference, despite TI from surgery to postoperative adjuvant therapy being shorter in the MIS group than ORH.


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